April 9, 2020
Hello Wise Patients! It’s been 19 days since since the shelter-in-place mandate went into effect. Hopefully, you’ve been able to abide by that and still enjoy the awesome and rare sunshine we’ve been getting lately. We are so grateful for the opportunity to care for such an invested and conscientious community. Let’s continue supporting one another.
We love hearing what content is useful or educational, and encourage you to share this information with any members of your network who could benefit. Also, as a reminder, we are offering a one-time, $75 cash telemedicine visit for non-established members. This was created with the hopes of it addressing our community’s health care needs while reducing face-to-face visits in clinics and hospital rooms in the region.
If a patient is happy with their care, we will give them the option to use their payment for the televisit towards their first month’s membership with Dr. Naomi Lee. We encourage any interested parties to reach out if they have questions.
We enjoyed this article from Outside which reports the latest findings about the health benefits of sun exposure. Definitely reinforces that continuing to get outside, while observing social distance precautions, remains essential! So let’s take advantage of those beautiful Seattle days — just don’t forget sunblock. (You know we had to say it!)
Mask Advisory: How to Make & When to Wear
The CDC has updated their recommendation about using cloth face coverings. They are now recommending wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission. King County is known to have significant community based transmission.
The important things to remember are that the masks should not be a reason to relax social distancing and hand washing efforts. Social distancing and hand washing remain the most important part of our collective efforts to reduce transmission. Cloth masks may reduce the spread of the virus, especially from asymptomatic patients. Cloth masks can be made from everyday household materials. The CDC has created a great instruction page for making your own mask at home if you desire to do so.
Shopping for the Essentials: Grocery & Pharmacy Strategy
You should feel comfortable grocery shopping and going to the pharmacy.
A helpful 19 minute podcast (9min30second on 2x speed!) on grocery store strategy is this interview of David Aronoff, Director of the Division of Infectious Disease at Vanderbilt University:
When not to go to the grocery store:
- Don’t go shopping if you are coughing and sneezing. Duh.
- Seniors, consider senior-only store hours, ordering groceries, or asking someone else to shop for you. You deserve it!
- Try not to go more than once weekly.
- Try not to bring your rowdy children with you.
While at the grocery store:
- Behave as if you, and everyone else in the store, have COVID-19 without symptoms.
- Respect the 6 feet physical distance guidance for droplet spread.
- Don’t touch your face, ever.
- You don’t have to worry about viruses entering through your skin.
- Don’t fondle food that you aren’t going to buy.
- Wearing a cloth mask will help protect others, including cashiers, from the droplets you generate talking, laughing etc.
- Thank the checkers and other employees. They are taking personal risk so you can keep eating.
SARS-CoV-2 stability on packaging and food surfaces:
- Be aware of frequently touched items like grocery cart handles, self-checkout stands, money, etc. Wipe those down if you can. How do you wipe down a dollar bill? Not sure. Wash your hands.
- SARS-CoV-2 is not particularly stable outside of the body. The virus loses stability over time.
- Coronaviruses are very sensitive to soaps and detergents.
- Washing hands 20 seconds soap and water does the job.
- Use hand sanitizer when washing is not available.
- Though intact virus was found on cardboard up to 24hours and on plastic up to 72 hours (NEJM March 17, 2020), there is no evidence that it can be transmitted to cause infection after those lengthy times. Infectivity likely drops off much sooner. Dr. Aronoff states that 99% of the virus should be inactive by 24hrs.
- Thus, cereal boxes and other packaging within your cupboard for a day are very safe.
- You can’t go wrong with washing your hands after you touch packaging.
- Vigorously rinsing fruits and vegetables should do the job. Vegetable washes are optional and unproven. Nobody on the Wise Patient team washes their fruits and veggies with anything more than water. Honest. Please don’t bleach your produce!
- The virus will be inactivated by high heat of cooking (stovetop, oven, or microwave)
- Once food is out of the package and on your plate, and your hands are clean, enjoy it!
Looking Forward: Advanced Care Planning
The current pandemic has unavoidably directed our attention to public health. This has also prompted many of us to examine our personal health habits. We’ve received your requests for suggestions on how to utilize quarantine to prioritize your health. Thus far, our recommendations have addressed exercise, nutrition, mental health, and more.
In this edition we’d like to highlight the importance of advanced care planning as a way to be proactive and prepared in your health. Engaging with advanced care planning is an important form of self-advocacy in the event of unexpected illness. Additionally, establishing your priorities and intentions will help your loved ones and your health team (including Wise Patient) effectively advocate on your behalf in these circumstances.
We’d recommend these great resources to start the discussion:
If you’ve never considered advanced care planning or discussed it with a medical provider we’d love to answer any questions sparked by the information above. Additionally, if you complete the form from the Conversation Project please share it with us over Spruce. We’ll store it in your chart as reference to advise future medical decision-making if needed.
State of the state:
IHME Resource Use/Death Projections:
The Institute for Health Metrics & Evaluation, a local health metrics powerhouse in South Lake Union, has recently published their forecasts for Washington. You can find their models, as well as the methods behind their modeling, here. Their current projections for Washington state, given the timeline of cases and social distancing measures imposed are as follows:
- Peak date of hospital resource was 7 days ago, April 2, 2020
- No general bed shortages; ICU or Hospital Beds
- Day with Most Deaths/Day: April 6, 2020 42 deaths (3 days ago)
- Total projected deaths (through 08/04/2020) in Washington: 700
Similar projections can be found for other states, as well as the national projection, at the above link. These projections are updated regularly, so they are a great tool to use when examining disease burden in our state.
This gives us cautious optimism. According to the data, we’re on the other side of this outbreak and should see a gradual decline in new cases. Our social distancing methods are proving effective, but continued practice of this in the long term will prove beneficial in flattening the curve and decreasing the rate of transmission of COVID-19.
This week, we’re continuing our staff spotlights where one of us from the Wise Patient team highlights how they’ve been living during the quarantine. This week we will hear from one of our Health Coaches – Abum.
The quarantine has brought out the side of me that knows how to find gratification from the comfort of my couch. I fell into the trap of
staying indoors, choosing a streaming service whether it was Netflix, Hulu, Amazon Prime, or Disney+ (yeah I know this is a problem), just to binge watch a
s much as I could to keep up with my friends on social media. Lost in this trap, it took me a couple of weeks to say “no” and find other means of gratification. Finding myself with free time, I could genuinely reflect on different aspects of my life and actually focus on some of the things that I’ve forgotten that I love.
I called my Mom and asked her if there was anything she needed or if there were any errands I could run for any family friends. As expected, there was a list. Excitedly, I went through that list, driving around Seattle and the Eastside, checking in and running errands. Coming back home, with sunlight to spare, I donned my running gear and hit the streets to go for a jog that was the first in a long time.
Recently I’ve started to use the app, “Headspace”, which focuses on mindfulness, sleep, and meditation. Since starting, it’s helped me reintegrate those practices into my daily routine. Whether it was blasting the tunes and having a power “hour” of music and wild dancing for stress relief and excitement, writing or watching old television shows, changing my mindset brought back the wide smiles and laughter that felt so foreign after a couple of weeks.
Do you have a way that you’ve been keeping busy, active during this time? Let us know and we might feature your activity in next week’s newsletter and can share it with other Wise Patients!
Reliable Sources to Stay Updated on the COVID-19 Outbreak
– A comprehensive list of resources is available on this past edition of our newsletter which is available on our website: https://imwisepatient.com/week-of-3-23-2020/
If you have any questions, please contact our office at: email@example.com