06/01/2020
A SARS-CoV-2 Update for my Patients
Hello,
I am thinking of you all during these tumultuous times.
What follows is an update on the SARS-CoV-2 pandemic. Given that new information is available every day and that guidelines are evolving as we learn more, I am doing my best to present accurate, up to date information below.
At the time I wrote this, there have been 270 confirmed cases of COVID-19 disease in San Luis Obispo County. Three patients are currently hospitalized and two of them are being cared for in an Intensive Care Unit.
Our county is moving forward with the state’s reopening plan. As I have stated in recent weeks, at this time, by far the best thing for all of us to do is to continue to:
Wear a mask when we are away from home and around others (at a store or medical office). The mask can be a cloth mask (easy to wash and reuse) or a simple surgical mask. If you do not have a mask a handkerchief or scarf is also an option. Be mindful not to touch your nose/mouth and eyes when you remove or adjust your mask.
NOTE:
-Sanitize your hands after taking the mask off
-Do not touch your face or the mask while wearing it
-Disinfect areas where the mask is stored while not in use
-Wash your cloth mask daily
-Continue to abide by social distancing standards
To view an expert’s input r.e. the importance of wearing masks watch minutes 8:40 to 10:19 of the this video: https://www.youtube.com/watch?v=5zdmC6MCt44
Limit contact with people who do not live in our own homes as much as possible.
Maintain good hand hygiene.
The CDC recently announced that infected surface to person transmission is less of a concern and this created some confusion. The article below clarifies the risk of catching the SARS-CoV-2 virus from contaminated surfaces. It is possible to get COVID-19 by touching a contaminated surface or object but this is not thought to be the main way the virus spreads. Thus, good hand hygiene remains important.
https://www.nytimes.com/2020/05/28/well/live/whats-the-risk-of-catching-coronavirus-from-a-surface.html?campaign_id=9&emc=edit_nn_20200528&instance_id=18874&nl=the-morning®i_id=88965983&segment_id=29399&te=1&user_id=ff4af67e331cba2d13d989803c0fd546
Please emphasize this to your family, friends, and others in our community.
OFFICE UPDATE:
My Office Remains Open:
My staff and I remain available to help you.
We are continuing to screen patients by phone to keep symptomatic patients (those with fever and/or symptoms of a respiratory illness) out of the office so that our office remains a sterile, safe place for us to care for non-symptomatic patients who do need to be seen.
My office remains open Monday-Friday during regular office hours and as always, I am available after hours for emergencies.
I am now seeing more patients in the office, but I am continuing to review all patient visits on my schedule days to weeks prior to a scheduled visit. My staff and I are calling each patient to decide whether it is best to see someone in the office, conduct the visit by telephone or, if possible, by video conference or to cancel the visit. Note, I am now doing most Annual Wellness Program visits in person so that I can perform a focused physical exam during these visits.
NASOPHARYNGEAL SWAB TESTING FOR SARS-CoV-2 AT MY OFFICE:
I currently have >10 “test kits” (swab/transport media) available to test patients in my office parking lot.
WHAT’S NEW:
LOCALLY:
Our local healthcare community continues to connect via phone conference on a periodic basis and our hospitals and local healthcare system are currently handling local COVID-19 cases well and continue to refine plans to handle new cases in the coming weeks.
Some elective, outpatient surgeries are being performed in outpatient surgery centers and hospitals. For some procedures, patients will be required to have a nasal swab test done to be sure they do not have an asymptomatic case of COVID-19 disease.
To date, our county’s management plan has continued to curb the number of new patients with COVID-19 so that our local healthcare system has not become overwhelmed like we have seen happen in other parts of the country.
Everyone needs to understand that Phase 2 of the reopening plan is not be a “return to normal”. All of us should wear masks when we need to be around other people that do not live with us, need to abide by social distancing standards and continue to be mindful of maintaining good hand hygiene. We will all need to “do our part” or we will likely have a major surge of COVID-19 disease.
HIGH DENSITY VULNERABLE POPULATIONS:
Our Public Health Department is monitoring our Skilled Nursing Facilities and Assisted Living Facilities and the California Men’s Colony carefully. These facilities are where there are dense concentrations of people who are vulnerable to severe complications of COVID-19 disease.
SEROLOGIC TESTS:
Progress on developing a reliable serologic test is being made but, at this time there is still NOT a reliable serologic test that we can depend on for this type of information. The challenge is that we need a REALLY good test (highly sensitive and specific) for the test to be useful.
MDVIP:
MDVIP continues to be supportive to my practice. I continue to communicate and collaborate with other MDVIP practices to share ideas and protocols to refine how I run my office to best help my patients and our community. Note, for those who are interested, MDVIP Connect has a link at the top of the home page that has useful information about the SARS-CoV-2 virus.
