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eNewsletter Spring 2020 – Covid-19, Telemedicine Q&A & More



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Spring 2020
E-Newsletter
 
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Important COVID-19 Information From MPCP Medical Director Jerry Levine, M.D., FACP
Dr. Levine explains the steps MPCP is taking to keep healthcare available to our patients during the COVID-19 crisis.


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man on a telemedicine appointment with his doctor

 








Telemedicine Q&A
FROM YOUR MPCP HEALTHCARE PROVIDER
Learn how MPCP is using telemedicine to help meet the health needs of our patients during the COVID-19 outbreak.


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father comforting his daughter

 








Helping Your Kids Deal with COVID-19 Anxiety
By JAMIE HARMS, M.D.
This can be a scary time for children. Here’s how to help your kids deal with coronavirus anxiety.


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Maryland Primary Care Physicians
HealthWise Volume 28, Spring 2020 | Locations | Find us on Facebook


Helping Your Kids Deal with COVID-19 Anxiety

By: Jamie Harms, M.D.

Everyone is talking about the coronavirus, and you can be sure that little ears are listening.  This can be a scary time for children. They may hear about COVID-19 deaths and worry what will happen if they or you get the disease.

Children and teens are influenced by what they see in their parents. If they see you dealing with the coronavirus calmly and confidently, they will feel more secure. Here’s how to help your children deal with COVID-19 anxiety.

Symptoms of anxiety

Anxiety is often expressed in your child’s behavior. Watch for these common symptoms of anxiety and stress:

  • Returning to behaviors they have outgrown, such as thumb-sucking, throwing tantrums, engaging in baby-talk, or bedwetting
  • New or recurring fears
  • Inability to relax or calm down
  • Excessive crying or irritation in younger children
  • Irritability and “acting out” behaviors in teens
  • Stomachaches, upset stomachs, or a loss of appetite
  • Trouble falling asleep, staying asleep, or having frequent nightmares
  • Difficulty with attention and concentration
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs in teens

Ways to support your child

  • Talk with your child or teen about the COVID-19 outbreak. Answer their questions in a way that your child or teen can understand.
  • Reassure your child or teen that they are safe. Tell them not everyone gets COVID-19 and discuss things your family is doing to stay safe, such as handwashing, cleaning and social distancing. See tips for fighting COVID-19 below.
  • Let them know it’s ok if they feel upset. Tell them how you deal with your own stress so that they can learn how to cope from you.
  • Limit your family’s exposure to news coverage of the event, including social media. A steady stream of COVID-19 news can raise your child’s anxiety level. Also, some information on social media is sensational or outright false and may frighten children.
  • Try to keep up with regular routines to help your kids feel more “normal.” With schools closed, create a schedule for learning activities and relaxing or fun activities.
  • Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

Show them how to fight COVID-19

Children will feel better if they know there are things they can do to stay well and help prevent the spread of coronavirus. Help them practice these recommendations from the CDC:

  • Cough or sneeze into a tissue or their elbow, then throw the tissue into the trash.
  • Wash their hands with soap and water for at least 20 seconds, especially after blowing their nose, coughing, sneezing, going to the bathroom, and before eating or preparing food. See this CDC video.
  • If soap and water are not available, use hand sanitizer.
  • Keep their hands out of their mouth, nose and eyes. This will help keep germs out of their body.
  • Practice social distancing: When in public, keep at least six feet away from other people.
  • Stay away from people who are coughing or sneezing or sick.

 Feeling stressed yourself?

 With all disruptions coming from the outbreak, it’s no wonder if you’re feeling more anxious. You can help your children by trying to be calmer. Listen to these simple mindfulness/relaxation exercises to relax and destress.

 To learn more, see this CDC information on COVID-19, or contact your MPCP physician.

Telemedicine Q&A

What is telemedicine?

Telemedicine is health care that is done through the video feature of your cell phone or home computer. MPCP is currently using Zoom, Google Duo, FaceTime, Skype and other apps to connect with patients. With these features, you can see your provider and your provider can see you while you talk together.

Why is MPCP using telemedicine?

During this time of coronavirus, telemedicine is a way for us to give you medical care up close but from a safe distance. It lets us keep in touch with our patients, manage ongoing health issues, and address new concerns. Telemedicine also helps people get care in their own homes, decreasing the number who need to go to the emergency room or the hospital.

How can my doctor really know what’s wrong if I don’t see him or her in person?

Your doctor will listen to your symptoms and ask questions, just as if you were in one of our exam rooms. Using video, your doctor will be able to see things that will help make a diagnosis. Those two things work surprisingly well much of the time. But if there is a concern at the end of your telemedicine visit that something is still unclear, your doctor will have you come into the office in as safe a way as possible for a face-to-face evaluation.

What equipment do I need to do a telemedicine visit?

You just need your smartphone, an iPad, or a home computer with a camera and microphone. If you don’t have any of those things, we can simply talk with you by telephone instead.

Can I get a prescription filled from the visit?

Yes, your provider can send any necessary prescriptions to your pharmacy electronically. If you need blood tests, X-rays or other tests, your provider will arrange for you to get them safely.

How do I schedule a telemedicine visit?

