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Coronavirus: Q&A with an Austin emergency room doctor

Dr. Natasha Kathuria, an ER doctor at Austin Emergency Center, answers some questions about the spread, containment and response to COVID-19.

AUSTIN, Texas — Dr. Natasha Kathuria has been a steady medical resource for KVUE's questions about coronavirus over the past few weeks. 

On Friday, KVUE's Mike Marut conducted a Q&A with some questions viewers have asked as well as questions that have remained unanswered.

KVUE: What questions have you been getting?

Kathuria: “A lot of it is around our ability to test and our sensitivity of the tests we do have. Most of these people we’re not testing, and we’re sending them home presuming they have the virus and giving them precautions about the virus. Most of the questions are, ‘How do I quarantine? What is the best way to quarantine myself? When can I return to work? Do I have to worry about sick family members? Is there anything I can do to treat this, how can I improve my immune system?’”

KVUE: You're very active on social media, have you seen social media be a double-edged sword of right and wrong information?

Kathuria: "Definitely. When coronavirus was first coming out, there were a lot of people minimizing coronavirus saying, 'It’s just like influenza. It’s just like the flu. It’s nothing to worry about, we’re all panicking for nothing,’ and I think minimizing the potential catastrophic effects from it is being on the wrong side of history. ... Our patients are reading on blogs, groups, friends, things like that and we see it all the time with everything, not just this virus."

KVUE: Is flattening the curve working?

Kathuria: “We’re not there yet for two reasons. One is we’re still ramping up testing. With ramping up testing, we’re going to have more cases – not necessarily that we’re having new infections, but we’re catching more people because we’re testing more people. It’s a little bit difficult to flatten the curve when we were really limited on testing initially. We’re obviously going to have more cases now that we have more testing and can test more people, and we no longer have travel restrictions and we can test people based on our clinical judgment, which should’ve been the case from the get-go. Now we’re doing with what we have and it’s doable. It’s absolutely doable. We’ve seen it happen in other countries and even other cities. The goal is that once it hits, we quarantine, we’re strict with the public, we do what we can to limit exposure and limit spread, and that’s when our teams come in and we do what we can to treat it and keep people alive.”

KVUE: Was testing for coronavirus normally done anyway? Or is this outbreak a result of seeing more tests?

Kathuria: “Testing was initially being very restricted. You had to go through the health department, get approval. Doctors could not test people who were dying. There were patients who died who never got tested who were young, healthy and on ventilators. [They] clearly had what any clinician would say, ‘This is coronavirus.’ It’s got a very distinctive CT image, everything else comes back, nothing is coming back positive, yet we were unable to test those patients. Obviously that was earlier in the course, now those patients can be tested, theoretically. The other problem is the sensitivity of the test. The test is not very good. If you come to me with symptoms, and say I can theoretically easily get a test, I can pull it out of my pocket and test you. If it comes back negative, I cannot say you don’t have coronavirus. Even if you are positive for the virus and I treat you, and finally one day you’re in the hospital and it comes back negative, I cannot discharge you saying you’re now healed of coronavirus.”

KVUE: Coronavirus has existed before this outbreak, correct?

Kathuria: “There are many coronaviruses: MERS, SARS, there’s so many types of coronaviruses out there. This is just one type of coronavirus.”

KVUE: Were we ready for this?

Kathuria: “No. I think that any provider would tell you that without hesitation. No. We were not and we are not ready for it. I think that is very important to be said that we are still not ready for it. In a world where I can’t even go into a room and treat a patient without having to prove my case to get the right mask to wear because I need to ration the mask. That is not something we should ever have to face. We were not ready for it. As you can see, we’re still struggling for tests. I’ve never had to fight to get a test or anything for a patient this hard ever. We’re fighting for tests, we don’t have vaccines, we don’t have treatments. Vaccines take time, treatment takes time, it takes studies and clinical trials. We can’t just make it and put it out there, but we were not ready to fight this war. The public needs to do their best to stay home, and I think we’ve been reacting well. The public has been doing their job and we’re so grateful to see that, but we’re not ready.”

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KVUE: Are we heading in the right direction?

Kathuria: “Yes, we are. Just in the last week being able to have testing at ERs and some clinics. They’re limited testing, the testing’s not that great, but we’re ramping things up. There’s so many companies trying to work with the government to provide even point of care testing which we’re hoping to have. There’s a lot of innovation happening and we’re hoping that if that ramps up quick enough, then we can flatten this curve quickly so we can prevent a lot of deaths. Things are still up in the air right now. Laws are changing to protect providers, protect hospitals so we can treat patients and we don’t have to navigate through all this red tape and everything else. This is a disaster. We can’t follow all these rules for every patient and protect ourselves and save all these lives at the same time.”

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KVUE: Has there been any testing relief?

Kathuria: “We’ve definitely had an increase in testing, more availability. It’s still very little. It’s still not nearly what we need. If we tested everyone we thought who had coronavirus, we’d be out in a few days.”

KVUE: The reactions from the state government and local governments, are they reasonable?

Kathuria: "Absolutely. Containment – we can’t prevent it, it’s already here. Containing it and treating it and the window to prevent it from spreading, that’s our biggest defense against this virus right now. People staying home, listening to the recommendations to limit gatherings, to limit contact with people as much as we can do that and for however long we can without destroying our economy and totally disrupting millions of people’s lives, which it already has. It’s a very fine line we’re walking right now.

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KVUE: Should we have seen this coming that it was going to get to this point?

Kathuria: “We saw it happen in other countries. We’ve seen it, we saw it, just moving slowly closer to America. We watched it happen. We watched how this played out and we did not prepare soon enough. From a clinician standpoint, from an epidemiologic standpoint, watching this virus move, we were terrified before it even got here.

WATCH: Coronavirus: Q&A with an Austin emergency room doctor

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