Question: I was just thinking that if I were to contract the coronavirus, I’d rather contract it later rather than sooner. I’ve heard more people say that they’d just rather get it over with, but I was thinking that it’d be better to wait because we’d have more science and doctors/hospitals would have more experience treating COVID patients. The science and experience would offer a better chance of having a better outcome. What do you think?
Answer: I agree. We know more and more each day and our knowledge and experience will improve patient treatment and outcomes. Please continue to try to avoid contracting the virus; the longer we can avoid SARS-CoV-2, the better! Here’s one interesting nugget of data from a prospective cohort study of 5,279 patients a a large academic medical center in New York City and Long Island (NY Langone) recently published in The BMJ that supports this position — while the risk of hospital admission remained constant during the study period (March 1st through April 8th), the risk of critical illness decreased. The authors state, “Our institution was stretched but not overwhelmed by the epidemic and did not experience important equipment or treatment shortages. The improvement in outcomes over time (in the setting of a functioning health system) raises the possibility that familiarity with the disease, ongoing iteration of protocols and practices in response to observed outcomes, and initiation of new treatments might improve outcomes even in the absence of vaccination or regimens known to be effective.”
The BMJ editors elaborated on this finding in an accompanying editorial, stating “Perhaps the most intriguing finding from the New York cohort was that risk of critical illness declined progressively over the study period, with a suggestion of declining mortality as well, without changes in risk of hospital admission. Several potential explanations worthy of future investigation include the influence of strain in hospital capacity on quality of care, allocation of resources, and disposition decisions in the emergency department; changes in care delivery over time, such as proning in awake, non-intubated patients to avoid intubation or better adherence to lung protective mechanical ventilation strategies; and changes in targeted therapy that might be beneficial (remdesivir and anticoagulation) or harmful (hydroxychloroquine).”