COVID-19

Resources and latest updates about COVID-19.

Updated May 6, 2020

OUR OFFICE:
  • We have remained open for acute care visits (UTI, sinus infection etc.) since the pandemic began. 
  • We will resume limited routine care visits starting May 4. Please call and be patient as we triage and accommodate the greatest needs first. 
  • Virtual (Zoom) visits remain an option for more routine matters and prescription refills. 
  • We will resume drawing routine lab tests to monitor thyroid, diabetes, and cardiovascular risk etc., but those who are “senior or medically fragile” will likely be asked to wait until June 12, though case-by -case virtual discussion is appropriate. 
OFFICE PROTOCOLS

(until no new cases of COVID19 in Forsyth or adjacent counties for 2 weeks):

  • The entrance door to CFM will still remain locked at all times.
  • BEFORE we open the door to greet you, you will be REQUIRED to wash your hands in the restroom across the hall.
  • BEFORE you enter the office, we will check your temperature and your Oxygen levels. If you have a temp equal to or greater than 99.5 OR your O2 saturation is below 90% then you will be asked to wait outside while we make a clinical determination. EVEN IF you are asymptomatic, you will be directed to the hospital if you meet both criteria.
  • When cleared to enter the office, you WILL BE REQUIRED to wear PPE in the form of a mask (which we will provide, if you are not already wearing one).
  • Staff who is assisting you for medical care will also be REQUIRED to wear a mask and gloves for the duration of your visit.
  • ALL supplements sales, and hand-signed prescriptions will now be handled on a “No Contact” basis which means that you should call ahead, text or email your request or orders, prepay for them and they will be placed on a metal tray for you to pick up.   Check in by phone from the parking lot and we can have your items on a tray outside the office door so that you do not even need to enter the office space.
  • We will limit the number of people (staff + patients+ family) to not > 10 at any one time, so please inform us if you plan to bring anyone with you to the office.  
  • We will limit time in the waiting room and remove all reading materials 
  • ALL delivery drivers and mail carriers will be restricted from entering the office unless they have PPE and washed their hands prior to entry. They will also be required to check temp and oxygen if they must enter. All packages will be wiped down to the best of our ability.
STAYING SAFE IN THE COMMUNITY 
  • WASH your hands (20 seconds soap and water especially before meal prep and before eating)
  • Maintain 6-feet social distancing   to slow the spread of the virus. If it does not feel right to you to go out, DON’T! 
  • Dr Campbell believes that different rules should apply to different communities. Other countries have applied a red/orange/green zones of restriction, and it is reasonable that in communities with extremely low or zero transmission, fewer lockdown rules can still be safe.
  • Although evidence is limited for their effectiveness in preventing transmission of SARS-CoV-2, either for source control or to reduce exposure, the wearing of cloth face coverings by healthy persons may prevent potential asymptomatic or pre-symptomatic transmission and is recommended by CDC in public settings where social distances can’t be maintained. Currently, it is advised to reserve surgical masks and N95 respirator masks for healthcare workers and first responders. Cloth face coverings should:
    •     fit snugly but comfortably against the side of the face
    •     be secured with ties or ear loops
    •     include multiple layers of fabric
    •     allow for breathing without restriction
    •     be able to be laundered and machine dried without damage or change to shape
  • If you feel sick, stay home. Do not go to work. Contact our office. 
  • If anyone in your household has tested positive for SARS-CoV-2 keep the entire household at home for 2 weeks, or until 2 tests in a row have been negative. 
  • Continue to work from home if practical. Masks are only needed if 6 feet cannot be maintained.
  • Avoid social gatherings of >10 people. Start small. Invite ONE friend over. At the risk of being wrong, if no one you know or work with has had COVID-19, Dr Campbell believes it is reasonable to have a friend over for cocktails, or to visit your parents for dinner. We have Mother’s and Father’s Days approaching.  If all in the family are healthy, it is a low risk proposition to visit them. Have a hug and dinner, but we do not recommend huge block party celebrations. The boost in oxytocin and dopamine will be good for everyone, and the risk of getting sick is lower than the risk of symptomatic social isolation.  If your community has COVID-19, maintain all the strictest precautions.
  • Maintain your sense of community and charity. Use Zoom or FaceTime to connect with those you care about and continue to check-in on those older or medically fragile sheltering-in-place.   
  • Use drive-thru, pick-up and delivery meal options. If dining in, maintain 6 feet distancing and use contactless payments if possible. It is now acceptable to send more than one family member to the grocery store, or even to shop in family pairs. 



