FMWC COVID-19 (Coronavirus) Update 3.20.20

Taking care of our patients is at the center of everything we do. Even as we adapt in these times of rapid change, our priority -you- remains the same.

We will continue to monitor and sort through available information to give you our best understanding of what to do to care for yourself and your loved ones.

Therefore, please take the time to read this communication about COVID-19 carefully, as it represents our best understanding of the situation as of today’s date. Our information includes the following:

  • What to do if you are not feeling well.
  • Supplements you may take that may help strengthen your immune system both now and in the event of illness.
  • What we’re doing about regular appointments, labs, and refills in given uncertainties.
  • Ideas for making sure social distancing does not lead to social isolation

We understand that many of you have questions that may be only partially addressed by this communication. Please note that Dr. Nchekwube and Ms. Juanita are unable to address specific questions by email or phone outside the context of an appointment.

If you have a question that is not addressed here and pertains to your specific situation, please feel free to schedule an appointment.

What We Know

The COVID-19 Coronavirus continues to spread here in the United States, and we are monitoring the situation to the best of our abilities.

The incidence of confirmed COVID-19 cases in our state and neighboring states has continued to increase, and it is likely that the number of unconfirmed cases is still high.

We are encouraged that so many people are following public health advice and are taking measures to protect themselves and their loved ones by practicing social distancing. We are also encouraged by the many ways the government and businesses are coming up with creative ideas to continue to serve all of us.

Given the potentially serious complications of COVID-19, should you start feeling sick, we ask that you contact us immediately to schedule a Telephone Appointment. While we recognize that many symptoms can be a sign of many other illnesses as well, out of an abundance of caution, we must consider the onset of not feeling well as possible COVID-19 infection and act accordingly.

Symptoms

COVID-19 Coronavirus is like the seasonal flu, in transmission. It is transmitted through the air by coughing, sneezing, spit created through speaking, and particulates spread through feces when going to the bathroom, as well as through particulates that land on surfaces. It is not clear yet how long the virus can survive on a surface, thus far it seems to potentially live at least up to one day on a surface, which could be the way it gets to you, by touching the surface and then you touch your face, for example.

For most people, COVID-19 Coronavirus appears to be mild, but the disease can change from being completely asymptomatic to very serious. It usually presents similar in many respects to the flu, with symptoms primarily including fever, cough, and malaise. A small number of people experience outlined symptoms with or exclusively have nausea, vomiting, and/or diarrhea. The experience can last from days to weeks.

For some people who get COVID-19 Coronavirus, the symptoms can be more serious and can progress to shortness of breath and even pneumonia. So far, given what we know, it appears that those with underlying health issues are more at risk for this progression. Please note that there are also reports of people without risk factors having complications.

Should the disease become more widespread in our state or neighboring states, our goal will be to prevent complications and identify anyone who may be at risk for more serious disease and obtain the appropriate treatment.

Testing

Testing as of date is still limited in the United States. Given this limitation, the priority is to test patients showing active signs of COVID-19 infection. Patients typically, therefore, must answer screening questions and test negative for an influenza test before receiving the COVID-19 testing.

Out of an abundance of caution, and given that testing is not yet widely available, we are treating the onset of certain illnesses as a sign of possible infection, and we have outlined our recommendation of steps you may take.

What We Are Doing

Given the Federal Government’s directives to limit personal interactions we will be implementing the following:

We will be rescheduling and/or offering Telehealth services to our patients who have appointments scheduled and are over 65 and/or have underlying health conditions. This includes all follow-ups and Annual Wellness Visits.

If you choose that you do not want to take advantage of our Telehealth Services when available, we will reschedule your appointment for 1 month from your current appointment date. We will call you before your appointment to confirm or reschedule.

If you already have an appointment scheduled, we are in the process of contacting you to let you know of the switch and offering a phone visit.

If you have the following, mild flu like symptoms, including but not limited to fever, cough, body aches and sore throat; we recommend you self-quarantine. You may call our office but please do not come to the office. You can communicate with our providers and we can provide you with services via Telehealth allowing you to speak with your provider via telephone.

If you have the following symptoms, chest pain, shortness of breath, fever, blueish color to your lips and/or have not been able to eat or drink anything in 24 hours please go to the ER. You can call our office. We will call the ER on your behalf and let them know you will be arriving.

Please feel free to call the office with any questions you may have concerning the above information.

Please note that the Federal Government has expanded Telehealth Services. Medicare and other insurance companies will pay for alternatives to in-office visits, including telephone visits and “virtual check-ins” for patients to connect with their doctors without going to the doctor’s office.

Please note that you must verbally consent to using virtual check-ins and your consent must be documented in your medical record prior to using the service.

