Opinion | Diagnosing and Treating Covid-19

The New York Times

To the Editor:

Re “How We Can Get Ahead of Covid-19” (Sunday Review, April 26):

Dr. Richard Levitan suggests that using oximeters to measure oxygen saturation at home will help prevent deaths from Covid-19. This is an unfortunate simplification of a very complicated disease process that we are just beginning to understand.

Working in a dedicated Covid-19 ambulatory clinic in Somerville, Mass., where we have evaluated more than 1,800 patients since mid-March, we have learned one thing for certain: It’s much more complicated than that.

Currently, we use home oximeters for some patients, but we have already seen risks with their use, including inappropriate reassurance for both clinicians and patients; false readings, both low and high; and inappropriate overreliance on a single number rather than complete assessment of the patient.

Home oximeters should be carefully studied to determine their appropriate role in the management of ambulatory Covid-19 patients. We should move swiftly but thoughtfully during the pandemic to ensure that we do not cause more harm than good.

Pieter A. Cohen
Somerville, Mass.
The writer is an associate professor of medicine at Harvard Medical School and a general internist at the Cambridge Health Alliance.

To the Editor:

Dr. Richard Levitan’s succinct article on a simple testing device for checking on the lung capacity of individuals seems like an inexpensive early alarm system. Perhaps our president could tout this in lieu of his other medical advice.

Alice Schaffer Smith
Palo Alto, Calif.

To the Editor:

Re “Trump Says Look to Light. Experts Urge Caution” (news article, April 24):

The suggestion that sunlight may slow the transmission of the novel coronavirus is debatable, and certainly Covid-19 remains a major issue in many of the sunnier countries worldwide. In practice most transmission of the virus happens indoors, where indoor ultraviolet germicidal lamps are far more effective at killing the virus. Unfortunately, these germicidal UV lamps can be a health hazard, both when used as an overhead light and for the unlikely application of using it within the body.

There may be a solution: A new type of UV lamp has recently been developed that both kills viruses and doesn’t have health risks. In our tests we’ve confirmed that these far-UVC lamps do indeed efficiently kill coronaviruses and don’t damage human tissue. Installing these far-UVC lamps in airplanes, classrooms, shops, restaurants and a multitude of other public locations would seem to have great promise for preventing the next big pandemic, not to mention the next seasonal flu epidemic.

David J. Brenner
Manuela Buonanno
New York
The writers are research scientists at Columbia University Center for Radiological Research.

To the Editor:

Re “Prescriptions Rose as Trump Praised Drugs” (front page, April 26), about the surge in demand for chloroquine and hydroxychloroquine:

Two shameful outcomes here: first, the sheer number of physicians, all highly trained in scientific thinking, who wrote prescriptions for hydroxychloroquine based on the president’s magical thinking; second, the sheer number of pills, all legitimately needed by people with chronic illnesses, that will end up gathering dust in the back of people’s medicine cabinets or thrown in the trash.

Edward P. Freeland
Lawrenceville, N.J.
The writer is a lecturer at the Woodrow Wilson School of Public and International Affairs at Princeton University.

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