Coronavirus Scare at
Patient presented to my office accompanied by the patient’s spouse. They had just returned from the U.S. and a cruise trip. The cruise trip had ended about one week prior to their return back to Chapala. The spouse of the patient had presented with flu-like symptoms but did not appear ill anymore. The patient who had a history of a chronic respiratory disease did present with a fever, dry intermitent cough and progressive difficulty breathing. The three most worrisome symptoms with a history of recent travel aboard a cruise ship.
Upon examination, the patient did appear ill, difficulty breathing, moderate fever and her oxygen saturation was low to the point that she would require supplemental oxygenation and be treated in a hospital setting, to manage her as I have had various times in the past with patients with similar history and presentation.
Earlier that morning CHAPALA MED equipped an exam room to isolate patients with respiratory infection symptoms in order to protect our staff as well as our other patients.
After examining the patient, I called ahead to a private hospital that I believe had the appropriate resources to manage her care. It just so happened that the hospital director, medical director, state epidemiologist and state health authorities had a meeting with them that very morning and gave them indications as what to do in the event a patient were to present to their hospital that was suspicious for COVID-19 infection.
I was advised to send the patient with a referral letter to INDRE at Hospital General de Zoquipan in Zapopan where they would be able to test the patient for COVID-19. There are only 2 public labs for testing in Guadalajara – Laboratorio Estatal de Salud Pública y en el Centro de Investigación Biomédica de Occidente (CIBO) del Instituto Mexicano del Seguro Social (IMSS). The only other PRIVATE lab that is certified to do this testing is UPC (Unidad de Patologia Clinica) on Ave. Mexico 2341 and the cost is approx. $5000 pesos. I have heard that one doctor here has testing done locally but I would be weary of such local testing.
The Medical Director of both the hospitals (private and public) as well as UDPC director confirmed the following the rules for getting tested for COVID-19.
1. The patient must be accompanied by a “healthy” friend or family member who speaks spanish. Both are to wearing face masks.
2. While the suspected patient is examined and swabbed in an adequately isolated area, the family member must be able to give a complete medical history in Spanish.
3. Results will take between 24-48 hours to be reported.
4. Meanwhile the patient has to be isolated or under quarantine while treated. The patient was kept at the INDRE at Hospital de Zoquipan for approx. 2 hours before being released back under my care.
5. The private hospital that met the criteria required by the local health authorities was Hospital Puerta de Hierro in Zapopan. She placed in a room where she was isolated and had separate air ventilation
6. One of the pulmonologists on my team assisted me in treating the case.
All the appropriate blood, microbiological and imaging testing was done.
And yes, as is the case with most COVID-19 cases, monitors and respiratory support was needed.
All the healthcare staff took all the appropriate conditions to protect themselves and the other patients. I was very impressed.
7. It turns out the patient had a moderate-severe exacerbation of her chronic respiratory infection most likely due to a viral infection but not the COVID-19.
8. Once the authorities at the INDRE reported her case as negative or no longer suspicious, the patient was treated in the regular ward and was released a total of 4 days after she was initially admitted.
I am very happy to report that the patient is now doing well and I hope she follows my recommendations to self-isolate herself due to her elevated risk factors for contracting this dreaded virus.