COVID-19 messages to our patients and community from Glenville Medical Concierge Care

cornonavirus - COVID-19 messages to our patients and community from Glenville Medical Concierge Care
COVID-19 Update 03.25.20:
Dear Patients:
We want to first thank all of our patients for heeding our warnings over the past two weeks to shelter in place and remain safe. This is the best and only way to avoid infection with the virus and we want to continue to have all of you stay at home and stay safe. Some important updates follow.
Our team at Glenville Medical is still here and taking every precaution to remain safe. We are in constant contact with local and national agencies about the current outbreak and how it might affect our patients. Thankfully, Greenwich Hospital has been extremely proactive about clearing out space in their medical units to accommodate potential COVID-19 patients.
Status of COVID-19 testing
Unfortunately, testing for COVID-19 remains problematic. Getting the test performed and the lengthy turnaround time make it very frustrating for patients who are currently symptomatic. Please know that we check multiple times every day on our patients’ pending tests and will reach out to you once we find out a result.
Another potential testing option in the future may be an antibody test to determine if you’ve been exposed to the virus in the past. These assays are still being tested in research protocols and we are not expecting them to be ready for outpatient offices for many weeks to months. We will continue to follow the data on these tests and let you know our opinion as the studies are completed.
Potential treatments for COVID-19
There have been many questions about current treatment options for COVID-19, especially hydroxychloroquine (Plaquenil). This is medicine used for rheumatologic and auto-immune conditions for decades that has shown both positive (French study) and negative/equivocal (Singapore study) results in the treatment of COVID-19 infections worldwide. Although we hope that further studies will show that it works well, there is no indication for asymptomatic patients to have it at home just in case they get ill with the virus – we do not favor stockpiling this medicine at home. This will reduce the supply for current patients that rely on it daily to control their chronic rheumatologic diseases.
Safety of food take-out and delivery
Some common concerns we’ve been asked about have related to the safety of food delivery/take-out. We don’t have any hard science behind our response, but intuitively we feel hot/cooked food makes more sense to order and we hope that everyone wipes down the outside of containers they receive as well as wash hands thoroughly after contact with any packaging. Limit grocery store exposures if you can and maintain strict social distancing and keep hands away from your face if you need to get supplies.
Obviously, we recommend the same precautionary measures to clean down surfaces after unpacking groceries and wash hands thoroughly. As it relates to mail and deliveries, we recommend leaving them overnight in the garage or mailbox before bringing them into the house if that’s at all possible. Try to open them up outside if you can rather than bringing them indoors. Lastly, we recommend avoiding all external visitors to your home, which include housekeepers, family and friends. Much of the possible viral spread is from asymptomatic carriers of the virus and we don’t want you to be at risk.
Stay safe and healthy while sheltering at home
For our patients that have relocated to other sites in the country, please remain vigilant in staying home and staying safe. Just because the New York/CT area seems to be an epicenter of this infection does not preclude the likelihood of other areas in the country from eventually experiencing the same volume of disease that we have currently. As stated earlier, the paucity of tests and the lengthy time of discovering the results means that any current numbers you see reported are likely lagging well behind the actual reality of infections. The bottom line is stay home and stay safe.
Now that we are all entering the second/third week of home quarantine, it is imperative for all of you to try to stay healthy, get rest, stay hydrated, exercise at home, stay in touch with family and friends, and walk outside if it’s safe to do so. We have local therapists who have offered to speak to patients if needed to discuss anxiety/depression symptoms. Let us know if you need such services. Using apps on the phone including Headspace, Calm, 10% Happier, and others could definitely help anxiety and insomnia related to this experience. Know that we are all in this together, that our office is here to help educate everyone about this outbreak, and that we are in daily discussions with each other about patients. It truly is a team approach to care and we are all very fortunate to have each other to lean on during these trying times.

Coronavirus Update 3.19.20:

Dear Patients:

Today we feel compelled to address the issue of the various POTENTIAL treatments of COVID-19 and preventative medications that have surfaced on social media and the news in general. Some of the medications mentioned include hydroxychloroquine (Plaquenil), chloroquine, remdesivir, several HIV drugs, and a Japanese drug used to treat influenza, among a host of others. Most of these drugs have very real potential adverse effects and their efficacy against treating patients infected with coronavirus has not been rigorously proved.

