What doctors want you to know about COVID-19

it is recommended that people stay at home as much as possible, going out only for critical needs like groceries and medicines, or to exercise and enjoy the outdoors in wide open spaces.

In this post I’m sharing some of what I’ve been reading about the COVID-19 epidemic. These experienced, knowledgeable, compassionate physicians share insights to help colleagues as well as patients. I thank them for taking the time to share in the midst of this crisis.

a perspective from China

Since 2016, Laura Jordhen, M.D. has been practicing in Shanghai’s United Family Xincheng Hospital and was chair of infection control for the hospital before becoming chief of its family medicine department in December. In an interview for the AAFP she said,

“(In China now) Things are slowly getting back to normal. Our ear, nose and throat clinic is reopening. Dental is reopening. The number of new confirmed cases is low.

People in Wuhan are still basically isolated in their homes, but throughout the rest of China schools are starting to open up. With still a few cases reported every several days in Shanghai, schools have still not reopened. It’s still very strict social isolation.

Massage, hair cut — any kind of business that involved physical contact or having people close together — was shut down around Chinese New Year, which started Jan 25.”

Read more of Dr. Jordhen’s insights on China’s handling of COVID-19 at

U.S. FP Shares COVID-19 Insights From Practice in China

an electron microscope image of the coronavirus
used with permission, CDC.GOV

from the National Institutes of Health

On the NIH Director’s blog, Dr. Francis Collins explains social distancing.

“What exactly does social distancing mean?

Well, for starters, it is recommended that people stay at home as much as possible, going out only for critical needs like groceries and medicines, or to exercise and enjoy the outdoors in wide open spaces.

Other recommendations include avoiding gatherings of more than 10 people, no handshakes, regular handwashing, and, when encountering someone outside of your immediate household, trying to remain at least 6 feet apart.

These may sound like extreme measures. But the new study by NIH-funded researchers, published in the journal Science, documents why social distancing may be our best hope to slow the spread of COVID-19. ” Read more at

To Beat COVID-19, Social Distancing is a Must

Practice Social Distancing.
provided as a service from the University of Oklahoma Medical Center

In A nine-step plan to deal with COVID-19 stress, psychiatrist Dr. Gerard Clancy offers this advice.

“7. Can-do list. Under the current guidelines there are many things we can’t do. With activities out in the community curtailed, this can leave down time. This has allowed us to create a list of what we can do.

This has included reading books, reorganizing the house and watching classic and new movies. It has also included my own version of Master Chef, where I need to cook dinner with what we have left in the pantry. It has been a challenge but also fun.”

Family of 4 sitting at a dining table.
I’ve heard some families say this is allowing them to eat dinner together more than usual.

Why Doctors and Nurses are Anxious and Angry

“Every single day for the past six months, I have recommended the flu shot for my patients, and every day a good chunk decline. When I ask why, most can’t articulate an answer. They offer only an inchoate distaste for vaccines, fomented by the oddly contagious anti-vaccine movement.

I remind them that their grandparents would have given their eyeteeth for the vaccines they blithely shrug off. I point out the entirely unnecessary resurgence of measles resulting from a falloff in vaccination rates.”

Dr. Danielle Ofri, a doctor at Bellevue Hospital and a clinical professor of medicine at New York University Grossman School of Medicine, is the author of “What Patients Say, What Doctors Hear” and the forthcoming “When We Do Harm: A Doctor Confronts Medical Error.

Review your family’s vaccination status at this previous post about vaccine preventable diseases.

exploring the HEART of COVID-19

I invite you to share your thoughts and experiences dealing with the challenges this disease outbreak brings into your life. What have you found helps you to survive and thrive though this? How will this change your life, good or bad? Share here or find me on social media.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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CDC-Coronavirus Disease 2019

Should your family receive vaccinations? YES

This coronavirus pandemic is serious. We don’t yet have a vaccine or effective treatments. To protect ourselves, our familes, and our entire communities we should all be practicing social distancing until advised otherwise. Please review these guidelines to prevent spead of this disease.

2020 vaccination recommendations from the CDC

These charts show 2019 guidelines but there were not major changes for 2020.

With a few exceptions for medical reasons I believe all adults should discuss vaccination with their physician and be immunized for any diseases for which they are at risk.

And I recommend that parents do the same for their children and adolescents.

RECOMMENDED ADULT IMMUNIZATIONS 2019
RECOMMENDED CHILD AND ADOLESCENT IMMUNIZATIONS 2019

questions to ask about vaccines and the immunization process include.

  • What contagious diseases is a person likely to be exposed to?
  • What are the risks of those diseases?
  • What are the risks of a particular vaccine for that person?
  • What are the risks versus benefits to other people?
  • What else can we do to prevent an infection?

Infectious disease control methods

The  developed countries  have eliminated or controlled many of the environmental sources of contagious disease by manipulating our environment.

