Front line physician prepared for pandemic

HARLINGEN — He’s taken the road less traveled, and it’s paying off — for many.

Dr. Christopher Romero is on the COVID-19 front lines at Valley Baptist Medical Center, combating a crisis he never thought would happen in his own back yard.

“ I took a less traditional path in medicine and did both my medical degree and a PhD simultaneously,” said Romero, internal medicine specialist at Valley Baptist and a Los Fresnos native.

“ At that time I decided that I would do my PhD work in the field of microbiology and immunology,” said Romero, 40.

“ I had a lot of wonderful mentors. I got to do some really great research in both the field of immunology in some labs that were developing vaccines.”

His research in microbiology included examining animal models of sepsis and severe infection and studying experimental methods of treatment. Romero pursued this kind of medical knowledge for the joy of learning, having no clue how he would some day apply his knowledge.

“ I didn’t realize how directly applicable that would be to something such as we’re facing today,” he said. “The microbiology coursework, we talked about pandemic responses and the public health efforts that are put in place to deal with outbreak events. It’s just been surreal watching something that was theoretical and talked about in graduate school classes manifest and having to cope with them in real life.”

And real life it has been, tragically, shockingly real. COVID-19 patients have filled Valley Baptist and other local hospitals to capacity; nurses and physicians have worked long hours tending patients struggling to breathe. The fear of infection weighs heavily on them all. Valley Baptist has implemented strict safety measures to prevent the spread of COVID-19 to staff or patients.

“ I’ve been helping the hospital develop their infection control plans, their isolation strategies and the logistics of how to manage this crisis on a day to day basis,” he said. “As things did reach kind of their worst level recently, I was even helping with direct patient care in the ICU and our isolation units just because there’s such a need.”

Certainly his studies prepared him for the current situation. He did some additional training in tropical and travel medicine in Galveston. He thought he might put his training to work some place overseas, but here?

“ It wasn’t something that I fathomed would be a reality the way that it’s unfolded here in America,” he said. “I thought that my microbiology skills would probably be applied in Latin America much more than they would be applied here in the United States.”

And so the work continues, in collaboration with his colleagues.

“ We have been participating in the Mayo Clinic convalescent plasma clinical trial here at Valley Baptist,” he said.

He and his colleagues are also participating in a study on the effect of autoimmune disorder medications on some COVID-19 symptoms that seem to be causing lung damage.

WHY THE INTEREST IN DISEASE?

“ If you look at the history of medicine, so many of the great challenges and great discoveries have been centered around one of the longest-standing battles of medicine, which is against infectious diseases,” he said.

He’s right. History books are replete with stories of great minds cementing their place in the trajectory of medicine through the discovery of microbes that cause disease and the development of treatments. Consider the work of Robert Koch, Louis Pasteur, Jonas Salk and Walter Reed to name a few. They continue to save lives even today every time someone avoids an illness because of their work.

Diseases running amok in the Middle Ages changed history. Case in point: The Bubonic Plague of the 14th Century which wiped out much of Europe. The drastic change in numbers affected the area’s economy. So many landowners died that their holdings became ripe for the taking, resulting in an economic boom. And recall, then, how such diseases as typhoid fever and smallpox wreaked havoc on Native Americans when the Europeans arrived.

“ Microbiology has shaped humanity and we’re seeing that play out even in our lifetimes in a way that is truly unprecedented for physicians in practice today,” Romero said.

COMPARISONS

“ Probably the closest corollary is HIV for modern medicine and practitioners, the initial unknowns and the way we’ve taken a disease that initially most people looked at as a death sentence,” he said.

HIV arrived on the scene in the early 1980s. Millions died before the medical profession developed anti-retroviral medications to control the virus before it develops into full-blown AIDS.

Now, Romero pointed out, it’s more of a chronic condition. Now medical professionals throughout the world are working around the clock to battle a new threat to the human scene — COVID-19.

Once again, in its early stages, the virus has overwhelmed the sensibilities of the community at large and challenged the capacities of nurses and doctors everywhere.

“ Hopefully, we’ll be able to turn the tide and get beyond it and move forward once again,” he said.

HIS FIRST PANDEMIC

Romero was still a child when HIV first made its appearance, so this is his first true outbreak.

“ The research I’ve done previously was around vaccine development and also around the treatment of severe sepsis from bacterial and even burn infections,” he said. “I did my dissertation research work at the Shriners Hospitals for Children in Galveston.” That hospital provides specialized care to children with burns.

Romero said COVID-19 is unique, among other things, because it’s highly contagious. It has an acute infection phase. Unlike many other respiratory infections that Valley Baptist commonly treats, COVID-19 targets a subset of the population that develops a more long-lasting convalescent phase from which patients must recover. This longer recovery period has required patients to be moved from short-term acute care facilities like Valley Baptist to long-term acute care facilities like Solara.

“ The long-lasting effects of COVID-19 in my mind are one of the stand-out features along with the virus’s predilection to trigger other really severe health situations such as stroke,” Romero said. “It’s a very unique virus in some of these regards.”

The virus causes strokes by thickening the blood. For this reason, emergency care workers now administer blood thinners to critically-ill COVID patients.

PROGNOSIS

With the scientists throughout the world working around the clock to understand COVID-19 and develop effective treatments, Romero looks to a hopeful future.

“ We have literally hundreds of companies working on vaccines, not only in the U.S. but also abroad,” he said. “The U.S. has the largest number of such activities going on. I’m cautiously optimistic that we will wind up with a vaccine down the line.”

Speculation on a timeline would be premature at this time. A vaccine may actually require a multi- component vaccine to trigger an immune response that will not only fight off infection but provide a long-lasting immunity. This brings to attention the problem of some recovered COVID-19 patients apparently losing their antibodies against re-infection.

“ We don’t yet know truly how long somebody will have resistance to COVID-19 after they recover from an infection,” he said. “And that also may play true for patients who receive vaccination against COVID-19.”

He cautioned that even when vaccines do become available, some safety measures may become a permanent fixture in the human scene. Those prevention measures, he emphasized, will still play a part in ensuring that fewer people will contract COVID-19.

“ I think there probably will be some basic fundamental changes that come into play in our daily lives,” he said. “We’ll look back on the way we did things before COVID-19, and it won’t necessarily look exactly like what we do after COVID-19.”

Sad, to some degree. Disturbing, yes. But it’s not all bad. Those changes could also help prevent the spread of other diseases which have always caused substantial fatalities.

Dr. Ameer Hassan, director of the neuroscience department at Valley Baptist, recently pointed out the low infection rate in Japan. The Japanese have been in the habit of wearing face masks for quite some time during the winter months. It is a gesture of respect to keep from spreading flu, colds or other diseases to neighbors. Perhaps face masks will become a new component of the global human culture.

Romero said he is optimistic that vaccines, prevention measures and new therapeutics will bring the pandemic under control sooner rather than later.

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