An Update from us on COVID-19

March 30, 2020

Dear Member,

We hope you and your loved ones are still quarantining and doing well. We would like to thank you for the outpouring of masks and offers of supplies. We will now be sending all donated items to the front lines to help protect our health care workers. 

Having symptoms: We have seen an increase in COVID-19 symptoms in our patients. As of this email we have not had anyone hospitalized. We have been in constant contact with those patients and helping them navigate this difficult time. Symptoms suspicious for COVID-19 can create anxiety. Breathing issues tend to manifest in different ways. It can be difficult to assess actual shortness of breath or anxiety. Some people have gone to the emergency room or urgent care to be checked. At these facilities vitals are taken and people have been sent home. Our goal is to keep you out these facilities. Vital signs can be checked at home. Some of these include – temperature, pulse and oxygen level. In our efforts to keep you home, we have been recommending an app called Digidoc for the Iphone. It uses your flash to check your pulse and your blood oxygen level. It costs $4.99 to download and we have checked its accuracy against our in- house pulse oximeter. It overall seems to serve as a good guideline. We have absolutely no relationship with this company. It can be reassuring to know this information while at home. Also, when doing virtual visits with us it is very helpful. Most of our patients have symptoms from 5 days to 2- 3 weeks duration.

The new 15- minute test: As of Friday, Abbott Laboratories has had the FDA fast track a new in office lab test for COVID-19 that only takes 15 minutes. The test is a nasal pharyngeal swab which is similar to our influenza virus testing. We have reached out to them to see the availability of this and will keep you informed. Hospitals will be receiving this testing first.

How long should you quarantine for: Most of us are hitting the 14 days of quarantine time. A big question is what is next and when we can see others. Well, the good news is most of you should be in the clear as far as contracting the disease yourself. However, we still recommend you quarantine, use social distancing, and stay home as much as possible. There is still a small risk when going out to get essential items. The recommendation for staying in for 14 days is based on the data that most (97.5% of people) show symptoms of COVID-19 by that time. However, there are some outliers. The recommended time to be 100% sure is 30 days, but even doing 21 days will give 99% certainty. Again, we still recommend these measures regardless of how much time has passed until things dramatically improve in our region.

Glasses instead of contacts/eye protection: Many people on the street have started to wear masks to protect themselves from others who may be contagious. Masks, especially the surgical masks, are mostly to keep YOU from contaminating others with your sputum as you speak, sneeze, etc. Studies have shown it only to be minimally effective against preventing airborne infection. N95s are better for airborne protection. However, your eyes are another source of entry for infection. As such, we recommend you wear eye protection if in an area that could be aerosolized (ie an elevator) by someone else who coughed, sneezed, etc. Once outside, the glasses are no longer needed with maintaining 6 feet between yourself and others. The American Academy of Ophthalmology recommends you keep your contacts in their cases and switch to your glasses. Contact lenses cause users to touch their eyes more frequently due to insertion and removal. Studies also show that contact lens wearers touch their face and eyes much more than those who don’t wear contacts. Please continue to regularly wash your hands with soap and water and refrain from touching your face.

When are you no longer considered contagious: The health experts have differing recommendations. The WHO (World Health Organization) recommends waiting 14 days from when symptoms subside. The CDC recommends at least 7 days from the start of your symptoms AND 72 hours of being afebrile. We recommend that if near someone who is older or immunocompromised you follow the WHO recommendation to be safe. We have been advising people on a case by case basis as to which criteria to follow, but 14 days remains the most prudent.

Other things you can do to possibly help stay healthy:

Meditation: COVID-19 triggers multiple inflammatory mechanisms. Meditation has been demonstrated to counteract at least 60% of those triggers. This can lower the likelihood and severity of the inflammatory cytokine storms that cause more severe cases. Two suggested free apps for this include Headspace and Calm. There are many benefits and we strongly recommend trying it.

Take a news break: The situation is too difficult for most people to cope on daily basis. We recommend people taking social media and TV news breaks often. Use the time to concentrate on other things such as your family, friends. Take advantage of this time to do exercise, read, journal, etc. It is not only okay to take a break from the news, we recommend it.

Mental health: 

The constant bombardment of COVID-19 updates is tough on most people’s psyche but especially those with underlying mental health issues. This is an unprecedented time. We do recommend that a “news break” could help you with this. However, for many this is not enough. The New York State Department of health has opened a free mental health hotline made up of volunteer psychologists and psychiatrists. Please do not hesitate to contact them at 1-844-863-9314. We also have a list of psychologists and psychiatrists doing virtual visits on and off insurances. However, many of them are donating their time to the hotline so we recommend you try that first.

Can you get it from your pet: The experts seem to agree that you cannot get COVID-19 from your pet. There were two instances of dogs testing positive for the virus in China and a cat in Belgium. Despite the pets having the illness, they still didn’t think they were contagious to humans. So as far as we are concerned, FIDO and KITTY are safe, and a good stress reliever to have around.

DIY Face masks for hospital workers: COVID-19 is so new that we don’t yet have direct studies to consult on the efficacy of different protective equipment. However, a 2015 study in Vietnam found that hospital health-care workers wearing cloth masks were far more likely to become infected with respiratory and flu-like illnesses than were people wearing disposable surgical masks. Cloth masks stopped just 3% of particles, and medical masks stopped 56%. A 2013 study by Cambridge University, studied how aerosolized bacteria and viruses passed through DIY mask materials inserted into a testing device. The study showed that only vacuum cleaner bags came close to matching surgical masks’ ability to block one type of virus; among cloth masks, tea towels blocked the highest percentage of the virus. We have seen nurses and doctors use the DIY masks to cover their N95s and keep them cleaner longer. This is because they need to continually reuse them. We don’t feel that DIY masks will be enough to protect health care workers. If you want to protect others by wearing one yourself, we believe a DYI mask would be perfect.

If you have or suspect you have had COVID-19 and want to donate plasma to others Mount Sinai Hospital has a program. Once you have fully recovered from COVID-19, Mount Sinai hospital is using your plasma to treat others who are more seriously ill. You can email covidserumtesting@mountsinai.org for further information. As of now there is NO commercial test to see if you have had the virus and are immune. We are in daily contact with all the commercial labs to see when this will be available. We strongly recommend continuing to usual social distancing and hand washing precautions even once recovered from presumed COVID-19 symptoms. There are still other viruses going around that have similar symptoms. Once antibody testing is readily available immunity will be better understood.

Some good news: 

Over 800 patients have been discharged from the NYC hospitals in the last few days.

Worldwide drug trials are currently active to find proper treatments using drugs already in use for other medical condition as a possible treatment for COVID-19. 

They will soon be able to test and trace those will the illness and help us come out of this quarantine situation. Until then though, stay put.

COVID-19 is mutating (changing how it looks) very slowly. This means any treatment and vaccinations should work for the next few years at the very least. In contrast the flu virus mutates much faster, making us vaccinate yearly. 

Virtual visits: We are physically in the office and available for in person appointments, however we are recommending deferring any routine visits at this time. We are available for virtual visits 7 days a week. Please do not hesitate to contact us to set one up for any matter. You can emailnikenji@flatironfamily.com for more information. 

We are all in this together. We are humbled and encouraged by all the acts of kindness, gratitude and hope we have seen during these difficult weeks. Please take heart in that and stay well. We can do this - hang in there and stay quarantined and safe!

Flatiron Family Medical

@flatironfamily

We leave you with this social- distanced rendition of Burt Bacharach's "What The World Needs Now is Love" by the Berklee College of Music