While we certainly favor rapid drug and vaccine development against COVID-19, reliable safety and efficacy need to be established with a reasonable degree of certainty before these drugs should be used universally in coronavirus-infected patients, or as a prophylactic agent. As physicians, we are always reminded to “first do no harm;” this dictum holds true in this scenario in our opinion. Now, if an unfortunate case arose where a patient becomes infected with coronavirus and is doing poorly, one then can lower the threshold for using some of the drugs out there that have been tried with some apparent success anecdotally.

Each case needs to be evaluated on its own merit and treatment of each case must also be individualized. It should be emphasized that most recover without specific interventions other than what we coin as supportive measures; e.g. rest, consuming a healthy diet, gentle exercise, stress-relieving measures such as yoga and meditation, and Tylenol (preferred over NSAIDS such as ibuprofen) for fever, etc.

Finally, we again urge you to remain within the confines of your home unless absolutely necessary.

Stay well and stay safe!

Steve Mickley, MD

Judith Shea, MD

Jeffrey Puglisi, MD

Ralph Cipriani, MD


 

Coronavirus Update 3.18.20:

Dear Patients:

We hope you’re all doing well and sheltering in place at home. With so much misinformation still surrounding COVID -19, we wanted to share this very knowledgeable perspective from Dr. Paul Auwaerter, Clinical Director, Division of Infectious Diseases at Johns Hopkins University School of Medicine. It’s a great read, packed with valuable, accurate information. Click here to download the Q&A with Dr. Auwaerter.

If you’re looking for additional news you can trust, check our website. We’ve placed real-time national and local newsfeeds on the home page, as well as a resource section within that contains helpful reports and links to other reliable sites. Check in frequently as the situation continues to evolve.

Stay safe and well. We are here if you need us.

Sincerely,

Steve Mickley, MD

Judith Shea, MD

Jeffrey Puglisi, MD

Ralph Cipriani, MD


 

Coronavirus Update 3.17.20:

Dear Patients:

At this time, we firmly recommend sheltering in place at home. This is the only way for the virus to be defeated once and for all. Don’t wait for the government to mandate this in the future…do it now!!

Please heed these warnings and don’t take any chances at all.

If you have any respiratory symptoms (sore throat, fever, cough, etc.), please contact your healthcare provider.

Check our website in the coming days for updates from the CDC and other local health agencies.

We are in this fight together.

Sincerely,

Steve Mickley, MD

Judith Shea, MD

Jeffrey Puglisi, MD

Ralph Cipriani, MD


 

Coronavirus Update 3.15.20:

We have been fielding many calls from patients over the past few days that either describe the viral symptoms (cough, sore throat, fever, aches, etc.) they are experiencing or the COVID-19 exposure contacts they have had in the last week.

The community spread of this virus is multiplying with increasing speed.  Hopefully, there will be new testing sites open this week in our area to help adequately determine the prevalence of infection.  Current criteria still require symptoms and a doctor’s note to get the test performed and the turnaround time is still unknown.

Therefore, we implore all members of our community to stay in their homes and venture out only if it’s absolutely necessary.

If you have any respiratory symptoms or any documented direct exposures to the virus, please call your healthcare provider. If you are a member at Glenville Medical Concierge Care, please call our office.

Our own infectious disease specialist, Dr. Ralph Cipriani, has an extremely informative Q&A podcast that can be downloaded here.

We are all in this together…these measures will protect us all.

Sincerely,

Steve Mickley, MD

Judith Shea, MD

Jeffrey Puglisi, MD

Ralph Cipriani, MD


3.12.20 Coronavirus (COVID-19) Update:

Dear Patients:

One of the most important roles we face as physicians treating this pandemic is to reduce the likelihood of community spread of the virus.

To that end, we strongly recommend the following measures:

  1. Please avoid all commercial transportation (including planes and trains) until we have a more complete understanding of the scope of infection in the community.
  2. Avoid all large gatherings as we feel asymptomatic transmission of this virus is a real phenomenon.
  3. Employ self-isolation/quarantine if you feel ill in any way, particularly respiratory symptoms including fever, chills, cough, sore throat, etc.
  4. Maintain at least 6 feet of social-distancing to avoid contact with airborne droplets.
  5. Wash hands for at least 20 seconds often throughout the day and please keep your hands away from your face.
  6. Clean cell phones as best you can.

