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This episode Dr. Kurt Bjorklund and Chief of Emergency Medicine Services at UPMC Passavant, Dr. John Landis, get together online to talk about how God is working on the front lines of the coronavirus (COVID-19) pandemic in Pittsburgh.

Mentioned in the Podcast
CDC Coronavirus Site - https://www.cdc.gov/coronavirus/2019-ncov/index.html

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Podcast Transcript

Kurt Bjorklund: Hey, welcome to Ask a Pastor. I am joined by a friend of mine, John Landis, who runs the emergency department at Passavant Hospital. He is a doctor here in the UPMC system and has been for a number of years. And we thought it would be great today just to have a conversation around some of the things that are happening with coronavirus. So first, just some real background things and necessary things for all of us to understand and know. And then as we get a chance to go a little farther, some of the spiritual questions around it as well. So, John, tell us first what is it that is significant for people as they are thinking about this issue? What is it that they should know about this whole thing that they are not hearing through all the media that they are taking in?

John Landis: Well, you know, I think some of the problem is all the media. You know, you get so many sources and different media, liberal, conservative, something down the middle, and sometimes it is hard to decipher exactly what to believe from the media. But, you know, I think if you have listened to what the CDC has to say, that is probably the best source to go through rather than cnn.com or Fox News or Yahoo. You know, that really gives the information that guides the medical community and how we approach folks. Is there something magic that that people do not know? I do not think so. In our discussion, I recall telling you that when I told my family that it was time to lock down time to quarantine, time isolate, you expect pushback from our kids that are age 18 and 20. You expect some pushback from them, and they really gave no pushback, as I mentioned. They said, when you said that, we knew you were serious. It has been good and they have managed that. So that is what I would tell folks is that this quarantine piece of it is not a joke. Social distancing pieces, not a joke, to wash your hands frequently, not just after you go to the bathroom, if that is something you do or do not do, wash your hands often after touching things. That video you showed yesterday before the service, gives the opposite side of washing your hands and then what did you touch. You can completely overwhelm yourself, kind of freak yourself out with that, did I touch something, do I need to wash my hands again. I do not think it has to be to that extreme. And, yes, we can talk about some of the anxieties that go with this whole thing that are equally as troublesome as the virus itself.

Kurt Bjorklund: One of my questions is, where is this headed? So social distancing, and quarantine makes sense. Like, I get it. I do not see how, in June, all of a sudden, people are magically saying, hey, we are going back and doing things we were doing two months ago. Give us a sense, just medically of where this is headed this summer and, in the fall, as well.

John Landis: Yes, that is, you know, a million- or billion-dollar question. I do not think that the medical community really knows. So of course, you know, some of the early information that came out was we wanted to flatten the curve. Well, what did that mean? From the medical community that meant doing things such that we did not have all the cases all at once, like New York did. We got that message in the Pittsburgh area early. And I think people have done a good job of isolating themselves. So, you know, at the hospitals, we have not seen the overwhelming number of cases like they have in the war zone in New York City, and that is certainly is a tough place. But, you know, where is it going to be in June? Well, hopefully, you know, we can flatten this curve. And by flattening the curve, we decrease the stresses on the health care system, decrease the spread of the virus, and buying ourselves some time to either find a treatment, to find a vaccine, or to let it peter out. If you look at the SARS virus and the MERS virus, which were two similar viruses, not as contagious, but they did not cause a global pandemic. We were worried at the time that they might, but those just died out on their own. So, if you do not have new people being infected, there could be some hope and prayer that the whole thing just dies out on its own. I doubt that is going to be the case, but that is certainly is within the realm of what we are thinking. So, I know I did not completely answer where we will be in the fall. I cannot imagine that we will all be isolated at home in the fall, because then we might all be choosing B, I choose B, right. So, you know, hopefully we are buying ourselves time to ramp up testing, ramp up tracing patients that are actively infected, and we will be able to have a positive outcome by the summer or fall.

Kurt Bjorklund: What do you make of this? I have had some people send me some things that say things like hey, there's treatments that we are not hearing about like hydroxychloroquine, zinc, and have gin and tonic every day, you will be fine. What do you make of those kinds of pronouncements from people?

