March 14, 2021 St. Patrick's Day Issue / View as Webpage
Your Weekly COVID-19 Updates
Paradise Valley Medical Clinic, Douglas M Lakin MD
9977 N 90th Street, Suite 180, Scottsdale, AZ 85258
480.614.5800 (phone), 480.614.6322 (Fax)
PLEASE READ THIS ENTIRE DOCUMENT AS IT IS OF
IMPORTANCE TO ALL PATIENTS

"We will be emailing you weekly during the COVID-19 PANDEMIC. We will provide you with the latest information and instructions to deal with the current outbreak as it develops in Phoenix."
CDC Releases Highly Anticipated Guidance For People Fully Vaccinated Against Covid-19
March 13, 2021

Arizona Plans To Meet U.S. Vaccine Goal: Everyone 16+ Eligible For a Vaccine By May 1
All Arizonans age 16 and older are expected to be eligible for a COVID-19 vaccine by May 1, the state's health director says.
"As long as we continue to get the vaccine and we don't have another winter storm that delays shipment, we should be right in line with that goal," Arizona Department of Health Services Director Dr. Cara Christ.

"We would open it up to 45+ at the beginning of April, or hopefully by April 1, and three to four weeks after that we would go to the 35 and above," Christ said. "Now keep in mind, starting in the first week of April we anticipate that vaccine to really, really increase. After the 35 age group, then we jump down to the 16 and above."

Christ is confident in the May 1 timeline as vaccine supply will be increasing, allowing the state to send doses to more locations, from large sites and community-based events to pharmacies and doctors' offices. 
"In April it sounds like the vaccine supply is really going to open up," she said. "As we get more vaccine, we're going to be able to open it up more. More and more places are going to have vaccine. We anticipate that May is a very doable timeline."
"It definitely could happen earlier. If we start getting 200,000 first doses per week, that's obviously going to speed up and we're going to be able to add additional appointments at our sites," she said.

March 12, 2021

New Coronavirus Variant Reported In Arizona
For the First Time
Arizona Department of Health Services announced on Friday that the P.1 variant of COVID-19, which was first identified in Brazil, has been detected.

Arizona Department of Health Services announced on Friday that the P.1 variant, which was first identified in Brazil, was recently detected in three COVID-19 test samples across the state.
This is the second new strain mutation of the virus reported in Arizona. The B.1.1.7 variant that first identified in the United Kingdom was reported in Arizona in late January.

The P.1 variant appears to be less vulnerable to our bodies’ immune systems, and there are signs it may be more contagious, according to health experts. Health officials also said previously infected patients could be more easily reinfected by the P.1 variant.
ADHS says the three FDA-approved vaccines are still effective against all strains, according to new research. New mutations in the virus are common as it moves across different populations.
The P.1 variant has been detected in at least 11 states, according to the Centers for Disease Control and Prevention.
ADHS is encouraging continued social distancing and use of face coverings to limit the spread of all infectious diseases.
March 11, 2021

Gov Ducey Announces Vaccine Distribution Expansion To People 45 and Older By April 1.
The hope for Arizona is to get as many people as possible vaccinated as quickly as possible.
"We want to vaccinate the maximum amount of people," Gov. Ducey said. "And the best way to do that, because the people that are most in harm's way, is by age." Gov. Ducey explains that the decision to focus on age instead of other factors, including disability, is based on the coronavirus's mortality.
March 8, 2021

Dr. Cara Christ: The CDC Issues Encouraging Guidance For Fully Vaccinated Individuals.
"Over the past few months, you may have heard me call COVID-19 vaccines the light at the end of the tunnel. As more and more Arizonans get the Pfizer, Moderna, or Johnson & Johnson/Janssen vaccines, we will start to see life returning to normal. That light is getting brighter by the day.
New guidance released today by the Centers for Disease Control and Prevention (CDC) gives us another reason to be excited about COVID-19 vaccines and to get vaccinated as soon as your turn arrives.
The CDC’s new guidance tells people who’ve been fully vaccinated that they:
  • can gather indoors with fully vaccinated people without wearing masks;
  • can gather indoors with individuals from one other household (example: having your family visit a fully vaccinated grandparent); and, 
  • do not have to stay away from others or get tested if exposed to someone with COVID-19 unless they develop symptoms (with the exception of those living in group homes and other congregate settings).
The CDC guidance notes that we’re still learning things about COVID-19, such as how effective vaccines are against variants of the virus, how well the vaccines keep people from spreading the diseases, and how long the vaccine provides protection. As we continue to learn more, public health guidance may be updated later to reflect the best scientific information. We do know now, however, that each of these vaccines is safe and highly effective at preventing severe illness, hospitalization and death from COVID-19."
Register For The COVID-19 Vaccination
On the AZDHS Website:

