COVID-19 Update #2

Flattening the curve in Oregon

At present, this seems to have worked. However, the area under the curve will remain the same so we expect as many people to get the virus, but the health care system will not be overwhelmed like it was in Northern Italy and New York.  Thus, we expect that there will be cases of COVID for the next 4-6 months.  

Please continue to maintain social distancing and frequent 20 second hand washing, particularly after returning from outings.  Realize that when social distancing is modified, the cases would be expected to climb, especially in Oregon where we socially distanced early.  Maintaining good ventilation of living spaces is also important, but rarely discussed.

Face coverings and respirators are entirely different upper airway coverings.  Respirators (such as the N-95) protect the wearer and face coverings protect the environment from viral spread.  This is why health care workers are needing the N-95’s whereas for visits to the store we are asked to wear face coverings.

If you experience symptoms

If you experience symptoms which you think may be attributable to COVID, please contact my office within 24 hours.  I have been following a number of New York residents with the condition and can help to provide the necessary medical recommendations.  As one affected physician said, one of the most frustrating things about the disease is that you want to do something, but there is little to do.  Daily contact with our office is something you can do and we can help with symptom control, timing and types of testing, timing of hospital visits, discussion of medications and the associated anxiety that everyone who has this disease experiences.

Most frequent symptoms:
Fever, headache, profound fatigue and muscle aches, sore throat, dry cough, shortness of breath, loss of appetite and diarrhea.  Loss of sense of smell or taste is also an unusual reported symptom.

I have commented previously in my prior two letters on how to address these symptoms but would add that nasal saline spray also makes sense as it appears the virus first attaches to the cells in the nasal passages.  I am also impressed by how long the virus affects individuals.  Whereas most viral illnesses are gone in 10-14 days, the effects of this one linger for weeks. People feel better for a day, attempt to return to their routine, and are back with the fatigue the next day.

Advance directives and POLST

As your primary care physician, I would like a copy of your advance directives for the chart.  This explains your wishes but is not a medical order.  The POLST (Portable Orders for Life Sustaining Treatment) which is reviewed with you then signed by your primary/treating physician is a medical order.  Most people who are independent and living on their own would want to be taken to the hospital. Several patients have asked for direction on this and I have provided it on a case-by-case basis.  No one wants to suffer, but most people want a shot at returning to a normal life.  I welcome virtual appointments to discuss this important issue.

Mental Health/Anxiety/Depression/Frustration/Economic uncertainty

These are all appropriate feelings when our lives have been so rearranged in the last month.  Feel free to discuss any of these issues with me, as they are all normal concerns and often would benefit from a confidential, empathetic, objective person to voice these concerns to.

Stay well, but Linda and I are here if you need us.

Bert Berney MD