John Landis: Right, so, you know, that again goes to where you might be getting your media information from. Again, if you go to the CDC, there is all sorts of information on hydrochloroquine and chloroquine, which are a couple of anti-malaria drugs. I will tell you from personal experience, taking them is no fun. I took them when we went to the Solomon Islands. One time we were in southern Costa Rica, and I took them and they cause headaches, nightmares, and trouble sleeping. They are not benign drugs. You know, zinc is over the counter. If you feel like zinc might help you then go ahead and take some zinc. But if you are really looking at the medical community and how we look at drugs, medications, now there just has not been any studies that say, this is a proven treatment for COVID-19. You know, we have medications that are proven treatments for high blood pressure, heart failure, diabetes, but we really do not have any track record with any of these medications. Then you are just dealing with anecdotal information, a story of someone saying, oh, well, I had high hydroxychloroquine and I got all better in two days. There just is not the study behind it. I will say, just a little plug for UPMC, we have started a study that is looking at hydroxychloroquine in the patients that our facilities are treating in the intensive care unit. So, we will get some information on it. There are other medications that have been released for compassionate use. Some of the antiviral medications the FDA has said while there may be some benefit to some of these medications, so the compassionate uses, we can use them off label. One medication was developed for Ebola. There may be some benefit in this virus. So, I would say that again, you know, refer to the CDC if you are reading about treatments, that may be quackery, may be not quackery. I know I read early about somebody in India that was drinking bull urine, and that was supposed to prevent coronavirus, probably not. You have to an amount of wisdom and not worry about this. And, you know, again, not worried that somebody's withholding medications that are beneficial. Speaking for the medical community, infectious disease community, we are doing everything we can for every single patient, and I will leave it at that.

Kurt Bjorklund: The government has now come out and said, hey, wear cloth masks. And then some people are saying, well, it is an option, you do not need to. When you go in public, is it helpful to wear a cloth mask or is it not?

John Landis: Yes, any sort of face covering is beneficial. You know, early on my wife was one of the first ones at the grocery store with a mask and some gloves on. Again, we do not really know a whole lot about how this virus spreads. And you know, there is some models that a simple cough or sneeze in the grocery store will spread this thing 12-20 feet. Granted, the masks that we use at the hospital, especially the N95 masks that are in the news, in short supply, those are virus safe that down to a specific micron, they will filter out what you breathe in. So clearly, those would be beneficial, but we are saying not everybody needs an N95 when you go to the grocery store. So, matter of fact, if everybody were N95's, we wouldn't have them to treat patients in the medical community. But I do think there is some validity to a face covering or a mask. You know, they have been doing it in Asia and China for a while, mainly for pollution reasons, but you have to wonder, they kind of nipped this in the bud in some of those areas so would it be beneficial to wear a mask. I would say short of not wearing anything at all, certainly a cloth mask is good. Next would be just a simple medical type of mask with loops behind the ears. And again, overkill would be using an N95 when you go out.

Kurt Bjorklund: Okay. Having been in medical community for a long time, I assume you have not seen anything quite like this in terms of its potential damage. Would that be fair?

John Landis: That would be fair and true.

Kurt Bjorklund: Okay. And so, as a person of faith as well, how do you see God interacting with this? What do you do when you walk into the hospital day after day, you see cases coming through, you know, I assume some really traumatic, some treatable, and okay, but what do you do with that from a spiritual standpoint?

John Landis: I think your question where is God in all of this? He is the same places that he has always been. I do not think that he changes throughout these types of human tragedies. Where was God during earlier plagues? Where was God during World War Two, World War One, and Civil War? He is the same place as he has always been. He is in that same place that says, I am here, if you come to me, certainly Christ as our Savior. But you know, if you take a step back and say, well, what hand could he have in this? You know is this something that is to bring us closer together? Is this something that has occurred from the evil standpoint as a plague on humanity to try and destroy everything that we have built up? I suppose, but I do not really know that God's goodness is really reflected in that. I must answer for myself each day again. I pray that we do not have the overabundance of patients like they have had in New York City. And, you know, certainly pray for my family and friends that they listen to some wisdom and do not worry about it too much. The biggest fear if you had to say that, I would have, is for my family. I do not necessarily worry about myself when I go to work. I know I am going to do everything I can and it is not like this is a zombie virus that you get sick and so be it. Certainly, plenty of people recover. But I do not worry about going to work and taking care of these folks. It changes how I work a little bit. But I try to not worry about my family, and reflect more on faith, and where God is in all this for them also.

Kurt Bjorklund: You mentioned a little earlier about the anxiety and other kind of things that come with this. Talk about that a little bit, how you see those issues inter-relating to this and being addressed.

John Landis: You know, I think there's multiple levels of anxiety that certainly can come along with this. There is the disease itself. There is the anxiety over, am I going to get it? You know, what is that going to be like? There is the anxiety over, oh, gosh, grandma's 85, she is in a nursing home, what is going to happen if she gets it? And what is going to happen if someone in my family gets it? What is going to happen if I get it? Yes, there is those sorts of anxieties. And again, I think you must rely on prayer and your faith when you are faced with those sorts of anxieties. There is not a magic pill that is going to reduce those anxieties. You know, you say, I do not know what God's bigger plan is for this whole thing. That is how I look at it, any plague, or war, or death of a family member. I do not know what God's goodness is at the end of the day. I mean, this is a small chunk of time, a small microcosm in the grand scheme of things. So that is to give us some hope at the end and not worry about it. As you had mentioned yesterday, for us as Christians, this is not all there is. But, you know, on the other hand, none of us want to go well, I am okay with getting COVID virus on the one hand and, you know, meeting Christ at the pearly gates. But that is just human for us to want to stay alive, right?

