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Two specialists help Santa Rosa Kaiser cope with new coronavirus

Coronavirus is an old acquaintance of Dr. Shu Yang and Dr. Jessica August, who are Kaiser Permanente Santa Rosa Medical Center’s key resources in combating the disease cutting a deadly swath around the world and shutting down Sonoma County.

The novel coronavirus, officially known as SARS-CoV-2, is from a family of pathogens known since the mid-1960s and responsible for maladies ranging from the common cold to two deadly epidemics in the past two decades.

“It’s a new family member,” Yang said, distinct from other coronaviruses owing to its pandemic-inducing capability to “efficiently transmit from person to person.”

The newcomer, which arose in Wuhan, China, in December, has killed more than 50,000 people in at least 180 countries and territories, including more than 5,000 in the United States and one in Sonoma County.

It is also formidable because it is “new in our bodies,” meaning no one has been able to build up natural immunity as they do from exposure to some diseases, Yang said.

“Everyone is susceptible to this infection,” she said.

Coronavirus primarily spreads from person to person through respiratory droplets produced when an infected person coughs or sneezes, according to the Centers for Disease Control and Prevention.

Yang and August, who came to the Kaiser Santa Rosa hospital about the same time last fall, are the only two infectious disease specialists on a staff of about 400 physicians who provide care for some 176,000 Kaiser members.

They spend much of their time consulting with medical colleagues - usually at hospital bedsides or in outpatient clinics - and they “sometimes get asked about some pretty puzzling cases,” Yang said.

Infectious disease is a wide-ranging specialty, August said, noting there is “an infection for virtually every organ in the body,” and that diseases can in some cases be hard to pin down.

“There are many you wouldn’t want to face as a patient,” she said.

Infectious diseases are caused by microscopic organisms known generically as microbes - bacteria, fungi, yeasts and viruses - found throughout the world. Most are beneficial, some are essential to our well-being and some deliver disabling afflictions such as smallpox, malaria, tuberculosis, cholera and HIV/AIDS.

Now, the two Kaiser staff newcomers are in the coronavirus spotlight.

Kaiser officials won’t say how many coronavirus patients they might have, deferring to county public health officials, who have declined to say where any of the county’s cases are being treated.

But Dr. Michael Shulman, physician-in-chief at the Santa Rosa facility, said Yang and August have both been “a tremendous asset” to Kaiser during the pandemic.

“They have tirelessly answered questions and provided expert guidance and support to our leadership team, physicians and staff,” he said, adding that other physicians “have expressed tremendous gratitude for their calm, level-headed leadership.”

Asked if SARS-CoV-2 is the worst coronavirus on record, Yang said that “right now I can’t draw that conclusion.” It’s a matter for the federal Centers for Disease Control and Prevention to determine, she said.

But it is worse than the last two notable coronavirus infections: Middle East respiratory syndrome (MERS), first reported in Saudi Arabia in 2012 and which eventually spread to more than 25 other countries; and severe acute respiratory syndrome (SARS), which arose in southern China in 2002 and spread to more than two dozen nations in the Americas, Europe and Asia.

No human cases of SARS have been reported anywhere since 2004 and while MERS continues, primarily in the Arabian Peninsula, there have been only two confirmed cases in the United States, both in 2014, according to the National Foundation for Infectious Diseases.

The death toll from SARS (774) and MERS (858) is a fraction of the 46,000 lives taken by SARS-CoV-2, a number about equal to the population of Rohnert Park. Government scientists last week estimated the new coronavirus could kill up to 240,000 Americans, nearly equal to half of Sonoma County’s population.

When might the infection peak?

“I don’t think we know,” August said. “Our message is to prepare for whatever happens.”

August, a graduate of Ross University School of Medicine in the West Indies, said she chose infectious disease as a specialty because a physician can literally “look at the disease process.” With an infected knee, for example, a tissue sample can be used to reveal the pathogen under a microscope.

“You see whatever is causing the disease very nicely in the lab,” she said. “It’s a nice connection between science and people.”

Yang, a graduate of Sun Yat-Sen University of Medical Sciences in Guangzhou, China, said she was struck by a medical school lecture opened by a surgeon’s assertion that “we are swimming in a world of microbes.”

Humans truly are coexisting with billions of single-celled organisms, most of them beneficial and some of them harmful disease agents, she said, acknowledging her job in a hospital carries a risk of infection.

Physicians follow prescribed protocols, wearing protective equipment, washing their hands and cleaning their surroundings, Yang said. Now, they also follow the basic precautions recommended to the public: social distancing and staying at home.

“It’s a risk we share with everybody else in health care,” August said, and both physicians insisted they are not heroes.

Emergency room workers, doctors, nurses, respiratory therapists and other hospital staffers are the ones deserving accolades for being “on the front lines dealing with the patients,” August said.

You can reach Staff Writer Guy Kovner at 707-521-5457 or guy.kovner@pressdemocrat.com. On Twitter @guykovner.

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