COVID-19 Updates

Information for making masks here
Last updated Sunday, 4/5/20

Virtual visits now available.

All non-urgent appointments are being moved to virtual (video) visits, starting Monday, March 23rd. Routine physical exams will be postponed for now. Urgent visits that can be handled via video will be. Only patients who need to be seen in person will have an appointment in clinic, with acutely sick patients scheduled in the afternoon so we can thoroughly disinfect everything before healthy patients are seen there again.

You can still schedule appointments online like you normally would, or by calling me at 971-599-1002.

Instructions for Virtual Visits:

-On your smartphone, download the app 'Signal.' This an app that provides encrypted video calls and does not record or store any of your information.

-At the time of your appointment I will video-call you on Signal.

-If you have any trouble using Signal, and you have access to an iphone, we can also do the appointment using Facetime. I prefer Signal because it is a more secure and private service than Facetime. If you don't have access to an iphone, we can use Skype.

------------------------------------------------------------------------------------------

COVID-19 has the potential to affect thousands of people in our community, but there are measures we can all take to help protect one another and minimize the harm. The situation is rapidly evolving and we will be updating this page regularly.

Remember, though this is new and you may be scared, we do not need to panic. As a community, our goals are threefold:

Protect the Healthcare System

Protect Vulnerable People

Practice Social Distancing

Focusing on these efforts will give our healthcare system time to respond not only to COVID-19 cases, but all of the other ways people can become critically ill. Slowing down the spread of the disease in our community will help ensure that people get the care they need. This is called Flattening The Curve.

STAY HOME, SAVE LIVES.

As we learn more about COVID-19 and the virus that causes it, recommendations will change. One thing that has NOT changed is to STAY HOME AND SAVE LIVES.  Several predictive models project that we will reach the peak surge around May 5, 2020, assuming full social distancing measures are in place through May 2020.  THANK YOU for doing your part in keeping our healthcare system, community, and vulnerable populations safe.

NEW CDC recommendation: Wear a cloth mask when going out in public.

Recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms. In addition to WASHING YOUR HANDS OFTEN, and STAYING HOME/SOCIAL DISTANCING, the CDC now recommends everyone should cover their nose and mouth with a cloth face cover when going out in public.  This is to protect other people in case you are infected, but this is not a substitute for social distancing.

You can find information for how to make your own mask here.

Cloth face coverings should NOT be placed on children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

Everybody:

  • Wash your hands frequently!
  • Limit your movements to essential errands, and try to stay home as much as possible.
  • Stay out of any restaurants or bars, including getting take-out food, and minimize your trips to the grocery store.
  • Wear a mask or cloth covering your nose and mouth when you are out in public or around anyone who is not a household member.
  • Work from home if that is an option for you.
  • Try to do all the normal things we do to keep ourselves healthy, like getting adequate sleep, eating healthily, and exercising regularly.
  • Wash your hands frequently!
  • Oh yeah, and wash your hands!

If we as a community take this seriously, we can drastically reduce the number of people who get sick and die. And if we do this right, it won't look like anything happened. As Dr. Emily Landon says, "A successful shelter in place means that you're going to feel like it was all for nothing. And you'd be right. Because nothing means that nothing happened to your family. And that's what we're going for here."

Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, commented, "I think we should really be overly aggressive and get criticized for overreacting." I hope that we are accused of overreacting a month or two from now. That would mean that the worst case scenarios that have been projected did not come to pass.

If you are sick:

-If you have a cough, low-grade fever (<100 degrees), runny nose, or sore throat, but no difficulty breathing, please stay home and self-quarantine. Get extra rest and fluids, use Tylenol as needed for body aches and guaifenesin for the cough. Limit your contact with others. Stay home until you have been without a fever and cough for 72 hours (without any fever-reducing medication). Call clinic if you have any questions.

-If you have a fever over 100 degrees or you are experiencing shortness of breath or chest pain, please call clinic so we can discuss your symptoms further. Depending on our conversation, I may recommend you stay at home and follow the advice above. I may also want to see you in person to further assess your symptoms. In the case that I want to see you, I will schedule an appointment for you and ask you to call me from the parking lot. We will conduct the majority of the visit over the phone, and then depending on what is needed, I may ask you to come into clinic, in which case I will give you a mask to wear while here.

Testing for COVID-19

As of Sunday, April 5th I still have a very limited supply of COVID-19 tests. At this time tests are reserved for individuals with severe symptoms requiring hospitalization, health care providers with significant symptoms, and a few other specific categories of patients.

In an ideal scenario, we would have plenty of COVID-19 tests, so we know precisely who is infected and can alert their social networks. Testing and notification are major tools in decreasing the spread of a disease. Some countries, like South Korea, procured many tests early on and dispersed them to the population. Our country has lagged far behind other countries in our testing capacity.

-Emergency Departments and Urgent Care clinics are still unable to routinely test individuals for COVID-19. Please do not go to the ER or Urgent Care requesting a test. Salem Hospital ER is not doing any COVID-19 testing as of 3/26/20 due to shortages.

-As the test kits do eventually become more available, the process will still be for you to call me first so I can determine if you need to be tested.

-Salem Health has been intermittently offering outpatient COVID-19 testing at 3 clinic sites as supplies allow. The phone number to see if you meet their criteria for testing is 503-814-0099. Feel free to call clinic first to see if you meet criteria for me to test you.

Changes in Clinic

All non-urgent appointments are being moved to virtual (video) visits, starting Monday, March 23rd. Routine physical exams will be postponed for now. Patients with possible COVID-19 symptoms are only seen in the afternoon to limit possible contact with patients who are not sick.

We have removed non-essential items from the waiting room, like books and magazines, to reduce cross-contamination. We have increased the frequency of disinfecting surfaces in clinic.

We are trying to keep up with the demand for personal protective equipment like masks, face shields, and gowns (and so far are doing okay in this regard, though we expect shortages in the near future).

Additional resources

Here is a 7-minute speech by Dr. Emily Landon, infectious disease specialist in Chicago, at the Illinois governor's press conference. I found her speech to be clear, concise, and effective.

Here is footage from a hospital in one of Italy's hardest-hit cities:

World Health Organization (main page on Coronavirus)

Centers for Disease Control (main page on Coronavirus)

Oregon Health Authority (main page on Coronavirus)

Governor's office (page on Coronavirus)

CDC Environmental Cleaning and Disinfection Recommendations

Nine Charts that Explain Coronavirus