We realize the importance of staying connected and intend to provide weekly updates in this format for some education, encouragement and challenge. Each week is different as our lives shift and change with the complexities we experience personally and jointly in these days. Our desire is to give you the facts as known at the time of these letters and assist in filtering the poignant developments for your consideration and application. As your healthcare team, you can count on receiving authentic communication from us and our remaining a positive force in this journey together.

COVID-19 Updates From Dr. Gee

04/20/2020

A tremendous amount has transpired since our last correspondence on COVID-19. The great news is that we have reached our first benchmark in our new, overused, pandemic lexicon of “flattening the curve” in Idaho. This is based on significant reduction of new cases reported given the profile of patients that have access to testing. Our collective efforts to mitigate the risk of an overwhelming healthcare crisis have worked to date. We can be grateful for this outcome. We have completed Round 1. Each of us has wrestled with our current status and experiences of the past month.  As we contemplate the implication of transitions and new norms of life, we have to focus on what is known and what we can control. I would like to highlight a few of these for perspective and, hopefully, some clarity as commentary, information overload, speculation and misdirection do not empower or encourage us as we face this infectious opponent. We must not add each other or our community to the list of things embattled right now.

Known and important:

*This coronavirus can transmit in the first 5-7 days prior to symptom onset in those who develop symptoms and potentially up to 3+ weeks after symptom resolution. It sheds from those infected but have no symptoms (asymptomatic infections). Any of us may be shedding without knowledge of it.

*Some healthcare supply chain limitations are improving. Others remain restricted such as testing capacity with rapid turnaround time, PPE, and contact tracing. These are core limitations that risk failure of the work done to date in keeping the outbreak contained if we don’t correct them. Idaho COVID-19 prevalence is not known, but if this is currently and speculatively around 5%, over 1.3 million of us would have to get the infection to reach 80% herd immunity for Idaho. (Most community disease dwindles out at 80% immunity  of a population). Not a good approach given net outcomes.

*Successful surge prevention countries such as Japan, South Korea, Taiwan, and Singapore have numerous factors that have led to their success. Mask compliance. Compulsory compliance. Philosophical compliance.  Look at the Daily Case Rate of Singapore, however. They were championed initially for their first 6 weeks of control from early February to mid March. Their easing of restrictions and behaviors to baseline life hasn’t gone very well in the past 1-2 months. Other countries with trustworthy data have succeeded. We need to take heed. Can’t speculate here on all the reasons. Just file it away for consideration. 

*Most current debates on relaxing measures to our new “normal” pit individual rights and collective rights in the realms of health and economic well being. There are critical issues surrounding all of this and they define how we view and treat each other. I would posit a simple stance that the individual and collective outcomes are not exclusive of each other (see below). 

So where do we go from here and what can we control? Fear and denial are not reasonable options as we process all this.  Clarity and simplification of the arguments are needed to act and implement what is possible individually and corporately. Hopefully in the past month, some personal simplifications have cleared your perspective, focused your values, and caused you to contemplate things that remain stable in your life. For many of you, that surrounds relationship with others, ideals, philosophy, or faith. Go deeper in these pursuits. I would encourage each of us to elicit others’ personal perspectives as we struggle with an understanding of where they may be stressed, bewildered or worried; you will be enlightened and better educated on the “facts” of their experience. Walk a mile in their shoes. From that position you can make a substantial difference in your village.

So what about COVID-19 clarity and simplification as our heads spin with perspectives from many directions? How do we jointly act as this virus threatens to create a persistent dystopia? How do we reconcile personal and collective rights? What we need to do for COVID-19 is fairly basic with what we already know. I doubt there will be a date of “all clear” for months at the earliest. Freedom of movement, travel, and gatherings will all have to be addressed as sources of potential flares or outbreaks. We need our community to move forward but this requires everyone’s participation just as we have for the past month. The basics of good hygiene and prevention of respiratory droplet exposure will be the champion in this battle. Wearing a facial covering or mask in public can not be overstated. Social distancing is constantly violated with shared air space when we are out in public. When I run an errand, I only see about 20-30% of people with covered faces. It’s not too much to ask. It’s an act of respect to others, not an ill-informed self-protective maneuver. Humble ourselves and let’s start to transition back to more normal movement and life. In the absence of a vaccine we can’t instantly create herd immunity without disastrous results. We can create a “barrier-herd immunity” while awaiting more options. Absent this joint behavior, we risk undoing our efforts. We don’t have personal or social reserves to do this all over again. Learn the lessons of others and look at the data; Singapore’s graph speaks volumes. Some would argue that compulsion or guilt would be the best way to achieve this; these also destroy. I am idealistic enough to say that we can do it for the right reasons out of respect and care for each other. Encourage others to do the same.

