It’s been awhile since my last update. It seems there is quite a bit of conflicting information circulating now. However, there is a need to keep you informed and there are some tidbits of advice that I’d like to offer in the ever-shifting landscape we are having to navigate.We are on a course for reopening that is unlikely to change unless there is a major surge in cases or hospitalizations. Here are some tips for re-entering public spaces in a thoughtful manner.

  • Wear a cloth face mask to protect others when you are out of the house. You may be an asymptomatic carrier and it helps prevent spread of germs; coronavirus or otherwise.
  • Avoid the use of public bathrooms if possible. Studies show that COVID-19 spreads quickly in poorly ventilated, crowded areas. There is some discussion that flushing a toilet can aerosolize virus particles. It has been shown that there is some COVID-19 in fecal (stool) matter. These are all generalizations, but added together and with a little common sense thrown in, avoidance of public bathrooms could help prevent spread. Pro Tip: wearing a mask will also protect the wearer by providing a barrier to viruses, albeit not a perfect solution and not a guaranteed safety measure, but any barrier is better than none if in a situation of unknown risk.
  • Washing your hands for 20 seconds with soap still remains once of the best defenses against COVID-19. If you are unable to avoid situations of possible exposure, washing your hands with soap greatly decreases your chances of being infected. The virus’s outside layer is lipid (or fatty). The process of rubbing your hands together helps the soap to break apart this layer and destroy the virus or render it incapable of working as well. Hand sanitizer is okay and great to use in low risk situations, such as retail shopping while maintaining social distancing. When in doubt though, hand washing is the way to go.
  • Being outside may be good for your mental health and a better place to start socializing. It is easier to maintain distance and the amount of coronavirus in the air is likely to be less than if in an enclosed indoor space.
  • Singing or yelling in a crowd is probably unwise. The act of singing or shouting out propels your germs onto other people more so than if using a normal talking voice. Based on some case reports of spreading in singing groups (as much as it hurts this music lover to say), some thought should be given as to whether a choir should resume or situations similar to choirs, i.e. groups of people singing near one another in church services should occur. How this translates to sporting events is yet to be seen. Cheering for your favorite team or yelling at the opposing referee in a crowd probably wouldn’t be good either.

** Please note some of these tips are observations based on current scientific studies, case reports and a cumulation of information. With the exception of wearing a mask and washing your hands, the above tips are not official recommendations at this time. As more information is gathered on this novel coronavirus, I will update tips and recommendations. **

As for an update in North Carolina, we are mostly meeting our goals for continuing the phases of re-opening. Currently, Phase 1 will be in effect until 5pm, Friday, May 22, 2020. Our testing has doubled, although it is still not as widely available as we want it to be. For a list of testing sites, visit: covid19.ncdhhs.gov. Ideally, we would be testing anyone who wants a test, but there are still some limitations, so please call before you go. We do have an increased number of positive cases of COVID-19 in North Carolina, but the percentage of positive cases remains stable. We know our numbers of positive cases are going to increase as we continue to increase testing, which is why looking at the percentage of positive cases is a better predictor of if we can advance to the next phase. Our number of people presenting to the ER with COVID-like symptoms and hospitalizations statewide have remained stable. Our ability to test, do contact tracing, and our supply of PPE (personal protective equipment) has also improved. If these trends continue as they are now, we will likely be able to enter phase 2 at 5pm on May 22nd. Keep in mind that the trends could change and this is still an evolving situation, but it’s looking hopeful as we move forward. Here is a graph that Dr. Cohen and Gov. Cooper presented in today’s press conference. You can find this information and other helpful information at the ncdhhs.gov website.

Notice we are mostly in green, and the trajectory of cases which is red is not as important as the trajectory of positive tests as a percentage of total tests.

Lastly, remember the keys to staying healthy and promoting a good immune system which include exercise, managing stress levels (stay off the internet or take frequent breaks), healthy diet, healthy attitude, and support from friends, family and community. Remember the 3 W’s: WASH your hands, WEAR a mask, and WAIT 6 feet apart and avoid contact. Continue to stay home as you are able.

Feel free to ask any questions! I will be starting to open up the office next week for in person visits. The plan is to reach out the day before your scheduled appointment to screen for any respiratory symptoms. Rigorous cleaning between patients will continue, and wearing a mask will be encouraged (cloth masks are okay, but there will be masks available for those without). I look forward to seeing some of you soon!