COVID-19 Update 3/23/20

There have been enough changes over the weekend that it seems appropriate to write again.  First, we are now sure that the virus causing COVID-19 is everywhere in Ohio.  A resident of Logan County has tested positive as have residents in surrounding counties.  For details on the cases, locations, and response within the state, please visit the Ohio Department of Health Website.

Perhaps more importantly for our hopes of managing this outbreak, Governor DeWine has issued a “stay-at-home” order.  This is a legally binding health order that closes non-essential businesses, limits non-essential travel, and generally requires the population to shelter in place for the coming weeks. 

We believe this was essential, difficult, and courageous for the leadership, but we also know that it is absolutely brutal and much more difficult for all of you who are losing paychecks, work, childcare, travel plans...  For as hard as this is, please, please take this seriously.  We will continue to do all that we can to assist you through this time, bring resources to our community, and support the larger health system; but that is not nearly enough.  We need to stop all spread of this now.  On Thursday the 12th, there were 8 reported cases in Ohio.  One week later, on 19th, Ohio went just passed 100.  Writing this on Sunday evening, we just learned that we have over 350 cases, adding more than 100 in the previous 24 hours.  More distressingly, officials are now saying that there is no effort to figure out how many people have it because it is spreading so widely and so quickly.  Activities that may have only been moderate risk last week become extremely dangerous now as larger and larger portions of the population become infected and begin spreading the virus.  Please stay home.  If you must go out for food, assume that everything you touch has the virus on it.  If you pick up produce, touch a container or box, or open a door - wash your hands with soap and water as soon as possible.  Truly, in any situation in public, stay six feet away from everyone.

To do our part in keeping all of us safe, we have now purchased and implemented a new computer-based system that allows us to have a video appointment with you.  If you would like to see how this works, please give us a call during regular business hours (937-404-2488) and we will set up a quick 3-5 minute practice visit with Nurse Cortney or Nurse Jen just so that we all know how things work.  We are able to handle many of the same things with video visits that we have done with in-person visits including many sick visits as well as routine follow-up.  We will also continue to keep our office open as long as we can do so safely.  If you would like a video or an in-person appointment, call ahead.  We will be working continuously to keep the office clean and simply ask that you be honest with us when we ask about fevers, cough or other respiratory symptoms (for you or anyone in your household).  Hopefully, we will be able to remain open for regularly visits through much of this time.

As always, we are grateful to have you as part of our work and our lives.  We welcome any feedback or questions that you may have, whether by phone (937-404-2489) or email.
 
Warm regards,
 
Rudi
 
Extra credit - Today’s idea is “closed groups.”  It is not only important that you not be interacting with more than 4 other people, but also that all of the people you are interacting with only interact with the same group that you are...  Think of it this way.  If everyone interacts with four other people (groups of 5), but each person in that group interacts with a different group 4.  You quickly end up with hundreds of exposures.  Here’s the example.

  • Al (A) and Betty (B) are a couple.  They meet with Carl (C) and Dianne (D) for lunch every day and Earnest (E) and Frank (F) their children most evenings.  They only have a group of four other people.
  • C and D have A and B in their group, but also meet with G and H.
  • E and F have A and B in their group and have two children I and J.


Already by the second day of this arrangement, A and B have been exposed to 8 people.  When you consider how this spreads out (particularly if some of the folks are younger people who might not have as much reason to be careful), you can see how one quickly gets to an exposure range in the 100s or 1,000s.  In short, if we are going to get this behind us, we really need to do all that we can to shut this down completely and quickly. 

Not only do you need to limit the people you are in contact with, but you need to make sure that the people you are in contact with are not in contact with other people.  For the group to be safe, it needs to have clear edges and not have members who are bringing in additional contacts from outside of the group.  If we all did this perfectly, the entire thing would be managed in about 2 weeks, literally trillions of dollars would be saved, and we could all get back to work and get ready for the summer.  While that is unlikely, the closer we get to that ideal, the better off we all will be. 
 
Double bonus: Take a quick read of this clever article that gives realistic hope that we might be able to get ahead of this thing and manage it: The Hammer and the Dance.  (And you can play with this cool calculator that is cited in the article: http://gabgoh.github.io/COVID/index.html)