COVID-19 Update
Dear Members,
Each day we hear about an increase in the diagnosed cases of COVID-19. We wish to remind you that these numbers are mostly rising because there has been a small increase in testing capacity. We were expecting this increase in the New York City region due to community spread. Most cases are mild and resolve within a few days. We have been in frequent contact with patients who are recuperating at home with suspected COVID-19 illness. The courses of their illness have been mild. The most common signs are fever, body aches, some congestion and a pressure on one’s chest (without shortness of breath) with extreme fatigue. Other symptoms have included just body aches or diarrhea and/or headaches. These symptoms last up to 5 - 7 days on average, waxing and waning. We recommend resting and further isolating in your home from others, if possible, during this time.
If you experience these symptoms contact us and we will conduct a virtual visit. There is no reason to go to an emergency room unless you are experiencing moderate to extreme shortness of breath. We will give you guidance as to the appropriate measures. A majority of people will resolve at home with COVID-19 related symptoms.
COVID-19 testing: We did receive a small supply of testing kits for COVID-19 in our office late this week. However, as of last night, the New York State Department of Health has mandated that outpatient testing for COVID-19 is no longer permitted due to the severe shortage of nasal swabs and Personal Protective Equipment (PPE) for health care workers. The testing is being reserved for those who are hospitalized. We are forwarding all test swabs we have obtained to the local hospitals for inpatient use. Many people are wondering if they had or have COVID-19. However, now that we are all quarantining (and you aren’t yet, you truly should be!), testing (which now takes up to 7 days for results) will not change the course of your illness. We will guide you through the entire process. There is a shortage of the viral medium for the nasal swabs and the personal protective equipment for those who need it. We feel strongly that we reserve the testing and PPE for those who need it the most.
Loss of smell (and taste): We have noticed that we have had quite a few calls from patients suddenly losing their sense of smell or taste with virus symptoms. After researching this, we have found these symptoms specific to COVID-19 infections. It can theoretically occur with any virus. Anecdotally, it lasts from a few days to 2- 3 weeks before resolving. This is usually a late sign of the virus. People often experience cough and congestion with fever earlier. However, it is our recommendation that anyone with no other symptoms other than a sudden loss of smell and/or taste take extra precautions to further isolate yourself from others.
Personal protective equipment (PPE): As most have heard there is an extreme shortage of PPE, especially masks. The hospitals state that within a few weeks they will have none at their disposal. In Lombardy, Italy twenty percent of physicians contracted the disease due to this issue. We know that a lot of our patients in their fear have purchased masks (both surgical and N95s). We ask that those of you who have this PPE and are willing to please send it to our office. We will forward to the local hospitals. The hospital emergency room and ICU health care workers are most vulnerable at the current time. We have received a few masks that we are using to see any patients. We are reusing these masks to keep our usage low given the shortage. Thank you to all who have reached out to us to donate masks to our office. We have been humbled by your generosity and care.
Checking up on patients: Understandably, there is an increase of anxiety with regards to COVID-19. We have a few patients that we contact daily to check on them. If you would like to add your name to the list please call our office or email Nikenji at nikenji@flatironfamily.com. We would be happy to have our office touch base with those patients on a daily basis as requested. Also, check on neighbors, especially the elderly and ask if you can get them groceries when you go. This helps to avoid further exposure as they are at the highest risk of more severe infections.
Children and COVID-19: Since our last letter more data has become available. It is now seen that young infants and toddlers are at increased risk. The number of children infected with more severe symptoms remains quite low. However, we recommend caution with younger children. 90% of children have a very mild illness, with 6% of those requiring hospitalization and the majority of those were young. Even with hospitalization, they mostly fared well.
NSAIDs and COVID-19: There has been some discussion that the use of NSAIDs (non-steroidal anti-inflammatories such as advil, motrin, aleve, excedrin, and aspirin) worsen the virus progression. Although the data isn’t clear, we feel it would be prudent to only use acetaminophen (Tylenol) as needed for fevers and pains.
Young adults not immune: In the United States 45% of those hospitalized have been between the ages of 18-49. It is important to stress this age group is not immune. They are vectors for infecting others especially those who are older or with weakened immune systems. Please follow the recommendation for quarantining and social distancing.
Other requests: We have received many requests for medications such as hydroxychloroquine and chloroquine. There are preliminary studies that these medications may be a treatment/prevention for COVID-19. We are currently not prescribing these medications if not indicated. Hospitalized patients for COVID-19 are first line if these medications are indeed needed. In addition, patients with medical conditions such as lupus need these medications and are having a hard time finding it. We have received many requests about blood type. This is not a routine test. We will likely not have this in your records unless you have previously requested it to be checked.
Nannies, babysitters, etc: We strongly recommend, if possible, to not have nannies, babysitters and cleaning people coming and going in your household. This is a source of potential infection. If possible, please consider continuing to pay them as most are fully reliant on this income.
Telemedicine: We are available for telemedicine “visits”. This is not only for COVID-19 concerns but any medical issue. We can evaluate and treat most issues via this method. Dr.Mian, our dermatologist, is available for any rashes and skin issues that occur. The duration of social distancing and quarantining is unclear. Thus, we recommend addressing all health issues as they appear as well as routine care.
We are hopeful that as we come closer to day 14 of quarantine, you will be at very low to no risk of infection. We remind you to continue to social distance when going for groceries. If you are high-risk try and avoid going out. Wash all bags, grocery items and your hands when you return prior to storing and consuming. The most effective way to prevent COVID-19 is through social distancing and staying at home. These measures should not be relaxed.
We are a community and will get through this by helping each other. No one should feel alone or isolated. We are here for you.
Stay well and reach out any time.
Warm regards,