CV🦠News - Week of April 13, 2020 – The Village Doctor

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CV🦠News – Week of April 13, 2020

Healthy greetings, Friends of TVD!

As you know, we continue to work hard at keeping our website up to date and hope you find this second issue of CV🦠News interesting and informative. Again, thank you to all five physicians at The Village Doctor for their brainstorming and contribution to this newsletter effort, as well as keeping all of us, and all of you, up to date on local news, numbers, testing, treatment, as well as some more uplifting stories. Thank you, Drs. Abrams, Phillips, Pittson, and Sangani! Let me also give thanks to the various contributors to our Hope and Grace page, a collection of works and perspectives gathered from around the world. Read on, learn, and enjoy.


RECENT NEWS – BLOOD TESTING

For weeks the news has been dominated by the challenges with testing patients for coronavirus, or COVID-19. These tests were those looking for active infection, testing for evidence of the actual coronavirus in the noses and throats of sick patients. However, these tests don’t tell us anything about a patient’s immune response to a COVID-19 infection. On April 10, Stanford University announced a blood test for coronavirus serology, a potential game changer. This blood test is different than the nasal swab tests used to detect the presence of SARS-CoV-2 genetic material currently present in respiratory secretions in sick patients.

Antibody testing, also referred to as serology testing, has the potential to identify individuals who have previously been exposed, and may potentially have some degree of immunity, to the novel coronavirus.  We know that coronavirus can cause mild and even asymptomatic infections in many people. We also know that many of the early diagnostic tests used by commercial and public health labs were difficult to obtain and had a high rate of false negative results.  Serology testing can help inform our understanding of coronavirus infection prevalence and identify those who have already been exposed.

It is important to understand that it can take 1-3 weeks before an infected person makes enough antibodies to be detected by this test (testing too early could yield a falsely negative result), and that a positive test result only reflects exposure, not whether you are currently infected (and capable of infecting others) or were infected in the past.  Further, while we all hope a positive serology test means a person is immune and “safe,” we do not yet know if, or for how long, that immunity may last.  We hope to get an answer to this important question over the coming weeks (or months).

SOCIAL DISTANCING… ON A BIKE?

We’re all familiar with the CDC guidelines about “social distancing” while walking with other people. But what about running, or biking? Of interest, an April 7 Belgian-Dutch study got a bit more specific and more conservatively recommends “that for walking, the distance of people moving in the same direction in one line should be at least 4–5 meters, for running and slow biking it should be 10 meters and for hard biking at least 20 meters.” Of course this study has generated a lot of interest (and relative criticism), but it is worth noting that if you are running or biking with others, please spread out! There is more worth reading in Wired magazine here

SPEAKING OF SOCIAL DISTANCING… SHOULD MY KIDS WEAR MASKS?

For the most part, as long as children are staying home, they should not need to wear a mask. As long as they can keep a safe distance away from others (over 6-10 feet) on neighborhood walks, they don’t need to wear them outside either. However, if you must take your child to the doctor, the pharmacy or grocery store, wearing masks in those settings could be beneficial

  • Do NOT put a mask on any infant or toddler under the age of 2 years or any child that is more likely to touch it/try to remove it than leave it safely in place.
  • Practice having your kids wear masks inside the home if you will need them to wear it outside.
  • Teach your kids to wash their hands and remember to have them wash before and after putting a mask on.
  • Make sure you model good mask-wearing behavior and consider making a mask for a stuffed animal or doll to wear for fun. 
  • For kids over the age of 3, talk to them about germs and why it is important to protect the community.
  • If wearing a mask makes them more worried, reassure them by emphasizing the steps you are taking to keep them safe. The New York Times has a great article addressing how to make kids more comfortable with seeing masks.
  • Remember, just because your child will cooperate with wearing a mask DOES NOT mean that they should be allowed to play with other children. Kids should still not be going anywhere unless absolutely necessary.

What kind of mask should they wear?

  • Ensuring the right fit is important (mostly so they don’t have to touch it frequently). Child-sized masks are typically 5×10 inches (adults are 6 x 12 inches), but that may still be too large for young children. 
  • Homemade or purchased cloth masks or bandanas are suitable for both kids and adults.
  • Masks should be washed after each use.


OK, SUPPOSE I’M SICK AT HOME AND THINK I HAVE COVID, BUT CAN’T GET TESTED, HOW LONG DO I NEED TO SELF ISOLATE?

To be safest, we recommend that you continue “self isolation” at home until seven days have passed since recovery of symptoms (defined as resolution of fever without the use of fever-reducing medications AND improvement in respiratory symptoms [eg, cough, shortness of breath]) AND at least 14 days have passed since your symptoms first appeared.  We previously recommended following the less-strict CDC guidelines, listed below, but until there are further updates on whether the persistent viral RNA shedding in asymptomatic recovered COVID patients Stanford is seeing represents infectious virus or not, we feel it is prudent to follow more conservative isolation guidelines. 

RELATED, IF SOMEONE IS HOME HELPING CARE FOR ME, WHAT SHOULD THEY HAVE ON HAND?

Safety and Cleaning 

  • Tissues (kleenex or toilet paper)
  • Disinfecting wipes
  • Paper towels
  • Face masks (simple surgical or home-made mask that covers the mouth and nose)
  • Gloves (to use when entering the sick room or cleaning after the sick person)
  • Bleach (DIY bleach preparation for disinfecting: 5 tablespoons bleach per gallon water)

Medical Supplies

  • Over-the-counter cold medicines 
    • Tylenol/acetaminophen
    • Sudafed/pseudoephedrine
    • Saline nasal spray
    • Afrin nasal spray
    • Cough lozenges
    • Tea with honey
  • Pulse-oximeter
  • Thermometer

Food and Drink

  • Chicken soup
  • Electrolyte-replacement drinks (if using sports drinks, cut in half with water)
  • Fresh ginger
  • Lemons
  • Honey for throat soothing

For more information, we found this Wall Street Journal article helpful

HOPE AND GRACE

If you have made it this far, time for a reward, something to lighten your day, and acknowledge the human spirit. Find some escape, or perhaps even inspiration, in this collection of works and perspectives gathered from around the world. Maybe even joy.  Please contact me directly if you have come across something that has lifted your heart today. Dr. Eric Weiss

Let me start by sharing some words and an image from one of our patients. She wrote a few days ago:

Seeing spring unfolding before me. These Tom turkeys strutting their stuff and last night, lying in bed with the great horned owls that have lived and hunted and raised a couple of chicks for nine years, courting again . The male and female hoot gently for hours, at different pitches, and last night they were on the roof just above my head. We come and go and the turkeys and owls keep on.”

Now, for another beautiful view! Himalayas visible for the first time in decades as pollution levels drop!

Time. This has been both a friend and foe during this Pandemic. Consider using your time to explore, “What is your essence?”, “What are your obstacles?”, “What do you need to heal to transcend your obstacles?”, asks Yajaira (Yaya) Morales, a friend of TVD in her piece, What is Your Essence?

And lastly,

“It was just a post on Facebook. I don’t know that I even considered it a poem,” said Kitty O’Meara. “You know, it was just a way of offering some comfort to my friends and myself.”

Let me recommend that you watch this rendition on YouTube: And the people stayed home

In the Time of Pandemic

And the people stayed home.
And they read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still.
And they listened more deeply. Some meditated, some prayed, some danced.
Some met their shadows. And the people began to think differently.
And the people healed.
And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.
And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed.

—Kitty O’Meara

Read more about this poem going viral here

*****

Yours, in health and resilience,

Eric and the TVD MD team…