Coronavirus Update!

What you REALLY need to know about COVID-19!

There is a lot of information circulating about the Coronavirus, some accurate and some just completely false. In all the details, I find that it is helpful to drill down to the most important points.

My goal here is to provide you with the best and most helpful information I can so that you will be able to remember and share this with others in order to help keep you and others around you healthy. 

1. C - Contagious: Every year we deal with multiple contagious viruses such as those that cause the common cold and influenza. COVID-19 is no different. One person can infect an average of 2-3 people. To reduce the spread of this virus, it is crucial that you:

1. WASH YOUR HANDS with soap and water for at least 20 seconds as often as possible, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
2. DO NOT TOUCH YOUR FACE, particularly your eyes, nose and mouth with unwashed hands. These are portals for viral entry.
3. SNEEZE OR COUGH INTO YOUR ELBOW, never into your hands and avoid touching anyone else which includes handshaking and hugging. Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

2. O - It's Okay, so don't panic!: This virus, like all other viruses, has it's intricacies and part of the confusion and hysteria is simply because we have a lot of unanswered questions. What we do know is that those at high risk for serious illness and death are: 

1. Individuals 60 and older
2. Individuals with underlying medical conditions such as heart disease, lung problems (such as COPD, asthma), diabetes, and any condition that causes immune suppression

In the vast majority of cases, people present with a flu-like illness (fever, body aches, cough and shortness of breath) with focus of infection more on the lungs.

Thankfully, children are largely spared from the severe disease, with the majority of deaths being in the elderly or otherwise high-risk individuals.

3. V - Be Vigilant to protect those around you: You may be young and healthy but in order to reduce the spread, especially to those most vulnerable, it is best to avoid large groups. This is difficult, but a crucial step to curtail both the spread in our community and reduce the likelihood of overwhelming our medical resources for those that desperately need it. I know this sounds extreme, but there is evidence that doing this (from past epidemics) saves lives and decreases disease and death. 

4. I - Infection: What symptoms should I expect:

1. Fever (>100.4 F)
2. Dry or productive cough
3. Shortness of breath

If you have any of these symptoms AND: 

1. Have been in close contact with a person known to have COVID-19 OR
2. Live in or have recently traveled from an area with ongoing spread of COVID-19.

CALL ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel and your symptoms. 

There are a few key difference between COVID-19 and other viruses like the flu. Typically flu is more of an abrupt onset with fever, body aches and cough, whereas COVID-19 appears to be more gradual with fever, cough and shortness of breath developing over a few days. Common cold viruses produce more runny nose and congestion as well as seasonal allergies. 

5. D - Diagnosis: How is infection identified and what can we do about it? 

The problem we face here is twofold:

1. We don’t yet have the test to diagnose COVID-19 or have a test that can be used in a clinically useful way (rapid and simple). 

2. Even if we did, there is no clear treatment for COVID-19, other than supportive care.

So what do we do? 

Our Plan

If this infection becomes more widespread in our area, here is what we plan to do:

Identify patients who may have COVID-19 and treat them outside of our clinic. While we want to help people who are sick, we don’t want to expose high-risk people to this virus. 

So: 

• We ask that if you have a fever or flu-like symptoms, that you do not come into the office. Instead we ask you to contact us via phone, email, or text. Be patient, as we are likely very busy with other sick people!

• Please tell us about your symptoms and we'll guide you in what to do next.  This may even include triage and evaluation in our parking lot. Remember that we cannot test at this time, and we cannot give you any treatment if you do have the virus. Yes, that makes things very difficult for all of us, but it is the situation we face and thankfully most people recover from the virus very well. 

• Also understand that we may have high-risk people at the office with other problems. Infected individuals in our office may spread the infection to others, so please understand, we are working to reduce risk to everyone.

• Again, if we become concerned about more exposure in our area, we will ask that you not come to the office if you are a high-risk person:

  • Over age 60

  • Diabetic (poorly controlled)

  • Significant lung problems (COPD, moderate/severe asthma) or heart problems

  • Other immune-compromising problems or medications.

• Very soon, we may also be in touch to reschedule your routine follow-up in order to keep healthy patients out of the office and have more room for sick patients that we deem necessary to be seen in the office. Please contact us if you prefer to go ahead and reschedule. 

• Also, do not go to the Emergency Room for routine symptoms. The reason to go to the ER is if you:

  • Have persistent shortness of breath or chest pain or

  • Are unable to hold liquids down and may be getting dehydrated

Remember to stay up to date on the most recent information. The best source, in my opinion is the CDC website dedicated to this pandemic, www.coronavirus.gov. 

We will also be providing updates here on our blog if we have any changes. 

Stay healthy!!

Author

Steven Manning, MD Dr. Manning is lead physician and owner of AccessMedicine, our areas first Direct Primary Care medical practice.