Hello everyone!
I hope you are fever free and doing well. As some of you know, I have switched to doing all visits via phone/skype/facetime. I will work on a new Zoom profile once I get the chance, so that I can “share” screens to go over results. The change to telemedicine was not one I wanted to make. I love seeing you in the office and physical exam, even if it seems routine, is an important part of your health. However, I made the decision after noticing last weekend that some patients/neighbors and friends were treating this like a vacation and jumping from one house to the other. With a virus that can be spreadable, but with no symptoms for 14 days…that just does not work. I don’t want to be exposed and then spread to any patients or my family. If there is something that I need to come in for, like questionable BP’s or something that can’t be done in telemed visit, we will adjust. If you are symptomatic with something that you think might be contagious and/or COVID 19, please let me know and we will walk through it together. I have very limited ability to test. But we will walk through it together.
FYI – Karen will be in the office from 9:30-1 TOMORROW (Friday)! if you would like to pick up any supplements.
Quarantine
At this point, I realize that many of us have seen video/TV confirmation of people surviving this virus. So many people are not taking it seriously. PLEASE LET ME TELL YOU THE PROBLEM WITH THIS LOGIC! First – If you don’t take it seriously because you think your immune system is good, you are exposing others. This isn’t a disease that just kills the person exhibiting poor judgement. Second – It lives 2-3 hours in the air and 2-3 days on several types of surfaces…and you don’t get sick right away…it takes a LONG time…up to around 14 days…. Think of all the people you come into contact with in 14 days! That is partially why the numbers are doubling roughly every 3 days in the US… In the next 6 weeks, we will all be impacted much more than a few days in the house together. The more we abide by the quarantine and use good judgement with “germ” control, the better we will be. THIRD and FINALLY, it is important to understand that while the death toll will be low compared to the infection rate….the REALITY is….at least 30-50% of those infected will need to be hospitalized in order to get better. OUR HOSPITALS cannot handle that load. This is where tough decisions will need to be made about who gets the in hospital bed vs a remote bed. Who gets a ventilator. Who gets the best treatment. No one wants to have to make those decisions and decide which patient gets standard of care vs. which patient doesn’t. But that is what is happening in Italy right now. I know I would not like to think that I was a portion of what made that happen. So let’s all try to be a part of the solution, not the problem!
Treatment
I have been trying to keep up, on a daily basis, with the new trials, for all of the treatments that are emerging as potential life savers. I know there are viral videos of people touting miraculous “turnarounds” with certain drugs. The downside is…there have been those who have suffered major negative effects to some of these medications. Granted, there have been many more positive cases…we know the biggest problem with this disease in severe cases is the overwhelming autoimmune response (some have read about ARDS, and the cytokine storm, etc)…The thought is, if some people have a high viral load, or an immune system that is fired up to the hilt., we could cause more harm than good. However, the antibody treatment looks very promising for severe cases. The three major drugs being looked at do as well…We just need to figure out timing, dosage and special exceptions/parameters.
“False” Tests
I feel I need to mention the ability/inability to test. While I have tested a few patients, what I have learned is these tests are not the most reliable. Flu tests, strep tests, Pt/INR tests all come with a report of the “specificity/sensitivity” for the test. This tells you how likely you will have a FALSE POSITIVE or a FALSE NEGATIVE. This is very important! Nowhere in the quest or CDC information can you find what the percentage is for FALSE POSITIVE or a FALSE NEGATIVE percentages. This is a first for me. I’m a nerd and I always try to know these things about the tests I’m doing. Because you have to know when to believe it, and when to NOT. In addition, CDC guidelines state that if a person is exhibiting symptoms of COVID-19 with a negative test, they should still adhere to guidelines as if it were positive.
Finally, I want to thank everyone who has shared my information as far as donating masks and protective equipment. There IS a shortage in the ERs and primary screening points. Please make sure those who are helping YOU survive this…survive.
You have all been amazing with your notes of encouragement and your shares. We are now open for supplement pick up a few days/week, and I am sending the rest from home office. If you need any replenishements, immune boosters, etc please let me know. Any appointments for the near future will be via telemedicine. QUEST LABS IS THE CLEANEST MOST EFFICIENT PLACE ON EARTH RIGHT NOW! Yes, that is what I am seeing. They are taking this very seriously, so please get your labs done if they are due.
As always, I wish you safety and wellness. Please try to find the laughter and positivity as much as possible!
Take care,
Dr. Ohms