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What’s the Buzz About Bug Spray?


Summer’s here and as you shop for insect repellant, you will be faced with a choice: Should you get one with synthetic (man-made) ingredients or one that is “natural”?

Some people worry that synthetic materials used in sprays – such as DEET and picaridin ‒ may be harmful. Others claim that natural sprays don’t work well, so why use them?

Here’s what you need to know about choosing a product that will safely keep biting beasties away this summer.

Synthetic sprays

The most popular bug sprays at your local store will probably have the chemicals DEET or picaridin as their main active ingredients.

DEET is one of the most effective repellants available. It works well against mosquitoes (up to 12 hours), ticks (up to 4 hours) and other insects. The Environmental Protection Agency has approved DEET for both adults and children 2 months and older, but frequent and heavy use may cause skin irritation. For adults, look for products that contain 15%-30% DEET, but kids 12 and under should use a product with 10% DEET or less.

Picaridin is made from piperine, the alkaloid that gives pepper its peppery characteristics. It is odorless to humans but smells repulsive to insects such as mosquitoes, ticks, fleas and flies. It keeps mosquitoes away for up to 8 hours and ticks for up to 5 hours. Picaridin is slightly milder than DEET, and skin irritation is less likely. Look for spray products, which generally work better than lotions or wipes, containing 20% picaridin.

Natural sprays

Natural insect sprays use plant-based substances instead of man-made ones. Not all natural sprays work equally well, so here’s what you need to know.

Oil of lemon eucalyptus is one of the most effective natural ingredients. It keeps away some ticks, flies and gnats, but it’s most useful against mosquitoes (up to 6 hours). Though it is natural, it isn’t recommended for kids under age 3. Look for products with 30% oil.

Sprays containing 2% soybean oil have been shown to provide up to 4 hours of protection against mosquitoes. Soybean oil is safe to use on infants and children.

Unrefined essential oils such as citronella, geranium and rosemary are promoted as all-natural repellants. But despite their popularity, they typically only work for about half an hour, and then the bugs will be back.

So what works best?

For the best protection against biting insects, choose a spray with synthetic DEET or picaridin. They repel a greater variety of bugs and stay effective longer. This is especially true if you live in an area heavily infested with mosquitoes.

If you prefer a plant-based product, and you live in an area where mosquitoes are less of a problem, sprays containing oil of lemon eucalyptus or soybean oil may give you adequate protection.

Besides using bug spray, see these tips from the CDC for preventing bug bites.

Dr. Keithley cares for patients in the Arnold office. She received her medical degree from Drexel University College of Medicine and is certified by the American Board of Family Practice.

I Recovered From COVID-19. Why Am I Still Sick?


Some people have recovered from COVID-19, but months later they still have symptoms such as shortness of breath, weakness, a racing heart and trouble thinking.

If you are one of these unfortunate “long haulers,” you may continue to be sick even though you have recovered and tested negative for SARS-CoV-2, the virus that causes COVID-19. Most people who get the disease make a full recovery, but it’s estimated that 10%-30% of patients continue to experience symptoms months after their initial diagnosis.

Anyone can be a long hauler

Even young people and those who had only mild cases are affected. About one in five young adults reports prolonged problems, and some people who were never hospitalized can’t climb stairs, get winded easily, and need oxygen for shortness of breath.

Doctors aren’t sure what causes these drawn-out symptoms, but an inflammatory response may be responsible. COVID-19 makes your body’s disease-fighting antibodies overreact, attacking healthy cells and damaging tissues and organs. If this inflammatory response continues, the outcome could be “long Covid” that lasts for weeks or months.

First steps toward treatment

It is not yet well understood how to treat long Covid, but anti-inflammatory drugs may be one answer. Also, doctors are finding that a program of rehabilitation can help. People with lingering fatigue can benefit from gradual exercise, including breathing exercises to increase lung capacity. And those with cognitive issues can recover with the help of a neuropsychologist. Ask your doctor about possible treatment plans.

Since COVID-19 is a relatively new disease, its long-term health effects aren’t fully understood. One thing is certain, however: the best way to avoid complications is to prevent COVID-19.

Common ‘long Covid’ symptoms

If you continue to suffer any of these symptoms after recovering from Covid-19, you may be a Covid long hauler:

  • Cough
  • Fatigue
  • Joint and chest pain
  • Shortness of breath
  • Headaches
  • Muscle pain
  • Changes in smell: food may smell bad
  • Confusion, forgetfulness, trouble concentrating


Victor Plavner, M.D.Dr. Plavner is a Maryland Primary Care Physicians, LLC partner, is certified by the American Board of Family Medicine, and practices at the MPCP Arnold office. He earned his medical degree at the University of Louvain, Brussels, Belgium; and at George Washington University Medical Center.