This video walks users through the process to register for COVID-19 Vaccine appointments using the https://podvaccine.azdhs.gov​​ website. This video shows each step including registering in the system, searching for and scheduling an appointment, and reviews the confirmation email users receive 
For More Information From Maricopa County
Pre-screening COVID-19 Vaccine Procedure & locations, Click the Links Here:


THOSE WITHOUT COMPUTER ACCESS OR NEED EXTRA HELP REGISTERING CALL 1-844-542-8201

After you received your COVID vaccination,
please let us know!

We would like to document this information into your chart.

**We only document vaccinations that are received/given, not future appointments.
Please be sure to send us again the second dose information after you get it!

BUT FIRST.......
PLEASE COMPLETE THE INFORMATION ON THE CARD BEFORE YOU SEND IT TO US!
What we need:
  1. Your name
  2. Date vaccination received
  3. Brand name
  4. Lot number if available.

**Email your COVID vaccine completed info HERE
...........Thank you
We Offer Telehealth And In-office Visits During The
COVID-19 Pandemic.
Please Call Us If You Need Medical Assistance.
480.614.5800
We Are Here For You!
PVMC COVID-19 OFFICE APPOINTMENT PRE-SCREENING
QUESTIONNAIRE
**EFFECTIVE 3/8/2021:
IF YOU HAVE COMPLETED 2 COVID-19
VACCINATIONS OF PFIZER-BioNTech OR MODERNA OR 1 COVID-19
VACCINATION OF JOHNSON & JOHNSON AND ARE AT LEAST 2 WEEKS OUT, NO NEED TO COMPLETE OUR QUESTIONNAIRE.
PLEASE CALL OUR OFFICE TO SCHEDULE AN APPOINTMENT.
ATTN PATIENTS:
Dr Lakin is using FaceTime ,
WhatsApp and Zoom to connect with you
for a 'Telehealth' visit. You can connect using your iPad, iPhone, Android phone, a laptop, or a PC with a camera.

Please watch these videos so you can be prepared and know how to connect with Dr Lakin for a 'Telehealth' visit.

CLICK ON THE PICTURES
FROM THE DOC
 COVID-19 LEVELS ARE NOW PLATEAUING ACROSS THE COUNTRY AND IN ARIZONA……. HOSPITALIZATION LEVELS ARE DROPPING AS THEY ARE A LAGGING INDICATOR OF COVID LEVELS.
 
WITH THE NEW UK VARIANT…… ANOTHER SURGE OVER THE NEXT 6 WEEKS IS VIRTUALLY CERTAIN TO OCCUR AS LEVELS OF THE UK VARIANT ARE APPROACHING 50% IN FLORIDA AND OTHER LEADING STATES.  
 
ARIZONA IS UP TO #14 IN THE COUNTRY …A SLOW INCREASE….
 
  
COVID EXPOSURE IS MUCH REDUCED WHICH SHOULD IN THEORY REDUCE YOUR CHANCE OF GETTING INFECTED, BUT WITH THE UK VARIANT’S INCREASED CONTAGIOUSNESS, EACH WEEK THE RISK GROWS FOR INFECTION.
 
 
WEARING BEST PROTECTION REMAINS THE RECOMMENDATION. A GOOD FIT IS MOST IMPORTANT TO ELIMINATE GAPS…DOUBLE MASKING IS ONLY ADVISED IF IT PROVIDES A BETTER FIT. NOW IS THE TIME TO USE YOUR N-95 OF KN95 MASK IF YOU HAVE IT.
 
  
 IN ARIZONA:
HOSPITALIZED PATIENTS SLOWED SIGNIFICANTLY.  
THERE IS MINUSCULE INFLUENZA IN ARIZONA BUT WE WILL CONTINUE TO MONITOR.
 
COVID TESTING:
COVID-19 TEST RESULTS ARE BACK
IN 24-36 HOURS
 
OTHER TESTING CAN BE OBTAINED AT OUTSIDE FACILITIES…HERE IS A LINK:
 
 
NATIONALLY:  
COVID-19 IS PLATEAUING OVER THE NEXT 6 WEEKS, BUT THE LARGEST SURGE YET IS YET TO OCCUR WITH THE UK VARIANT OVERTAKING OTHER STRAINS OF COVID.  NOTHING HAS CHANGED THE PREDICTION.
 
