Hospital Leaders Step Up Support for Released COVID-19 Patients

Loudoun and the rest of Virginia entered the latest phase of reopening July 1, allowing restaurants bring more people inside and people to gather publicly in groups of up to 250. It was welcome news to businesses that have been trying to make ends meet under strict limits to gathering, dining and shopping.

Loudoun’s COVID-19 statistics continue show positive trends following a recent spike that health officials attributed to a beach week trip by Loudoun teenagers. As of Tuesday, July 7, the Virginia Department of Health was reporting 4,252 cases of the virus in Loudoun, 280 hospitalizations, and 93 deaths. That represented 252 new cases, five new hospitalizations and six new deaths over the previous week. Key metrics being closely watched by public health officials—the rates of hospitalizations and new cases, along with the percent of positive test results—all were in decline this week.

“The real challenge is going to be over the summer,” said Loudoun County Health Department Director Dr. David Goodfriend. “Those same risk factors that lead to these adolescents getting infected is going to lead to them being impacted on a daily basis” as people return to beaches and socializing, he explained.

While the coronavirus is fatal mostly to elderly patients, anyone can be hit with a serious case that could land them in the hospital and, perhaps, face them with long-term recovery challenges.

Inova Loudoun Chief Medical Officer Dr. Christopher Chiantella said of the people who test positive for COVID-19, about 85 percent are going to be fine. The other 15 percent will wind up in the hospital, and about 5 percent will end up intubated, getting some sort of help breathing.

In Loudoun, most hospitalizations have been for people 40 years old and up, although 25 people in their 30s have been hospitalized, along with six people in their 20s and three people younger than 10 years old. Chiantella said patients in their 30s and 40s have been among those treated in Inova Loudoun’s Intensive Care Unit. The average stay is around a week. And, he said, there isn’t currently a reliable way to predict which patients are going to take a turn for the worse.

“Chances are, you’re going to do fine,” Chiantella said. “But it doesn’t mean that everybody in your circle is going to do fine, and we don’t have a way to predict who isn’t going to be fine and who is, because it’s not always intuitive.”

The youngest person to die from the virus in Loudoun was in their 40s. Across the state, people as young as their 20s have lost their lives to the virus.

And while it’s most dangerous to older adults and people with other medical conditions, it can have a lasting impact even on younger people who are hospitalized but recover.

Being discharged from the hospital, Chiantella said, is not the end. Even after a short visit, COVID-19 patients have to self-isolate for a period of time, and may still need other medical treatments outside the hospital.

And recovering from a lengthy hospital stay can be an ordeal of its own, especially after the ICU.

“You come out with weakened lungs, your body is deconditioned, you have potentially had the machine breathing for you,” Chiantella said.

Inova Loudoun is standing up a multidisciplinary team to help people who have spent time in the ICU recover and reacclimate to life outside the hospital. That can take weeks.

“It’s about physical therapy, occupational therapy, speech, it’s about we’re finding a certain number of people are feeling fatigued for some time,” Chiantella said. “There can be mental health and behavioral health issues related to this, too. So, the consequences of having the virus can be far-reaching. Some of them can be emotional, and it verges possibly on post-traumatic stress disorder.”

Doctors are also limited in their treatment options. While various treatments are used for patients depending on their specific needs, there are still no cures for COVID-19.

“At the end of the day, the treatment is mostly supportive, and that’s why it makes it even more dangerous for all this, because it’s not like you can line everybody up and give them five pills and they’re going to be fine,” Chiantella said.

And people who do not suffer serious effects from the virus can still be dangerous to others.

“When you think about the youngest of the young who feel invincible, who think that this doesn’t really apply to them, or you read we’ve had very few young people who end up in the hospital … those are the folks that go home to their parents, their grandparents, their immunocompromised person, their aunt who has cancer,” Chiantella said. “To me, this is the big issue. The public health part of this is huge.”

Goodfriend said household members of the people on that beach trip have contracted the virus.

He said the places that have been most successful fighting the spread of the virus have been those that paid strict attention to public health precautions like hygiene, physical distancing, and mask wearing. He gave the example of what his son saw on a business trip to Rhode Island: “when he was there, the public was monitoring each other. In places you would go, somebody would call you out if you didn’t have a mask on.”

Leave a Reply