Unlike many physicians, I have decided to keep normal office hours through the pandemic. There are many illnesses that cannot be diagnosed from a video conference, and monitoring of ongoing issues cannot be neglected even though we are social distancing.
I am taking special precautions to protect myself, staff and patients:
*Only one patient at a time is allowed into the office, and I sanitize all contact surfaces are thoroughly between patients. I have high-efficiency filters in the heating/AC system, and I am also running two HEPA filters to further remove any airborne viral particles. Some consultations can be done outdoors in the garden or over the phone.
*I will be wearing a mask and lab coat to protect myself and the patients, and I ask that patients wear face coverings except when being examined.
*My only current office assistant, Carrie, had years of experience as a phlebotomist and lab tech, so she is familiar with isolation procedure.
*If you are ill with any of the symptoms of Covid-19 PLEASE NOTIFY US BY PHONE BEFORE COMING IN. It is possible that you will be examined and tested in the parking lot to avoid contamination of the office.
Fortunately, I now have capability to test for Covid-19. I have both the nasal swabs to test for active infection as well as the phlebotomy supplies to check for antibodies for recent and prior infection. All insurances are required to pay for the testing at no cost to the patient.
Unfortunately, many of the technicians performing drive-through testing are not adequately trained in swab collection procedure, so studies are showing up to a 30% false negative rate from those tests (meaning that the test was read as negative, but the patient actually had the disease). Also, in an effort to make testing more widely available, the US is allowing the use of tests that have not been vetted, so their sensitivity and specificity are unknown. Hence, I encourage you to come to the office to have testing done so that we can have the greatest possible confidence in the results.
This section is information and suggestions for my patients regarding the novel corona-virus known as Covid-19. It is based on my knowledge as of April 17, 2020, and I will try to update it as more information is available.
The emphasis of my practice has always been prevention so that dire situations could be avoided, and prevention continues to be crucial in this situation. Covid-19 is NOT the flu, and the virus is far more deadly and contagious than the influenza for which we vaccinate yearly. No one will know the mortality from the virus until the pandemic is over, but it appears that young, healthy people with the disease have a mortality between 1-4%, while people who are elderly or have any underlying disease (diabetes, hypertension, heart disease, etc.) have a much higher mortality, perhaps as high as 30%. The latest information from China suggests that their overall mortality has been close to 8%.
One of the difficulties in screening and containing the virus is that there are people who are infected but appear healthy (asymptomatic). Consequently, there are people in communities who inadvertently spread the disease. Sadly, there is no proven treatment for the virus, and no prevention until there is a vaccine, perhaps a year from now. Our best defense is to keep ourselves as healthy as possible and avoid potential exposure. Inconvenience now may obviate more drastic measures in the future.
As horrible as the losses have already been, those of us in California are fortunate that the Bay Area mayors and the governor acted promptly to stop large gatherings and to order shelter-in-place. Social isolation is very emotionally painful, but a necessary step to curb the spread of the virus. Consider this an opportunity to try new recipes at home, to exercise at home or outdoors, or to read a new book. Please try to work from home if it is feasible. I know that as the isolation continues and we (hopefully) stay well it is tempting to relax the social distancing. Please do not get together with friends! Although the social distancing recommendation is 6 feet between people it has been shown that aerosols from conversation can travel as far as 20 feet. Wearing a mask helps reduce the droplet and aerosol dispersion, but the mask may not be fitted correctly for protection.
Of course, hygiene is of utmost importance. Stockpiling hand sanitizer and aiming coughs at one’s arm are not the answer. Everyone must wash their hands thoroughly and often. Difficult as it is, avoid touching your face. Many years ago I started wearing washable leather gloves when I traveled on public transit to minimize germ exposure. If you can wear any gloves — even gardening gloves — it will decrease your contact and may make it easier to avoid touching your face.
Keeping the home and workplace as clean as possible are key. The simplest way to sanitize is to use dilute bleach (4 teaspoons/quart of water) on door knobs, light switches, kitchens, and bathrooms. There are numerous other cleaning products that work well, and are listed here:
Please take care of yourself and your family. Eat well, get plenty of sleep and exercise, and take any recommended vitamins or supplements. I want you to be well and stay well.
Mon, Tues, Thurs 9 a.m. - 5 p.m.
Wed 2 p.m. - 7 p.m.
Friday - emergencies only
Due to Allergies, please Enjoy perfume and scented lotions elsewhere