COVID IMMUNIZATION:
PFIZER, MODERNA AND JOHNSON & JOHNSON (JANSSEN) VACCINES ARE PROCEEDING AT HIGH LEVELS.  THESE VACCINES ARE AMAZINGLY EFFECTIVE…100% IN PREVENTING HOSPITALIZATION AND DEATH FROM COVID…ALL OF THEM. THERE IS NO REASON TO AVOID THESE VACCINES. GET WHICHEVER VACCINE YOU CAN AT YOUR EARLIEST POSSIBLE DATE.
 
POSSIBLE COVID VACCINE SEVERE
ALLERGIC REACTIONS:
OCCURRING AT A RATE OF
1 IN 50,000 (VERY VERY LOW)
YOU SHOULD PLAN ON PROCEEDING WITH IMMUNIZATION UNLESS YOU HAVE A KNOWN ALLERGY TO PEG (POLYETHYLENE GLYCOL) …. A COMPONENT OF THE CARRIER IN THE VACCINES.
 
PERSONAL INTERACTIONS IF YOU HAVE NOT HAD THE COVID VACCINATION:
FOLLOW ALL MASKING AND DISTANCING PROTOCOLS 100%.   COVID IS MUCH LOWER CURRENTLY, BUT THE UK VARIANT IS STARTING TO SPREAD. REDUCING RISK IS NOT THE SAME AS ELIMINATING RISK.  THOSE AT HIGHEST RISK SHOULD NOT BE TAKING ANY CHANCES, PERIOD!
 
PERSONAL INTERACTIONS WITH ONE VACCINE …. AWAITING YOUR SECOND:
14 DAYS AFTER YOUR FIRST VACCINE YOU ARE ~50% PROTECTED FROM MILD/MODERATE COVID INFECTIONS GENERALLY AND ~72% PROTECTED FROM SERIOUS COVID INFECTIONS. FOLLOW ALL MASKING AND DISTANCING PROTOCOLS.   COVID IS MUCH LOWER CURRENTLY, BUT THE UK VARIANT IS STARTING TO SPREAD. 
 
 
 PERSONAL INTERACTIONS 14 DAYS AFTER YOUR SECOND COVID VACCINE:
IF YOU HAVE HAD 2 VACCINES AND IF YOU ARE 14 DAYS BEYOND YOUR SECOND VACCINE, THEN YOU ARE ~95% PREVENTED FROM GETTING MILD/MODERATE COVID, AND VIRTUALLY 100% PREVENTED FROM GETTING SEVERE COVID.  YOU SHOULD CONSIDER MORE INTERACTIONS AND OUTINGS IN THE COMMUNITY BUT FOLLOW GENERAL MASKING AND DISTANCING PROTOCOLS.
 
ACCEPTABLE BEHAVIORS FOR TWICE VACCINATED PEOPLE INCLUDE:
SHOPPING AT STORES (WITH MASK) …. OK
 
GOING TO THE DENTIST, DOCTOR, VET…. OK
 
VISITING WITH OTHER PEOPLE WHO ARE TWICE VACCINATED WITHOUT A MASK…. OK
 
HUGGING FAMILY AND FRIENDS AND CHILDREN…. WHO HAVE BEEN VACCINATED OR NOT VACCINATED…OK.
 
AIRPLANE TRAVEL SHOULD STILL BE AVOIDED.…SUGGEST HOLDING TRAVEL UNLESS NECESSARY, ESPECIALLY DURING SURGE LEVELS.
 

YOU CAN SEE DAILY TRENDS FOR ARIZONA AND THE U.S. HERE, ON THE CDC WEBSITE…JUST CHOOSE ‘ARIZONA’ FROM THE LIST.
 
 
To monitor the curse of COVID in Maricopa County, go to: https://covidactnow.org    
 
REMEMBER…. BEING OUTDOORS AND DISTANCING ARE THE #1 EFFECTIVE METHOD FOR LESSENING EXPOSURE AND RISK. THE COOLER WEATHER OFFERS MORE OPPORTUNITIES TO VISIT…THIS IS FINE BUT KEEP DISTANCING AND USE THE WEATHER AND OUTDOOR VENUES TO YOUR ADVANTAGE. OUTDOOR INTERACTIONS ARE 20 TIMES LESS LIKELY TO GET COVID EXPOSURES THAN WITH INDOOR ACTIVITIES. (20 minutes of outdoor exposure is equivalent to 1 minute of indoor exposure.)
 
