Santa Barbara Doctors ExtraCare – June 2020 Newsletter
June 2020 ExtraCare Newsletter
Summer is here and our community is starting to reopen. We too are beginning to see patients in the office with a protocol spearheaded and outlined by Dr. Viglione below. As we start to emerge from our homes I’m taking this opportunity to remind you to wear your mask. Remember, this pandemic is far from over and your health and safety remain our number one priority.
Opening Celebration!
The last few months have been extremely trying on the community of Santa Barbara, and we THANK YOU for bearing with us while we try to optimize your care. Virtual visits have been an extremely effective bridge to normalcy, but we’re excited to be slowly and incrementally re-opening the offices. Safety is our #1 priority and we’ve been working hard designing a protocol, guided by CDC updates and recommendations, to maintain sterility in the office setting. Below are 5 important ways we plan to achieve this:
- Appointment Triage: Those MOST in need of a physical exam or bloodwork, and those at highest health risk, will be prioritized for safety. If an issue can be resolved with a virtual appointment we’ll recommend to do so to minimize overall traffic into the facility.
- Zero waiting or congregation: We’re spacing out appointments to allow for zero overlap among patients. This is a win-win because we know that being HOME is your safest location. This will minimize aerosol transmission when implemented in conjunction with stringent disinfection protocols.
- Disinfection: The entire office is currently being cleaned with bleach based products 3x daily in addition to before and after each patient interaction. NO 2 patients will have direct interaction because of extended visit times and purposely spaced out time slots. Separating potential exposures in TIME and SPACE will provide better protection.
- Strict temperature monitoring:As the most sensitive marker for Covid, the first measurement obtained will be your temperature. If it’s over 100.4 then we’ll ask for a Covid PCR test prior to an office visit to minimize any potential risk of transmission.
- Personal Protective Equipment: We ask that everyone who enters the office wear a face mask or covering to prevent droplet spread. Doctors and Nurses will be wearing N95 respirator masks with face shields throughout the encounter and maintain adequate social distancing as much as possible.
We’ve been having tremendous success so far and will be opening up more in-house appointment slots as safety and efficacy continues to be demonstrated. We’re beyond excited to open up the community and remain confident that slow steps, with constant re-evaluation, will get us there sooner. Thank you for your amazing resolve throughout these challenging times!
The Science Behind Masks
As our stay at home orders are being lifted and more businesses are starting to open, we are beginning to see our predicted uptick in COVID-19 case numbers in Santa Barbara County. While it is exciting to finally be able to sit outside at a restaurant in town, I want to caution you that now, more than ever, it is imperative that you take precautionary measures to reduce your risk of being exposed to the virus.
Every day we are learning more about this pesky bug and as our understanding improves, so does our ability to guide you in mitigation strategies. What I see emerging as one of the most important ways to protect yourself is to wear a mask. Politics and personal preference aside, the science speaks for itself, and once you finish reading this article, I hope that I will have convinced you to put it on.
The CDC estimates that about a third of coronavirus infections are asymptomatic. A study out of China, recently published in JAMA, suggests that asymptomatic patients are more likely to be women, and more likely to be younger, in their 20s, 30s and early 40s. Furthermore, the researchers found the asymptomatic individuals shed the virus for about eight days, compared with 19 days among those who did have symptoms.
Think about this. If this is true, then any person who you interact with could potentially be infected and contagious. It is for this reason, that we practice universal precautions in the office and I suggest that you should do so in public as well.
Thanks to good old shoe leather epidemiology we have been able to learn a lot about how this virus is spread. We once believed that the main source of transmission was from touching infected surfaces. We now know that’s probably not true. We learn by studying outbreaks, including the infamous Washington choir practice in which one pre-symptomatic individual infected 45 of 60 choir members, and the restaurant outbreak in which only patrons sitting at the table of the infected individual and downwind of the ventilation system became ill. And let’s not forget about the early cruise ship outbreaks where the only explanation for the large number of people becoming infected could be through the ventilation system. These outbreaks have taught us that the primary source of transmission of COVID-19 occurs through inhalation of respiratory droplets, hence the importance of the mask.
I apologize for the fuzzy image above but I wanted to include it in this article to bring home a point. Which is that even a homemade mask protects you from germs far better than no mask at all.
So now that I have convinced you to wear a mask, the next question is what type of mask should you use? No question that surgical masks filter somewhat better than homemade cloth masks but cloth masks, made of the appropriate material and fitted correctly, are actually quite good. It makes sense, but cloth masks made from fabric with tighter weaves (such as a high quality t-shirt material) probably work better than scarves or bandanas but truthfully, any covering is better than none.
Remember to always wash or sanitize your hands before putting on, and before taking off your mask. Avoid touching your mask when it’s on your face. If you do touch your mask then sanitize your hands. Avoid touching the mask when you take it off (grab the ear loops instead) and wash your cloth mask in warm, soapy water after every use.
And lastly, my pet peeve, don’t wear a N95 masks with a valve. They may protect you from your neighbor but they do not protect your neighbor from you.
For those of you who haven’t had the opportunity to read Dr. Atul Gawande’s recently published New Yorker article I have included a link below. I admire how eloquently he presents the facts and I wholeheartedly agree with his plan for safe reentry.
https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry
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Copyright © 2021 Barbara A. Hrach M.D. FACP, All rights reserved.
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