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At this point, the public testing sites are testing anyone who wants to be tested. However, I would caution against this slightly, for two reasons:

1. When you are asymptomatic, you may test negative, but actually be too early in the infection to test positive. This may give a false sense of confidence, and you may spread the infection to others in that time.
2. In some of these public sites, you are walked through a self swab. The swabbing process is particularly important and affects the accuracy of the test. Again, getting a negative test when you actually have the virus can be dangerous.

I think we should be testing as many people as possible, but I also think our results should be as accurate as possible if we’re going to really be able to contain the spread.

So with my patients, I test if they have a constellation of symptoms that sound like COVID-19, OR if they have even one symptom with a known contact. I do tend to wait for symptoms because it makes it less likely the test will be negative when they actually have the virus. I always recommend that if they’ve been in high risk contact with someone with the virus that they behave as if they have the virus for 2 weeks (meaning self quarantine) regardless of symptoms. Ultimately, this should be a conversation between you and your doctor.

*****UPDATE*****

Things have changed significantly, but I have left the above, because there is important rationale there. Now, there are populations that it is important to test as often as possible as we re-assimilate into normal life. This will help us assure less asymptomatic spread, and help contain the virus. There are many caveats when considering when to test–for instance, if you are about to go visit loved ones and want to ensure you aren’t carrying asymptomatic infection, it may be a good time to be tested. I maintain that a conversation with your primary care doctor or an infectious disease specialist is the best way to go to decide when to get tested–it’s can get pretty complicated.

Unequivocally yes!!

It should have been done sooner, and the numbers show that we have absolutely saved lives by doing so. It’s also realistic that we won’t be able to live this way forever—the mental health implications alone are difficult to ignore. However, there should be no “getting back to normal.” This is not a situation you can slap a bandaid on and pretend didn’t happen. There will have to be significant changes to the way we operate as we try to reopen things and maintain some social distancing until we have the situation fully under control. If we don’t, we will absolutely see a much worse second spike.

• Hand washing, clean surfaces, and social distancing!
  • These are the single most important tools you have at protecting yourself and preventing the spread of this virus.
  • remember, 30 seconds of hand washing or sanitize your hands with alcohol based sanitizer, before and after eating, any time you’ve entered your home from outside, after touching any packages from outside, after interacting with others at work (if you are still working), after touching items in a wallet or purse, etc.
  • Wipe down surfaces that are touched frequently on a regular basis: door handles, steering wheel, refrigerator door, computer, cell phone, etc.
  • Remove shoes (leave them outside or in a mudroom), change, and shower when you get home.
  • Continue to remain distant, even as our business begin to open. THIS IS IMPORTANT. We have seen the curve flatten, but we are far from out of the woods, and we will absolutely see a worse second spike if we do not do this. Do not go back to hugging, kissing, shaking hands, sitting in groups. I’ll include an image (that isn’t mine, but I’m not sure of it’s origin) to help drive this point home:

• Masks:
  • what we have seen is that wearing masks in public does seem to prevent the spread of illness.
  • It is imperative that you wear them correctly, and DO NOT TOUCH THEM while you are out and about.
  • You should also know how to appropriately take it off so that you don’t accidentally infect yourself while taking it off: wash or sanitize your hands, remove it from the point furthest from your face (from the ear loop or from behind your head, not grabbing the portion covering your mouth), and then dispose of it or immediately prepare it for sanitizing (if reusable or cloth) and wash your hands. Removing protective equipment is one of the times you are most likely to infect yourself, and part of the reason it wasn’t initially advised for the general public.
• NOT GLOVES:
  • Most people do not know how not to cause cross contamination when wearing gloves.
  • Have you ever noticed how many times you see your doctor change gloves if they are performing a long procedure? Or do you notice that they don’t glove until they intend to touch the things they want to touch while clean and then immediately re-glove if they have touched something outside of that field? That’s because there is nothing about gloves that makes them inherently germ free.
  • Gloves are only clean as long as they haven’t touched a dirty surface. The minute they’ve touched a dirty surface, they are the dirty surface, and they are spreading germs, just like dirty hands.
  • Don’t wear gloves, and wash your hands frequently. You are less likely to feel a false sense of security, more likely to do what is correct and prevent the spread of illness.
  • *don’t forget to click the hyperlink*
• Healthy diet
  • A healthy diet is essential to a healthy immune system. Supplements are wonderful, but our body REALLY likes to see things naturally, from foods. That’s how we were meant to get our nutrients. Not from pills. So it’s best to eat a diet that is rich in plants and varied in color to ensure you’re getting the vitamins, minerals and antioxidants your body is craving.
• Exercise
  • If you know me at all, you know I say EXERCISE FOR EVERYTHING!! From diabetes and hypertension to weight management to anxiety and depression to dementia…exercise can be my non-pharmacologic prescription for all of it. And guess what–there’s some evidence it can help boost your immune system and help protect against deadly complications in COVID-19 infection. So you know I had to include it in the list, right?!. Click the hyperlink on the main bullet for the main article and click here for my previous post on staying healthy during the pandemic.
• Vitamin c? Zinc? Other supplements?
  • In the medical community, you’re seeing mixed feelings about using these things to try to help prevent and treat the viral illness. You guys know how I feel about them from previous posts. I also discussed elderberry, specifically in COVID-19 here.

