By:
BG TNI Soroy Lardo, MD, Internist, FINASIM, Infectious Diseases Consultant
Director of Research and Development
Indonesian Army Central Hospital of Gatot Soebroto
Introduction
Unveiling the uncertainty of Covid-19 may require a rigorous scientific approach based on a humbleness spirit. As clinically observed, it is immensely arduous to follow the trail and behaviour of the virus in terms of virulence intelligence and adapt the host for rapid replication in cells (especially the lungs) that it is easy to develop ARDS (respiratory failure). This has been proven through our oneyear experience involving a multidisciplinary team at the Indonesian Army Central Hospital of Gatot Soebroto (RSPAD Gatot Soebroto). As such, a humbleness spirit would be required to allow hand-in-hand cooperation amongst the multidisciplinary team, pertinent health parties and government to further cope with the severe impacts of the Covid-19.
The Covid-19 virus has a spike that functions as a grabber in the naso-oropharyngeal and cleavage tracts, which once enters the lung cell receptors, millions of Covid-19 replications exceedingly fill the lungs and disrupt the respiratory system. Its mutation is smooth yet unexpected and engages just like a special force movement combined with its smart combat intelligence sense, yet it is not all that it has. Currently, with the development of the strain mutation, the SARS-CoV-2 variant with Spike G614 has replaced D614 as a form of pandemic dominance. The consistent increase in G614 at the regional level suggests a superiority of DG614 associated with lower RT PCR Cts and a higher viral load in patients with variant G614 with higher titer growth than a pseudo-type of virion.
The movement of the Covid-19 to date has increased dramatically. Not only is the case getting more complex with various comorbidities in the emergency room and special treatment, but also at the community level, the spread of superspreaders is difficult to control due to the community’s indiscipline to implement preventive behaviour by wearing a proper mask, conducting social distancing, and checking continuous hand hygiene.
RSPAD Gatot Soebroto serves as the highest referral military hospital, the forefront of defence health against Covid-19. The capability of the organization, infrastructure and human resources is currently under a challenge to face the problems and complexities that will emerge in several months to one year ahead.
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