Changing Things for a While to Slow Down Coronavirus and Maybe Keep our Health System Afloat: Post 5
3/21/2020
Today I started to write about our health care system, why it's failing, and what we can do to restructure it. But that's several blog posts and not urgent, and I decided instead to start with what we can do/not do, to prop our health system up for as long as we can.
1. Stay home. Practice social distancing. Don't go shopping. Don't go into restaurants. Don't go into grocery stores or big-box stores. Have your groceries and restaurant orders delivered or loaded into your car. Don't go to a pharmacy - use the pick-up window or delivery (or mail prescription services - also many pharmacies will sell you over the counter cold and other meds through the pick-up window). Stay home.
2. Don't go to the doctor's office unless directed. If you feel sick, first try to access telemedicine. Call your doctor's office and/or check their website and ask if they do telemedicine visits. Look on your insurance company website and your employee benefits website/app and see if there is a telemedicine benefit. There might be one now that wasn't there a few weeks ago. Organize that now, so you aren't searching when you feel ill. If you need medical care and you don't need to call 911 for an emergency, then telemedicine should be your source if at all possible. If you are asked to come in to your doctor's office, request that people working there use personal protective equipment (PPE - masks, gloves, gowns, etc). Don't sit in a waiting room with other people. Check in by phone or text, wait in the car or somewhere away from others until you are called into a room. If you need emergency care, call 911. Don't drive to the ER. You'll wait forever and get exposed to the coronavirus, likely. This allows the health system to allocate emergency care effectively. And, the EMTs/paramedics might be able to provide you with information needed to decide to get telemedicine instead. These are the warning signs of severe COVID-19: trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face.
3. Don't have routine health screenings - no blood pressure checks, routine labs, adult vaccines, screening colonoscopies, Pap smears.
3. If you are well, call your local blood donation center and schedule an appointment to donate blood. We are running out. We need yours.
4. If you feel sick, ask your doctor for information about what to do. If you don't have access to a doctor for this, look up your county health department website or call them, and ask about what to do. Don't go to an urgent care or minute clinic to ask questions. If you do need to go to one of these, call first, just like the doctor's office.
5. What is a fever? Most authorities define a fever as an oral temperature of 100.4 (38 Celcius) or above. If you "normally run a little low on temperature," you still will make enough inflammatory mediators from an infection to have an actual fever of 100.4 or above. It's not true that people with lower normal body temperatures have fever at less than 100.4.
6. What medications can I take at home if I have fever, cough, or shortness of breath? It's ok to take acetaminophen (Tylenol) for fever. Right now there is controversy about whether ibuprofen and aspirin make the coronavirus infection worse. So, if you can avoid them, do so. You can also take cough syrup (dextromethorphan is over the counter; codeine and Tessalon Perles require a prescription). Decongestants and antihistamines are unlikely to help COVID-19, but they will help allergies and regular viral colds. Also, you can try my hot toddy recipes, if you drink alcohol, but don't mix with codeine:
7. Make these phone calls:
-your employee benefits office/insurer to request telemedicine benefits.
-your elected officials to thank those who are making good policies, and to ask them to require all insurers including Medicaid to cover telemedicine visits. Medicare has already put this into place - Medicare will pay for a telemedicine visit or telephone call the same as an office visit, during the pandemic. Also, if your locality isn't closing restaurants, bars, shopping malls, etc, call and ask that that be done asap.
8. Read these websites for information:
-The American Public Health Association
-The Centers for Disease Control and Prevention (CDC)
-Your local (city or county) or state health department.
Right now, I don't see anything on the CDC website I disagree with except that using a bandana or scarf is an adequate mask substitute.
Update on 3/23/2020: CDC has a new bot that is pretty good for helping one decide whether to seek medical care - called Clara (the coronavirus self-checker). However, in addition to the "use bandanas and scarves" nonsense, the business response planning I don't agree with. Their focus is on reducing transmission in the workplace. Instead, CDC should recommend that everything close except health care, infrastructure, and food supply. There's talk that CDC will recommend people going back to work 2 weeks after having COVID-19. We don't know how long people shed virus and are contagious after infection. And up to half of people shedding virus are not symptomatic. I'm extremely disappointed that CDC is not recommending a nation-wide shut-down to only those sectors I listed above. I'm going to keep monitoring CDC for case counts and death rate/death doubling time, but I'm taking my guidance from WHO going forward. Other than Clara the bot. It's pretty good.
9. Don't read or listen to these:
-The White House daily briefings (lots of things said there that aren't true, and many are dangerously wrong)
-Video or audio interviews with "the man/woman on the street."
-Fox stations
-Television stations owned by Sinclair Media
10. Do read or listen to these:
Information from your city, county, or state public health officials
Your doctor
Nurses
More to come on where the weak points are in our health system. Be well. And stay home.
Today I started to write about our health care system, why it's failing, and what we can do to restructure it. But that's several blog posts and not urgent, and I decided instead to start with what we can do/not do, to prop our health system up for as long as we can.