Kurt Bjorklund: Absolutely. There is a God given instinct to say, I want to survive, live, and cultivate on this earth as much as I can. That is part of, I think, how God wired us in creation, and you see it even in the creation mandate back from the beginning of Genesis, to give dominion to the earth. So those are all God given things that are part of being human.

John Landis: Right, right. You know, we talked about it as a family yesterday. You know, there is some anxiety that is associated with being in close quarters for a while when you have not been in close quarters. But, you know, it is amazing how you can get to re-know your college kids that have come home, and interact with them, and do some things, and remember some memories. My wife hid Easter eggs yesterday for my grown adult children that we had not had an Easter egg hunt with. She hid their Easter baskets with some box candy in it. I mean, you know, if this had not happened, they probably would not be home for Easter. They would be off to college studying finals and whatnot. We still do have one at home but you know, just brought back some good memories. And so, you know, you still must ask yourself is that part of God's plan for this to bring us back together, to escape all the day to day things, not that they have gone away. But certainly, if you look outside, there is a lot less external pressure on folks to get together with friends, to hang out with friends, to go to the bar, you know, whatever college age kids might do. So, it has been fun in that in that respect, but you know, there is some anxiety that can be associated with, oh, you left the seat up, and where did you learn to leave the seat up? Well, four years of college and it’s just me, I leave the seat up. So, you know, those can be challenging anxieties. But you know, the anxieties again, you must deal with them with just your faith and prayer. And realize that the medical community is doing everything that they can, and the government's doing everything they can. I mean, this is kind of out of left field. As you said, in my 25 plus years of experience and in medicine, having been through HIV during training and after, there was 9-11, was another big one, and we were all worried about anthrax and things after that. SARS came along, MERS came along, of course, it never hit this country. So that was kind of a low level. It's kind of an unprecedented thing. But, the medical community, regardless of what you hear in the media, is as prepared as we can be.

Kurt Bjorklund: So, it is interesting that the time just being home more, I think is for everybody is a unique adjustment, and yes, we did something similar. We had always, when my kids were little, done an Easter basket hunt throughout the house, scavenger hunt. We re-did it yesterday. And on Easter Sunday I had that all going on and it was just almost weird, but it was fun in its own way. So, we have a couple minutes left. John, tell us what do you want people to know about this whole thing that would be important as a doctor who works in it, with it, day after day, right now, what do you want people to know that would be important?

John Landis: Well, as I said, I think you must watch where you get your sources of information. So, you know, I always refer when friends and family asked me, what about this, what about that? I will refer them to a section of the CDC website, which provides good information. I sent out in a group text to the guys in our small group, early on, it's serious, washed your hands, isolate, stay at home, wear a mask if you go out, those are all important things. We are at a stage right now, where in Pittsburgh at least, we have flattened that curve, and we have gotten a hold of this. But now is not the time to say, well, they say that the cases are not as bad as they have been so maybe I can just go out, meet with friends, and I'll have a party. Those are the sorts of events where it is like, oops, now we got 20 or 30 new cases. So, it is not time to take our foot off the gas as uncomfortable as it might be. We need to really stick with what we are doing right now. Interestingly, in the emergency department, we have seen a decline in the patients that we have been seeing. We are not seeing quite as many belly pains and chest pains. My concern with that is people are sitting at home, you know, with some medical problem that normally, if COVID were not out there, they would go to the hospital. So, people need to know that the hospital and especially the emergency department, but the inpatient units if you must be admitted, it is not like we are the whole places and the COVID board. You can safely come to the emergency department and not expose yourself for whatever your problem might be. That is a big thing I wanted to get out there. People have medical problems, do not ignore them. You know, we are always there and we are not inundated. This will not be like going to the ER in New York, where there is lots of bad things going on. We will leave it at that. So, if you have a medical problem, please, you know, do as you would have done in any time of need. So those are really some of the big things.

Kurt Bjorklund: That's helpful. Super! John, well, thank you for taking a few minutes here to just share your perspective. And hopefully, for those of you listening, you found just some credible information here to help you as you navigate this season. And as always, if you have things that you would love to hear us talk about on this Ask a Pastor podcast, send them to askapastor@orchardhillchurch.com, and we will be happy to interact with it in the days ahead. Thanks, and have a great day.