  • indoor plumbing
  • water treatment facilities
  • screens on windows
  • air purification
  • wear gloves to prepare food
  • inspect restaurants
  • signs in public restrooms reminding us to wash our hands.
Hand hygiene saves lives.
Hygiene remains vital to infection prevention even when immunizations are given.

However, we haven’t eliminated another source of infectious disease- other humans.

Rarely do we isolate or quarantine people with infections. Most of us have gone to work, school or social events with symptoms suggestive of infection- a cough, runny nose, upset stomach- putting our friends and colleagues at risk.

This coronavirus pandemic is serious. We don’t yet have a vaccine or effective treatments. To protect ourselves, our familes, and our entire communities we should all be practicing social distancing until advised otherwise. Please review these guidelines to prevent spead of this disease.

15 DAYS TO SLOW THE SPREAD

RESOURCES FOR understanding COVID-19

an electron microscope image of the coronavirus
used with permission, CDC.GOV

Tips from your Family Doctor

CDC-Coronavirus Disease 2019

exploring and sharing the HEART of health

Thanks for reading and sharing this important information about protecting the HEART of health.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

Dr.  Aletha 

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These may be good options as long as we need to stay in our homes.

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Will measles become the next pandemic? a book review

Diseases that haven’t occurred much in the past 20 years are making a comeback all over the world. And they are largely preventable.

Influenza has arrived in the United States with some areas already experiencing epidemics. We pretty much expect this to happen in the winter despite wide availability of influenza vaccine.

But other diseases that haven’t been seen much in the past 20 years are making a comeback all over the world. The number of measles cases continues to climb, with 5 countries accounting for half of the world’s victims- Congo, Liberia, Madagascar, Somalia and Ukraine.

In 2019 the United States almost lost its measles elimination status because of a nearly year-long measles outbreak in New York, with the greatest number of measles cases since 1992. The New York State Department of Health declared the outbreak over in October, and the Centers for Disease Control and Prevention announced it would maintain the country’s elimination status.

And in a part of the world that conjures up images of a tropical island with sunny skies and pristine beaches, Samoan children are dying of measles due to increasingly low vaccination levels, currently only 31%. Over 5,100 measles cases have been reported since the outbreak, with 74 recorded in a recent 24-hour period alone, according to Samoa’s government. 

The low vaccination rate this year was caused in part by distrust of vaccinations that spread last year after two infants died after a vaccine error- nurses incorrectly mixed vaccines with another medicine. The accident compounded the worldwide spread of misinformation about vaccines. 

The anti-vaccination movement made the list of the World Health Organization’s top threats to global health in 2019

CBS NEWS

I don’t know if anyone has suggested it , but it seems we may be entering a pandemic of measles. Here is a review of a book explaining what that means.

Pandemic by Sonia Shah

Sonia Shah , a science journalist, has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

Tracking contagions from cholera, to Ebola, and beyond

And she answers the “why” in the introduction-

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

Let me back up and define some terms.

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

Epidemic– the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less.

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

map of the world
In a pandemic, an infectious disease may spread all around the world.

Why infectious disease still matters

With healthcare focus on chronic diseases like heart disease, diabetes, cancer, and dementia, even physicians can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

Cholera is rare in the United States now, but in the past it has been deadly here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors recognized this, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope
photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark

how disease spreads

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles.

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

Pandemic includes extensive footnotes and a glossary of terms used in the book.

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

Here are other resources about how infections spread and how they can be stopped

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”

created by Mark Honigsbaum and animated by Patrick Blower 

 

When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed

by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

 At this link read how Dr. Gretchen LaSalle

blows the whistle on anti-vax false claims

an excerpt-

“Vaccines are recommended for personal health and required for the greater good. To protect those who can’t be vaccinated and to preserve the health of our communities, many vaccines are required for school entry. If you choose to participate in the community (ie, attend school), you have a duty not to harm those you come into contact with. And if you can’t make that decision for yourself, sometimes the states have to step in and make that decision for you. But still, you always have the choice to keep your kids out of school. The consequence for you is that you are now in charge of educating your own children. The consequence for your child is that their health is at risk and they are deprived of socialization and interaction with their peers. But, hey. You always have a choice! “

For a review of vaccine preventable diseases read my previous post

Vaccination prevents disease

exploring the HEART of preventing disease through vaccination

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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August Timely Topics- back to school

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

Photo by Pixabay on Pexels.com

August Timely Topics

Most schools encourage and even require vaccination to protect all children from disease. This has become a controversial and contentious topic so we’re going to visit the medical reason vaccinations make sense.

Measles-not gone, not forgotten

Recommended Child and Adolescent Immunization Schedule
from the Centers for Disease Control and Prevention

The start of school in August reminds me of my college days- especially since I met my husband in college, the University of Oklahoma. I was studying pre-med; he was in graduate school, using his veterans’ educational benefit after discharge from the Army. Here are a couple of posts about his military service and our courtship.

