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

03/19/2020

It is important that we maintain communication and connection in these unprecedented times. Each of you undoubtedly is feeling stress and tension for various reasons of altered plans, schedules, expectations, financial loss, inconvenience, loved ones’ health risk, and the list could go on.

I am writing you today to give some encouragement and challenge. It’s important that we remain vigilant with the health recommendations that have been given so far. The separation that has been encouraged and implemented in our community will likely have a significant impact on the overall rate of spread and ultimately allow for allocation of resources to more effectively address the health needs of our community. No one can prognosticate fully on these matters and I am not attempting to do so at this time; I’m only attempting to give a tempered distillation of what is known today. We are fortunate to have the observed lessons from other nations and communities who have been ahead of us in this infection cycle and for that we can be grateful.

In spite of no active cure, several developments are worth noting and may help with some of your individual uncertainty or anxiety:

*combination anti-viral HIV medication and chloroquine, an antimalarial medication, have had some significant beneficial results in a few patients at the University of Queensland in Australia. These are readily available and currently manufactured. However, it could be some time before numerous validated studies can be performed.

*determining more accurate colonization of individuals who have minimal symptoms or are carriers of the virus is being looked at with widespread community testing in Seattle through the Gates Foundation and the University of Washington. They are implementing large population testing with mail in swab samples from home. They then can more quickly isolate carriers and early infected individuals to help with containment. Additionally, this will reflect more accurate data on the rates of severity within our communities by knowing the true “denominator” of infected individuals for more precise rates of morbidity and mortality.

*current testing in the U.S. is based on detecting virus in a patient’s nose or mouth in those who meet stricter testing criterion; many companies are working on point of care blood tests that detect IgM and IgG antibodies to the Covid-19 virus which will help identify in lower level patients if the “cold symptoms they had last week” was Covid-19 or not. This individual knowledge will give personal clarity. These are not readily available but are pending stream-lined FDA approval.

• vaccine for Covid-19 will be the multi-billion dollar holy grail. It will happen but likely on the backside of this unfolding story due to inherent logistics and production. Just as the 2009 Swine flu epidemic (H1N1) has led to the continued inclusion of this flu strain in the most recent flu vaccinations given in 2019-2020, a new vaccine will likely be used widely in vulnerable populations in the future. This will take many months or longer for widespread use.

The points above are given for thoughtful contemplation of where we are as a community and where things will change. The current focus of intervention is to slow the initial inertia of this infection. Higher and more effective level of care may then be given to the 15-18% of the population that do get severe Covid-19 hopefully for better outcomes.

The challenge I give to each of you, along with myself, is in the contemplative response to this challenge and opportunity. Not many times in life is there a “reset” button on what you value and with which you occupy yourself. No gatherings, no sports, no class, maybe even no work. In the midst of this anxiety-provoking condition, we need to give each other the support and “presence” that each of us need in various ways. Make the most of it. How many of us remember the perspective or feeling we had on September 11th, 2001 or Hurricane Katrina in 2005? This time it is in our own streets, neighborhoods, schools and community.  Act and invest in the community you wish to have. A word of encouragement, an errand run, protecting and still connecting with the at-risk population, dispelling anxiety for a friend or neighbor, patience in the midst of inconvenience are all remedies we need. This season will reveal and stress everyone’s character and we should strive to bring out the best in each other.

We have seen the stressful effects of these events on some of you this week at Main Family Medical. We have had no known exposures through our facility at this time. Each of my staff recognize the important role we play presently. Our attention and focus has been to educate, direct, and coordinate those who have concerns about coronavirus while maintaining and meeting all the essential routine care needs that you and your family experience. We have been as strategic as we can to remain present on site delivering the safest care possible. We have protocols in place for limiting and preventing exposure to our patients and team. We are not offering Covid-19 testing at this time due to numerous factors but are directing and coordinating the care of those who need to be tested. We are seeing only healthy patients with routine medication and well evaluations in the morning and those who have any illness symptoms (the vast majority of those ill right now have nothing to do with coronavirus) in the afternoon.  We are getting telemedicine set up this week so we can offer an additional route of care for you as well. This will be for the types of conditions that do not require physical examination.

We hope to be a steady and calming resource in this uncertain time. This is our current mission. It is an honor to be your health care team.

With gratitude and honor,

Dr. Gee, on behalf of our Main Family Medical team