REDUCE RISK BY REDUCING CONTACTS!!!!   Assume EVERYONE has COVID. You will not eliminate risk even while the prevalence of the virus is lower in the community, but reducing your exposure remains highly effective.  
Please continue to be vigilant!
Read this article on how to approach different locations you might consider exploring and to understand risks and ways to reduce risks.  https://www.erinbromage.com/post/the-risks-know-them-avoid-them
 
TOP PODCAST DONE WEEKLY
BY DR. MICHAEL OSTERHOLM
(UNIVERSITY OF MINNESOTA)  
 
He is a world-renowned epidemiologist who was credited with first elucidating TOXIC SHOCK SYNDROME in the 1980’s.
He provides comprehensive and understandable/actionable ideas related to COVID.

Here is Dr. Osterholm Latest PODCAST:

"In this episode, Dr. Osterholm and host Chris Dall discuss what the "third act" of the COVID-19 pandemic could look like in the context of vaccines and variants, easing of restrictions throughout much of the US, and the CDC's guidelines for fully vaccinated individuals."

According to Dr. Osterholm……
 
Vaccination will be helpful to reduce COVID, but it will not be adequate, even at 1 million vaccines per day. At best, by the time of the next predicated surge only 40-50% of the population will be immunized. This is not enough for herd immunity.
 
The UK variant surge is expected in 6-8 weeks, but there are differences of opinion among experts.  Dr. Osterholm feels the data supports a strong surge and feels we should all prepare for this eventuality. Do not become complacent.  Use all precautions. Now is the time to prepare. Use your best mask.
 
Changing the vaccine schedule, to allow 1 shot instead of two, at this time, may be a strategy that is chosen to reduce overall risks and increase the population coverage given the high demand and limited supply.
 
There is strong evidence that lengthening the interval between shots will not reduce effectiveness.
There is strong evidence that all vaccines current and planned, strongly prevent severe illness, hospitalization, and death…. even after 1 single shot.
 
·        Our new baseline is being set higher than in the past, at about 70,000 cases per day and the addition of the UK variant will likely create the largest surge seen and darkest days of the pandemic yet to come in the next 6-8 weeks.

·        Even with excellent immunization rates, we will only achieve 50% population protection in the next few months, so we need to keep with distancing, masking, and hand washing. These will still be the most important preventive step for the country.

·        The new UK variant of COVID is more readily transmissible and may cause slightly worse COVID cases…. the data remains unclear but there is evidence that it causes a higher level of virus in the body.
 
·        The UK variant is NOT resistant to our current vaccines, but the South African variant may be resistant.  Get vaccinated as soon as possible with whatever vaccine is available to you.
 
·       STOP SWAPPING AIR………the only way to prevent transmission strongly.
   
·        Limit your exposures.  Do not delude yourself into thinking you are safe if you are celebrating with family and others, in modest numbers, if the people you are sharing with are not being extremely careful.
 
·        Schools should reopen at this time given the latest data of limited spread in those settings. The data is clear on this. That said, data is to be monitored and the UK variant may alter this equation.
 
Summary of Dr. Osterholm’s Thoughts:
·        Viral Gravity: The virus works at its own pace and time. It will seek out people to infect. Nobody is risk free, all situations have some risk, and ‘everyone’s bucket leaks.’
·        Assess the risks of various activities and choose accordingly.
·        Physical distancing is the most important method of avoiding infection. Far and away the most effective.
·        Masks are somewhat effective…. use them.
·        We are still in the 4th inning of a 9-inning baseball game…. So be patient and continue to be vigilant.
·        This is not like the flu pandemic of 1918. There was not a quiet fall and second wave in the winter…. the fall did not let up, and we will see various locations coming and going with increasing and decreasing infection and risk.
·        Pandemic Fatigue should be avoided at all costs…maintain vigilance!
·        Pandemic Anger is a real issue…. people who feel COVID is a hoax. There is no answer for this other than to maintain your own plan.
Vaccine to be available more broadly in the coming months, but unless more people are willing to take the vaccine, we will fail with the vaccination program.
·        As Dr. Osterholm says……” You may have given up on the virus, but the virus has not given up on you….!!”
 