Please note that the Medicare coinsurance and deductible will apply to telehealth services.

What You Can Do

Since it appears that COVID-19 will continue to spread, our goal as a practice is to help slow spread as much as possible especially to our most vulnerable populations. We are therefore making the recommendations below.

Below is an outline of ways to strengthen your immune system.

Our goal is to do all we can to keep any cases of COVID-19 in as mild a form as possible. Based on our current research, we have developed the following responses:

Optimal Supplementation

We are recommending the following when dealing with the onset of COVID-19 or other flu/cold symptoms. Please talk to your doctor for what will be appropriate.

Vitamin C-500 MG-1 or more daily

Quercetin-500 MG- 2 times a day

Super D Plus- 1 a day

If you are healthy, not 65 or older and/or do not have any underlying health condition(s) you may come into our Wellness Shoppe to purchase these products. If you are 65 and above and/or have any underlying health condition(s) please do not come to The Wellness Shoppe. Please contact Ms. Christina, the manager of The Wellness Shoppe at 219-985-8741 and she would be happy to ship these supplements to your home. Please also note you can order these supplements online at http://www.wellnessshoppes.com

Supplementing If Feeling Ill

Should you feel ill, we recommend that you take the following as soon as possible starting when you first begin to feel ill.

Super D Plus- 2 Capsules by mouth twice a day

C-Lysine- 2 capsules by mouth every six hours

V Clear Cherry EPS 7630 Cherry Cough Syrup-2 teaspoons every 4 to 6 hours or as needed

Garlic is a known antiviral, so garlic in raw or capsule form.

If you are feeling ill, please do not come to the Wellness Shoppe to purchase these supplements. Please contact Ms. Christina, the manager of The Wellness Shoppe at 219-985-8741 and she would be happy to ship these supplements to your home. Please also note you can order these supplements online at http://www. wellnessshoppes.com .

If you are healthy, are not 65 or older and/or have any underlying health condition(s)you may come into our Wellness Shoppe to purchase these products. If you are 65 and above and/or have any underlying health condition(s) please do not come to The Wellness Shoppe. Please contact Ms. Christina, the manager of The Wellness Shoppe at 219-985-8741 and she would be happy to ship these supplements to your home. Please also note you can order these supplements online at http://www.wellnessshoppes.com.

If You Are Feeling Ill

Given limited testing capabilities, we are considering the onset of any flu or cold-like symptoms such as fever, dry cough, nausea/vomiting, and/or malaise as a sign of possible COVID-19 infection. Should you feel unwell with these symptoms, we highly recommend you self-quarantine (please see below).

Please contact us immediately if you are experiencing what we have considered above as mild symptoms. Please don’t wait; contact us right away so that we can monitor you appropriately. Should we feel that daily monitoring is appropriate, we will discuss that with you during that initial call.

Please make sure to note the very first time you start feeling sick and let us know that when you first reach out. From the best information that we can gather, most COVID-19 infections are still mild. If the disease does become more significant, however, this usually happens on day 4 through 7 of disease symptoms and thus knowing when you first developed symptoms helps us monitor your care more closely.

Self-Quarantine

If you need to self-quarantine because you have been exposed to or are exhibiting signs of COVID-19, here are some recommendations:

Pick a room and stay there. If possible, designate a separate bathroom for your own use. Wipe down surfaces with a 1/10 bleach/water solution daily Wash your hands thoroughly and well before and after using the bathroom as well as before and after eating. This article in the New York Times give further tips for self-quarantine. https://www.nytimes.com/2020/03/06/health/self-quarantine-coronavirus.html.

Daily Monitoring

Our goal is to make sure that all our patients receive the care they need. While most people experience mild symptoms, we are aware that some people are more vulnerable and will need extra care. Thus, we have set up the following monitoring appointment model: If you are in our monitoring protocol, we will likely ask you to do some self-reporting for vital signs, we will give you a list of what else we may need.

We are trying to set this up as thoroughly and efficiently as we can while also making sure that everyone gets the care that they need.

Social Distancing

Social distancing is the practice of creating space between yourself and others with the intention of slowing the spread of any disease. The concept of social distancing is behind the ongoing closing of schools, sporting events, places of worship, and other public gathering places as well as the newest recommendations to avoid gatherings of more than 10 people.

How to Practice Social Distancing

The goal is to keep a space of 6 feet between you and anyone else. If you’re outside, perhaps a little closer, but a minimum of 6 feet indoors. Unfortunately, we need to do more than switch to elbow bumping from handshaking to avoid spreading germs. In terms of close family contact, if you or your family are doing a good job of keeping social distancing beyond the walls of your home, then you can relax the boundaries slightly at home.