1. Stay home. Practice social distancing. Don't go shopping. Don't go into restaurants. Don't go into grocery stores or big-box stores. Have your groceries and restaurant orders delivered or loaded into your car. Don't go to a pharmacy - use the pick-up window or delivery (or mail prescription services - also many pharmacies will sell you over the counter cold and other meds through the pick-up window). Stay home.
2. Don't go to the doctor's office unless directed. If you feel sick, first try to access telemedicine. Call your doctor's office and/or check their website and ask if they do telemedicine visits. Look on your insurance company website and your employee benefits website/app and see if there is a telemedicine benefit. There might be one now that wasn't there a few weeks ago. Organize that now, so you aren't searching when you feel ill. If you need medical care and you don't need to call 911 for an emergency, then telemedicine should be your source if at all possible. If you are asked to come in to your doctor's office, request that people working there use personal protective equipment (PPE - masks, gloves, gowns, etc). Don't sit in a waiting room with other people. Check in by phone or text, wait in the car or somewhere away from others until you are called into a room. If you need emergency care, call 911. Don't drive to the ER. You'll wait forever and get exposed to the coronavirus, likely. This allows the health system to allocate emergency care effectively. And, the EMTs/paramedics might be able to provide you with information needed to decide to get telemedicine instead. These are the warning signs of severe COVID-19: trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face.
3. Don't have routine health screenings - no blood pressure checks, routine labs, adult vaccines, screening colonoscopies, Pap smears.
*Exception: children should get their vaccines on schedule*
Do get the necessary chronic illness management care - for diabetes, heart disease, hypertension, asthma, emphysema, kidney disease, etc. But try to do it by phone. Send photos of your blood pressure and blood sugar readings, measurements from your iPhone/Apple Watch/Fitbit, and talk with your doctor, encouraging them to handle this remotely.
3. If you are well, call your local blood donation center and schedule an appointment to donate blood. We are running out. We need yours.
4. If you feel sick, ask your doctor for information about what to do. If you don't have access to a doctor for this, look up your county health department website or call them, and ask about what to do. Don't go to an urgent care or minute clinic to ask questions. If you do need to go to one of these, call first, just like the doctor's office.
*These are the symptoms/signs of COVID-19: fever, cough (usually dry), shortness of breath, usually starting 2-14 days after exposure.*
*You may not know when the exposure happened, since people can shed the virus without symptoms, and the virus lives on surfaces.*
5. What is a fever? Most authorities define a fever as an oral temperature of 100.4 (38 Celcius) or above. If you "normally run a little low on temperature," you still will make enough inflammatory mediators from an infection to have an actual fever of 100.4 or above. It's not true that people with lower normal body temperatures have fever at less than 100.4.
6. What medications can I take at home if I have fever, cough, or shortness of breath? It's ok to take acetaminophen (Tylenol) for fever. Right now there is controversy about whether ibuprofen and aspirin make the coronavirus infection worse. So, if you can avoid them, do so. You can also take cough syrup (dextromethorphan is over the counter; codeine and Tessalon Perles require a prescription). Decongestants and antihistamines are unlikely to help COVID-19, but they will help allergies and regular viral colds. Also, you can try my hot toddy recipes, if you drink alcohol, but don't mix with codeine:
Hot Toddy
1 shot whisky or brandy or rum
1 shot lemon juice
1 shot honey
fill a mug up with hot water, enjoy
Texas version
1 shot tequila
1 shot lime juice
1 shot agave nectar
then the hot water thing
7. Make these phone calls:
-your employee benefits office/insurer to request telemedicine benefits.
-your elected officials to thank those who are making good policies, and to ask them to require all insurers including Medicaid to cover telemedicine visits. Medicare has already put this into place - Medicare will pay for a telemedicine visit or telephone call the same as an office visit, during the pandemic. Also, if your locality isn't closing restaurants, bars, shopping malls, etc, call and ask that that be done asap.
8. Read these websites for information:
-The American Public Health Association
-The Centers for Disease Control and Prevention (CDC)
-Your local (city or county) or state health department.
Update on 3/23/2020: CDC has a new bot that is pretty good for helping one decide whether to seek medical care - called Clara (the coronavirus self-checker). However, in addition to the "use bandanas and scarves" nonsense, the business response planning I don't agree with. Their focus is on reducing transmission in the workplace. Instead, CDC should recommend that everything close except health care, infrastructure, and food supply. There's talk that CDC will recommend people going back to work 2 weeks after having COVID-19. We don't know how long people shed virus and are contagious after infection. And up to half of people shedding virus are not symptomatic. I'm extremely disappointed that CDC is not recommending a nation-wide shut-down to only those sectors I listed above. I'm going to keep monitoring CDC for case counts and death rate/death doubling time, but I'm taking my guidance from WHO going forward. Other than Clara the bot. It's pretty good.
9. Don't read or listen to these:
-The White House daily briefings (lots of things said there that aren't true, and many are dangerously wrong)
-Video or audio interviews with "the man/woman on the street."
-Fox stations
-Television stations owned by Sinclair Media
10. Do read or listen to these:
Information from your city, county, or state public health officials
Your doctor
Nurses
More to come on where the weak points are in our health system. Be well. And stay home.
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