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COVID-19 Update: Stress During the Pandemic, Frequently Asked Questions,  COVID-19 Projections & Immune-Supporting Foods

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Covid-19 Update, March 27, 2020
Newsletter
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Dear Priority Physicians member:

Although we strongly advocate that you minimize encounters outside your home, we suggest you think of this as physical distancing, rather than social distancing. People are communal beings, and we encourage you to discover alternative forms of social interactions. Think creatively about how you can maintain social connectedness, even if you cannot leave your home. Can you call a friend or relative on the phone? Can you try out video conferencing through one of the many platforms available? Can you walk outside, talking with neighbors from a distance across the street?

No matter what your pre-COVID life was like, your current experience is most likely fundamentally different. The outbreak of COVID-19 is stressful in many ways. While we always focus on optimizing your physical well-being, we are equally concerned with your mental health. Anxiety about a disease can be overwhelming and cause strong emotions. Isolation from our friends and family can magnify these fears. Many of us feel lonely and confined, which can be associated with a depressed mood. Finding strategies to cope with stress will help keep you, the people you care about, and your community stronger.

Stress during the pandemic can include
  • Fear and worry about your own health and the health of your family and friends
  • Feelings of numbness, disbelief, anxiety or fear
  • Feelings of sadness or hopelessness, or frequent crying
  • Difficulty sleeping or nightmares and upsetting thoughts and images
  • Changes in appetite, energy, and activity levels
  • Anger or irritability
  • Difficulty concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs
Things you can do to support yourself
  • Connect with others. Talk with people you trust about your concerns and how you are feeling. Maintain healthy relationships and build a strong support system.
  • Stay informed through reliable sources. Look beyond rhetoric and arm yourself with trusted knowledge. We are committed to providing you with accurate, current information.
  • Take breaks from watching, reading, or listening to news stories, especially social media.
  • Create a structured, dedicated work environment.
  • Maintain a regular routine of your daily activities, including scheduled meals and breaks.
  • Take care of your body. Eat healthy food, exercise regularly, get plenty of sleep, and minimize alcohol.
  • Make time to unwind. Engage in activities you enjoy. Try new things!
  • Get outside as often as possible, especially as the weather improves. Relax in the yard with your family, walk your dog, read a book on a blanket in the sun, or move your home office outside for the afternoon.
As always, if you are struggling, please call us. We are always available to answer questions or talk through your concerns. Our goal is to help you build resilience that can sustain you through this unprecedented period. Despite the physical distance we must maintain, you are not alone.

Sincerely,

Dr. Brian Morris


Frequently Asked questions

 
We also want to address some of the more common questions that our patients have asked in the past week.  We’ll continue to add to this list as this pandemic progresses. 

If I’ve had the virus, when can I return to work/ get out of self-quarantine?
The consensus is that patients quarantine for 14 days after symptoms start.  If the symptoms are minimal, but if you have been diagnosed with COVID-19 via a nasal swab PCR test, then the recommendation is to quarantine for 14 days after the test was performed. It is recommended that you have 2 negative nasal swab PCR tests that were taken at least 24 hours apart before returning to work or being cleared from a full quarantine.

How will we know who has had the virus and who hasn’t if many people get it and have mild symptoms?
We are awaiting the availability of an accurate IgG antibody test.  IgG antibodies are the antibodies that your body makes once you’ve cleared an infection and are immune.  They are also the antibodies that we test to make sure a vaccine has worked properly.  Once this test becomes widely available, we will be able to get a more accurate picture of which patients have had the mild cases of COVID-19 and are now immune.  Again, it’s VERY important that any IgG test is highly accurate.  We certainly wouldn’t want to tell a patient incorrectly that they’re immune to COVID-19.

I have a CPAP machine.  Is it safe to continue to use it if I have an infection?  Can it be used like a ventilator to help me breathe? 
For patients with obstructive sleep apnea, a CPAP machine can be an essential device for sleeping properly and taking stress off the heart and lungs while you sleep.  CPAP machines are safe to continue to use while fighting off any lung infection.  They do not worsen the condition or force the infection deeper into the lungs.  There is a possibility that they could exacerbate the aerosolization of viral particles in your immediate vicinity and potentially increase the chance of your partner getting infected.   This is a very infectious virus to begin with though, and most partners who sleep in the same bed seem to be giving it to the other partner regardless of CPAP usage.  As to the second part of the question, unfortunately CPAP machines are not a substitute in any way for a ventilator.  They cannot generate the pressure to force air into damaged or fluid filled lungs.  Even if they could, you’d need to be intubated in order to deliver that much pressure.  Otherwise, the mask pops off your face, or the air is forced into your stomach along with your lungs.
 
I can’t smell (anosmia). Do I have COVID-19? 
Anosmia as the inability to smell and can be caused by a variety of medical conditions.  The most common of which is seasonal allergies.  As we come into the Spring, the inability to smell is much more likely related to allergies than COVID-19.  Exposure to certain chemicals including tobacco smoke, alcohol, and some prescription medication can also cause a loss of smell.  There is, however, a certain subset of patients with COVID-19 who temporarily lose their ability to smell.  This typically comes with a constellation of symptoms that are more characteristic for COVID-19, most notably a fever that would not be seen with allergies.

Do you think it’s likely we’ll be off social restrictions by Easter? 
Not only is this unlikely, but it would almost certainly be dangerous.  We continue to see the number of cases increase exponentially both locally and nationally.  Eventually, this exponential curve will start to flatten out and then fall.  Once this happens, it will be reasonable to re-evaluate which quarantine measures to keep and which to relax.  Our best guess is that we’ll see peak infection sometime in the next 3-4 weeks, with it hopefully falling off after that. There are many models that have been shared modeling the COVID-19 projections of cases, severity of illness, and resources that you may have already seen.Click HERE to access one model's interactive projection for the United States or by each state individually.
 

8333 Naab Road, Suite 360
Indianapolis, IN 46260
317.338.6400

13914 Southeastern Pkwy, Suite 208
Fishers, IN 46037
317.415.9900

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