If we continue at our current level of restriction (which is limited and uneven) we will see:
 
THE VACCINE IS THE LIGHT AT THE END OF THE TUNNEL, BUT WE NEED TO GO FROM VACCINE TO VACCINATING PEOPLE.  
 
THIS VACCINE IS A GAME-CHANGER...AND WILL PROVIDE THE PROPER FORM OF HERD IMMUNITY AS WE ROLL IT OUT NATIONALLY.
 
·        Proper behavior is the most effective means of limited COVID. Distancing is #1 for prevention.
 
·        Wearing a mask is a good idea but it will not result in small doses of virus exposure that then result in immunity. This is a false statement so do not willingly expose yourself to high-risk situations with this thought in mind.
VACCINE:    
 
PFIZER AND MODERNA VACCINES SHOW EXCELLENT RESPONSE RATES IN THE 95% RANGE…. SIMILAR TO IMMUNIZATIONS LIKE POLIO AND MEASLES…THEY WILL BE THAT EFFECTIVE.
 
THIS IS A MAJOR ACHIEVEMENT AND RIVALS THE POLIO VACCINE AS A GAME-CHANGER.
 
THE JOHNSON AND JOHNSON VACCINE SHOWS EXCELLENT RESULTS WITH SEVERE DISEASE, DEATH, AND HOSPITALIZTAOIN…. EFFECTIVE IN THE 90+% RANGE.  FOR MILD DISEASE IT IS LESS EFFECTIVE THAN THE MODERNA AND PFIZER VACCINES, BUT THIS IS ONLY ONE SHOT, DOES NOT HAVE TO BE KEPT FROZEN SO NO CONCERNS ABOUT IT’S CHAIN OF CUSTODAY, WHICH IS A CONSIDERATION AS WELL.

ALL STUDIES ARE ‘DOUBLE BLIND……PATIENT AND DOCTOR DO NOT KNOW IF THEY HAVE THE ACTIVE IMMUNIZATION OR PLACEBO….AND PLACEBO CONTROLLED……1/2 THE DOSES ARE INACTIVE….’ THIS IS HIGH SCIENCE AND INFORMATION WE CAN FEEL CONFIDENT IN.  SINCE THE DOCTORS AND PARTICIPANTS DO NOT KNOW WHO IS GETTING WHAT….AN INDEPENDENT BOARD WILL CONTINUE TO REVIEW THE VACCINE UNDER STUDY. THIS IS HOW SUCH TRIALS ARE SUPPOSED TO WORK AND IT IS REASSURING, NOT DISHEARTENING, THAT THEY ARE PROCEEDING IN THIS MANNER. THIS IS REASON FOR CONFIDENCE…. NOT DISAPPOINTMENT!
 
 
I AM CONFIDENT THAT THE VACCINES DELIVERED ARE SAFE BASED ON THE ANNOUNCED PLEDGE OF THE CEOs OF THE MAJOR PHARMACEUTICAL COMPANIES INVOLVED. 
  
I DO NOT ADVISE COVID antibody testing to determine your status. IF YOU ARE CONVINCED YOU HAD UNDIAGNOSED COVID, we will continue to do the COVID ANTIBODY TEST for any patient that is concerned about past infection or current immunity.

The BLOOD TEST will identify people who have had COVID infection in the past and who now have immunity from infection.  The exact degree to which this immunity is effective is unclear, but we believe that people who are COVID POSITIVE BY BLOOD WORK will have protection for at least several months or longer.
 
ANTIBODY BLOOD TESTING IN OUR OFFICE, AT SONORA QUEST WITH THE EUROIMMUN TEST, IS EXTREMELY ACCURATE.  
 
Nasal testing for acute COVID infection is available at the office. Feel free to check your COVID if you have any reason for concern.
 
Alternative testing sites will be listed weekly and expanded. You can find them on our website on the rotating screen and the list is linked below as well. 
 
LOCATIONS FOR COVID TESTING OTHER THAN OUR OFFICE…SEE OUR UPDATED LIST:
 
LATE NIGHT TESTING AT NEXTCARE FACILITIES IS A CONSIDERATION. HERE IS THE LINK:
 
 
How to Proceed Day to Day in ARIZONA ……?
 
