Coronavirus Risk and Diagnosis by Al Heilman MD

I am a physician and the editor of I felt the need to share the letter I received 3-14-2020.

The time for all of us to take action is immediate.

Please feel free to share. What we do in the next few days will have a profound effect on our future.

I have provided information on 2 issues in this blog. The first is what to do now to lessen your risk and the second is how to know if you have a coronavirus infection and what to do. I have also referenced the CDC website as this information is changing daily.

If you feel ill, first contact your physician by phone/email before going to their office. This is key so you can get help/advice without infecting the whole office.

If it is an emergency call 911 and tell them you think you might have the virus.

It appears if better access to testing is coming soon. You will still need an order to get tested from a health professional as of this writing.

The first is a copy of letter about what you can do today to lessen risk of being infected. This is now published as a blog.

From:  Dr.Asaf Bitton MD, MPH

Executive Director | Ariadne Labs  Brigham and Women's Hospital | Harvard T.H. Chan School of Public Health

I know there is  some confusion about what to do next in the midst of this unprecedented  time of a pandemic, school closures, and widespread social disruption. I  have been asked by a lot of people for my opinion, and I will provide  it below based on the best information available to me today. This is my  personal and well-informed opinion, and my take on the necessary steps  ahead. What I can say as a physician and public health leader, is  that what we do, or don't do, over the next week will have a massive  impact on the local and perhaps national trajectory of coronavirus. We  are only about 11 days behind Italy and generally on track to repeat  what is unfortunately happening there, as well as much of the rest of  Europe very soon. At this point, containment through contact tracing and  testing is only part of the necessary strategy. We must move to  pandemic mitigation through widespread, uncomfortable, and comprehensive  social distancing. That means not only shutting down schools, work (as  much as possible), group gatherings, and public events. It also means  making daily choices to stay away from each other as much as possible to  Flatten The Curve (see below). Our health system will not be  able to cope with the projected numbers of people who will need acute  care should we not muster the fortitude and will to socially distance  each other starting now. On a regular day, we have about 45k ICU beds  nationally, which can be ramped up in a crisis to about 93k. Even  moderate projections suggest that if current infectious trends hold, our  capacity (locally and nationally) may be overwhelmed as early as  mid-late April.  Thus, the only set of interlinked strategies that can  get us off this concerning trajectory is to work together as a community  to maintain public health by staying apart. The  wisdom, and necessity, of this more aggressive, early, and extreme form  of social distancing can be found here. I would urge you to take a  minute walking through the interactive graphs - they will drive home the  point about what we need to do now to avoid a worse crisis later. So what does this enhanced form of social distancing mean on a daily basis, when schools are cancelled? I can suggest the following: 1. No playdates, parties, sleepovers, or families visiting each other's  houses. This sounds extreme because it is. We are trying to create  distance between family units and between individuals across those  family units. It is uncomfortable, especially for families with small  children or for kids who love to play with their friends. But even if  you choose only one friend to have over, you are creating new links and  possibilities for the type of transmission that all of our  school/work/public event closures are trying to prevent. The symptoms of  coronavirus take 4-5 days to manifest themselves. Someone who comes  over looking well can transmit the virus. Sharing food is particularly  risky - I definitely do not recommend that people do so outside of their  family.  We have already taken extreme social measures to address this  serious disease - let's not actively co-opt our efforts by having high  levels of social interaction at people's houses instead of the schools.  Again - the wisdom of early and aggressive social distancing is that it  can flatten the curve above, give our health system a chance to not be  overwhelmed, and eventually may reduce the length and need for longer  periods of extreme social distancing later (see what has transpired in  Italy and Wuhan). We need to all do our part during these times, even if  it means some discomfort. 2. Take walks/runs outside, but  maintain distance (ideally 6 feet between people outside your family).  