Introduction and General Commentary:

Dr. Ted Rosen

1. This is truly a time of national crisis. We must put aside our legitimate differences of opinion on other issues and work together to vanquish this virus.

2. At this point in time, social distancing is the most effective way we can combat the spread of COVID-19. Any way you can contribute to that concept will be of value, including reducing the number of patients coming for face to face office visits. Postpone elective procedures, delay return visits for stable established patients, and practice teledermatology in any way and as often you can.

3. While the literature cited below suggests there may be utility of hydroxychloroquine in both post-exposure prophylaxis and therapy of active disease, keep in mind this treatment has not been verified in a rigorous randomized controlled study. Prevention of spread is still paramount.  I would hate for people to just rely on this drug instead of getting thorough and appropriate evaluation.

4. While small scale successful studies of remdesivir have proven promising, it will be a while until larger trials verify efficacy, alert us to common adverse events and allow mass production and distribution. This may be the “next Tamiflu” but this won’t happen overnight.

5. Testing on at least one vaccine has started. There are multiple vaccine products in various stages of development. We will have a vaccine, but not in time to deal with this acute pandemic.

6. Practice good hand hygiene and remind all patients you encounter to do the same.

7. It may come to a mandatory national lockdown which will extend for some period of time; maybe 14 days, maybe longer. Be prepared for the possibility you may need to shelter in place.

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