Ask The Docs

Submit Your Questions

Dr. Rupie

@dr.rupie

www.drrupie.com

Dr. Rupie is a board-certified Internal Medicine specialist who has been a practicing physician in Hawaii for over a decade. She has served as an executive hospital board member and as a physician advisor and medical director for major health systems. Rupal has had a wide scope of practice through telemedicine, urgent care, outpatient clinic and as an acute care hospitalist in both city and rural settings both nationally and internationally.  In her career, she has overseen the care for tens of thousands of patients.

Dr. Chauhan

@weprescribehi

www.weprescribe.com

Dr. Chauhan trained at the Brighton and Sussex Medical School in England. He worked in both England and Canada before settling in Hawaii in 2016. He has experience in hospital, clinic, and urgent care settings, as well as telemedicine. He has completed more than 12,000 telemedicine sessions with patients all over Europe. Dr. Chauhan believes that good health means being at your best, both physically and mentally, and that every person should have access to the care and medications they need to achieve this state of well-being.

Frequently Asked Questions

What do we currently know about coronavirus?

We first heard of the “Coronavirus” causing COVID-19 sometime in January. It was anew species of virus for humans and appeared in Wuhan China sometime in December.. There was definite concern about it spreading quickly, but there was a ton of uncertainty about the potential of this virus. So we began to discuss it, but weren’t sure what to expect of it. There was hope that it could be contained w measures put in place like quarantines in & education regarding how to prevent spread. But that didn’t work or was too little too late. Since then, the situation has exponentially evolved and we are sitting on a global pandemic w effects on the lives of every single human on the planet. And numbers in the US are skyrocketing.  

How does it compare to the flu?
We now know it has the potential to be deadlier than the Flu. We also know that it is much more contagious, making it very dangerous. We STILL do not know everything about it though. Why? Because it is brand new in humans & we only know what we learned in the past several months and continue to learn as we go. There is hope for treatment & for development of a vaccine w the quick actions being taken around the world. Things are constantly changing as we get more information, at times literally hour to hour. What is relevant at this moment may become irrelevant tomorrow.
What actually is the Coronavirus?

It’s not just one virus that makes up the Coronavirus family. Coronaviruses are a group of a bunch of viruses, many that only infect animals and until last 2019, only 6 that were known to infect humans. One of those 6 human strains of coronavirus causes the common cold. Other strains include SARS and MERS. The strain we are dealing with today is SARS-CoV2. This is the strain that causes COVID-19. It previously only infected animals but mutated so that it was capable of infecting humans in late 2019. Humans have no immunity to it, because we’ve never been exposed to it before. And it has shown itself to be highly contagious.

-The human coronavirus mentioned on old Lysol cans/wipes refers to the strain that causes the common cold.⠀
-International and air travel has been the catalyst for the spread. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
-It appears that people are contagious before symptoms develop. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
-It appears possible that droplets can stay in the air for hours and on surfaces for days⠀⠀

Why is this a big deal and why are we taking all of these extreme measures?

Because WE need to contain it NOW. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
This is not the flu or like any other virus that we’ve previously dealt with in our lifetime. We have seen how dangerous it has been in other countries and are beginning to see the gravity of spread and the impact here in the US.⠀⠀⠀⠀⠀⠀⠀⠀⠀
Mortality rates are high even if we haven’t identified all of the folks who have it in the community due to erroneous tests and lack of testing.⠀⠀⠀⠀
Those over the age of 80 appear to be at the highest risk of death. And though the risks are higher for those who are elderly, immunocompromised, & who have co-morbid conditions, that does not mean younger folks are without risk. We are starting to see young people getting very sick and multiple in their 20s and 40s on life support across the country.⠀⠀

Why should we be worried about what happened in Italy and Spain?⠀⠀⠀⠀⠀
What is unfolding in Europe can very easily happen in the US, especially if we ignore it and don’t act.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
They have run out of ICU beds and life support machine in some areas- meaning they are literally having to choose between who gets treated and who is not treated when someone needs help, whether COVID-19 related or not. ⠀⠀⠀⠀
What are some of the concerns specific to Hawaii?

Many of us live in multigenerational households, making it difficult to separate from one another if anyone gets sick.. putting those at high risk at an even higher risk. Even if one family member gets a minor illness, this could be deadly for an elderly family member or someone with chronic medical disease.
⠀⠀⠀⠀
As of today, we already have a shortage of protective equipment- facemasks for our healthcare team at the front lines in hospitals- our nurses, our doctors, our techs and staff. And in Hawaii we also have a shortage of healthcare workers, we are already around 800 physicians short and 900 nurses short. If our healthcare workers start to get exposed -sick or require quarantine, the results will be disastrous as there won’t be enough folks to care for those who get ill, whether from COVID-19 or any other illness/injury for that matter.

