Dr. Stephanie Stuart, emergency room physician and chief of medical staff for Adventist Health Sonora and its outpatient clinics, is among the health care professionals who treat about 100 patients a day in the hospital’s emergency department.
Stuart estimates about one-third of daily emergency department patients are potential COVID-19 cases during the recent surge of the highly contagious delta variant.
She and her coworkers in the emergency department are seeing so many unvaccinated individuals infected with COVID-19, including some who eventually die from it, she views part of her duties as chief of medical staff is to speak up at times in favor of vaccines and dispel myths about home remedies portrayed as magic bullet preventions or cures.
COVID-19 had contributed to the deaths of 96 individuals in Tuolumne County as of Thursday morning. That total includes at least 23 coronavirus deaths since Aug. 1, with individuals in their 20s, 30s and 40s among the deceased. Two of the 96 individuals who died of COVID-19 were vaccinated. The other 94 were unvaccinated.
“Vaccination is the only safe way, the only proven way, to prevent catching severe COVID,” Stuart said Thursday morning outside an emergency department entrance designated for ambulance crews and their patients. “Ninety-five percent of our medical staff are vaccinated here because we believe it’s safe and effective and it works.”
Stuart estimates she and her coworkers in the emergency department are seeing 30 or more potential COVID-19 patients a day. Most of them are exhibiting respiratory symptoms, trouble breathing, coughing, or low oxygen levels. She and other ER physicians work 10-hour shifts. Part of each day there is one doctor assigned to the emergency department. During peak hours each afternoon and evening, there are three doctors on ER duty.
Before 11 a.m. Thursday, Stuart introduced two emergency department colleagues, Dr. Joe Protacio and Dr. Steve Wang. Wang was wearing full personal protective equipment, including a gown, gloves, mask and face shield, because like all emergency department staff, he sometimes has to care for COVID-19 patients.
“We care because we are seeing the consequences of people who aren’t vaccinated and they get critically ill, and then some of them die,” Stuart said. “We’re seeing younger people and older people, otherwise perfectly healthy, they are dying also. It’s not just people with comorbidities. That’s another excuse I see people use online, an excuse not to get vaccinated. That COVID only kills people with comorbidities. That’s not true.”
A great deal of misinformation about COVID-19, vaccines, masks and home remedies has been created, pumped up and amplified on exponential levels via social media and other online platforms.
Last year, the malaria drug hydroxychloroquine was touted as a wonder drug preventive measure and cure for COVID-19. Scientific studies have shown there is no evidence taking hydroxychloroquine is effective in preventing a person from contracting coronavirus or developing COVID-19.
A primary myth Stuart hopes to deflate these days is ivermectin.
“Ivermectin is a drug approved for treating parasitic infections,” Stuart said. “The interest in ivermectin came from a lab where some scientists noticed it might have properties that could make it effective to treat viruses. When it comes to treating people, what works in the lab doesn’t always work on humans.”
There were theories that ivermectin might work against coronavirus, Stuart said. Researchers started doing tests on people in spring 2020, to see if it could help with COVID-19. A paper was published in the journal Chest. Researchers had a pool of patients. They gave the patients multiple drugs. Some of the patients got ivermectin.
One of the groups of patients that received ivermectin did better against COVID-19 and were less likely to die, Stuart said, but it’s crucial to note the same group of patients also received steroids.
“We now know steroids reduce the risk of dying from COVID,” she said. “It’s part of the treatment we use here in this hospital and in hospitals around the world. Everyone is using steroids to help treat patients with COVID pneumonia, COVID patients who require oxygen therapy. These are moderate to severe COVID patients, a step before they have to go on ventilators.”
Patients with more severe COVID-19 might need a lot more oxygen, via oxygen therapy, or they might be put on a ventilator, Stuart said.
The problem with ivermectin is all the false claims and hyperbole online. Poison control centers across the country have seen exponential increases in calls from hospitals asking about patients who are overdosing on ivermectin, Stuart said.
“People are getting it from Tractor Supply, from feed supply stores,” she said. “Ivermectin is mainly used for deworming livestock. Sheep, cows, horses. In humans, we use it for treating lice.”
Stuart said there have been a couple patients in recent weeks who have come to the emergency department with liver injuries due to ingesting ivermectin.
In the past year, more researchers have scrutinized ivermectin and focused on more rigorous, randomized clinical study methods, Stuart said. This more rigorous research included use of ivermectin and placebo — sugar pills.
“They found ivermectin made no difference in COVID patients,” Stuart said. “That study was in Colombia.”
Regardless of scientific research showing ivermectin is useless against COVID-19, people are still taking it because they falsely believe it will reduce the likelihood of catching COVID-19 and is useful at treating the virus once they catch it. No rigorous scientific studies show ivermectin works for either purpose, Stuart said.
“It will not reduce the likelihood of catching COVID,” she said, “and it will not make you better faster. Ivermectin can hurt humans. It can cause liver inflammation and liver failure. That’s the main thing we’re worried about. It’s toxic to the liver, especially in high doses.”
Hydroxychloroquine was popular last year, but it’s been debunked to the point where demand for it has slowed to a trickle.
“We’ve heard anecdotal stories about people here in Tuolumne County taking it, but we never had anybody here in this emergency department with a toxic reaction to hydroxychloroquine,” Stuart said.
Another popular myth Stuart addressed is that the coronavirus vaccines got pushed through and approved too quickly. She said thetruth is medical professionals and lab researchers and scientists have been testing vaccines similar to the COVID vaccines for years before COVID-19 emerged.
In addition, the Trump administration eliminated a lot of red tape in the bureaucracy of drug approval, Stuart said. That helped speed up the process to bring out the vaccines that work, vaccines that she emphasized are definitely the best way to avoid dying of COVID-19.
Asked about monoclonal antibody treatments, Stuart said they have been promising among select groups of patients who are already sick with COVID-19. She emphasized that monoclonal antibody treatments are not a magic wand or a magic bullet.
“We want patients to do the things that work and won’t hurt them,” she said. “We’re all on the same team. We want COVID to be gone and for life to get back to normal, just like everybody else. Our doctors are not part of a government conspiracy or a big hidden agenda. We all spent a minimum of 11 years training and learning how to clinically interpret and use scientific research to help save lives.”
Stuart, 40, was born in Sonora, graduated from high school in Winnemucca, Nevada, studied biology at the University of Nevada, Reno, and graduated at the top of her class to study four more years at Johns Hopkins University School of Medicine. She did her residency at Texas A&M and returned to Sonora with her husband in 2011.
She’s been with Adventist Health Sonora and Sonora Regional Medical Center the past 10 years. As chief of medical staff for Adventist Health Sonora she helps guide more than 285 professionals at the hospital and its outpatient clinics.
Contact Guy McCarthy at firstname.lastname@example.org or 770-0405. Follow him on Twitter at @GuyMcCarthy.