What we now know about COVID-19 is that it has many different faces, much like the other illnesses caused by coronaviruses. This is why it is extremely important to stay home if you feel ill at all, and to move around as if you have the illness regardless. We have tested people who seemed relatively asymptomatic (meaning without symptoms) and found them to be positive. However symptoms include:

• Headache
• Fever
• Cough
• Sore throat
• Chills/Rigors
• Muscle Aches
• Shortness of breath
• Fatigue
• Nausea
• Vomiting
• Diarrhea
• Loss of smell or change in smell
• Loss of taste or change in taste

It is a new Coronavirus that is believed to have originated in a bat in Wuhan, China. It causes the illness COVID-19. It has mutated at least 2 times (honestly, evidence shows many, many more) and is now causing a pandemic. It is believed to have a mortality of between 1-3%, but this could be lower, because we aren’t testing enough mild cases. Either way, it is causing lots and lots of people to die and will cause people to die unnecessarily if we don’t do our parts to continue to slow the spread.

Covid-19 is the illness caused by Sars-CoV-2, as discussed above.

Video explaining Infection

Kid-Friendly Video

I’m going to risk something by telling you this, this COVID-19 thing…it’s getting to me. Some of it may be the typical stuff…but, this experience for me is so deep. My heading on my website…wife/mom/physician/woman. This virus makes me vulnerable in every aspect. It has shaken every piece. So I realized, I’m going to take a risk, like I did with starting the blog in the first place, and write it out. (Scroll through the pictures below for each point of view.)

PHYSICIAN

WIFE/MOM

WOMAN

Soulful Sunday 4/5/2020

I am so happy for everyone else that they are finding this quarantine time a time to slow down and be more productive. Focus on themselves. Focus on their goals. Whatever. Yep, you heard it. While I’m happy, I’m also, a little…irritated..that it hasn’t worked out that way for me.

Yeah, I know. I signed up for this. It also doesn’t make it easy to see everyone posting about lounging in pajamas, having no where to go, getting fat on snacks, being bored, while I’m literally more tired than I’ve been in a while trying to give my children more time because they have more time while mommy has less time, because now she has to clean, make sure they have 3 meals instead of 1, learn constantly about a brand new illness, attend (virtually) no less than 3-4 meetings weekly about said illness, while continuing my previous workload.

So while y’all are complaining—I kinda want y’all to—stop. Practice some gratitude 😘. Because I would do something strange for a week—or 4—in pajama pants unable to leave my house. If I could be bored just once (I actually don’t think I’ve ever been bored left to my own devices). I’m an introvert, y’all. That sounds positively glorious!! (Minus the kids of course…but even with them, we could make this thang work😂). But I’m trying to check myself…I am. I signed up for this. I did this to myself. And…gratitude, right.

So, I’m grateful to be employed. There are so many who have lost their jobs and are struggling. I don’t get to be upset when I can support my family. I have responsibilities at home because I am not quarantined alone, and don’t have to worry about getting lonely. I am able to feed my children. I am able to help others rather than being completely helpless during this time. I am cleaning this beautiful house I for which I prayed so long. And I said I don’t get to be upset. That’s wrong. I get to have feelings. I don’t get to wallow in them. Because I have a lot to be grateful for.