There is an excellent town hall discussion of the COVID-19 outbreak being broadcast on CNN tonight at 10 pm EST. We feel it would be worthwhile watching to get updated information.

We are all in this together…stay well. Let’s keep each other healthy.

Sincerely,

Steve Mickley, MD

Judith Shea, MD

Jeffrey Puglisi, MD

Ralph Cipriani, MD


3.9.20 Coronavirus (COVID-19) Update:

Dear Patients:

As you likely know, we are now experiencing some community spread of the coronavirus, including NY, CT and NJ. The situation could likely worsen over the next several weeks.

Here are important points we feel all should know during this outbreak:

  1. Call your healthcare provider’s office (but do NOT “walk in” please) to alert them of any symptoms of respiratory infection including fever/chills, cough, shortness of breath.
  2. Call your healthcare provider’s office to report any contact with persons potentially infected with COVID-19, regardless of whether or not you are manifesting symptoms. They will determine if you need COVID-19 or other viral infection testing at Greenwich Hospital’s outdoor testing facility located in the employee parking structure at the hospital.
  3. If you get this testing done, the results will likely be available in 3-4 days…in the interim, maintain strict adherence to self-quarantine at home to prevent the spread of this virus further in our community.
  4. Consider deferring non-essential office visits until the scope of the community spread of this infection becomes more apparent.
  5. We are getting calls about what specifically constitutes a high-risk patient. We feel that individuals who are over the age of 70, those who have chronic lung or heart conditions, those with diabetes, those who are using chronic immunosuppressants or on chemotherapy fall into this category…many of our recommendations to quarantine patients are to protect the individuals in this high-risk category.

Here are excellent resources from the CDC and Greenwich Hospital:

We are all in this together. Let’s continue to be vigilant about protecting one another.

Be safe and well. Call us if needed.

Sincerely,

Steven Mickley, M.D.

Judith Shea, M.D.

Jeffrey Puglisi, M.D.

Ralph Cipriani, M.D.


 

2.29.20 Coronavirus (COVID-19) Update:

Dear Patients,

The Center for Disease Control (CDC) is closely monitoring an outbreak of the respiratory illness caused by the 2019 novel coronavirus (2019-nCoV) first identified in Wuhan, Hubei Province, China. Patients have been asking about their risk and we want to offer you the most recent information and recommendations.

Please be reassured that the immediate risk of coronavirus to the American public is low. There has only been one case of person-to-person transmission in the U.S. (in the state of California).

Public health agencies around the globe, including the World Health Organization and the CDC, are keeping a careful eye on the coronavirus and taking steps to prevent illness from spreading. While the risk of 2019-nCoV is still considered low in the U.S. and no cases have been reported in Connecticut at this time, the CDC urges all to do their part to help respond to this emerging public health threat.

Most importantly, stay healthy during the current flu and respiratory disease season by:

If you think you may have been exposed to 2019-nCoV (visited China or any other high-risk affected areas) in the last 14 days or had close contact with a person confirmed with 2019-nCoV infection; feel sick with fever, cough, or difficulty breathing):

First, please call your healthcare provider. Then, follow CDC guidance on how to reduce the risk of spreading your illness to others.

If you are traveling or planning a trip: Stay up to date with CDC’s travel health notices related to this outbreak.

For additional information and updates, we recommend these reputable sources:

For more information locally, please call the Greenwich Hospital Coronavirus Hotline at 203.863.4500. Rest assured we are keeping in close contact with the Infectious Disease department at Greenwich Hospital who are in turn in close contact with local, state and national health departments and their updated guidelines.

We are fortunate to have Dr. Ralph Cipriani at Glenville Medical Concierge Care who is an Infectious Disease specialist and is leading our response to this virus.

Yours in good health,

Steven R. Mickley, MD

Judith F. Shea, MD

Jeffrey S. Puglisi, MD

Ralph J. Cipriani, MD

 

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