by: Dr Pearce
HEALTH CARE EFFECTS/CHANGES
As the health care system mobilizes to a new reality there have been some major changes. All these changes are to stop the spread of the Corona Virus. Health care is an industry that has never had many layoffs until now. Surgeries and procedures that can wait or are not emergencies are on hold. So hospitals are at low volume; many clinics have shut down or nearly shut down including dentist offices and vision clinics. Many workers have been laid off or furloughed (thinking they will come back soon). Our clinic has reduced salaries to providers and we have had many staff gone from work as volume decreases which means money/payments to clinics decreasing. Many of us providers are working from home with telephone or video visits. If someone needs to have a back pain evaluated, e.g. then we send them into our clinics to be examined by the few providers in the clinics. Many patients have not been sent and are managed by remote methods. This is a risk so we have to be careful not to miss something that would be more obvious in an exam room together. Optional vaccines and some blood tests and specialist visits have been postponed for a long time unless it becomes an emergency that is worth the risk of all being exposed.
On the other hand, a branch that is booming is mental health which can be accomplished well via video and somewhat less well, by phone.
Managing this illness on a personal level is all about risks. The risks are unseen and delayed so many don’t believe it. Years ago I burned my fingers repeatedly on a soldering pencil shaft since I only saw the redness at the tip. I had to discipline myself that there was a danger I couldn’t see and must avoid.
The risk isn’t just to you but to anyone you come in contact with.
AEROSOLS VS. DROPLETS
For droplets (snot, saliva, phlegm, mucus) a video on coughing from the mythbusters on YouTube is a great demonstration, which shows that your secretions travel up to 6 feet. For aerosols, think of smells which come from very tiny particles of odor molecules or viruses in the air that don’t fall for a number of hours and go away if there is a breeze outside a building. These are usually found in enclosed spaces like planes, cars, houses, buildings. So now you can see why we wear masks covering the nose and mouth, keep a distance, and stay out of buildings as much as possible. It is a waste of time and uncomfortable wearing a mask when you are walking or riding a bicycle outside unless you are going to be closer than 6 feet to others.
Just think of sex—that won’t be difficult: If 2 people are monogamous then no sexually transmitted infections, STIs, can enter their pool. If they step out of the relationship they can bring back an STI to the other partner. For the Corona virus, those you are exposed to frequently without protection are in your pool. But some have to step out to go shopping. Some step out of the pool for less essential reasons. Stepping out can bring the virus to your pool or someone you are close to for a short time outside of your pool like a bus driver or store clerk.
Now someone walking in a building without a mask or not keeping distance, is like they entered your pool and urinated in your pool. They might say they have the right to not wear a mask which is like saying they have the right to urinate in your pool, but all in the pool can be affected.
I saw an elderly couple waiting for their food outside a restaurant and they smiled and said their “masks were in the car.” How does that help the others they were around? There was a man in the restaurant ordering with the mask off his nose and later off his mouth. I left quickly to not be exposed. The mask protects others, not you. You may believe you don’t have a case without symptoms and there is no need to protect others but belief is not a fact.
The evidence shows if all take the protective measures: distancing, isolation, masks, washing of hands and exposed surfaces, that the herd (all the people in the many pools) will have less people with the disease and less deaths.
Please be safe so the rest of us can stay healthy to serve you now and in the future. You are part of a HERD. We need each other to behave like responsible adults.
PLEASE REGISTER TO VOTE AND THEN VOTE IN NOVEMBER.
If you didn’t vote last time, then you should be satisfied with the result we got. I realize many of you readers may not be citizens but others you know are and you should push them to vote to improve your situations. Make sure a politician’s actions benefit people like you. Words are Cheap.
Keep those questions coming, Be safe!
Daniel Pearce, D.O., FACOI, AAHIVMS
Clinical Associate Professor of Medicine, Loma Linda University School of Medicine
Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic Medicine
HIV, Hepatitis B,C, Transgender, Suboxone Specialist, Borrego Health (Riverside, San Bernardino, San Jacinto)
Member, Coachella Valley Clinical Research InitiativeREFERENCES: Medscape®