Stay positive. We can do this. Antibody testing on your blood to clarify your COVID-19 immunity status can now be easily provided through our office at Main Family Medical with next day results. We have had barrier methods in place for the past month and believe we can provide you confidence in this area. We are triaging everyone who calls for appropriate coordination of care. Telehealth visits are provided for those active and suspicious of illness; these remote video visits are also available for you who prefer not to come to the office. We have been wearing masks at our practice for the past 5 weeks and will remain in this fashion for some time to come. We are doing all that we can to keep your baseline health needs addressed and out of the hospital system. More than ever we want to be your resource in navigating options as we shift through these phases. Being an independent and small practice allows us to pivot and adapt quickly for your benefit as new developments occur with the pandemic. We are available to further clarify any COVID-19 issues, questions or discussion. Laura, Michele and I remain very committed to giving you evidenced-based recommendations on all of this.

Let us know how we can meet your needs and serve you at this time. Please wear a facial covering. Our mutual success depends on it. Ask others to do the same. Let’s keep moving forward to what we all desire.

Gratefully,

Dr Gee for the whole team at Main Family Medical

We realize the importance of staying connected and intend to provide weekly updates in this format for some education, encouragement and challenge. Each week is different as our lives shift and change with the complexities we experience personally and jointly in these days. Our desire is to give you the facts as known at the time of these letters and assist in filtering the poignant developments for your consideration and application. As your healthcare team, you can count on receiving authentic communication from us and our remaining a positive force in this journey together.

COVID-19 Updates From Dr. Gee

03/11/2020

Information on COVID -19 (Coronavirus) is rapidly increasing and daily evolving. Your healthcare team at Main Family Medical is continually seeking up-to-date and accurate information from the Center for Disease Control (CDC) and local Health Departments. We strive to provide quality care to every patient while ensuring that we protect all patients and staff as well.
Our information to you is based on what we know as of March 11, 2020. It is currently known that this virus causes upper and lower respiratory illness and ranges in appearance from a simple cold to significant respiratory failure. It is primarily spread through respiratory secretions. The CDC indicated that over 80% of the 40,000+ positively tested patients out of China have mild cold symptoms while the mortality concerns are highest in elderly patients and those with pre-existing conditions. These statistics do not indicate the baseline rate of all positive Coronavirus patients in the general populations as many may not have enough symptoms to have been tested or evaluated. To date, no cases have been documented in Idaho, but this will certainly change given the cases in surrounding states.
Prevention measures for the Covid-19 virus are the same good hygiene practices needed for cold and flu prevention throughout the year. These include the following:

• Wash your hands with soap and water thoroughly for 20 seconds. Use at least 60% alcohol hand sanitizers if not washing your hands.
• Avoid touching your eyes, nose and mouth with unclean hands.
• Cover coughs and sneezes with the crook of your elbow or a tissue and then immediately throw the tissue in the trash and wash your hands.
• Minimize exposure to others if you are ill. Stay home from work or school. Take particular consideration for those with chronic illness and elderly in your spheres of interaction.
• Disinfect surfaces that are frequently touched such as phones, keyboards, doorknobs, etc.
• If you show signs of respiratory illness and must go out, wear a mask. CDC does not recommend that those who are well wear masks.
• Eat, exercise and sleep with good health in mind.

If you or your family member are experiencing any signs of respiratory illness (cough, shortness of breath, fever) and feel you need to be seen by a provider, we will have you speak over the phone with one of our Triage staff. They will ask about recent travel, cruises, and possible exposures to COVID-19. They will also speak with you about what symptoms you are experiencing. WE DO NOT HAVE THE ABILITY TO TEST FOR COVID-19 AT MAIN FAMILY MEDICAL. If there is a possible exposure, we will coordinate appropriate care with your local Health Department.
If you are scheduled at Main Family Medical for respiratory illness, shortness of breath, fever or cough we will ask that you remain in your car and call when you arrive. A staff member will then call your cell phone when we have an exam room available and escort you in through the rear entrance if able. This is to limit exposure to other patients and staff and decrease the potential spread of any viruses.

Please refer to the following websites and phone numbers for more information:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://www.who.int/health-topics/coronavirus
https://coronavirus.idaho.gov/
Central District Health (Ada, Boise, Elmore and Valley Counties): Operates weekdays from 8:30 a.m. to 4:30 p.m.; call the hotline at 208-321-2222.
Southwest District Health (Adams, Canyon, Gem, Owyhee and Payette Counties): Operates weekdays from 8 a.m. to 8 p.m.; call the hotline at 208-455-5411.
South Central Public Health (Blaine, Camas, Gooding Jerome, Lincoln, Minidoka and Twin Falls Counties): Operates weekdays from 8 a.m. to 5 p.m.; call the hotline at 208-737-1138.
North Central Health District (Idaho County): Operates weekdays from 8 a.m. to 5 p.m.; call the hotline at 208-748-0400.