April 23rd Update on Coronavirus from Crystal Run Healthcare

Dear Patients of Crystal Run,

I’m writing once again to update you about the COVID-19 pandemic, about what we are doing to help keep you safe and healthy, and with some additional observations about the pandemic and your health.

Sadly, since my last newsletter, there have been many more New Yorkers diagnosed with COVID-19, and many more have died.  Most affected are those with preexisting illnesses and those living in nursing homes. The hopeful signs I spoke of previously, however, are increasing—fewer people are reporting symptoms of COVID-19, and in both our region and throughout New York, the number of hospitalizations, patients requiring ventilators, and the daily death rate have declined.  

The public has continued to act responsibly, doing the difficult work of “physical distancing.” This change in behavior has been very hard on individuals and families, but has been necessary to curtail the spread of the novel coronavirus.  Some in New York and elsewhere have been protesting that by “closing down” business as usual, government has destroyed the economy and is violating their rights—and are demanding that counties and states be “reopened.”  If we fail to contain the spread because we “open” too soon, however, more will be sickened, and more will die.  If that happens, no thoughtful person will be rushing out to restaurants, to the movies, to sports arenas, to parades or to family gatherings.  The way to responsibly “reopen” our state and our country is by maintaining physical distancing until science and facts indicate it is safe to do otherwise.

The disruption to our economy and our way of life resulting from this pandemic will have serious consequences—including health consequences if people do not obtain needed medical care, either because they are afraid to or because they cannot afford to as a result of loss of jobs and health insurance.  But these concerns will not disappear if we resume normal activity too soon and infection again increases—in fact they could increase.

We remain hopeful that the new serologic tests will provide additional insight into the true prevalence of infection with COVID-19 and the question of immunity. These studies are blood tests which determine whether antibodies to a virus exist as the result of prior infection or immunization. Serologic tests are commonly used to determine immunity to other diseases including measles, mumps, rubella, chicken pox, etc.  While we hope to be rolling out this testing at Crystal Run within the next few days, testing materials remain in short supply, and the characteristics—including the accuracy—of these tests remain relatively unknown.  In addition, we don’t yet know whether a positive antibody implies immunity to future infection, and if it does, for how long.  These are answers that only thoughtful and well-coordinated research can provide.  A study reported in the last few days revealed that about 4% of the Los Angeles population has antibodies to the novel coronavirus.  If confirmed, this means that 25 to 50 times as many people were infected with the virus than previously thought. That would mean that the virus is much less lethal than we thought—but that the overwhelming majority of people remain susceptible—all the more reason to continue physical distancing for now, because with 96% of the population at risk, many could still become ill and succumb to COVID-19.

We continue to work hard to ensure that our offices remain safe for our patients.  Individuals with upper respiratory symptoms or unexplained fever should not come to our offices, but instead call our CORONAVIRUS HOTLINE at 845-643-3909.  Symptomatic patients are directed to our COVID-19 evaluation sites where they can be safely evaluated and tested if necessary.

Despite the current pandemic, we understand you may have non-COVID-19 related medical issues that require attention. This week, the Washington Post reported a major decrease in the number of heart attacks (myocardial infarctions), strokes and other acute medical problems being evaluated by physicians.  For the most part, doctors do not believe this represents an actual decrease in the incidence of these medical emergencies.  Instead, people are fearful of seeking medical attention in the midst of a pandemic, and so remain at home—sometimes until it is too late. Symptoms that would have caused you to seek medical attention before COVID-19 should still cause you to seek medical attention. For symptoms that do not appear to be immediately life-threatening, you may want to call first or arrange a prompt telehealth visit, but needed care should not be delayed.

We remain ready to evaluate and manage all your medical concerns.  A copay-free telehealth visit may be all that you need, or may be the initial step in helping to determine whether you need an in-person visit. Either way, telehealth visits are really easy to arrange and require no special technical expertise—if you can use your mobile phone, you can have a successful telehealth visit.

If you do need an in-person visit, we have made it as easy and safe as possible. We have established “no-wait rooming” for those of you who need to come to our offices—you go directly from your car to an exam room or other in-office destination. For those who require only blood tests and vital signs, we have developed a quick and efficient process.  If you need a regular office visit, our providers—physicians, surgeons, advanced practice providers and others—are available to see you. For those with both underlying medical problems and symptoms possibly related to COVID-19, we will arrange for you to be seen by your provider without posing a risk to other patients. Check-in and check-out are performed by phone, further minimizing your time in the office.

Last week I wrote about using this time to begin an exercise program or diet, or to commit to scheduling your mammogram or colonoscopy. As I mentioned, being healthy helps protect you from the high risk complications of COVID-19.  Since my last note, we have received some additional information that should be a call to action for some of you—tobacco smoking and/or vaping, as well as obesity, appear to be associated with a much higher risk of COVID-19 related complications, and there are some preliminary reports that regular aerobic exercise may provide some protection against those complications as well.  There’s no time like the present to begin forming some healthy new habits—or to eliminate some bad ones. 

Thank you for reading, and thank you for trusting us with your care.  We are here if you need us.