COVID 19 RESPONSE AND COMMENTS:
…….AND SO IT BEGINS
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.
If the COVID-19 story in ARIZONA was a book, we have just finished the preface (March), and are now about to start reading the story (April/May). Like an assigned book from high school, it’s way too long and daunting…. but we must get through it. Yes, all that has been before is just the setting for what we are about to experience in Arizona…. but we will finish this story and we will get a good grade.
Know that our office is responding to COVID-19 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.
Stay Healthy & safe,
PS…. By reading our newsletter you declare that you are a person who is informed and taking action. Your preparation is about to pay off. All your efforts at social distancing and cleanliness need to be doubled at this time…. if you want to stay healthy, prevent transmission of COVID-19, and help your family and community. Continue to take seriously the steps listed below."
CORONAVIRUS (COVID-19) SUMMARY:
WE ARE HERE FOR YOU DURING COVID-19
We are available for you during the COVID-19 pandemic.
We are ready to serve.
We are connecting with you
via phone, fax, email, and telehealth medicine.
We are handling your medical needs.
CURRENT OFFICE SCHEDULE
MONDAY-FRIDAY from 7-12 noon we will be doing TELEHEALTH/PHONE visits with patients.
MONDAY-THURSDAY …. WE WILL BE OPEN FOR APPOINTMENTS 1PM-2:30PM ……BY APPOINTMENT ONLY (LIMITING EXPOSURE)
MONDAY-THURSDAY……WE WILL BE SEEING POSSIBLE COVID PATIENTS 2:30-3:30PM (AT YOUR CAR…APPOINTMENT ONLY….IN PROTECTIVE GEAR)
If you come to the office and the door is locked, please call from your phone to speak with us. If you don’t have a mobile phone you may knock on the glass door. Best to just call ahead to reach us.
REDUCE RISK BY REDUCING CONTACT WITH THE VIRUS
REDUCE CONTACT WITH THE VIRUS BY:
Washing hands frequently….20 seconds is advised, but any hand washing is helpful.
Use hand cleanser in between washings…if available.
Clean your cell phone daily with a cleansing wipe or UV light.
Shower or bathe daily. Twice daily if you want to feel more relaxed.
Don’t Pick Nose, Rub Eyes, or Pick Teeth with your fingers
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.
Stay away from people who are sick with COVID-19. Only caregivers should be in contact with COVID-19 patients and they practice high level cleaning to prevent spread.
Maintain social distancing practices, avoid getting within 6 feet of people (other than immediate household occupants)
IF YOU ARE SYMPTOMATIC AND HAVE BEEN TOLD YOU MAY HAVE COVID-19 ……BUT TESTING IS NOT AVAILABLE …….DO AS FOLLOWS:
Self-Quarantine for 7 days from the start of illness and FOR at least 3 days after fever and major symptoms have resolved. If you can quarantine an additional week, that is advisable.
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 situation allows
Wash your hands frequently.
Wear a mask if you have one. Wear when with others as much as is possible.
Shower/bathe twice daily if possible.
All household contacts should self-quarantine as well with only minimal outside interaction.
LIMITED 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. We are focusing on highly at-risk individuals with mild symptoms or patients with more significant symptoms. We are not screening asymptomatic patients.
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 done 35 tests and have now had 3 positives. All are doing well (one needed IV fluids but is improving.) Positive test results are now reporting back in 24-48 hours. Negative tests are still taking 3-7 days.
IF YOU 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-19 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-19 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.
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID-19 OR IF YOU HAVE BEEN DIAGNOSED WITH COVID-19:
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
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-19 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.
IF YOU ARE ILL AND CONCERNED YOU MAY HAVE COVID-19 INFECTION:
Contact the office via phone or email
We will contact you and review a plan of action for you.
• Since most people will have mild symptoms (80+% will do well with cold symptoms only), very little will be done other than routine measures to treat a cold.
• If you need to be seen we will consider a video visit vs. seeing you at designated times for such visits.
SINCE WE ARE LIVING IN THE TIME OF COVID-19 WITH TOILET PAPER IN SHORT SUPPLY, I AM INCLUDING SOME TIMELY ADVICE:
Your Bottom & TCB (Taking Care of your Bottom) & Rectal Itch/ Irritation:
Dr. David Price of Weill Cornell Medical Center in New York City shares information in a Mar. 22 Zoom call with family and friends on empowering and protecting families during the COVID-19 pandemic.
This is a rather extraordinary video by a critical care pulmonologist in New York who personally decides which patients to put on ventilators. He did this video call with his friends and family to explain COVID-19 and answer their questions. They recorded the call and it’s getting passed around now. It’s a long video – almost an hour – but it’s very informative and really quite calming and encouraging. I thought you might like to see the video and/or read his notes (which are below in the link). You’re welcome to share the video far and wide.
Clear steps to take to avoid getting COVID-19 that should make you feel calm and empowered.