Throughout the COVID-19 pandemic, the word “change” has overwhelmingly become laden with connotation of difficulty, confusion, and hopelessness. From lost jobs to missed rents to curves that won’t flatten, many of the changes happening around us are wrought with pain and hardship.
But positive changes are happening, too, one being an in-the-works vaccine, perhaps the fastest ever developed.
And in the meantime, the medical community is making constant headway on how to treat the disease. Those treatments, Lompoc Valley Medical Center General Surgeon Dr. Chris Taglia said, look completely different today than they did five months ago.
“When things hit this community in Lompoc the hardest was probably at the end of March, beginning of April,” Taglia remembered. “That’s when they were seeing the peak of the disease in New York, so we got a lot of our protocols from the hospitals in New York, which is where I did my fellowship training. I had a bunch of buddies back there who were willing to share their treatment algorithms.”
At the time, Taglia said, treatment was heavily based on using hydroxychloroquine, an immunosuppressant, and azithromycin, an antibiotic used to treat infections.
“When all of that information came about—the different journal articles that were published showing the lack of benefit of hydroxychloroquine—we immediately threw that out of the protocols,” Taglia said. “We started using convalescent plasma.”
Convalescent plasma treatments, in which a recovered person’s antibodies are given to a sick patient, continue to be a strong part of treatment today. Dr. Lynn Fitzgibbons, director of quality and research and medical education at Cottage Health, wrote about the benefits in an Aug. 13 email statement, and encouraged those who have recovered to donate their plasma.
“At Cottage Health, we are very interested in the potential of convalescent plasma as a tool for fighting the virus in the most severe cases when patients are hospitalized,” Fitzgibbons wrote.
Another positive change for Santa Barbara County came with access to remdesivir, an antiviral medication.
“We kind of always knew it was effective, we just didn’t have any,” Taglia said. Then in May, “Santa Barbara County got an allotment.”
At that, time Lompoc Valley Medical Center had “a ton of patients from the federal prison who were quite ill,” Taglia said, so the hospital got the highest allotment among local hospitals.
“It wasn’t a magic bullet,” Taglia said. “But there was a definite improvement.”
Another advancement came in June, when a U.K. study revealed the benefits of steroids, particularly dexamethasone, in treating critically ill patients.
“That’s something that was frowned upon when this all started,” Taglia said. “Then the data came out from the U.K. study, and now everybody’s using steroids and they seem to make a definite impact.”
For a small community hospital, Taglia said that most patients will be treated in accordance with the set guidelines coming from the larger medical community. But, he added, there are rare times when “you have to throw the kitchen sink at someone.”
“Even before steroids were popular, before that U.K. study came out, we had a few patients who were not in a good way, and we used steroids and saw benefit,” Taglia said. “Certainly that was off-label use, and that’s maybe one small example of when we didn’t follow the set guidelines that were out there.”
Luckily, knowing when to try something outside the box is not a decision that doctors in Northern Santa Barbara County have to make alone.
“There’s a bunch of pulmonary critical care specialists who are down in Santa Barbara. I have a good relationship with all of them, and so we constantly have group emails back and forth,” Taglia said. “If I had a difficult-to-treat patient, I’d call one of them and say, ‘Hey, what do you think about this?’ or, ‘I’m thinking about steroids, is that a good choice?’”
Dr. Scott Robertson, chief medical officer at Dignity Health Central Coast, believes there’s more positive advancements to come.
“We follow the science, which has evolved, again allowing us to safely care for our patients and community,” Robertson wrote in an email. “The science will continue to evolve, and we will stay current alongside these advancements.”
Highlight
• The Santa Maria Kiwanis Aktion Club gave a sheep named Aktion Jackson to Santa Maria’s Los Flores Ranch Park, adding to the park’s existing array of farm animals, city officials recently announced. The sheep was purchased from Andrew Tinoco, “an incoming senior at Pioneer Valley High School and an active member of The Patch community pumpkin event held each October at Los Flores Ranch Park,” according to the city. After the Santa Barbara County Fair was canceled, local students had to find creative ways to sell the animals they raised for the fair, and this was Tinoco’s solution. The public can visit Aktion Jackson at Los Flores Ranch Park from 9 a.m. to 6 p.m., Wednesday through Sunday.
Staff Writer Malea Martin wrote this week’s Spotlight. Send tips to spotlight@santamariasun.com.
This article appears in Aug 20-27, 2020.