COVID-19 and Bariatric Surgery

There is an abundance of information on the web about COVID-19. Each day, there is new news. Multiple updates are available about the global cases, deaths, and recoveries. I’ve found the Johns Hopkins website to be helpful when looking at the statistics. In China, the majority of cases now fall into the “recovered” group, not the “active” group. In the US, almost all cases are active and few are recovered.

There are some clear trends…COVID-19 is much deadlier for older patients and those with pre-existing medical issues. For example, if you have a history of COPD (emphysema) and diabetes, your risk is much higher. Those with immune compromise are also at higher risk…patients on chemotherapy. Diabetes is an immune suppressed state. In my opinion, those patients should be very cautious about public exposure.

Our office has taken the following measures to limit the spread…

• We reschedule patients with active cough or respiratory infection symptoms.
• We ask patients to not enter our office with these symptoms, if they have fever greater than 100.4, have had direct contact with a known COVID-19, or if they have recently traveled outside the US.
• We have no more than 10 people in our waiting room, at any given time.
• We also encourage patients to take advantage of Facetime/Skype/televisits—our fee for a self-pay patient is $50. We are doing televisits on Wednesday evening and Saturday morning.
• We continue to use good hand-washing and contact precautions.

COVID-19 appears to be only spread through airborne particles…it’s like the flu in some senses. If you cough or sneeze, you produce a mist of secretions which may contain the virus. Most infections will likely occur by inhaling this mist…yes, it’s kinda gross inhaling other people’s secretions! Masks will limit the inhalation of larger particles but not the individual viral particles. However, the mask must fit properly and limit air travel around the mask. It’s also probable that people can get infected when the particles lodge in the eyes. It has been known for years that the eyes may allow the ingress of infections. My personal opinion is that the inhalation route is the most common route to get COVID-19 and this may lead to a more rapid progression of symptoms…the virus lodges directly on the target tissue.

There are also asymptomatic carriers of the virus. Patients may have an active infection but not show any major symptoms. How often in South Texas do we attribute our dry cough and congestion to “allergies” and the weather? I am NOT saying that everyone with a dry cough and allergic symptoms has coronavirus. However, there are asymptomatic carriers and these people may continue to unknowingly spread the virus…this makes containment of the virus difficult.

There is some good news. The virus is fairly easy to kill with ultraviolet light and chlorine based disinfectants. Being outside in the sun (without lots of people around) is pretty safe. Sunlight kills lots of germs! Therefore, we encourage our patients to get outside but practice social distancing. Go outside and exercise, garden, stretch, play with your direct family members. Since you may be at home more, take advantage of the opportunity. Use your time outside to manage your stress. Stress eating is a common problem for bariatric patients. Take a pro-active approach. Go exercise and de-stress daily!