Wellscape Updates in the Time of COVID

In-Person Office Visits at Wellscape

Per guidelines of the Phase 3 reopening, which started mid-July, I’ve reopened the office for limited physical exams. This can include wellness exams as well as evaluations of problems that require some hands-on examination. As much as possible, we can meet virtually in advance to avoid spending too much mask-time in my small office!

If you are having symptoms of acute illness that may be related to COVID-19 infection, or if you think you’ve been exposed, please reach out by text or phone. 

For routine visits, per the established protocols:

• Expect to receive a series of questions prior to the visit which help to assess your risk for COVID-19
• Please wear a facial covering or face mask to the appointment
• Expect to have your temperature taken when you come to your visit

Additional measures that are being followed by Wellscape Direct MD include:

• Spacing out of appointments to allow ample time between visits
• Thorough cleaning of all high-touch surfaces and equipment between each appointment
• Availability of hand-washing and hand sanitizer
• Posted attestation and signage encouraging standard protocols
• Also, the PT group in the larger space outside my office also is following protocols, and has limited patient appointments

Other News

Capsule Pharmacy

There’s a new pharmacy in town! It’s called Capsule and does not have a location, but rather comes to you (within a certain vicinity of Boston). They do take insurance, but also utilize coupons to try to provide lower pricing. My experience so far is that they’ve got a super convenient app and great customer service. They can’t always match the cheapest price around, but sometimes they are cheaper than the standard pharmacies.

They make it easy to sign up and to transfer your prescriptions if you want to give it a try. Or you can let me know if you want to try it when you’re next in need a medication refill.

Flu Season

There’s already a big push for flu vaccinations for the upcoming year. This is going to be especially important given the backdrop of the Coronavirus Pandemic. Flu vaccination, along with all the measures of physical distancing, wearing a mask, and hand & surface-washing will all help prevent spread of the flu.

You can get your flu shot at most pharmacies, minute clinics, and local flu clinics. If you are having difficulty finding a flu shot, please let me know so I can help!

Ongoing Measures to Protect You and Others from COVID-19

It’s generally thought now that the likelihood of spread between people comes from direct contact, that is, being in close proximity with someone who has it, whether or not they have symptoms. Poorly ventilated spaces and longer direct contact, especially in close proximity, with someone who has it, increases the chance of spread.

Which is why we continue to encourage:

• Social Distancing (better said “Physical Distancing”)
  • Maintain physical distance from other people, at least 6 feet, especially if not wearing facial covering
• Use facial coverings
  • A recent study compared types of facial coverings
    • Summarized: avoid bandana-type and fleece facial coverings
  • Here is a link from the CDC on how to use and make a facial covering.
  • Reminders:
    • Facial coverings aren’t perfect, but help to minimize spread
    • Remember not to touch your face even while wearing a mask
    • Be careful in removing your mask that you minimize how much you touch it
    • Have more than one so you can wash them frequently
    • Wash your hands thoroughly after removing your mask
• Continue thorough, frequent hand-washing & surface-cleaning
  • Although it now appears that there is less risk of spread by contaminated surfaces, it is still a good habit to wipe down high-touch surfaces and wash hands frequently
  • Continue to avoid touching your eyes, mouth, nose, and face
  • Instructions for proper handwashing from the CDC here.
  • General guidelines for prevention of COVID-19 here.
  • Additionally, avoid touching your eyes, mouth, nose, and face.
• These are all good rules for upcoming Flu season as well

What to do if you are having symptoms of COVID-19

• Know the symptoms of COVID-19.
• Call (don’t physically go to) your doctor if you have a concern about COVID-19; please don’t flood the Emergency Department unless it is warranted.
• If you are having severe symptoms such as severe difficulty breathing, chest pain, etc., then call 911.
• Thankfully, the vast majority of people can stay home while they recover from COVID-19, under supervision of their doctor.
• There are numerous symptom checkers which can help with decision-making, including whether or not to get testing, in conjunction with your doctor:
  • CDC Self-Checker
  • Apple/CDC COVID-19 Screening Tool
  • Buoy COVID-19 Symptom Checker

When to Quarantine for COVID-19
The CDC offers guidance on knowing when and how to quarantine.

Testing

The struggle for available, timely, and accurate testing unfortunately continues.

That being said, there is more availability and the decision aids above in conjunction with conversation with your doctor can help decide if you should get tested.