For low and medium risk patients during this time:
1.     Continue to maintain physical distancing when in public spaces or with groups of friends/family.  This remains the most important preventive strategy…. far better than even masks.
2.     Wear a mask or face cover in closed spaces. In open area spaces, masks are not necessary if space is maintained.  This is done more to protect the community than it is to protect ourselves.  When you wear your mask, you reduce the possibility that you will spread COVID unknowingly.  When the people in your immediate community wear their mask, they are preventing the spread from them, to you.  Encourage others to wear a mask for all our protection.   
 
Some cloth masks are not particularly effective and masks with valves are ineffective…these are to be avoided.
IN ORDER OF RELIABILITY AND HELPFULNESS
·        N95
·        KN95
·        SURGICAL MASK
·        THICK CLOTH MASK

NOT ACCEPTABLE (THESE ARE NOT PROTECTIVE):
·        THIN CLOTH MASKS OR GATERS
·        MASKS WITH VALVES
3.     Do repeated hand cleansing and washing…. This is critical to prevent silent spreading of COVID.
4.     Protection of the eyes is a consideration. Data on this is supportive but not conclusive as to the degree of protection.
5. Expanding your interactions can begin to take place, following the above preventive strategies and considering the following risk profiles.  Do observe the places you are going to make sure they are maintaining appropriate practices.  If you do not see people interacting appropriately, you should reconsider your exposures in such venues during this time of transition to higher levels of community COVID. Until it is clear what level of increase, we are seeing, we must remain conscientious:
a.  Open air venues/public spaces (parks/trails/patios/open air malls) provide excellent ventilation and have a low risk of spread.
b.  Stores that are large/cavernous, which allow for distancing, and which demonstrate proper protective practices among their employees are lower risk.
c. Smaller businesses that are employing excellent protective practices and which provide for distancing are lower risk. Do not linger longer than necessary in such public spaces…. conduct your business and leave.
d.     Read this practical guide about public spaces & exposure…. https://www.erinbromage.com/post/the-risks-know-them-avoid-them
6.     If you have symptoms of any sort that might concern you for COVID…. get tested so that you know your status.
7.     If you are doing all the above and are not in a high-risk group (see below) then you can expand the amount of activities and outings you participate in over the coming weeks.  High risk patients should continue to limit activities to a greater extent.
 
High risk groups include:
·        Age 75 or over
·        Obesity (BMI 40 or above)
·        Lung disease (emphysema/COPD) or current significant smokers
·        Chronic kidney disease (Stage 4 disease or greater)
·        Diabetes…. not well controlled
·        Congestive Heart Failure
·        On immune suppressing medications for cancer or rheumatological/inflammatory conditions
 
Medium Risk groups may want to be more cautious but can increase activities. These include:
·        Men Age 65 to 75
·        Hypertension
·        Diabetes…well controlled
·        Asthma
·        Obesity (BMI 35 or above)
 
Know that our office is responding to COVID, and we are here to help. Reach out for assistance if you are not feeling well. We will develop a plan of action for you to move forward.
 
Yours in good health,
Dr. Lakin
 
 
RECOMMENDED LINKS IN THIS NEWSLETTER AND IN GENERAL FOR COVID INFORMATION:
 
INTERNET SITES WITH BEST INFORMATION:
 
Risks with different activities…how to gauge risk:
 
Accurate US statistics by age on COVID infections:
 
What we can expect of COVID in next 1 year:
 
Can follow here for ARIZONA UPDATES DAILY and best trending information to know what is out in the community:
 
Most informative graphics:
 
Get your Mask up to N95 Level:
 
If you have symptoms of COVID…. you can run through a simple checklist on-line to see if you should be concerned:
 
Understanding the various vaccines under development
"Please Wear Your Masks In Our Office!"
In order to keep the infection rate down, it’s important that we continue to stay home, practice physical distancing, wash hands regularly, and wear a mask if you must leave your home. At our office, we are following CDC guidelines and strive for ways to keep our patients and staff safe.
We are requiring that all patients and visitors entering our offices cover their nose and mouth.

You can do this with a scarf, a homemade cloth mask, or your own surgical mask.
Masks have been shown to decrease the spread of coronavirus from infected people, even those who do not have symptoms.

We have a limited supply of paper mask and will make these available to patients while they last, however, we strongly encourage you to bring your own covering.
 
One Year Anniversary of Covid-19 Pandemic
Survey: This past week marked the one-year anniversary of the COVID-19 Pandemic...
It's been a challenge, but I see light at the end of the tunnel.
Coping well, but feel everyday life will never be the same.
Keeping safe, but concerned this pandemic will never end.
We Are Here to Take Care of Your Healthcare Needs.
We Are Here to Serve!
 