If you are over 50; have high blood pressure, diabetes, lung conditions, or coronary heart disease; or are caring for a family member who is ill, then keeping the social distance of 6 feet even at home will be paramount.

Avoid large crowds. Note that most of these events have now been cancelled.

If you are going out or interacting with people who are sick, cover your nose and mouth with a light scarf. Masks will not, unfortunately, prevent you from falling ill, but they will help prevent you from spreading things farther.

If you can work from home, please do. An important part of social distancing is to protect those who for economic reasons or job requirements are not able to work from home.

How to be well

Get time outdoors. Just because social gatherings are not recommended does not mean staying indoors 24/7. The importance of being in nature to emotional and physical health is well documented. Take advantage of the emerging spring weather to take your dog for a longer walk or your child for a bike ride. Get exercise. Many fitness centers are now providing online classes, or again, go for a walk or run outdoors. If you’re working from home, make sure to move around throughout your day to get away from the computer.

Go on a news fast. The information coming out about COVID-19 (and the accompanying misinformation) is coming faster than most of us can process it. While we’re not recommending swearing off news completely, we’re also aware that constant monitoring is counterproductive. Decide how frequently you want to check the news (once or twice a day) and stick to it.

Create time or space zones. If you are working from home, have a family meeting to work out zones in your house for work and for play (or times in which to do each). Especially with children at home, establishing clear boundaries about what to do where or when is helpful for keeping the peace.

Eat healthy meals. Take this opportunity to cook something new or involve your children in learning to cook.

Have a project. Especially if your children are home from school, come up with a project that you can all work on together each day. Creating a Scrapbook, building a giant Lego project and reading a book. If you are juggling work and family from home, having a common project to come together around can help your kids know they’ll have your full attention for a defined time each day.

Connect, connect, connect. More than ever, we have ways to connect through electronic means. Make sure to stay in contact with loved ones through phone calls, online chats, or handwritten cards and letters. Look for ways to help. There are plenty of people in our communities who are restricted in their homes because of preexisting conditions. Offering to do their grocery shopping at the same time as yours, running other errands, or setting up a video chat can be a lifeline to the outside world.

Practicing Good Hygiene

While we know you’ve heard this a lot lately, it never hurts to be reminded about personal hygiene. Frequent and thorough handwashing is essential. Wash your hands for at least 20 seconds. Use hand sanitizer if handwashing isn’t an option, but washing your hands is more effective.

Remember that your face is considered a “hot zone.” Every time you touch your face, you potentially transfer the virus to your person. We realize that not touching your face is almost impossible, so wash your hands/sanitize your hands frequently.

Use a tissue to cover your nose and mouth when coughing and sneezing. When finished, throw away the tissue and wash your hands. If you don’t have access to a tissue, use your elbow to cover your mouth.

Clean surfaces and fixtures in the bathroom and kitchen with a 1/10 bleach/water spray or disinfectant regularly. Also disinfect doorknobs. Protect your hands when opening doors with a handle or use your hip or forearm to nudge the door open.

Get plenty of sleep. At least 7-9 hours per night.

FAQs

Labs

If you have concerns about getting your labs until we have a better handle on this outbreak, you may consider labs optional and we will work around that.

Prescriptions

If you are concerned about getting your medication(s) refilled and have been to see our providers within the last 12 months, we will send in a 3-month refill for you. Please make sure to ask your pharmacy to reach out electronically to us to make sure we are refilling the correct dose at the correct pharmacy.

Also note that some insurance plans may have restrictions on when medications can be refilled.

Travel

We recommend avoiding non-urgent airline and cross-country travel.

You can also check out current CDC guidelines for travel: COVID-19 information for Travelers

Work

If you are not feeling well, then please stay home and see our instructions above for self-quarantining. If you need a physician’s note because you are not feeling well, please set up a 15-minute Telehealth appointment with our providers so we can evaluate your health and ability to work.

If your question is about whether it’s safe to go to work, we suggest the following questions to help guide your decision-making:

Is your workplace offering you the opportunity to work remotely?

Is the COVID-19 Coronavirus spreading rapidly near you?

Are you in a high-risk profile (over age 50, with underlying health issues)?

If the answers to any of these questions is yes, then carefully consider whether to stay home from work.

If you need additional guidance about your specific work situation, again, please set up a short phone appointment with our providers to discuss.

Other Questions

If you have specific questions about your health or your medications in relation to the COVID-19 Coronavirus, please feel free to contact our office to set up a phone appointment. This communication is posted on our website and an abridged version may be sent to you via email, portal or text.

Sincerely,

The Staff at Family Medicine & Wellness Center. PC.