We are open for regular visits

Dear Member,

A lot has changed since our last newsletter: New York City went from having the most cases of Covid-19 in the nation to the least; Black Lives Matter protests occur nightly and hopefully changes are in the midst; and the city is slated to open phase 2 on Monday, June 22nd.

Flatiron Family Medical will be closing our offices Friday, June 19th, in celebration and a time for reflection to commemorate Juneteenth. Juneteenth marks the day that enslaved African Americans in Texas finally learned they had been freed, over two and a half years after Abraham Lincoln's Emancipation Proclamation. To learn more about Juneteenth, we encourage you to go to www.juneteenth.com and further educate yourself on this important commemoration.

Covid-19 is still around: We urge you not to lapse in how careful you are and stop social distancing or wearing masks with others outside your home. We still see cases of covid-19 and are only 4 weeks from when they were occurring at a very high rate. We became the lowest rate of transmission in the country due to our steadfastness in keeping vigilant, not because there is no covid-19. It is still very present and still very serious. Twenty-one states have been having an increase in their rate of Covid this past week with 10 of them showing their highest rate now since this all started in March. Over 117,000 people have died from covid-19 and it is unfortunately far from over. “In general,” the CDC writes, “the more closely you interact with others and the longer that interaction, the higher the risk of Covid-19 spread.” Please wear a mask and stay safe. https://www.cnn.com/videos/us/2020/06/17/friends-test-positive-coronavirus-after-night-out-florida-bar-warning-cpt-vpx.cnn

Antibody testing: We have switched from using quest, which uses Abbott, for testing to LabCorp - as they started to use Roche for testing. Although it is still a far from perfect test, it is slightly more accurate than the Abbott test. That being said, we still believe we are seeing a lot of false negatives (people we believe had the disease who are not testing positive). Either that or patients are not producing antibodies.

Increasing your quarantine circle: We understand, everyone is getting quarantine fatigue and wanting to be with others. Anytime you increase your circle, the risk does tend to increase. However, with careful screening of your friends or relatives, it can be done with low risk. However, we would discourage this if you or they have immunocompromised people within their circle or care for an elderly relative or friend. Keep in mind that we are still within the first wave of this pandemic.

Here is how we compare to Italy who is nearing the end of their first wave:

Iceland: In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males. Other countries are watching to see if this holds true for them as well.

Toilets: As if we don’t have enough to worry about, a new study in the Physics of Fluids Journal showed that a virus can be spewed out of a toilet when flushed. They recommend you put the seat down when you flush, wash the toilet seat before use as some of the virus may have settled on there and to wash your hands well as the handle may have particles on it as well. But, no one knows if this amount of virus is infectious.

Protests: The Black Lives Matter protests continue nightly. For our patients who have been out there giving their support and attending the protests, we do recommend coming in to be tested for Covid-19 (with a nasopharyngeal swab) whether or not you have symptoms. It is important that we continue to test and then trace contacts and quarantine those who are positive to keep this virus from spreading out of control once again. This helps protect our most vulnerable populations.

Asymptomatic shedding: There has been some conflicting reports whether people do shed if have no symptoms or do not shed. The CDC studied the passengers on The Diamond Princess cruise and found that the high rate of infection meant that asymptomatic passengers and pre-symptomatic passengers are indeed spreading the virus.

Long haulers: Unfortunately, there are some of our patients who are still experiencing symptoms of covid-19 months after infection. This includes extreme fatigue, headaches, brain fog, palpitations, shortness of breath, intermittent fevers and fogginess. This does not mean they have been reinfected, rather that they are having long term symptoms. No one knows what this means yet in terms of how to treat or why it occurs or in whom. We are keeping an eye on any new information regarding these so called “long haulers” as we have quite a few in our practice and hope to help them recover sooner than later.

Positive nasal swabs: We have seen our own and read about other patients who continue to test positive with the nasal swab weeks and even longer after dealing with the height of the sickness. We feel that after 2 weeks, even though you may be swabbing positive, you probably are no longer infectious. The swab cannot differentiate between live and inactive viral particles which is what they think is occurring.

Encouraging news: The University of Oxford found that dexamethasone, a steroid that is readily available and cheap, has lessened the death of severely ill patients with covid-19 who are ventilated by one third. It has also decreased the death rate in those who need supplemental oxygen by one fifth. No benefit was seen for those with milder illnesses. This is definitely good news and hopefully continue to prevent unnecessary deaths from covid-19.

Check ups and regular care: We are now encouraging those who are due for check ups, vaccines, follow ups, etc that are not related to covid-19, to call and come in or do a virtual visit. We take your safety very seriously and are making sure that patients are socially distanced in our office and our staff are all wearing masks and cleaning surfaces and purifying the air throughout the day. It is important not to neglect our routine health during this time. As a reminder, we also have Dr Carol Livoti, who is available for gynecological check ups or follow ups or urgent issues in person and Dr Kiran Mian, who is available for all things dermatological - both medical and cosmetic procedures. If you have any concerns about coming into our office, please call us so we can hear you and hopefully reassure you.

Again, our offices are one of the safest places to be in the city! As such, we do require that ALL patients wear masks to enter our facility. Those who don’t have a mask will be given a mask upon entry into the office. Those who refuse to wear a mask will not be seen (we actually can’t imagine any of our patients not cooperating). Again, for those who are far or too high risk to travel in, we are still available virtually and encourage you to follow up that way as well.

Stay well and safe and keep wearing masks!