Our office is using all techniques to reduce exposure to a minimum during your visit. These include: 
·       Temperature checks of all patients and staff.
·       Masks for all people in the office.
·       Cleansing of hands and surfaces repeatedly.
·       Multiple Super-HEPA filters to filter out potential virus and particles in the office.
·       High Level UV light air cleansing in the office to eliminate bacteria and viruses in the air.
 
  We have expanded our Telehealth Visits during increased COVID-19 cases, but are still seeing patients in the office.  
In addition, we are connecting with you via
phone, fax, email, and telehealth.
 
 
OUR CURRENT UPDATED
OFFICE SCHEDULE
 
DOORS OPEN     
7AM - 4PM Monday through Thursday
7AM - 11AM Friday
DO NOT JUST ‘DROP IN’…YOU MUST HAVE A SCHEDULED APPOINTMENT.
 
IN OFFICE APPOINTMENTS: MONDAY - FRIDAY
ARE BEING ADJUSTED…. WE WILL CALL YOU TO CONFIRM IF APPOINTMENTS WILL BE KEPT OR CHANGED TO A TELEHEALTH VISIT
 
MONDAY - FRIDAY from 10:30AM - 12 Noon
We will be conducting TELEHEALTH/PHONE visits with patients.
 
MONDAY - THURSDAY
WE WILL BE SEEING POSSIBLE COVID-19 PATIENTS 3:00PM - 4:00PM (IN YOUR CAR…APPOINTMENT ONLY…. IN PROTECTIVE GEAR)
 
   COVID-19 SUMMARY:
 
REDUCE RISK BY REDUCING CONTACT WITH THE VIRUS
 
REDUCE CONTACT WITH THE VIRUS BY:
1.   Washing hands frequently….20 seconds is advised, but any hand washing is helpful.
2.   Wear a mask or face covering when out in public.
3.   Use hand cleanser in between washings…if available.
4.   Clean your cell phone daily with a cleansing wipe or UV light.
5.   Shower or bathe daily.  Twice daily if you want to feel more relaxed.
6.   Do not Pick Nose, Rub Eyes, or Pick Teeth with your fingers
7.   Do not go out or to work if you are ill…. or think you are ill.  If you are unsure, check your temperature. If over 99.8 you should not be going out.
8.   If someone in your house is ill, treat them as though they have COVID.  Have them get tested and you should quarantine as well.
9.   Stay away from people who are sick with COVID. Only caregivers should be in contact with COVID patients and they practice high level cleaning to prevent spread.
10. Maintain physical distancing practices, avoid getting within 6 feet of people (other than immediate household occupants)
11. Limit your activities to the minimum interactions you can do to maintain your daily living.
12. Leave mail and other paper products for one to two days on the shelf or in the garage (outside the house) …then bring them in after sitting for 24-48 hours to reduce the potential for transmission.
13.  Groceries cleaning should be considered, although not as strict as initially indicated when the pandemic began.   See this video link for excellent detailed information:  Click Here
 
IF YOU ARE SYMPTOMATIC AND HAVE BEEN TOLD YOU MAY HAVE COVID ……BUT TESTING HAS NOT BEEN DONE YET …….DO AS FOLLOWS:
·        Self-Quarantine for 14 days from the start of illness and FOR at least 3 days after fever and major symptoms have resolved. 
·        Do not share a bathroom with housemates if possible. Use your own bathroom.
·        Do not share utensils with others and clean your own utensils and/or use paper/disposable eating materials.
·        Wait 1 day to wash the clothing you wear. Clothing can be washed after sitting out for 24 hours (virus is not transmissible at that point via clothing).   Others can wash your clothes using this approach.
·        Avoid sharing living spaces with housemates, to the extent your living situations allows.
·        Wash your hands frequently. Use cleanser on surfaces frequently.
·        Wear a mask & gloves when in the presence of others. Wear when you are with others as much as possible.
·        Shower/bathe twice daily if possible.
·        All household contacts should self-quarantine as well with only minimal outside interaction.
 
