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Quick Hits

My experience with COVID-19

How I quarantined and recovered from the virus.

My team began our annual cataract surgery mission to San Pedro Sula, Honduras, on Sunday afternoon, March 8, flying via Delta Airlines. While on the flight I developed a mild cough. Feeling I had a URI once in Honduras, I took the local version of NyQuil. The next morning, sitting in the Lions Fraternidad Eye Hospital awaiting the start of surgery, my epiphany occurred. I had fatigue, chills, myalgias and the cough was worse. I put on my surgical mask and isolated myself and went back to the airport to head back to Atlanta. I knew that a potential COVID-19 patient should not be in Honduras.

TREATMENT & TESTING

By Sunday night, I had quarantined myself alone in the basement of my home. My wife and children were quarantined upstairs. It took almost two days to arrange COVID testing. Oral Tylenol and NSAIDS were effective. My max temperature didn’t go beyond 101.5º. The concern of my physician friends actually fueled some anxiety, as one of them and a patient of my internist were already on ventilators.

HOW I SPENT MY FREE TIME

Podcasts, streaming video and reading were my new life. Thanks to my teenage daughter, I had a Spotify subscription and relied on podcasts, such as The Daily, The Economist and NPR shows. I kept up to date with COVID statistics.

My fever subsided and coughing lessened by week’s end, and I felt if this was the worst, I could handle it. Six days after symptoms began and 2 days after fever abated (I felt normal other than the occasional cough), my test result reported I was COVID-19 positive.

WHAT TO DO?

CDC and Emory ID guidance recommend isolation 72 hours after fever and symptoms abate or after two negative COVID-19 tests more than 24 hours apart. At that time, there was no way to get two more tests. WHO guidance recommended staying in isolation for 2 weeks after symptom resolution. Given a previous mitral valve repair and my age of 67, I was worried about a second wave, a cytokine storm that could develop, so I stayed quarantined. Podcasts, news and discussions on kera-net (the online resource of the Cornea Society) were inundated with COVID-19 talk. I joined BMC’s “Off the Grid” podcast to discuss infection experience along with other infected ophthalmologists and served on Zoom calls for the Atlanta Ophthalmologic Society and, ultimately, CNN.

HOW DID I GET IT?

As part of my medical practice, I had done FAA exams on commercial airline pilots that had left China and Italy. I had visited Washington, D.C., museums within the incubation period, spent time with my daughter’s guidance counselor who was also sick and treated hundreds of ophthalmology patients in my practice. I was not sure of the exact origin.

It is interesting that all but two of my 11 team members took prophylactic hydroxychloroquine to prevent malaria in the days prior to our trip. Did I have a mild case of COVID due to hydroxychloroquine? Is that possibly the optimal time for hydroxychloroquine — after exposure but before symptoms?

It is now 50 days since my COVID symptoms began. I’m happily back in the office practicing “protected slow-motion ophthalmology.” I’ll keep listening to podcasts and doing video conferences and try to forget the ventilators. And I will try to maintain the uptick in collegiality and newfound acceptance of mortality, remembering that just 2 months ago you simply could not have made this up — and if you did, no one would have believed you. OM

QUICK NOTES

Icare launched two new devices, the CenterVue DRSplus Confocal Fundus Imaging System and the Icare ic200 handheld tonometer. The DRSplus uses white LED illumination to produce images, and the ic200 is a new version of Icare’s handheld rebound tonometers, able to measure IOP without anesthetic drops or air puffs.

Sight Sciences launched the latest version of its OMNI surgical system for MIGS procedures. The OMNI can perform both ab interno trabeculotomy and transluminal viscoelastic delivery. Its new features include an updated Luer lock fitting and pull pin; an ergonomic handle and flexi-grip surface; and improved deployment and retraction of the microcatheter.

Ocular Therapeutix announced topline results from a Phase 3 clinical trial for DEXTENZA, for the treatment of ocular itching associated with allergic conjunctivitis (AC). DEXTENZA met all of its pre-specified primary endpoints in the trial. Ocular Therapeutix plans to submit a supplemental new drug application to include treatment of ocular itching associated with AC.