You can simply call your MPCP office to schedule a telemedicine visit. If you prefer a particular video platform, just let the scheduler know when you make your appointment. Otherwise, a medical assistant will call you before your appointment to help you connect for your televisit. You may also be advised to collect your medication bottles, gather information such as your blood sugar or blood pressure logs, and to take your temperature or weigh yourself prior to your visit.

Will my insurance cover the visit?

Yes, insurance companies are encouraging doctors to connect with their patients through telemedicine.

What We Have Learned About COVID-19

Jerry Levine, M.D., FACP, Vice President Medical Director

SARS-CoV-2, the virus that causes COVID-19, has spread rapidly over the past year. In Maryland, as of December 29, there have been 269,442 cases and 5,740  deaths. As Maryland is now experiencing an increase in COVID-19 activity there is substantial information to give you the facts on how the virus is spreading and how you can protect yourself and your family.

How the coronavirus spreads

Strong evidence from published reports indicates that respiratory transmission is the primary way COVID-19 is spread. Direct contact spread by touching contaminated surfaces is presumed but is likely only an unusual method of transmission.

If you have the virus, infectiousness peaks about a day before you show any symptoms and decreases within a week of symptoms onset. This virus has a variable transmission biology. Most people who are infected do not transmit the virus, however some may transmit the virus in clusters called “superspreading” events.  It appears that a combination of viral, host (an infected individual), and environmental factors affect the transmission of COVID-19.

The virus spreads in large droplets or fine aerosols that are expelled from an infected person. Droplets are large particles that fall to the ground within six feet, but aerosols are smaller particles that can remain suspended in the air for longer periods. These particles can be transmitted in exhaled breaths and likely become aerosolized by coughing, sneezing, or singing.

Individuals who are infected with SARS-CoV-2 virus can transmit the virus whether they show symptoms or not. Some individuals remain without symptoms (asymptomatic). Based on case reports, it appears that you may be infected for about five days before you start experiencing symptoms, and infectious spread begins about two days before any symptoms start, peaking around one day before symptoms develop.

In a community the amount of pre-symptomatic spread will vary based on the extent of active cases and successful isolation and quarantine of close contacts. It has been shown that the proportion of pre-symptomatic individuals will be higher in areas without case tracking and isolation of contacts.

Evidence shows proximity, how close you are to an infected individual, is a key factor for spreading the virus – that’s why social distancing is so important. Poor ventilation has also been shown to increase transmission, resulting in cluster transmission in areas where people gather. Studies have found masking, in health care settings and in the community, decreases transmission. Allowing for air flow, opening windows, improving ventilation, and events being held outside will reduce spread of the virus. Regular hand washing is paramount to infection control overall.

How COVID-19 affects your body

Early in the disease, the SARS-CoV-2 virus initially affects the upper respiratory tract (nose and throat) and then spreads to the lower respiratory tract. The virus has a viral spike (S) protein that attaches to our angiotensin-converting enzyme receptors (ACE2 receptors) in our respiratory tract. Children younger than 10 have about half as many receptors compared to adults. This may explain why Children are about half as likely as adults to get infected.

While the long-term outcome of having COVID-19 is not fully known or understood, most individuals experience mild illness. However, there can be significant effects on your heart, brain, and lungs. Other challenges such as physical weakness, fatigue, and GI symptoms have been noted. The majority of symptomatic adults with COVID-19 return to their usual state of health within three weeks of testing positive.

Prospects for a vaccine

Since the beginning of this pandemic, there has been a tremendous effort to create a COVID-19 vaccine as soon as possible. Vaccine safety remains paramount, and safety will not be compromised. Clinical trials have included groups at highest risk.

The Maryland Department of Health has published its COVID-19 Vaccination Plan, which would distribute the vaccine in three phases.  Initially the vaccine will be available to first responders, essential health care workers, individuals with high-risk medical conditions, and adults 65 and older. We remain months away from having a vaccine available to the general public.

MPCP has confidence in the process of vaccine development and distribution. We look forward to being part of vaccine distribution and will communicate details when they are available.

What you can do now

  • Masking and social distancing remain the best way to prevent the spread of the disease.
  • Hand hygiene – washing and using sanitizer – is key for infection control.
  • If you have been exposed to COVID-19, tell your MPCP healthcare provider immediately so we can evaluate your level of risk. If your exposure is high risk, we recommend quarantine isolation to lower the risk of spreading the virus.

What MPCP is doing to meet your health care needs while keeping you safe

  • Safety of our patients and staff is our primary concern; we are working to minimize your risk of exposure during office visits.
  • We are asking patients with an acute illness, especially a respiratory illness, to call our offices –don’t just walk in.
  • Our providers are able to communicate and see patients via Audiovisit and TeleMedicine visits as well as in-office visits.
  • Patients are undergoing testing for COVID-19 when clinically appropriate. We also offer antibody testing when appropriate.
  • Patients are encouraged to maintain their scheduled elective visits.
  • We are providing safe access to the use of our laboratory.

Be diligent with hand washing and wear your mask! Cover sneezes and coughs, increase your hydration, maintain social distancing, and minimize non-essential travel. Our mission continues to be guiding you through this crisis. We are available for you.