COVID-19 From a Family Doctor's View

Apr 23, 2020

Credit Harrisonburg Family Practice

Dr. Greg Jesteadt is a physician at Harrisonburg Family Practice and a clinical professor of family medicine for the University of Virginia.  WMRA's Bob Leweke reached out to him for his perspective, as a physician seeing patients, on the COVID-19 crisis.  Dr. Jesteadt emphasized that his views are his own, and not necessarily those of other physicians at the practice, or at UVa.  Bob began by asking him what he’s seeing in his practice now.

DR. GREG JESTEADT: Over the last, I'd say three to four weeks, there was a gradual increase in what we call telemedicine where we see patients basically through a computer screen, as much as we can.

And initially we were having patients screened at the door, so they would not come in, and over time we saw 20 or 30 patients in a day.

Four or five weeks ago, two patients would be coming in looking like they had the flu and we would gown up and have the nurses swab them, and they would not have the flu. That gradually got more and more and more and more.

Now we're seeing a pretty steady, at least in my practice, a good steady I'd say 1/4 of my patients who are showing up, that are like, "Hey Doc, I got a fever of 102 and a headache, and I just feel like garbage. Do you think I should go get tested?" And then I have to explain to them that you can't go get tested. There are no tests. You know there's no widely available tests, and there haven't been this entire time, so I just tell them to hunker down at home and don't go to work and follow the CDC guidelines. 

Before there's any symptoms, is actually when the virus is being spread just by breathing. And that is the crazy part of this. So that's why it's so difficult to prevent. That's why social distancing is so important. That's why wearing a mask is so important because most people are sick for quite a while before they even know it and that's when they're really spreading it. It's obvious if you're sick to stay away from people. It's not so obvious when you're not sick, and people are just completely disregarding that.

BOB LEWEKE: Well I wanted to ask you about the testing issue because Governor Ralph Northam announced this week that he's forming a task force to try to better address the outbreak including ramping up testing for the novel Coronavirus, and Virginia has been criticized for lagging behind in testing. What do you think needs to be done to solve it?

DR. GREG JESTEADT: That's beyond the scope of what I do. That's a public health issue. That's a manufacturing problem. That's a logistics problem. This is where the oversight of essentialized task force, overseeing the entire nation's problem, would come into play. So being criticized locally for not having enough tests... I don't know what that translates into. Did Governor Northam just ignore the issue? Probably not, he probably lost the bidding war to Arizona over their agents or whatever else you needed to make this happen. So all these things just put together, I don't understand it.

BOB LEWEKE: Yeah, and so what I hear you saying, and this is why you emphasize so much that that even before people get sick, they don't know if they're carrying the virus and that's why it's so important to physically distance and to where the mask if you have to go out and so on.

DR. GREG JESTEADT: Exactly, unless you have an N-95 or better grade mask, wearing something over your face, whether it's just a homemade mask or you know a t-shirt that you just sort of make that goes around and covers your nose and mouth, that protects other people from you if you are sick and you don't know it yet. Or maybe you do know it. It still protects others around you when you're sick. Wearing a mask is one of the most selfless, kindest things you can do right now when you go out and about.

BOB LEWEKE: Well let me ask you this question, based on your observation. As you know Harrisonburg has become one of the hottest hot spots for confirmed cases in Virginia, in terms of the number of cases per capita, why do you think that is?

DR. GREG JESTEADT: I think the cases around here are burgeoning, you know from a data perspective, because somebody got a hold of some tests. And random from a large number of people.

BOB LEWEKE: Oh, so you're saying that we might have more reported cases in some places just because we may have a little more testing there. And that's kind of a measurement effect that's independent of how many people are actually infected.

DR. GREG JESTEADT: I suspect that is the case.

BOB LEWEKE: Dr. Jesteadt, thanks very much for your insights, I really appreciate your time.

DR. GREG JESTEADT: My pleasure sir. Be safe, take care of yourself.

BOB LEWEKE: Thanks, bye-bye.

DR. GREG JESTEADT: Bye-bye.

Dr. Greg Jesteadt is a physician at Harrisonburg Family Practice and an assistant professor of family medicine at UVa Health.