Des Moines ER doc sees more patients with COVID-19 and awaits his own test results

Editorial: We catch up again with Tom Benzoni to find out what's happening in emergency rooms

The Register's editorial

On Friday evening, a Des Moines Register editorial writer caught up again with Dr. Tom Benzoni, a Des Moines emergency room physician. This is our third interview with him since the novel coronavirus pandemic hit Iowa. Here are edited excerpts from the interview: 

Can you provide an update from the ER?

Things are picking up locally. Some patients coming in know they’re positive because they had a test and now they’re developing breathing problems or other symptoms.

We hadn’t been seeing as many strokes and heart attacks, but now it seems we’re getting back to a normal load, plus the COVID-positive patients.

When we talked with you a few weeks ago, you had scheduled a test with Test Iowa. Did you get results?

I had a test. The swab felt like it went all the way to my brain. That’s how you know they did a good job. She did a good job. No, I haven’t gotten results. (Our interview was about 10 days after he’d gone for testing). 

What do you think about businesses in Iowa now offering antibody testing to the public?

What are you going to do with the results? The problem is we don’t know if the information is dependable, and then let’s say you get a negative test. What then? Even if you have some immunity, you can still carry the virus on your hands and clothes to others. You may still get reinfected. 

People have to understand the long view, and the long view is that eventually this coronavirus is going to be in the pool with the other four coronaviruses and it’s going to be like a cough or cold or anything else for most people. 

Please elaborate on that. 

Think of the coronaviruses as one through five, and we’ll call COVID-19 number five just to keep it simple. Most of us got the first four as kids. A bunch of snotty noses. Or parents caught these from their own kids who picked them up at school and daycare. You don’t get very sick when you catch them again because your body has those viruses in its immunity library. Eventually COVID-19 will be like that. 

But if you’re my 96-year-old dad, any viral infection can be damn serious.

You were riding your bike today. Do you feel it’s safer outside with more air circulation? 

We have a saying in medicine: The solution to pollution is dilution. When you cut your finger, what are you supposed to do? Wash out the cut. Dilute. When we are outside in circulating warm air, viral droplets are diluted. 

My biggest concerns are at work. I’ve been coughed and sneezed on by kids throughout my career. Now I get coughed and sneezed on and that’s not their fault. I’m going to get sick one of these days, and I hope my wife doesn’t get sick at the same time. (Benzoni’s wife is also a physician). 

Fewer elective procedures and surgeries have reduced revenue for hospitals and clinics. I can’t help but wonder if doctors will feel even more financial pressure to encourage more testing and procedures to generate income. What do you think?

That could happen. This is an opportunity to reform how health care is paid for and provide just a straight salary to doctors the way Mayo Clinic does so there is not an incentive to provide more care. That includes care that may not be necessary. 

Do you think Iowa has flattened the curve? 

Iowa has been pretty good. There are also many asymptomatic people. We have to remember there’s a lot more to society than the health care system. Yes, driving less means we’ve cleared the skies and people are being nicer to each other, but we have to figure out a way to move forward.

What else have you been thinking about lately? 

There’s a bunch of interesting syndromes with this coronavirus and we will start to understand the way this virus manifests: Kawasaki disease in kids and COVID-toe. (Kawasaki disease often involves fever, rash and inflammation and primarily affects children under 5.)

What the heck is COVID-toe? 

It’s really interesting. It’s a swelling caused by clots in small blood vessels. Some patients are presenting with large blood clots that can lead to strokes and embolisms, but small clots can block blood flow in capillaries that deliver blood throughout the body. 

I haven’t seen a case yet, but I’m on the lookout for it.