5 Tips to Stay Safe as Quarantine Ends

By: Victor M. Plavner, M.D.

With Maryland taking steps to reopen, you may be tempted to think the Covid-19 crisis is over. Not true ─ the coronavirus is still out there, with new cases being reported every day. To avoid a second wave of infections, you need to take precautions to prevent the spread of the virus. Here are five tips for how to re-enter public life safely.

  1. Remember the basics

We all learned safe habits during the quarantine. You should keep doing them when in public:

  • Wear a mask
  • Wash your hands and use hand sanitizer
  • Avoid touching your face
  • Practice social distancing: 6 feet apart
  • Disinfect surfaces and equipment
  • Limit contact with people who are at higher risk, such as the elderly and those with chronic illnesses. Remember, if you are infected, you can spread the virus before you show any symptoms.
  1. Avoid confined spaces

Try to stay out of places where air can be trapped or is unfiltered, such as elevators, break rooms and small shops. When possible, take advantage of any outdoor or open-air areas where people can meet while maintaining a healthy distance.

  1. Have a coming-home routine

Create a daily routine for arriving home to prevent bringing infectious germs into your home. Depending on your level of risk, this may include:

  • Using hand sanitizer before entering your house
  • Cleaning personal items with disinfectant before going in, such as keys, mobile phones, and things in your pockets
  • Taking a shower
  • Washing your work clothes
  1. Stay alert at gatherings

As we return to gathering socially, we should maintain a certain level of caution. This includes distancing or limiting interaction with people who don’t have the same level of concern about the virus. We have no way of knowing where someone has been, or their level of exposure to possible infection, so our best protection is to avoid getting close to people in restaurants, churches, stores, bars and other public places.

  1. Take care at work

If you work near others or have to attend meetings, try to keep some space between you and other people and wear a facemask. Try to keep surfaces in work and meeting areas sanitized.

The same applies to having lunch with a group of work friends. The wise thing is to skip this custom for a while. Eat lunch alone or carve out some personal space.

See this Wall Street Journal article for more tips to stay safe while you’re out and about.

Victor Plavner, M.D.Dr. Plavner is a Maryland Primary Care Physicians, LLC partner, is certified by the American Board of Family Medicine, and practices at the MPCP Arnold office . He earned his medical degree at the University of Louvain, Brussels, Belgium; and at George Washington University Medical Center.

Flu Season Forecast

By: Celisa McGrone, CRNP

Cold weather is on the way, and with it comes another flu season. Before the flu can knock you down, find out how to fight back and avoid the misery it brings.

Flu – short for influenza – is a common virus that infects millions of Americans each year. For most people, the flu isn’t dangerous, but people over 65, young children, pregnant women and people with chronic medical conditions are at greater risk for serious complications, such as pneumonia and sepsis.

The flu vaccine is the most effective way to prevent the flu, but the tricky virus can mutate and produce nasty new versions of itself. The vaccine protects against three or four types of flu – and is updated yearly — but since the vaccine is manufactured ahead of time, sometimes a new strain pops up, putting more people at risk.

Flu season usually starts in October, so there’s no time to waste. Here’s what you can do.

  1. Get a flu shot: No surprise here – the annual flu vaccine is the number one way to protect yourself and your family. The vaccine is not 100% guaranteed to prevent the flu, but it greatly lowers your risk. Also, if you get the shot and get sick anyway, the vaccine can reduce the severity of your symptoms.
  1. After you get the shot, it takes up to two weeks to reach maximum protection, so the sooner you get the vaccine the better. The CDC recommends that everyone six months or older get the shot before the end of October.
  1. Take action to prevent infection: Doing these simple things can greatly reduce your risk of getting infected, or of you spreading the virus to others.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands with soap and water often. If they aren’t available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated with flu germs.
  • Try to avoid close contact with sick people.
  • If you are sick with flu symptoms, the CDC recommends you stay home for at least 24 hours after your fever is gone.


  1. Ask your doctor about antiviral drugs: If you get the flu, antiviral drugs can be used to treat your illness. They can’t cure the flu, but they can make your illness milder and shorter.


Next steps


Celisa McGrone, Certified Registered Nurse Practitioner, received her Master of Science in Nursing degree from Mercer University. She sees patients in MPCP’s Arnold office.