Dear BFM Family,
We know you have been inundated with a lot of information regarding the Coronavirus Disease 2019 (COVID-19), and it is difficult to filter fact from fiction. We want to provide you with facts, obtained from the CDC, World Health Organization, infectious disease specialists and epidemiologists, with the purpose of keeping you updated on this virus, the public health response, as well as the steps we’re taking in our clinic to address this issue and remain accessible to our patients. As your primary care providers, our purpose is not to cause more panic, but to inform so that you can keep yourself and our community as healthy as possible and so that you can be prepared for the news and government directions that will continue to come out. This is not a virus to fear, but it IS a virus for which to prepare and be proactive – that is our goal and our hope for you.
Current Issues: Containment & Mitigation
COVID-19 is a very contagious respiratory illness with a tendency to cause a viral pneumonia that is already spreading quickly in the United States (far more than current “confirmed cases” suggest). Because of this, we support recent CDC and local, state and federal government recommendations regarding “social distancing” as our primary method to slow down the accelerating spread of COVID-19. The spread is currently “silent”, as we have extremely limited testing capabilities and very strict testing guidelines, so the confirmed cases vastly underestimate the actual number of cases. It is important to know that over the next 2-3 weeks, we will see a significant increase in cases. Do NOT panic, follow CDC and Health Department as well as local, state, and federal government recommendations. If we begin aggressive social distancing now, we can hopefully prevent this virus from spreading more exponentially and reaching a critical mass, overwhelming emergency rooms, hospitals, ICU beds and ventilators, as we currently see in Italy and even areas of Washington state. Again, WE CAN SLOW THIS DOWN by adopting these social distancing measures NOW, but it is the responsibility of every individual to do so – YOU can save lives by starting this NOW. Avoid gatherings of more than 50 people. If you are over 60, or have chronic illnesses, avoid even smaller gatherings – less than 10. Resist shaking hands and hugs and other physical greetings for now. Wash your hands for 20 seconds and use hand sanitizer OFTEN (>60% alcohol). Help your neighbors, especially those who are older and more vulnerable – offer to get groceries, etc., to help them minimize their risk. Wipe down surfaces, computers, and phones w disinfectant regularly. Be GOOD to each other!
Symptoms and Severity
For most healthy adults, COVID-19 presents with symptoms similar to the common cold or flu. Symptoms typically begin 2-5 days after exposure and can last for 1-2 weeks. Symptoms can include chills, fever and cough, and many people can have mild symptoms or even have none at all. Even higher risk individuals (over 65, history of high blood pressure, heart disease, diabetes, kidney disease, asthma, COPD, kidney disease, cancer or immunosuppression, among others) will by and large recover, but a higher proportion of these individuals will require hospitalization and life support (15-20%). COVID-19 appears to be more dangerous than the flu, especially because we have no immunization. It appears to be twice as contagious as the flu and anywhere from 5-10 times as deadly, especially for those vulnerable groups listed above (as high as 5%-10% fatality rate). Younger people can still become very sick and even die as well, but at a much lower rate (0.1-0.4%). Children seem to either have very mild symptoms or no symptoms at all and there have been NO deaths under 10 years old reported in the world, although children can probably spread the virus to others.
No approved medication exists for this viral infection, so the treatment is managing symptoms at home (i.e. take acetaminophen for fever, drinks lots of fluid and rest.) until symptoms are fully cleared. At this time, it appears MOST HEALTHY PEOPLE CAN TREAT THIS AT HOME WITH NO MEDICAL INTERVENTION. The total time you may need to stay home and isolated is fourteen days. HOWEVER, if your symptoms worsen with shortness of breath, increased confusion or clouded thinking, you should contact our office or call 911.
At this time, COVID-19 testing is limited due to several factors, including shortage of testing materials and laboratories performing the test, and strict guidelines on who should be tested based on severity of symptoms and travel. Therefore, our providers will help make the decision whether a patient should get tested, prioritizing the highest risk patients first until testing becomes more widely available. As testing becomes available, we will communicate how this may change.
Please know our office will be working diligently to field questions from patients and determine if you can be seen in our office, or if a provider will contact you via telephone or by a Telemedicine appointment (which we will be starting THIS WEEK). Depending on the symptoms, we may also direct you to an emergency room for more aggressive treatment.
Please do not hesitate to keep or call to make an appointment at our office out of fear of exposure, although we are expanding opportunities for “virtual” appointments for routine follow-ups using Telemedicine, which should roll out this week. In addition, our office has implemented every safety precaution to prevent exposure to you and our staff.
Finally, help us all to stay healthy by practicing prevention, being prepared but not panicking, and knowing our providers and staff are working hard to ensure the health and safety of our patients, staff and community.
Stay Well and Stay Calm,
Benjamin Stahl, MD, FAAFP
Dr. Larissa Riojas DO, FAAFP
Ashley Simpson, PA-C
Victoria Reigelsperger, MSN, RN, MPH, FNP-C
Staff of Boerne Family Medicine