MORE EXPANSIVE TESTING IS CURRENTLY AVAILABLE IN OUR OFFICE. 
It is being done at the end of the day, in your car, by myself…. wearing protective gear. 
IF YOU ARE ILL AND CONCERNED YOU MAY HAVE COVID INFECTION OR SIGNIFICANT COVID EXPOSURE:
Contact the office via phone or email first for instructions:
480-614-5800
 
Please do not walk into our office if you think you have COVID infection. We will not see you in the office. Only in your car, and with that, you should contact the office to be seen at the end of the day.
If you think you have COVID and are truly short of breath, you need to go to the Emergency Room, not to our office. We are not equipped to handle low oxygen levels.
 
COVID KIT:
 
This is what you should have at home to prepare for possible COVID, to monitor yourself if you were to get infected:
 
DIGITAL ORAL THERMOMETER: MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
 
PULSE OXIMETER:  TO CHECK OXYGEN LEVELS. MANY BRANDS ARE FINE...HERE IS ONE EXAMPLE:
 
 
OTHER ITEMS FROM THE HOME MEDICAL KIT:
 
·       TYLENOL, ADVIL, OR ALEVE
·       Sudafed 30mg tablets
·       Chlorpheniramine 4mg tablets
·       Robitussin DM syrup
·       Imodium AD
 
COVID COURSE:
 
THREE PHASES OF COVID:
·       JAILBIRD Day 1-10
·       PAROLE BIRD 11-17
·       FREE BIRD 17+
       
JAILBIRD:  STRICT QUARANTINE...... 10 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS
 
PAROLE BIRD: DAY 11-17…. VERY CAREFUL WITH ALL ATTENTION TO MASKING, DISTANCING, HAND CLEANSING: NEXT 7 DAYS AFTER QUARANTINE
 
FREE BIRD: DAY 17 AND BEYOND.... NO RESTRICTIONS.
Although I do not recommend testing to prove the virus has cleared after infection, if you have testing and are clear, then the above protocol is not applied.
 
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
 
Common/Hallmark symptoms:
·        High fever (over 100.4, but can range from 99’s to 104+)
·        Fatigue
·        Cough
 
Other symptoms can include milder issues:
·        Loss of Smell and/or Taste
·        Nausea without Vomiting
·        Sore Throat
·        Aching muscles throughout the body
·        Headache
·        Occasional diarrhea …
·        Nasal congestion (occasional)
 
TREATMENT:
Symptomatic treatment for the most bothersome symptoms
 
·       Plan to: Monitor temperature twice daily and record.  
·       Monitor oxygen levels twice daily and record. If dropping
significantly you should be in touch.
 
For the oxygen/Temperature:
 
  1. Check your temperature twice daily and keep a log. No temperature is dangerous…adults do not have to worry about this. This is just about monitoring your condition. If you have concerns, be in touch.
 
2.     Check oxygen level twice daily and keep a log. A declining oxygen level can indicate early de-compensation from COVID.  Normal oxygen saturation is 97-100%.   If lower than that it may be normal for you, but the trend is what matters.  If you are declining into the low 90’s, if you are feeling particularly short of breath…then it is time to check at the Emergency Room (which is safe to do!)   If you have concerns…be in touch.
 
 
Aches and Pains and Fever:
·        Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:
·         Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets...1 – 2 x per day,
·        Drink good amounts of clear liquids (anything you can see through)
 
Sore Throat:
·        Saltwater gargling
1.   Dissolve 1 teaspoon of salt in a glass of warm water.
2.   Gargle for 15 seconds and spit.
3.   Repeat during the day every 2 – 4 hours to relieve pain.
·        Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets...1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.
 
 
Cough:
·        Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.
·        Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.
·        You may require a prescription cough syrup with Codeine.  Contact me if that is the case.
 
 
Sinus Congestion and Drainage (RARE SYMPTOM):
·        Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.
·        Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.
 
 
Nausea Treatment:
This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.
 
If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment.  Sometimes we use them in combination either as a pill or a suppository.
 
The KEYS are:
 
1.   Settling the Stomach…so that liquids can be taken
2.   Focusing on Liquids…so that dehydration does not set in
3.   Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!
 
When to Seek Medical Assistance
•          There is no medication to treat this virus, so the resolution takes time.
Worsening symptoms/Signs of Complications:
•          If you are getting significantly short of breath please be in touch.  If progressive and worsening, you need to be seen and possibly hospitalized.  Best to go the ER if shortness of breath is a significant symptom
 
How Long to Recover
•          The COVID is a viral infection that will generally take from 3–7 days to develop, 3-7 days to improve and then from 3-7 days to completely resolve.

Stay Safe!