OTHER COMMENTS:
I will continue to update you with any changes that I need to make to keep my office a safe, sterile place to care for patients that need to be seen in person. Please call my office if you have any questions.
As we progress through our 3rd month of the COVID-19 pandemic, I encourage everyone to focus on keeping good “self-care” a priority. Find ways to stay physically active (walks, home exercises, online workouts), be mindful of your dietary choices (eat lots of plants, especially non-starchy veggies) and to try to stay socially connected with family/friends via phone or on-line video.
My staff have been working hard to help me adjust what we are doing at my office. I deeply appreciate their help.
I remain fully committed to helping you stay healthy and informed.
With a virtual hug to all,
Dr. Hilty
==================
What follows is information that I have included in my most recent email “blast”, but I will continue to include it in my email updates for those that would like to refer to the information that it includes.
Medical Supplies at the Office:
At the office we continue to be mindful of our supply of disposable gloves, masks, disinfectant wipes, and paper towels and continue to creatively find ways to use items that can be washed after use to make our supplies last longer. Currently, we have what we need to care for patients safely. Thank you again to several patients who brought us some much needed N95 masks and homemade cloth masks.
SELF CARE:
The uncertainty of how long we will need to disrupt our normal routines to avoid a major increase in cases of COVID-19 disease I suspect is wearing us all down a bit. To help improve how we are feeling, the best thing that we can do right now is to maintain good self-care:
Rest/Sleep
Try to maintain your normal bedtime/wake time
Morning Meditation
I like to use the Calm App
Others tell me that they benefit from using Headspace App and/or Ten Percent Happier (www.tenpercent.com)
Here is advice from a MDVIP Colleague: https://www.mdvip.com/about-mdvip/blog/coronavirus-triggering-anxiety-and-depression-heres-what-you-can-do
Physical Activity:
Walk or hikes
Doing a home workout (push-ups, dips, squats, and planks)
Do a workout online.
This link has some suggestions: https://www.mdvip.com/about-mdvip/blog/dont-let-shutdown-stop-your-workout
Our Public Health Department Fall Prevention Program has produced some free online exercise videos:
SLO Public Health Fall Prevention Program
Michelle Zulim-Clark
mzulimclark@co.slo.ca.us
https://www.slocounty.ca.gov/Departments/Health-Agency/Public-Health/Department-News/Preventing-Falls-and-Helping-Seniors-Stay-Active.aspx
If you would like to be on a newsletter email list, go to the following link:
https://slocounty.us16.list-manage.com/subscribe?u=e385f7ee799cd1c9de9002b23&id=802bf2468f
Upper Body Strength
https://cuestacollege.techsmithrelay.com/W7Ln
I use a 'thera-band' in the video, but you do not need one to perform the exercises.
Lower body strength
https://cuestacollege.techsmithrelay.com/disy
Chair Yoga
https://cuestacollege.techsmithrelay.com/aCEb
The SLO Adult School has online fitness classes:
Online Registration Home Page:
https://slcusd.asapconnected.com/
Online Registration for Lifelong Fitness Classes:
https://slcusd.asapconnected.com/ =25273
Staying Connected with Family/Friends / Keeping Mentally Busy:
Call or use Face Time or Duo or Zoom to communicate with family members or friends
Here are some suggestions from a MDVIP Colleague of things you can do at home to keep your brain busy: https://www.mdvip.com/about-mdvip/blog/3-helpful-ways-boost-mental-health-during-quarantine
Eat Wisely and Staying Well Hydrated:
Keep up your normal meal routine.
Look for opportunities to eat more plants, especially non-starchy veggies
Drink plenty of water: Goal 1.5-2.0 liters/day (50-65oz/day)
Consider Limiting News Intake:
Reading too much or watching too many news shows about the COVID-19 Pandemic can be stressful. Consider picking 1-2 articles/news shows to watch and then move on
Hopefully, these suggestions are helpful.
Cleaning High Touch Surfaces:
If you do not have Clorox wipes:
Make a dilute bleach solution:
Mix:
5 tablespoons (1/3rd cup) bleach per gallon of water
OR
4 teaspoons bleach per quart of water
Some of my patients are cutting rags into small squares and soaking them in the bleach solution and then putting them in a zip lock bag to make reusable wipes.
Use alcohol solutions with at least 70% alcohol.
If you do not have a bleach solution or alcohol-based cleaning solution:
Washing surfaces with soap and water is helpful. The coronavirus has a lipid membrane and is thus very susceptible to washing with soap and water.
HELPFUL CDC SITES:
CORONAVIRUS (COVID-19)
https://www.cdc.gov/coronavirus/2019-ncov/index.html
This is the “main page”
In the San Francisco Bay Area we’ve “flattened the curve” of COVID-19 infections, saving thousands of lives. But as we slowly go back to work, school, and ot...