Bullets to Blessings

Two Words and Two Left Feet

Of course, the main goal of school is education- lectures, textbooks, assignments, studying, projects, experiments, and tests. Reading is vital to all of these-books are the basic building blocks. That’s why Dolly Parton gives books away- read why here.

Overcoming the Dream Killers

Overcoming the dream killers-Watercress Words.com

Can medical knowledge make you a better patient?

And speaking of tests, here’s one for you. Find out how much you know about medicine by taking this quiz that I wrote especially for blog readers.

CAN MEDICAL KNOWLEDGE MAKE YOU A BETTER PATIENT?

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

myReader Rewards club- photo of woman on a bench reading a book

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Summer is the perfect time to start or increase physical activity. I’ve been using a fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

6 tips to cope during a flu epidemic

To many people “the flu” is any respiratory illness characterized by some combination of fever, cough, congestion, headache, fatigue, and body aches. But it more correctly refers to influenza

  1. If you think you have “the flu”, you probably don’t. (This season may be an exception.) 

Another doctor posted on Twitter , “If you feel like you’ve been run over by a truck, but you haven’t , then you have the flu.”

To many people “the flu” is any respiratory illness characterized by some combination of fever, cough, congestion, headache, fatigue,  and body aches. That term has become so nonspecific even we doctors use it that way. But it more correctly refers to influenza, which is  one of many viruses that cause illness. The illnesses caused by the other viruses are usually called “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis and pneumonia.

I recommend this resource  from the Centers for Disease Control and Prevention to understand

influenza symptoms 

emergency warning symptoms that warrant an emergency room visit 

influenza complications 

The human respiratory system
The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay)
  1. If your doctor thinks you have “the flu”, you probably do.

Prior to the availability of the “rapid flu” test, we doctors diagnosed influenza by the characteristic symptoms, confirmatory findings on exam, and knowing there was an outbreak in the community. The test is not absolutely necessary but is helpful for confirmation in the event the illness doesn’t progress as expected.

3. The best way to prevent influenza is by vaccination.

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) , the National Foundation for Infectious Disease and every other reputable medical organization recommends vaccination against influenza.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, just like there are with any medical procedure, or lots of other things we do in life. In this case we have decided the benefit outweighs the risk.

  1. If you want to avoid getting influenza, avoid being around people who may be infected.

This means everyone, since one may be contagious 2 to 3 days before symptoms. It’s not a coincidence that influenza outbreaks coincide with the American holiday season (approximately November through January). So to protect us all,

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • If you absolutely must go out among other people, put a mask over your nose and mouth.
  • Cover your nose and mouth when coughing or sneezing
  • Wash your hands frequently.
  • Wash frequently touched surfaces frequently.
Hand hygiene saves lives.
a common sight now in public restrooms
  1. If you do get sick, don’t ask your doctor for an antibiotic.It will not help. 

    Antibiotics attack bacteria. Influenza and 99% of all respiratory illnesses are due to viruses.

Tamiflu

The antiviral drug Tamiflu, generic oseltamivir,  will “shorten the duration and severity of symptoms” by 1-2 days, if started early (within 24-48 hours). There is some evidence that it will also lessen the risk of serious complications , especially in higher risk people (see below ).

I warn people that even with Tamiflu they will still feel miserable for a few days. But if it gets you back to school or work a day earlier, it may be worth the cost.

Oseltamivir can also be prescribed for prevention, if you know you have had close contact with someone with confirmed influenza, such as a household member. It’s only effective though for that episode, a 10 day course taken as soon as possible after exposure.

Xofluza

Xofluza, generic baloxavir, is for treatment of uncomplicated influenza for children and adults 12 years and older, who have been sick for no more than 38 hours. Patients take 2 tablets as a single dose. It is not approved to prevent influenza.

Home care of influenza

Otherwise, the treatment is“symptomatic” or “supportive” care:

  • Rest; eat and drink as normally as possible; extra fluids if running a fever 
  • Non-prescription cough/congestion /pain/fever meds

Don’t confuse Tamiflu (generic oseltamivir) a prescription anti-viral drug with Theraflu, an over the counter drug that treats symptoms.

Theraflu does not affect the course of the illness.

Here are  general guidelines  on what to do if you get a respiratory illness.

  1. You can die from influenza, but you probably won’t.

Influenza causes uncomfortable disabling symptoms but most people recover fairly quickly and fully. In some cases influenza can progress rapidly and overwhelm the respiratory and/or nervous systems,  leading to death.

People also die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia.
Healthy lungs with no signs of pneumonia.

High risk persons-take influenza seriously

Persons with chronic illnesses like diabetes, lung disorders, chronic liver or kidney disease, depressed immune systems and cancer , as well as infants and persons of advanced age are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

sharing the HEART of health in flu season

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

And please share this vital information-you may help safe someone’s life.

                              Dr. Aletha