Coronavirus update

As the Coronavirus epidemic spreads across the country, patients deserve guidance on how to protect themselves.

Village Health follows and refers to the CDC Guidelines [https://www.cdc.gov/coronavirus/2019-nCoV/index.html] as the most up to date source for information on this serious infectious disease threat.

How can we distinguish between common colds, bronchitis, community-acquired pneumonia and Coronavirus? We start by assessing the risk.

WHO IS AT HIGHEST RISK?

Of course, everyone is at some risk in Michigan right now, but those at highest risk are people who have:

A. Had direct contact with a confirmed or suspected Coronavirus patient (i.e. being a distance of 6 feet or less away from the infected person for a prolonged period (at least several minutes), living with them, or having them cough or sneeze near you while you were not wearing the recommended protection [e.g. a face mask/covering nose and mouth, gown]).

B. Traveled by air anywhere in the last two weeks – but especially to a country or state with a dangerous level of Coronavirus infection (currently this includes anywhere in Europe, New York or Washington state). Surprisingly, Michigan has the 5^th highest number of confirmed cases and things will likely get worse before they get better.

C. Chronic medical conditions that make a COVID-19 infection more dangerous. These include, but may not be limited to, HEART DISEASE, LUNG DISEASE (including ASTHMA and a history of SMOKING), DIABETES, CANCER or IMMUNE DEFICIENCY.

D. Age over 60. Anyone in their 80’s or older are at the highest risk and should remain indoors (see detailed infection control precautions below).

E. Occupational risk such as a job in healthcare involving direct patient contact or first responders in public safety.

NEEDING TESTING VERSUS GETTING TESTED

If you have any of the above risks AND you are having respiratory and/or flu symptoms such as cough, fever, body aches, trouble breathing, chest pain with breathing or coughing, fatigue, or significant GI symptoms – especially persistent diarrhea, significant loss of sense of smell or taste — then you may be a candidate for testing for the Covid-19 Coronavirus.

Unfortunately, testing kits are scarce and the delay in getting results is running up to ONE WEEK. Plus, most of the hospital curbside Coronavirus testing guidelines disqualify even high risk patients unless their illness severity warrants admission to the hospital. So, many who seek testing are currently being turned away. That doesn’t mean they should go on about their lives as per “business as usualâ€. Instead those with symptoms and risks, need to self-quarantine at home for 2 weeks or until cleared by their doctor.

VILLAGE HEALTH REMAINS OPEN 24/7

Originally, Village Health was using the above guidelines to screen for patients and then consulting with epidemiological authorities at the state and local level to determine if the patient should be tested. However, the clinical picture is changing very rapidly. Currently, we are offering the curbside test in limited cases, contingent on risk factors and availability, which is subject to change on a daily or even hourly basis. Call us for a phone consultation at (586) 752-7256. We remain open 24/7.

NOTE: if you are having infectious symptoms, as described above, DO NOT come to Village Health in person, call ahead first. If you are not having infectious symptoms, we are seeing patients in person in the usual manner. You MAY be asked to wear a mask. Village Health staff is REQUIRED to wear mask and gloves will ALL patient contact, regardless of their medical issues. All patient rooms are disinfected after EVERY encounter.

Despite the Coronavirus pandemic, many patients still have routine infection problems. These are common conditions such as Influenza, Bronchitis, Upper Respiratory Viruses like the common cold, Strep Throat or Pneumonia. These conditions have not stopped during the Coronavirus outbreak and they are still more common. Village Health can screen for these diseases with rapid swabs and/or x-rays. However, due to the Coronavirus situation, this testing has to be cleared by phone first.

Note that common cold symptoms like sneezing, runny nose and nasal congestion are NOT suggestive of a Coronavirus infection. However sneezing can spread viral particles of all types so those suffering from the common cold should stay at home and limit exposure to family members! Bedrest is best.

GENERAL PRECAUTIONS

The best thing you can do to protect yourself and your family is to SHELTER IN PLACE and take preventative actions such as washing hands often (for at least 20 seconds of vigorous scrubbing) or using hand sanitizer (thoroughly using a product with at least 70% alcohol content) when soap and water are not available.

Avoid touching your face, nose and eyes! If you do, wash hands immediately. Avoid putting your hands on frequently touched surfaces in public places as much as possible.

Carry a spray or other bottle with soapy water in it and some paper towels. Use them after pumping gas or other dangerous public exposures (some are unavoidable – like grocery shopping). Disposable latex or vinyl gloves are good if available and should be discarded in the trash immediately after use – before they can contaminate other surfaces.

Practice a rigorous routine of cleaning and disinfecting frequently touched surfaces in your home. Avoid travel and areas with large crowds, when possible. Avoid “close talking†and keep at a least a six foot distance in conversations.

In general, this virus attacks the lungs. In order to get to the lungs, it must go through the nose or the mouth (and possibly the eyes). These “gateways†to the lungs must be protected. The threat is primarily from droplets that arise from coughing and sneezing and from virus particles that can live for days on hard surfaces.

CORONA AVOIDANCE TIPS

More tips for living in the age of Coronavirus:

• Have liquid soap or hand sanitizers just inside each door to your house and inside your car. Use it as soon as you enter.
• Use hand sanitizers with at least 70% alcohol concentration.
• To disinfect surfaces, a dilute bleach solution (5 tablespoons of bleach in one gallon of water or 4 tablespoons in one quart of water) is recommended by the Centers for Disease Control. Note that most EPA-approved cleaners will suffice but may be more costly.
• Avoid handshaking, in favor of a friendly nod or wave or try a fist or elbow “bump†(a “virtual†fist bump is even better!)
• Use more intense precautions (such as avoiding most public places) in the event you are elderly or have serious medical problems such as heart disease, uncontrolled hypertension, Diabetes, emphysema or an immune deficiency. The same applies if you have a family member in one of the above categories living with you. Smoking appears to significantly increase one’s risk.
• Most of all, avoid panicking and all the negative health consequences that come with intense anxiety. Eat healthy foods and drink plenty of fluids. Get adequate sleep. Exercise daily. Avoid cigarettes and excessive alcohol intake. In other words, continue living a healthy lifestyle.

Remember, the chance of contracting Coronavirus illness is still low and the chance of becoming seriously ill or dying from the virus are even lower.