We are expanding office hours for patient visits as COVID levels are low
In addition, we are connecting with you via
phone, fax, email, and telemedicine.
Our office is using all techniques to reduce exposure to a minimum during your visit. These include:
emperature 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.
OUR CURRENT OFFICE SCHEDULE
8AM - 4PM Monday through Thursday
IN OFFICE APPOINTMENTS: MONDAY-FRIDAY
8AM---10:30AM & 1PM-3:00PM
MONDAY-FRIDAY from 10:30AM---12 Noon
We will be conducting TELEHEALTH/PHONE visits with patients.
WE WILL BE SEEING POSSIBLE COVID PATIENTS 3:00PM-4:00PM (IN YOUR CAR…APPOINTMENT ONLY….IN PROTECTIVE GEAR)
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. Don’t 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.
Groceries should be prepared as per the video link below, with attention to cleansing before putting them in cupboards and the refrigerator/freezer. See this video link for excellent detailed information:
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.
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. Results within 24-36 hours generally.
It is being done at the end of the day, in your car, by myself…. wearing protective gear. We are focusing on at risk individuals with mild symptoms or patients with more significant symptoms. We are not screening asymptomatic patients unless they have had COVID exposure.
Symptoms for testing:
Fever (100.4 or above) and cough (without other explanation)
Fever (100.4 or above) and sore throat (without other explanation)
Fever (100.4 or above) and chest pains (without other explanation)
Milder fever and symptoms with recent travel from NYC or SF/Seattle.
We have completed 170 tests and have now had 7 positives (no new positives in 6 weeks). All our patients are doing well (one needed IV fluids & resolved his infection.)
Testing is returning more slowly in MAY AND JUNE
Positive & negative test results are now reporting back in 5-7 days (this is a delay compared to previous. Sonora Quest is developing new systems to handle increased throughput, and we anticipate the delays will lessen with time, but for now, we are having to wait longer for results.)
Do remember that asymptomatic people are spreading the virus, so you must be vigilant and protective around all people you are exposed to.
IF YOUR ARE ILL AND CONCERNED YOU MAY HAVE COVID INFECTION:
Contact the office via phone or email first for instructions:
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 end of 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.
WHAT IS OUR CURRENT EXPECTATION FOR THE COURSE OF COVID?
At this point in time the are many uncertainties about the course of COVID in the US and in Arizona, but I can provide some educated speculation:
The virus has flattened in MAY IN ARIZONA and will pick up slightly in June as Arizona OPENS UP…..then it will wane in the summer. It is likely (although not certain) to show a seasonal trend like the flu…..not d
isappearing, but becoming much less common, in the summer months.
In September and into the fall and winter we are likely to see a recurrence of infection broadly in the state, country, and world. More significant restrictions will become necessary at that time.
Using increased testing (swabs and blood work) we will be able to more finely tune plans for physical distancing in different locations based on results of the presence of infection and its frequency in particular areas. This will allow for waxing and waning restrictions in local areas based on data from testing and mathematical projections.
If OPENING UP is to be safe, we all must maintain distancing, wears masks, not go out if sick, and wash our hands repeatedly.
Nature is immunizing us more generally, and when we have blood work to confirm previous infection, we will find a great number of asymptomatic individuals having been infected and this will provide ‘herd immunity’ which will be very helpful as time goes on.
Antiviral medications will be found through clinical studies and we are likely to see effective treatments made available within 6 months. Remdesiivir (Gilead Pharmaceuticals) has already demonstrated some effectiveness in highly ill patients and it is anticipated it will be effective in more mildly symptomatic patients. Additional studies are demonstrating more effectiveness. Production is being ramped up and it will become more generally available. Additional competing compounds are under development as well and a recent study of other antivirals compounds (a combination of 2 antivirals + interferon) was just shown to reduce duration of infection. Unfortunately, a recent large study of Hydroxychloroquine failed to show positive effects.
Immunizations will be developed, but will take 12-18 months to come ‘on line’
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.
High fever (over 100.4, but can range from 99’s to 104+)
Other symptoms can include milder issues:
Loss of Smell and/or Taste
Nausea without Vomiting
Aching muscles throughout the body
Occasional diarrhea …
Nasal congestion (occasional)
Symptomatic treatment for the most bothersome symptoms
Aches and Pains and Fever:
1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:
Advil (Ibuprofen 200mg), 2
3 x per day or Aleve (naproxen 220mg), 1
2 x per day,
Drink good amounts of clear liquids (anything you can see through)
Dissolve 1 teaspoon of salt in a glass of warm water.
Gargle for 15 seconds and spit.
Repeat during the day every 2
4 hours to relieve pain.
Pain relief medications: Advil (Ibuprofen 200mg), 2
3 x per day or Aleve (naproxen 220mg), 1
2 x per day, or Tylenol 650
1000mg four times per day.
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.
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, don’t 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 Healthy & Safe!