Try not to use public facilities like playground structures as  coronavirus can live on plastic and metal for up to 3 days, and these  structures aren't getting regularly cleaned. Try not to have physical  contact with people outside of your family. Going outside will be  important during these strange times, and the weather is improving. Go  outside every day if you can but stay physically away from others. Try  not to have kids play with each other (even outside) if that means  direct physical contact. Even basketball or soccer involve direct  contact and cannot be recommended. If people wish to go outside and have  a picnic with other families, I strongly recommend keeping distance of  at least 6 feet, not sharing any food at all, and not having direct  physical contact. Invariably, that is hard with kids, so these shared,  "distant" picnics may be tricky. Do not visit nursing homes or other  areas where large numbers of the elderly reside, as they are at highest  risk for complications and mortality from coronavirus. We need to find  alternate ways to reduce social isolation in these communities through  virtual means instead of physical in-person visits. 3. Reduce the  frequency of going to stores/restaurants/coffee shops for the time  being. Of course trips to the grocery store will be necessary, but try  to limit them and go at times when less busy. Consider wearing gloves  (not medical - but perhaps washable) and of course washing hands before  and after really well. Leave the medical masks and gloves for the  medical professionals - we need them. Maintain social distance from  folks. Take-out meals and food are riskier than making food at home  given the links between the people who prepare food, transport the food,  and you. It is hard to know how much that risk is, but it is is  certainly higher than making it at home. 4. If you are sick,  definitely stay home and contact a medical professional. If you are  sick, you should try isolate yourself from the rest of your family  within your house as best as you can. If you have questions about  whether you qualify or should get a coronavirus test, you can call you primary care team and/or consider calling the Partners Healthcare  hotline staffed 8AM-8PM every day - 617 724 7000, or the Massachusetts  department of public health at 617 983 6800.  Don't just walk in to an  ambulatory clinic - call first. Obviously if it is an emergency call  911. 5. We need to push our local, state, and national leaders to  close ALL schools, events, gatherings, and public spaces now. A local,  town by town response won't have the needed effect. We need a statewide,  nationwide approach in these trying times. Contact your representative  and the governor to urge them to enact statewide closures. As of today, 6  states had already done so. We should be one of them. Also urge them to  fund emergency preparedness and make increasing coronavirus testing  capacity an immediate and top priority. I realize there is a  lot built into these suggestions, and that they represent a real burden  for many people, businesses, and communities. Social distancing is hard  and may negatively impact others, especially those who face  vulnerabilities in our society. I recognize that there is structural and  social inequity built in and around social distancing recommendations.  We can and must take steps to bolster our community response to people  who face food insecurity, domestic violence, and housing challenges,  along with the many other social inequities. I also realize that  not everyone can do everything. But we have to try our absolute best as  a community, starting today. It is a public health imperative. If we  don't do this now voluntarily, it will become necessary later  involuntarily, when the potential benefits will be much less than doing  so right now. Asaf Dr.Asaf Bitton MD, MPH | Executive Director | Ariadne Labs  Brigham and Women's Hospital | Harvard T.H. Chan School of Public Health

reference for graphs

The second part of this blog is about how to tell if you have a coronavirus infection. This is an excellent link.

In Conclusion

The most important thing to do is frequently wash your hands and follow the recommendations about social distancing referenced in the first part of this blog. This virus is very serious and information is rapidly changing. Follow the CDC recommendations daily. Here is a link to there website. Some individuals may be carriers and have little or no symptoms. They could still infect you and your family. Better testing is essential. Stay informed with trusted references like the CDC. Social media is full of misinformation and claims that may lead to a delay in action or cause illness. Here is the link to the CDC website.

You can maintain your health and immune function best by eating well and getting enough sleep. If you are sick you need get evaluated by a physician or health professional. DO Not Go to work or school if you feel sick.

Staying in contact with family and friends is very important for your bodies immune response and to our human needs for connection. Call up an old friend or write an email or text to your family and friends. Check on your neighbors.

Also using meditation and other mind body techniques as an adjunct can improve and help maintain your immune function and health in stressful times. Use the technology we have to make all these things a priority.

Stay safe and well.


Al Heilman MD

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“Alone, we can do so little;

together, we can do so much”

  Helen Keller


Concerned Homeowners  & Businesses of Lake Conroe