Wife/Mom

So as I’ve said, the numbers aren’t surprising to me. And because I understand that most people do well with this illness, I’m not overly concerned about my family catching the illness. I’m concerned about me catching the illness, not doing well due to my asthma, or because I’ve been called to work in the hospital and overly exposed to the virus, and leaving them. I’m concerned that I’ll expose them and then they’ll expose more vulnerable extended family…so I’ve been pretty strict about in-laws and no visitation—which is hard.

This is the first Easter in his entire life, that my 7 year-old won’t see his 8 year-old cousin. It’s become something of a tradition…now there are 4 of them…well 5, counting my sister-cousin and her son who would really be offended if he weren’t counted. His grandmother here wants to come hide eggs, and he doesn’t understand why he can’t at least give her a hug—I still go into work everyday, and there’s no way they can socially isolate from me, so they don’t need to expose their 70 year old grandmother—just in case. Do you know how I would feel?! But that’s also hard, telling my loving, touch as love language, 7 year-old he can’t touch.

And we haven’t even talked about the fact that there are no cleaning ladies, babysitters, date nights…guys. I’m tired. My husband is tired. These people talking about all this extra time they have…God bless them. Can they use all that extra energy to keep my kids for me when this is all over? My husband and I need a vacation to sleep. And then to have some fun. And then to sleep again. Yes? Thank you!

Gratitude? I’m so thankful that my babies are being able to slow down. They normally have to wake up at 6:30 and are gone until 7pm most nights. It’s quite the schedule. I’m so grateful for this slower pace for them, to be…kids. There’s a lot more screen time…I’m trying to be okay with it. It’s beautiful, actually.

I’m a physician. But I’m also a math brain who really gets the numbers. For instance, at the risk of alienating you, I’ll divulge that I was the kid in high school calculus who didn’t pay attention but still managed to make 103—as an average. I majored in psychology so I had to take a stupid number of statistics courses, and for my honors thesis, because I was too cheap to purchase the software, I did my ANOVA calculations by hand (to be fair, I had a small sample size). I’m that kid. So I visualize most of this stuff in my head as these guys talk. It just makes sense to me. At first when I was posting that we should be more worried about influenza…guys, I really thought our freaking government would get control of this thing before we had to worry about it. Like they did with Ebola, swine flu, and all the things before. I gave this administration too much credit. So once it was obvious they were completely irresponsible, none of this, I repeat, NONE OF THESE NUMBERS, have surprised me.

What has surprised me is watching my colleagues be told that they can’t use PPE by people who never took an oath to heal, serve, and protect patients. I’ve been surprised to watch entities that are supposed to protect us do so little to ensure our safety. I’ve been truly saddened to see how little value physicians’ lives hold, how some hospitals are falling right in line with devaluing their lives, and families are losing their fathers, mothers, and children. Resident physicians—physicians who never got to see the rewards to all their hard work—are dead because our leaders chose not to protect them, and agencies chose to weaken the requirements for PPE to things that have been shown to be inferior rather than push back and insist that the health care workers at the front lines be protected. And physicians—physicians are being asked to do this for FREE in some instances. And many are choosing to. Because we took an oath. After YEARS of people believing we are the reason that their bills are higher, not taking our directives, blaming us for everything from autism to cancer to make a quick buck, my colleagues are going and dying FOR FREE to save a life! Think on that.

I’m heartbroken. I’m disgusted. I’m scared at times. I feel extremely vulnerable. I love my profession. All I’ve ever wanted to do in my entire life is help people in this way. I would never watch someone in distress and not help them simply because I didn’t have protective equipment. I couldn’t. I’m also not sure I want to endanger my family, and/or leave them sacrificially, though. Someone mentioned a physician draft…I don’t know how plausible that really is. But what if I didn’t have a choice? I forget often, but I have asthma.

I like to end in gratitude, because that’s what keeps me grounded. I am so grateful to work for the employer I do! They have done an amazing job in all this. No one is perfect, but they have done everything they can to keep their front line workers and patients safe. They have been remarkably transparent. They have been leaders in the community. I don’t give kudos lightly, but they’ve earned it. I’m also grateful to be able to serve my patients, my friends, my church family with my knowledge during this uncertain time. I’m grateful that things that seem scary to others aren’t as scary to me, and that my knowledge has equipped me to be prepared throughout this entire process. I’m grateful for all the people who are expressing their gratitude for the sacrifice of those in the front line! They are such a light!!! I’m thankful for those who are praying for us. And I’m thankful for those who have read this without judgment.