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Episode 13 Transcript

A Coronavirus / COVID-19 Pandemic Update

Erin Everett:

Hey everybody. Welcome back to Exclusively Inclusive. I’m your host, Erin Everett, nurse practitioner. Wow. Things have changed so much in the United States and across the world. Just even in the last two weeks. Obviously we’re talking about the current pandemic COVID-19, Coronavirus. This is a new virus, we’re still learning more and more about it every single day. And I know a lot of you have questions about the virus, whether it pertains to the actual virus itself or your own healthcare concerns or how it’s impacting you financially and economically. So today’s episode I want to talk to you guys a little bit about where to find good quality information on Coronavirus or COVID-19, and also the things that we’re doing at our practice to ensure our patient safety and make sure that you’re getting access to the good quality care that you need. You don’t have to wait until the pandemic is over to address your health concerns that are COVID unrelated or not.

Just because the pandemic is here, it doesn’t mean that your anxiety, depression, diabetes, or high blood pressure just magically vanishes. We understand the need to be able to access us as your provider and continue to have good quality healthcare. So today we’re going to be talking about all of that. And of course, if anybody has any specific questions about the things that I’m discussing today, please feel free to email me at erin@exclusivelyinclusivepodcast.com, that’s erin@exclusivelyinclusivepodcast.com. Okay, well let’s get started. The first thing I want to talk about is the Coronavirus, and where you can get good quality information. Depending what news source you’re looking at, you’re definitely going to get mixed information. And that’s part of the problem right now, is that you have different news platforms citing one thing and then you might turn on Fox News and they’re saying something completely different and also potentially minimizing the concern surrounding it.

So it’s very important that our patients take this very seriously. Coronavirus or COVID-19 is a very serious viral infection. And previously we thought it really only impacted people aged 60 and older or immunosuppressed or immunocompromised patients more seriously. But we’re finding that it doesn’t really matter how old you are, you can still be at risk of having a severe Coronavirus infection. Just like the flu, some people will experience those symptoms differently. So you’re definitely going to have cases where Coronavirus or COVID-19 might be impacting someone on a more mild to moderate basis. And you can not let that influence your decision to not socially isolate, because there’s still going to be an overwhelming amount of people that experience a moderate to severe case of COVID-19 that will require them to go to the hospital and seek treatment. The issue there is if everybody gets sick at the same time, the hospital cannot care for you. So that doesn’t just mean those of you who are experiencing symptoms of Coronavirus or COVID-19, it also means individuals who maybe couldn’t get to dialysis and now they have fluid volume of load.

They’re not going to have a bed for you. They’re not going to have a bed for people who are having an exacerbation in the chronic heart failure. You might have a different type of infection. You might have a serious skin infection or abscess. Well, if the hospitals are overwhelmed with people taking for patients who are experiencing COVID-19 they also won’t be able to take care of you for your regular chronic medical issues. So this is a big deal. So you’re going to see increased number of deaths related to COVID-19 but also other comorbidities because if the hospitals get overwhelmed they won’t be able to give you the level of care that they previously were able to do. So it’s so important that people are socially distancing. And no, that doesn’t include you going and sitting in your driveway with your neighbors at distance apart so that you can still talk and hang out.

I’ve been seeing a lot of that on social media and what concerns me about that is that you don’t really know if they have the virus and have had a recent coughing fit and it’s in the air, you don’t know and you’re just increasing your risk. We do know that in general Coronavirus or COVID-19 is transmitted through contact droplet. What does that mean? Well, contact droplet means that you can get it from touching a surface and then touching your face. Or you can get it from a droplet. So if somebody sneezes or coughs, it can land on you. It can enter your own respiratory airways. It can land on your face. A lot of infections enter people through their eye. They don’t think about that. But touching your eyes and having those areas exposed is another way to contract the virus.

There’s also research and some publications to support that after the virus has been aerosolized, meaning if somebody has had a nebulizer treatment or some sort of thing that helps the virus circulate in the air, the droplets can linger in the air for three hours. I don’t think that’s going to be limited to the hospital. Again, we’re not entirely sure, but we don’t want to figure out that out the hard way either. So just take extreme precaution. We do acknowledge that it can be a lonely time. Social distancing can be really lonely, but of course it’s extremely necessary. So there are other creative ways to keeping in contact with your loved ones. If you think that you have symptoms of COVID virus, it is really important that you don’t just show up at your healthcare provider, that you’re actually calling ahead of time and you’re immediately quarantining.