  • Exercise is GOOD for you. If you prefer going to a public gym:
    • Try to go during off peak hours
    • Wipe down equipment with bleach or 60% alcohol or more disinfectant, let it dry 60 seconds 
    • Keep your hands off your face. 
    • Wash hands after EACH machine
    • Stay 6 feet from others
    • Bring your own towel and be mindful where you set it down!
    • Do NOT go to the gym if you are sick or have a fever 
  • Practice good hygiene: 
    • Wash your hands, especially before and after touching your mask, any object or surface touched by others.
    • Avoid touching your eyes, nose and mouth. Break habits of nail biting and pen chewing now.
    • Disinfecting frequently touched surfaces: remote controls, cell phone, keyboard, mouse, steering wheel, turn signal, gear shifter, garage door opener, doorknobs, toilet handles, debit card, purse
    • Use hand sanitizer before getting into your car after you have been in the grocery store or other heavily populated areas.
    • Sneeze or cough into a tissue or the crook of your elbow. (then discard tissue, wash hands)
    • Disinfect surfaces frequently following manufacturers guidelines for contact time. 
  • Gloves:  Will only spread germs if improperly worn.  Using your ungloved hands – and washing them often – is recommended for the typical tasks of everyday life. The CDC only recommends gloves when
    •    Touching the buttons or handles on a gas pump when disinfecting wipes are not available.
    •     Cleaning and disinfecting surfaces.
    •     Handling dirty laundry, kitchen items, or trash from someone who has the virus.
  • Even in these cases, gloves are only effective when proper procedures are followed. To use disposable gloves, the CDC recommends these steps for removing them:
    • Grasp the outside of one glove at the wrist without touching your bare skin.
    • Peel the glove away from your body and pull it inside out.
    • Hold the glove you just removed in your gloved hand.
    • Peel off the second glove by putting your fingers inside the glove at the top of your wrist.
    • Turn the second glove inside out while pulling it away from your body, leaving the first glove inside the second.
    • Dispose of the gloves safely. Disposable gloves should never be reused.
    • Wash your hands with soap and water for a minimum of 20 seconds once gloves are off.

Lessons from COVID-19: Healthcare is Self-Care

May 5, 2020 | Ellie Walaitis Campbell, DO, MS, DAAFP, AIHM/ABOIM

Few predicted that a respiratory virus could simultaneously disable both the American Healthcare system and the economy. As our medical-industrial complex overpowers the modern sick care system, and Big Pharma dictates most of the care, one of the most important lessons from the past 30 years has been that healthcare is really SELF-CARE. The more emphasis a patient places on therapeutic lifestyle changes, the better their overall health. Patients who implement protocols to identify healthier choices in what they eat, drink, do, and think can often achieve self-management health goals without the use of prescription medications. Reducing pharmaceutical dependency results in less overall cost, less need for medical intervention and happier, healthier patients. 

A patient without excess oxidative stress, who is nutritionally replete, and is relaxed in mind and spirit has the stronger immune system.  While “herd immunity” may be a goal of a population, it is really the strength of just ONE immune system that matters most—your own. 

COVID-19 has brought the world to its knees. For at least 8 weeks, most of the residents of the United States stopped “business as usual.”  They stopped going to the movies; they stopped eating fast food; they stopped driving their cars to work, and they stopped going to the doctor for routine health maintenance. 

Despite the myriad restrictions of this pandemic, humans rediscovered ways to connect with their families, to exercise within their own homes, and to prepare and cook their own food.  We have mutually discovered that we are more creative and resilient than we thought.  

Never has so much scientific data been generated so quickly. We have more anecdotal medical data since Wuhan China reported its first case of SARS-CoV-2 than has ever been seen for a single illness. We have ways to exchange information faster than humankind has ever witnessed, and “lay people” have equal access to the data with research scientists and epidemiologists, and the CDC-generated health data is being seen by more people than ever in its history. 

The current healthcare situation is very fluid regarding the numbers of cases being reported daily, with the meaning of all the data likely taking years to elucidate. It may be premature to draw absolute conclusions. Since this virus is newly identified and particularly dangerous for seniors and people with co-morbid conditions, it is associated with great fear. 

Many people have unexpectedly died. However, an unintended consequence of the lock-down is that MANY people have unexpectedly lived. 

Below is the chart of the data from the NCHS total mortality data from the CDC’s website. On average approximately 55,500 people die every week in the US from all causes. On March 20, 2020 President Trump issued a “shelter in place” order. This was the 12th week of the year. On April 10, CDC reported that by the 14th week of the year, the weekly mortality data dropped to 49,770 and by the 15th week of the year it was down to 28,174.  The data were re-adjusted the next week and now the 14th week is reported at 60,324, the 15th week at 55,905, and the 16th week at 28,483.  Nevertheless, we now see 27,000 fewer people than average died in the 16th week of the year. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/04242020/nchs-mortality-report.html

It will be interesting to see over time if the data are adjusted to include suicide, alcohol related deaths and deaths from murder and domestic violence, even if the patients did not actually have the virus infection, they may not have died had we not been in quarantine. We have heard anecdotal reports that these types of cases have all increased. Also, there have been concerns that COVID-19 deaths are both over- and under-reported. There is pressure is some locations to include COVID-19 as a cause of death, even when death was from other causes (like 25 years of smoking,) and the patient HAPPENED to have a positive test. And yet, we also know that inflammation from viral infections can trigger strokes and heart attacks. When cardiologists see an increase in heart attacks in the middle of flu season, influenza is often not listed as a cause of death, even though it was the inflammatory trigger that set off the fatal infarction. Some of these cases will certainly be among the COVID-19 deaths, but not reported as such, and this may be compounded by false negative tests in which the patient HAD the disease, but the test was negative.  We will likely never have an accurate count and simply recognize it as such. 

