DEA News : Dr. Larry Gilstrap

Dr. Larry Gilstrap is a Florida native. He graduated from the University of Miami School of Medicine in 1970 and completed his residency in Obstetrics and Gynecology at Wilford Hall USAF Medical Center in San Antonio. He completed a fellowship in Maternal-Fetal Medicine at the University of Texas Southwestern Medical Center in Dallas.

Dr. Gilstrap spent 20 years in the USAF as a medical officer and was awarded the Legion of Merit Medal upon his retirement as a Colonel. Following his service, he returned to UT Southwestern as Associate Professor and then Professor of Obstetrics and Gynecology and Director of the Maternal-Fetal Medicine Fellowship. He became Professor and Chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at UT Health Science Center at Houston.

Dr. Gilstrap has published over 200 peer review publications, 147 scientific abstracts and over 100 book chapters and four textbooks, including four editions of Williams Obstetrics. The American Board of Obstetrics and Gynecology recently establish the ABOG/CDC Larry Gilstrap fellowship in Infectious Diseases and STD’s in honor of Dr. Gilstrap upon his retirement. This fellowship honors his legacy and recognizes his profound impact and influence on the health of women and children. Dr. Gilstrap retired from medicine in 2017.

COVID-19 is not our first pandemic, there were 3 before identified by presumed sites of origin: Spanish Flu (1918), Asian Flu (1957), and Hong Kong (1968). Influenza A is the only flu that can cause a pandemic. Over 500 million people or 1/3 of the world’s population were infected with the Spanish Flu with over 50 million deaths worldwide. The Spanish Flu was a H1N1 influenza A virus with genes of avian origin.

Where did COVID-19 virus start? It is related to coronaviruses isolated from bats in China. Scientists suspect the virus may have jumped to another animal and then to humans. The first human case caused by novel coronavirus causing COVID-19 was reported by officials in Wuhan City, China in December 2019. Wuhan City is the capital of Central China’s Hubei province and has a population of 11 million people.

What are coronaviruses?
– large family of viruses which may cause illness in animals or humans
– in humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS)
– influenza virus is different, cause illness but not as virulent

Why the name COVID-19?
“CO” stands for Corona
“VI” stands for Virus
“D” stands for Disease

SARS-CoV-2
“SARS” stands for Severe Acute Respiratory Syndrome
“CoV-2” stands for coronavirus 2, which causes COVId-19

Cases and Deaths (as of July 20, 2020):

  • World = 14,608,517 cases
    608,487 deaths
    (4.2% population)
  • United States = 3,808,104 cases
    140,528 deaths
    (3.6% of population)
  • Texas = 339,000 cases
    4,044 deaths
    (1.2% population)

State of Texas Hospital Data:
Total Staffed Hospital Beds = 54,646
Available Hospital Beds = 11,167
Available ICU Beds = 1,004 (76% of ICU beds in Dallas are occupied)

Influenza versus COVID in United States:

  • Influenza (October 2017 – May 2018)
    45 million cases
    810,000 hospitalizations
    61,000 deaths (0.14% population)
  • COVID (as of July 20, 2020)
    3,808,327 cases
    140,528 deaths
    (3.6% population)

Medical Conditions that Increase Risk of COVID-19:
Serious heart conditions
Chronic kidney disease
COPD
Obesity
Sickle Cell Disease
Organ Transplantation
Type 2 Diabetes
Corticosteroids or other immunosuppressive medications

COVID-19 Testing:
Viral (nucleic acid or antigen tests) = check samples from the respiratory system (NASAL SWAB) to determine whether the infection that causes COVID-19 is present. Nasal swabs are used to detect a current infection.

Antibody Test (BLOOD TEST) = used to determine if the patient previously had the virus, these are not used to test for current COVID infection as it may take 1-3 weeks after infection to make antibodies. Antibodies might prevent reinfection; it is currently unknown how much protection antibodies provide or how long this protection may last.

How to Protect Yourself:
Face Mask that covers your nose and mouth
Social Distancing at 6 feet apart
Frequent Handwashing (20-30 seconds)
Avoid touching face, nose, and eyes
Disinfect Surfaces
Avoid Crowds of more than 10 people
If other serious medical conditions = stay home

Universal Masking to Prevent Transmission

Largest Healthcare System in Massachusetts with 75,000+ employees:

prior to universal masking, showed new infections among healthcare workers who came in direct or indirect contact were increasing exponentially – from 0% to 21.3%. (increase of 1.16% per day)

after universal masking, showed healthcare workers with positive tests declined from 14.7% to 11.5%. (decrease of 0.49% per day)

Two Symptomatic Stylists with positive tests of COVID-19 who exposed 139 clients, both the stylist and client wore face mask during the exposure time (Missouri, 2020):
No symptomatic secondary cases were reported
Among 67 clients tested for SARS-CoV-2, all tests were negative

Current Vaccines:
more than 160 vaccines in development
135+ vaccines are not yet in human trials
26 are in human trials;
18 of those are in Phase 1 Safety & Dosage
12 of those are in Phase 2 Expanded safety Trials
4 of those are in Phase 3 Efficacy Testing
1 of those is in Approval

Just this morning, Oxford University was cited as having a promising vaccine.

COVID-19 Myths:
Prolonged use of masks may cause CO2 intoxication and oxygen deficiency
Drinking alcohol protects you against COVID-19
Spraying and Introducing Bleach or other disinfectants into your body helps prevent COVID-19
The ability to hold your breath for 10 seconds or more without coughing means you are COVId-19 free
COVID-19 can be spread through mosquito bites
Ultraviolet (UV) lamps should be used to disinfect hands or other areas of your skin

FACT: People of all ages can be affected by the COVID-19 virus

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