Social distancing is very different to quarantining. With social distancing, you’re really only leaving the house if you absolutely need something. You can sit on your back deck away from everybody else as long as it has enough space in between people. You can walk your dog around the block. As long as you’re keeping that six feet recommendation and not having any contact with people. That’s what social distancing is. You might have to go to the grocery store, you might have to go to the gas station, the pharmacy, opt to go through the drive through at the pharmacy because it’s less exposure to people and you’re only then interacting with the person taking those measures. But if you become symptomatic or you find out that you’ve been exposed to Coronavirus and even though you don’t have symptoms, you need to move into what we call quarantining.

If you’re under a quarantine, you are not leaving your house to go get groceries, you are not going to pick up medications, you’re not doing any of those things. You need to assign or have somebody else that can do that for you. And there’s also a lot of delivering services. A lot of pharmacies have increased the amount of deliveries that they’re doing. Depending on what area you’re in, I’m sure there’s a local pharmacy that has a delivery service where they can come and bring your medications and drop them at your front door, and once they’ve left you can get the medications and bring them in your home. So, part of the panic around people going out to the stores and buying all this stuff was because social distancing and quarantining, I feel like we’re getting very confused. And there was also a lot of uncertainty about what was happening.

A lot of misinformation and not a lot of guidance from administration, so I understand that, but we don’t anticipate there to be any food service shortages. We don’t anticipate that type of thing. So it is a good idea to have some extra supplies on hand should your social distancing turn into a quarantining effort, so that you don’t have to worry too much. And that can be in the form of just like some canned soups, those types of things. Just enough to get you by should you have to actually stay in your home for two weeks. You don’t need enough to stay in your home for six weeks. If we get to the point where we’re having a forced quarantine, there are going to be other services that we’ll be able to deliver groceries and things like that, but we’re not there yet.

If we continue to social distance, hopefully we won’t have to have a forced shutdown or quarantine. But again, the numbers are changing every day and recommendations are changing every day. Over the next couple of weeks you should expect to see an increase in the number of cases. We recently, even at our clinic had the ability to test patients. So, of course the numbers are going to increase. These cases were already there, so now expect of the next two to three weeks a spike in cases. But if we’re doing everything right after that, we should see a decrease in the amount of diagnosed cases. And if we don’t see the curve go down, that’s when we’re probably going to be anticipating more strict guidelines from the government on what we can do and when we can leave our house and those types of things.

Obviously there’s already a lot of news coverage on Coronavirus and how it’s spread and symptoms, so I’m not going to go over it too heavily but of course, if you have a fever, a cough, you feel unwell, you feel fatigued, body aches, pains, it’s worth a phone call to your provider to figure out if you need to be screened for COVID or go onto a quarantine.

Also several counties across Georgia, at least I can’t speak for other States, but I’m sure it’s also true, have set up hotlines that you can call. And as testing centers and their access increases, they’ll be screening you to determine if you need a test and where to go to get your test. So that will be helpful too. I highly recommend that people try to stick to evidence-based resources such as the CDC. So cdc.gov has their own website for Coronavirus at cdc.gov/coronavirus/2019. And that’s because the outbreak started in 2019 even though we’re in 2020. So you can go there and find all the latest information. It actually is really nice too because if you run out of hand sanitizer, pretty much everybody has a bottle of bleach laying around their house. It will give you the instructions on how to dilute your household bleach to the appropriate strength so you can be cleaning surfaces should somebody in your home get sick. You should be doing this anyways just to stop the spread of other viruses and infections, but it has some really good tips there.

It also has a video demonstrating the appropriate way to wash your hands. I think us healthcare providers and healthcare workers forget that we were trained at one point to wash our hands properly when we first entered school. And in general, the general public does not wash their hands properly for the right amount of time and they don’t wash in between their fingers and underneath their nails, and that type of thing. So there’s a really nice video on there teaching you how to wash your hands properly. It sounds simple, but we’re finding that keeping surfaces clean and washing your hands and not touching your face seems to be really decreasing the amount of infection and the transmission.

So those are the main things that we’re pushing. Also, one other really good resource when you’re done listening to my podcast would be to listen to Dr Sanjay Gupta’s podcast. He has one called Coronavirus Fact Versus Fiction. And he’s constantly posting episodes and I’m looking and they are not very long. So you have some that are seven minutes, six minutes, 10 minutes. So they’re just little brief updates because he wants to be the myth-buster for Coronavirus just like I’m the myth-buster for all things LGBTQ related, he’s the myth-buster for Coronavirus. And so as you know, different myths are posted or there’s uncertainty with information, he is clearing all that up and posting an episode. So definitely keep that one in your library because I think that is going to help stop hysteria. We don’t need to be panicking, we don’t need to be hysterical, we just need to be smart and cautious so that we can live through the next several weeks and months, because of course everything has changed so rapidly.