In terms of non-respiratory deaths that have occurred in spring of 2020, Column E was added to the CDC data set. Column E is achieved by subtracting the number of respiratory deaths (D) from total deaths (C.) By doing this, respiratory deaths are excluded from the data set. The average weekly death rate has been 52,711 from week 40 of 2019 until week 8 of 2020. However, during the last 8 weeks (from February 24 until April 19, 2020) the average number of deaths has only been 45,414. 

With the presence of SARS-CoV-2, the non-respiratory American death toll is DOWN from expected —by 7297 deaths per week, or 58,376 year-to-date.  For comparison, the deaths from COVID- 19 in the US as of 04/26/2020 are 54,435.  https://coronavirus.jhu.edu/map.html   In other words, FEWER people have died in the US since COVID arrived than would have been expected without it.

 

So, what are the possible explanations for the drop in US mortality starting around the 7th or 8th week of 2020?

Four plausible contributors are fewer violent deaths (accidents, murders, car wrecks), less air pollution, better diet, and less access to healthcare.

Sheltering in place has resulted in a dramatic decrease in motor vehicle traffic. National Highway death data is not yet available, but some states such as Georgia are reporting up to 12% fewer automobile deaths. 

Fewer planes in the sky and cars on the road means less fossil fuel emissions, cutting air pollution dramatically.  Air pollution has been linked to deaths from asthma, COPD, heart attacks and even dementia. Atlanta similarly saw improved health during the 1996 Olympics, when tele-commuting resulted substantially fewer hospitalizations for respiratory illness. During the Olympic Games, the number of asthma acute care events decreased 41.6% https://pubmed.ncbi.nlm.nih.gov/11180733/

Most restaurants closed at least part of March and April 2020. In the absence of access to fast food, processed junk food and fried everything, many Americans learned to cook. Some are preparing their own meals for the first time. The lowest income population is finding food scarcity a real issue in both variety and quantity, making smaller meals a reality for many. And yet, from simple sandwiches to improvised family feasts, the fat content dropped, and the nutrient density of meals may have actually increased. 

When doctors go on strike, mortality rates drop. https://www.researchgate.net/publication/23311966_Doctors’_strikes_and_mortality_A_review

When cardiologists go to their annual meeting, the deaths from heart attacks are fewer.  https://www.ahajournals.org/doi/10.1161/JAHA.117.008230 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2038979

When COVID-19 strikes, it appears that non-COVID mortality rates drop. Patients access healthcare less often. Avoiding care in the hospital unless it is absolutely necessary is one way to avoid the adverse events which make hospital errors the 8th-leading cause of death.

The US is not the only country with drops in total mortality; “Central Mumbai, home to some 12 million people, saw deaths fall by about 21% in March compared with the same month of 2019, according to municipal data. Overall deaths plummeted 67% in Ahmedabad, the biggest city in Prime Minister Narendra Modi’s home state of Gujarat, over the same period.”

https://in.reuters.com/article/us-health-coronavirus-india-casualties/mystery-of-indias-lower-death-rates-seems-to-defy-coronavirus-trend-idINKCN2260WM

Currently, conventional medicine offers no prevention or treatment for mild to moderate COVID-19 and the hospital mortality for those sick enough to require mechanical ventilation is around 88%. Prevention is paramount, and the best advice is to “flatten your own curve.” Therapeutic lifestyle changes to support nutrition (usually with additional supplements), sleep, exercise, and meditation is critical.  Consider an outpatient consultation with an integrative and holistic physician, or an osteopathic physician trained in manipulative medicine for respiratory illness.  “Alternative” healthcare providers may offer “non-conventional” solutions during this pandemic. Over time, the data will show if there is a post-COVID spike from neglecting chronic conditions or if there will be an epidemic of wellness as patients learned to drive less, cook better quality foods, wash their hands, sleep better, meditate and stay home when they are sick. Healthcare is self-care, and COVID-19 may have helped us see that more clearly than ever. 

 



 

RESOURCES

 

1. HELP ME!!

I have (or think I have) Coronavirus! What do I do?

Click here to get more information on what you can do to stay safe during this time. 


2. International College of Integrative Medicine
April 1, 2020

ICIM POSITION STATEMENT ON 2020 CORONAVIRUS (COVID-19) OUTBREAK


3. Safe at Home Schedule

Creating a new daily schedule may help you avoid going stir crazy while you are safe at home. Feel free to adapt to your situation! Click here for our tips!

 


4. Read: The Coronation – An Essay by Charles Einstein

5. URI Protocol

Have more questions? Stay informed directly from the CDC as they continue to post the most recent data and information regarding COVID-19:

https://www.cdc.gov/coronavirus/2019-ncov/index.html