Dr. Anne Truong, MD, on Coping with Coronavirus

A brief YouTube interview (May 2020) with Dr. Anne Truong, MD about the COVID-19 pandemic's operational impact on hospitals—notably mandatory postponement of non-COVID (elective) surgeries, resulting low ward occupancy (~30%), staff furloughs/forced PTO, and financial strain—and about emerging therapeutics. Dr. Truong summarizes conflicting Remdesivir evidence: a March study (~397 patients) reporting a 31% faster recovery but no mortality benefit; a contemporaneous Lancet study showing no benefit versus placebo; and an upcoming larger Gilead trial (≈5,000 patients) expected to report by end of May.
Questions this video answers
About 30% full.
About 397 patients.
31% faster recovery.
It showed Remdesivir was no better than placebo (no benefit).
Approximately 5,000 patients enrolled; results expected by end of May 2020.
Chapters
Joining me now from Washington, D.C. owner, operator of Trong Rehabilitation center for Regenerative Cell Therapy and Daily Ledger contributor, Dr. Anne Truong, MD. Doctor, hospitals. Let's talk about him. What have you seen? What did you see during. I guess I don't even know where we are in terms of this, quote, pandemic in this country because you just simply can't believe the numbers. But let's say a month ago your hospital that you worked in or work in was pretty much cleared out and got ready for this surge of cases that never came. In the meantime, there are bills to pay and there's no patients in the beds. So I would imagine that the hospital where you work right now is probably sustaining a little bit of a financial crunch.
You're right on that. Because when this all broke up, you know, the key was to conserve beds. So that way we can expect a surgical COVID patient. So what happened are those patients that usually will require surgery for like spine surgery, for neck surgery, back or even heart surgery or even heart catheterization or abdominal surgery were put on hold because they wanted to conserve ppe. What happened was that auto surgery after the surgery they go on to the ward and the nurse would take care of of them in the ward and they could possibly, some of them may go to icu. So there is a downflow effect affecting radiology because the radiology department don't do as many MRIs or X rays as much. The nurses that are prepared to take care of these patients that require elective surgeries are not as busy from what I hear. The units, the units and the ward were about 30%, 30% full. So what's happening was that the nurses are now they're starting to find things that they need to do. Like what I heard was some of the nurses are now doing housekeeping duties just to so that they have hours and get paid and that, you know, some of them are required to use their paid time off to supplement the pay they would get. So you're right. I mean, holding off elective surgery was something that brought on more negative effect than we anticipated at this point. And I have a lot of patients that are nurses and they're saying that they're being asked to take vacations this week or the following week, just, you know, to use their time off.
And elective is not even the right word. We shouldn't be calling it elective surgery when you're talking about heart stents and things like that. What we should be labeling this is non coronavirus related care. In a hospital because everything else is just as well, not everything, but certain percentage of these procedures are just as important, should be just as important anyway as treating a coronavirus patient. And what have we done to our hospital system? You think about it doctor, because it's not just in Virginia where you are and you practice, but you multiply this around the country, you know, virtually every governor issued the same orders, hey, you know, stand down and wait for the flood, the flood that never came. And there is some good news here, I guess if you believe Dr. Fauci and I don't believe everything that Dr. Fauci says, but he's talking about a treatment that could be at hand. And you know we've talked about hydroxychloroquine. Well now there's this Remdesivir that appears to be doing good things for people and cutting down the time of recovery and maybe even stopping people from heading into death with what do you know about this drug?
Well, Remdesivir is actually what they call a nucleotide analog. So how it works is that it goes into the cell and it stops the virus from replicating. And it's been used in Ebola and has been used in MERS and SARS several years ago. And so there's a study that came out around in March that looked at about 397 patients and they found that it was helpful in patients with severe COVID 19 disease who are hospitalized and that it accelerated their recovery by 31% so they go home faster. But they didn't show any changes in fatality rate at this point. So Dr. Fauci is a little encouraged about it. But still we need to have more clinical trials, randomized placebo controlled trial. I want to mention also there was another study that came out in Lancet of this week from China around between February to March that shows that Remdesivir is no better than placebo. So you know, it's still out there to need to be determined. So there's a positive case and there's a negative case. And Gilead, who is the maker of remdesivad is coming out a bigger, a bigger clinical trial in May with 5,000 patients enrolled all over the world with severe Covid cases and patient on ventilator. So I'm looking forward to seeing the result from that. It should come out by the end of May.
See this is what happens when politicians get out of the way of the free market and the ingenuity of American and American know how and businesses that produce these kinds of drugs. They screwed up the hospital system maybe permanently. A lot of hospitals will not be able to recover from this. In the meantime, the private sector is trying to come up with a treatment and also we hear maybe getting closer and closer to a vaccine. Hopefully that will come soon. Dr. Trung, thanks.
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