There are a variety of tests now: the PCR test, antigen test, and antibody test. Some are rapid and some have to go to the lab; each test specifies if they take samples from the nasopharynx, mouth, nose, or blood. They all have their shortcomings, but along with assessing risks and symptoms, may be useful in determining next steps.

If you have a significant exposure or symptoms consistent with COVID-19 and test negative, self-isolation protocols would still be applied.

Here is a list of testing sites available in Massachusetts:

• How to find one in your area
• Mapper of MA test sites
• Listing as of August 25, 2020

Travel

As of August 1, 2020, Massachusetts has issued a COVID-19 Travel Order, summarized here.

All visitors entering Massachusetts, including returning residents, who don’t meet an exemption, must:

• Complete the MA Travel Form prior to arrival, unless you are coming from a lower-risk state
• Quarantine for 14 days or produce a negative COVID-19 test result that has been administered up to 72 hours prior to arrival in MA; you must stay quarantined until you receive a negative test result

Failure to comply with these requirements can result in a $500 fine per day.

Stress and Supports

Feeling stressed out? Wishing the pandemic was over already/! You’re not alone!!

The level of stress from this pandemic continues. We continue to face a tremendous amount of unknowns, economic uncertainty, and complete disruption of life as we know it. Some are facing severe financial crisis, poor access to food and medicines, personal health crisis, and grief from worry for and loss of loved ones. Anxiety is at a high.

In the face of this, I’m encouraging everyone to take a deep breath. We can only control our own thoughts, emotions, and actions. We are all in this together. We do know that the measures above can help, so focus on the part you can play.

Additionally, this is a good time to work on self-care to stay healthy, manage chronic medical conditions, and help manage the stress:

• Stay informed with reliable sources but LIMIT how much social media and news you watch pertaining to the pandemic.
• Find a way to exercise, preferably on a daily basis. There are a lot of online opportunities for this!
• Eat mindfully. Try to make healthy choices while acknowledging that there may be difficulty obtaining certain foods, and that we may all find some relief in some comfort foods.
• Meditate, practice relaxation, deep breathing. There are a lot of apps and online programs that can assist with this.
• Stay socially connected, virtually. Reach out to family and friends. Utilize facetime, zoom, and other apps to connect face-to-face.
• Sleep: shoot for 7-9 hours. Stay on a schedule.
• Stay hydrated.
• Limit caffeinated beverages, especially if you are feeling anxious.
• Limit alcohol use. Alcohol can further mess with your mood and disrupt your sleep.
• Stimulate your brain. Reading, puzzles, projects, conversations. Join an online forum on a topic that interests you. Find things to stimulate your thinking.
• Be creative. Expressions of creativity can help manage stress as well as are good for the soul.
• Laugh! Find a funny movie, read some jokes – laughter helps lift the mood and relieves stress!
• Give back. Find ways to do things for others. If you know how to sew, make facial coverings for neighbors. As the saying goes, “perform random acts of kindness.” Donate, if you can. Send food or gift certificates to your local hospitals (check to see their preferences). Consider donating blood if you are not in a high-risk group.

The CDC has some recommendations along with a hotline if you are feeling in crisis: CDC Stress and Coping

There are a lot of meditation apps that can be helpful; Ten Percent Happier has done a podcast addressing “How to Handle Coronavirus Anxiety“ – worth taking a listen.

It’s important to take good care of yourself. We’ve done a good job in MA (and New England) in flattening the curve, and curbing the spread. But we are now in the marathon phase . . . so it’s a good time to establish good habits that can help preserve your health and well-being!

COVID-19 In the News

Race for the Vaccine

This topic is frequently in the news with good reason. There is hope that this can get us back to some semblance of normalcy. There is tremendous pressure, and influx of money, to select companies to produce a vaccine. While there has been some hopeful results, we also want to make sure that what is produced is effective outside of small samples of people or in the lab, and not harmful.

We remain hopeful, but meanwhile, we know what measures do work to minimize spread!

Be Wary of Methanol Hand Sanitizer Products

Methanol can cause serious side effects, so please check any hand sanitizer that you purchase for ingredients.

Here’s a listing from the FDA for products to avoid.

Resources With Up-To-Date Information

Please seek out reliable sources of information. There is a lot out there that is not! Doublecheck things before promoting. Ask questions. It is important to be critical consumers of internet and news information!

• MA Dept of Public Health, in coordination w/ CDC
• CDC general information
• CDC Guidance for People at Higher Risk
• STAT

Please be safe and take good care!