So as I mentioned before, life has changed a lot, and a lot of people are scared and nervous and they don’t know what life’s going to look like even a week from now. Maybe some of you are sitting at home wondering how you’re going to make secure income. I really feel for you and at our clinic we want to be able to be there for you. So how do all these changes impact our practice? Well, basically at our clinic we’re really trying to keep patients safe. We’re asking that if people are sick, they don’t come in for an appointment, they call the office first. And we have quickly, very quickly Dr. Smitty and I were able to implement telemedicine. And so what does that mean for you? It means that we can still have a visit, but you don’t have to come into the office.

So, we’re asking our patients if you’re sick and you don’t feel good to give us a call before you show up to your appointment because maybe you had that followup scheduled and you weren’t sick when you scheduled it and you’re thinking, “Oh, I’ll just talk to her about it when I get in there.” No, if you have symptoms, even if you think it’s just allergies and you haven’t had a fever, unfortunately, fortunately, whatever you want to call it. Not everybody with Coronavirus has a fever. We’re finding that some people can actually go with just slight elevations in their temperature. Again, that’s as of me just recording this. So the facts and the situations are going to change because we are testing more people and we’re getting more data. So we’re being overly cautious by telling patients, call the front desk and schedule a telemedicine visit.

And that’s just not even if you’re sick, perhaps you’re at home and you don’t want to come into the office because your social distancing, which is great, give us a call. You don’t have to cancel your appointment, you can just change it to a telemedicine visit. The software is really great, the front desk will walk you through it through your call. We still have to bill insurance so we have to collect copays and whatnot. So you’re able to do that over the phone and then the front desk will give you a timeframe of how I’m available. Because sometimes we experience a little bit of technical difficulty so it’s not going to be like, “Okay, your visit is right at 9:00 AM.” We’re going to give you a window of time to be available for the visit, especially if you’re at home socially distancing or not working or working from home.

It’s also the patients have been able to be more flexible with us as well. So that’s worked out. But sometimes if the internet is slow because there’s a lot of people using it now. It might take a few attempts for me to text you. So we will verify your updated information, we’ll verify that this is the appropriate phone number. And so you’ll get a text message and you’ll click the link, it lets you join the virtual waiting room. And it will ask you to allow access to your phone’s microphone and camera. And that way I can see and hear you through the visit. If you don’t have a smart phone or you don’t want to use your smart phone, we’re also able to email you a link. So if you’d rather sign in and use the webcam on your computer, we can email you the link.

So you just need to let the front desk know when you call and make the appointment what your preferred method is, because some people prefer to do the visit on their computers. So once that’s there and I’m ready, I’ll just call you and then we’ll have a virtual visit, which actually has worked out really well because the video quality is really clear. Obviously I can’t listen to your lung sounds. I don’t think anyone thought that I could, but so obviously we can’t do that, but I can actually do a fairly decent assessment through the video if you’re having respiratory distress, or I can ask you to take a deep breath because sometimes you can hear people wheezing when they do that. There’s different techniques and things that we can do to assess you and make sure are getting a good quality visit. It’s definitely not subpar.

And of course it’s not the same as if I was able to like actually listen to your heart and lungs with my stethoscope. But those are luxuries sometimes and we’re able to really do a pretty decent thorough assessment depending on what’s going on just by looking at you and listening to you and asking you to do different things. If you have a thermometer at home, I would have that prepared for your visit. I have been asking my patients what their latest weight is. So if you have a scale, weigh yourself, we’ll check your temperature. For those of you who have blood pressure monitoring cuffs at home, I’ll be asking you to take your blood pressure and then it’s just like you’re at the office. I can keep an eye on your blood pressure, I can make sure you don’t have a fever and checking on your weight.

And those are really the basic vital signs that we take anyways when a patient is in the office. And so we’ll do that and then we’ll talk about what you have going on. If it’s not a sick visit, we’ll just talk about your regular routine stuff anyways. We’re able to do medication refills through telemedicine. So, don’t feel like you’re going to run out of medications if you don’t come into the office, we can do a telemedicine visit and we can talk to you about whether it’s your HIV, whether we’re doing a prep follow up, ADD follow up, depression, anxiety, those types of things. We can talk about all of that. Now, if you’re wanting to establish care, traditionally telemedicine visits were reserved for established patients and you can in certain situations do it for new patients. And on March 18th, the Georgia Medical Board pretty much allowed us a lot more flexibility and range with these telemedicine visits.

