Medi Center – LCM 54 Summer 2021

February 2020, International Congress Number 31 on Emergency Care and Reanimation. By the Society of Emergency Med- icine of Mexico. Acapulco, Guerre- ro from 10 to 14 of February.

In February, it was a new subject, we only knew it was a viral disease of ample contagion and fast contagion speed, causing a lot of deaths with unknown causes. We knew it was an international emergency and we had to pay attention. A few days after the congress the disease rose to be categorized as a global pandemic. And the world began to prepare. At the time it was in Italy, it began to appear in Spain.

Dr. Alejandro Grimaldo returned to Cabo San Lucas and began preparing for what he believed would be a global pandemic. Dr. Grimaldo began acquiring masks, suits and sought out to find out as much as we could of this new disease, way before most even took it as a serious threat.
On Abril 2020, Dr. Grimaldo received a call from a personal friend, his friend’s father, Caesar, had fallen ill in Tijuana, and there was no one there who knew how to stand up to covid.
Caesar, 59 years old, 210lb, and High Blood Pressure, was flown in via air ambulance, at the time of his arrival had been sick for a week and a half and had 60% lung damage. Caesar was immediately put on high-flow oxygen, without intubation, it took two weeks of recovery and lung-oxygen therapy to completely recover. From March to April, Dr. Grimaldo saw an average of 10 covid patients a day.

What makes Dr. Grimaldo’s practice different is that he specializes in house calls. Managing covid as a house-call would turn out to be beneficial, as patients are quarantined in their own homes.

Since, Dr. Grimaldo has noticed two other spikes since the original outbreak, the highest during April-May-June, the second during December- January- February. At this point, Dr. Grimaldo has seen more covid patients than he can count. Those who don’t make it have all been tended to at stages where the illness was very far along. Active awareness of the evolution of symptoms, self-exploration, and a good medical historian are fundamental allies to the doctors fighting off covid.

Dr. Grimaldo says fending off covid is about counteracting general inflammation, keeping the patient hydrated and well-rested. The best way of fending off covid is sleeping well, drinking lots of water, doing exercise, eating healthy, and using your face mask properly.

Sleeping well, drinking water, and eating well, is what will fight off covid, if we’re lacking, covid may wreak havoc, and in fighting it off, Dr. Grimaldo will have to stop further deterioration while aiding the body in getting hydrated and rested enough so that it may carry out what it should have been capable of doing in the first place. Preventive actions are best, getting and staying healthy is the best way of never even coming into contact with covid.

“Falling ill to covid is to have war be waged within your body for 15 days, it’s a war between the virus and your immune system. Your body’s capacity to fight back depends on hydration, and sleep helps the immune system proliferate, it’s the number of soldiers, the more antibodies you have, the larger the mass of the inflammatory cells aiding you, the better your capacity to react. If you don’t sleep well, if you don’t keep well hydrated your immune system is deficient and the virus can grab on. The virus grabs on to your immune system which then causes a cascading severe inflammation to try, desperately, to counteract the virus from spreading. It’s the severe inflammation that leads to death in most cases. That’s why we try to avoid the inflammatory process with good nutrition and a healthy lifestyle.
The virus and illness because have a few stages. The first 15 days is the viral phase, it’s the war phase. During the first few days, although we don’t know of antivirals at this time, no treatments to kill the virus, there are treatment options that restraint the viral reproduction. It’s a lot easier to fight off a disease that reproducing at 20% instead of 100%. That’s what we can do when we identify the virus early on.
In advanced stages, there’s no longer any point in restraining the viral reproduction, after a certain point the viral load is so big that your immune system cant eradicate it. All we can do is reduce inflammation and prescribe antibiotics to avoid secondary infections. If your immune system is fighting off disease at 100% it means nothings stopping other diseases such a bacteria and fungus to set in.
In Mexico, three are kinds of tests available. Two for early detection and a third says how your immune system reacted to the infection. The third isn’t a diagnostic tool. The first two are the PCR and the Antigen test. PCR detects the virus genome, it takes its gene and tells you if it’s there. And the Antigen tests detect the virus proteins. The difference between the two is when you have it taken. Antigen tests are best within the first 5 days of contagion. It helps us within the first five days. After that is becomes less effective. PCR gets better the longer the virus has been in the host’s body. PCR is the most effective and can detect the virus from day 1 until day 15, because it’s tracing the virus’s gene.
The PCR tests has about 95 to 98% efficiency, and the Antigen test is a little lower than that. The Antigen test is a lot cheaper and it’s a really fast test, the only problem is that it’s less effective after the first 10 to 12 days.“

If you don’t go out, the virus won’t find you.
Dr. Grimaldo.