We have extremely limited resources. Across the islands, we have around 300 ICU (critical) beds and around 500 ventilators (life support machines). Many hospitals are often at capacity at various times throughout the year normally. We have a population of 1,400,000. Even if a small percentage of our population gets sick at the same.. there will not be enough resources for everyone to have access. This is super serious. We ALL need to play our part.

What can I do?

Flatten the Curve. What does that mean?⠀⠀⠀⠀⠀⠀⠀⠀⠀
It means slowing the spread and that means doing everything YOU can do to not get infected. The problem is that you could spread the infection without even realizing you have caught it, especially since it takes time for the symptoms to show. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
We need to slow down the rate of infection so it’s more manageable & so that everyone who gets sick enough to need medical attention or life support, can get it. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
Take action NOW, isolation and social distancing.. the one thing that’s worked elsewhere in the world. 

What are some of the concerns specific to Hawaii?

Many of us live in multigenerational households, making it difficult to separate from one another if anyone gets sick.. putting those at high risk at an even higher risk. Even if one family member gets a minor illness, this could be deadly for an elderly family member or someone with chronic medical disease.
⠀⠀⠀⠀
As of today, we already have a shortage of protective equipment- facemasks for our healthcare team at the front lines in hospitals- our nurses, our doctors, our techs and staff. And in Hawaii we also have a shortage of healthcare workers, we are already around 800 physicians short and 900 nurses short. If our healthcare workers start to get exposed -sick or require quarantine, the results will be disastrous as there won’t be enough folks to care for those who get ill, whether from COVID-19 or any other illness/injury for that matter.

We have extremely limited resources. Across the islands, we have around 300 ICU (critical) beds and around 500 ventilators (life support machines). Many hospitals are often at capacity at various times throughout the year normally. We have a population of 1,400,000. Even if a small percentage of our population gets sick at the same.. there will not be enough resources for everyone to have access. This is super serious. We ALL need to play our part.

Are we overdoing it?

Nope, not with so many lives at stake. Many of us are likely to get COVID-19 at some point, though it seems to be mild 80% of the time, the 20% who get super sick will need medical attention. So we need to act now to spread out the cases. This is why schools are closing, travel is being restricted, events are being cancelled. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
– PLEASE be socially responsible & stay at home –

🚨What can I do to be socially responsible and protect myself and others?⠀⠀⠀⠀⠀⠀⠀⠀
– If need to be around others, keep a distance of at least 6 ft⠀⠀⠀⠀⠀⠀⠀⠀⠀
– Don’t shake hands or hug, shakas and waves instead ⠀⠀⠀⠀⠀⠀⠀⠀⠀
– Don’t get together with friends in person. Use technology. ⠀⠀⠀⠀⠀⠀
– Cancel gatherings- church services, birthday parties, events⠀⠀⠀⠀⠀⠀⠀⠀⠀
– Don’t contribute to large crowds, hello Costco shoppers & airports⠀⠀⠀⠀⠀⠀
– Work from home⠀⠀⠀⠀⠀⠀⠀⠀⠀
– Avoid all non-essential travel⠀⠀⠀⠀
– Do not share any personal hygiene products
What do I do if I am sick (fever and cough) and not sure if I have COVID, but don't need medical attention?⠀⠀
– If you’re sick, stay home & isolate yourself from others in home
– Isolate yourself by staying in a separate room and use a separate bathroom if possible. Use separately designated plate/cutlery for food. Manage your trash (tissues, etc.) yourself and keep it contained. ⠀
– Disinfect frequently touched surfaces – Do NOT go to ERs, hospitals, urgent cares unless you have an urgent need- Use Telehealth to virtually see a doctor to assess your needs (in Hawaii @WePrescribe)⠀⠀⠀⠀⠀⠀⠀⠀⠀
– Know the symptoms &when to seek medical attention
⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
We all MUST do this together or it doesn’t work. Think of others.. yes it’s a disruption, it’s inconvenient, & its painful for business. But measures are needed in the short term to save lives and keep this period of inconvenience as brief as possible, you CAN help! ⠀⠀
Interested in other ways you can help?
There are lots of ways you can support the community while keeping social distance.