So at least for the next 90 days we’re going to be able to do new patient appointments through telemedicine. We’re still trying to work out the kinks, we’re going to be learning together. And so our office will help go through all that and make sure your insurance is up to date, and that we can get everything organized like that. And now we’re probably not going to be encouraging people to schedule new person well visits because that’s a pretty detailed head to toe assessment. But if you have a health concern and you want to establish care because you have uncontrolled depression, anxiety or ADD or you want to talk about STDs and all that kinds of stuff, we can take care of all of that. And so we can do new patient appointments that way.

The other thing is for people who are listening are thinking that, “Oh, but I don’t have insurance.” We still offer the same self pay rates for the telemedicine visits. So you don’t have to worry about not having access to care. It’s a strange and uncertain time and we might have to change the rules a little bit or how we’re doing it. So, we’ll let you know if something’s changed when you call to make the appointment. But as of right now we’re able to do this and we’re trying to work it out so that our patients aren’t worried about their med refills, and they’re worried about they can’t talk to me about what’s going on. It was really creative. We’ve actually had patients with wounds and stuff, and we can take a look at that through the webcam. There was no problem, that’s actually really easy to do. And I’ve been able to coach people on how to measure it and draw the borders around it.

So it’s actually kind of fun and it’s a good way to check in and make sure that you’re still taking care of yourself because we all need to be practicing self care during this very stressful time. Stress and anxiety just makes your susceptibility to other illnesses a lot higher because when we’re tired and worn down and we’re not taking care of ourselves, our immune system will take a hit. So it’s really important that we don’t panic, that we’re just again cautious and making sure that you’re keeping in touch with us. If you’re listening and your provider does not offer telemedicine and you’re thinking, well, how am I supposed to get my hormones? How am I supposed to get my anxiety medication? I don’t understand. There are some offices that are refilling for their patients for the next 90 days. But if you’re experiencing a shortage in that or you’re not able to get in touch with your provider, give us a call on establish care, we’re able to take care of you and address most of your needs.

There’s going to be things that we’re going to have to say, “Okay, well, let’s take care of that after things have settled down.” But for anything more immediate that we can manage to telemedicine, we’re definitely doing it and we’re having a lot of fun with it. So, just a quick summary. Coronavirus, COVID-19 is nothing to play with. It’s definitely serious, but nothing worth panicking over. I gave you the CDC resource and Dr. Sanjay Gupta’s podcast to listen to. And then of course any medical concerns you’re having, please give me a call. We can take care of it. We’re sanitizing the office constantly. We’re limiting the amount of patients in there that do actually have to come in for a face to face visit. We’re limiting that, we’re sanitizing all of our equipment in between visits. So we’re taking care of our patients, we’re taking really good care of our patients.

And we are able to get protective equipment and offer COVID testing to those that really need it. We might be expanding that, but again, it’s a moving target. So I’m not making any promises or commitments to testing at this point because we’re just trying to do the best we can for those that really need it. But yeah, if you need us, we’re here. Give us a call, we’ll have a visit. Please don’t stress out too much. And if you find yourself really not doing well with this social distancing, call me. Call your friends, FaceTime, get on these virtual things. There’s a lot of platforms that allow you to have multiple users at once. It’s not ideal, but it’s better than nothing. And for right now it’s what we have in order to keep ourselves safe, healthy, and sane. So, utilize some of those things and then give me a call if you need me.

Upcoming in our future podcasts, just because we’re not leaving the house and hanging out with a bunch of people doesn’t mean that I’m not producing podcasts. So, the next few things that you have to look forward to actually is Dr. Sally Huber, an amazing urogynecologist. I did interview her, we’ve got it ready to launch, so she’s going to be coming up. Take a listen, we’re going to be talking about so many different fun things as it pertains to everything below the belt with LGBTQ care, and also talking about, after that we’ll be posting another episode about HIV. I get a lot of questions about HIV signs, symptoms, how you contract it, how you can avoid it, what does it mean for you living with HIV and the medications and things like that. So I did record a podcast with information about that.

So please continue to listen and subscribe because every time you subscribe and give me a review, I’m actually able to access more listeners, which is the point of the podcast. Like Sanjay Gupta, he’s a fact and fiction myth-buster for Coronavirus, and I’m your myth-buster for everything all LGBTQ care related hormones, HIV, you name it. So keep listening and remember everybody, stay fierce and live your truth. And call me if you need me, okay.