April 9th Update on Coronavirus from Crystal Run Healthcare

Dear Patients of Crystal Run,

I am writing, once again, to update you about the COVID-19 pandemic and about what we are doing to help keep you safe and healthy, and with a few suggestions about what you can do to help maintain your own health.

The toll of COVID-19 becomes more apparent with each passing day. There are some hopeful signs—the number of individuals coming to Crystal Run with symptoms of COVID-19 and the number of hospitalizations has decreased. Sadly, the death toll has continued to rise—my heart goes out to all those affected. While no one is completely safe from this infection, individuals with preexisting illnesses, and some ethnic/racial groups are at greater risk.

The public has acted responsibly, doing the difficult work of “social,” or more accurately, “physical distancing.” This change in behavior has been hard on individuals and families—but remains our best weapon against the threat of COVID-19.

We continue to see a large number of COVID-19 patients at our dedicated evaluation sites in Orange, Rockland and Sullivan counties. The good news remains that the overwhelming majority of those individuals do well, and recover at home, often with fairly modest symptoms.  It is important to emphasize that the course of this illness can turn rapidly—a change in condition, particularly difficulty breathing, should prompt immediate medical reevaluation. It is also important to understand our current thinking concerning individuals with COVID-19 symptoms who test negative for novel coronavirus. Many of those individuals are likely infected with the novel coronavirus, and anyone who is symptomatic should follow the same plan for isolation/quarantine. Why? The characteristics of the current tests for COVID-19 are not fully understood—while a positive test is unlikely to be a false positive, a negative test (one that does not show the presence of the virus proteins) could well be a false negative (a negative test result despite the presence of infection). 

We are 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. Despite the hype of the past few days, these studies are not yet readily available—we will let you know when they are. These tests will ultimately help provide assurance as people return to work and to their more normal routines.

We continue to take measures to increase social distancing in our offices. Symptomatic patients continue to be directed to our COVID-19 evaluation sites where they can be safely evaluated and tested if deemed necessary. If you do have any upper respiratory symptoms or unexplained fever, we ask that you not come to our offices, but instead call our CORONAVIRUS HOTLINE at 845-643-3909. You will be directed to one of our COVID-19 evaluation sites to be seen by appointment, safely and efficiently.

At the same time, we understand you may have non-COVID-19 related medical concerns. Some things can wait, but others should not. Uncontrolled blood pressure, diabetes or congestive heart failure cannot wait. Painful arthritis cannot wait. And even screening for colon cancer and breast cancer can only wait so long. Rest assured that we remain ready to evaluate and manage these and many other conditions. Our robust telehealth platform continues to mature and evolve—for many of you, this may be a great option, providing all the attention you need. For others, telehealth 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—if you email using your phone or computer, you can have a successful telehealth visit!

If you do need an in-person visit, we are doing everything possible to assure your visit is a safe one. We have established a no-wait rooming process; you go directly from your car to an exam room. For those who require only blood tests and vital signs, we have developed a quick and efficient process. For those most at risk due to age or underlying conditions, we even offer “outdoor” blood drawing. And 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 can 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.

While I have your attention—this is a great time to think about your health—“on the other side” of COVID-19. This is the time to start planning—and start doing. Remember the exercise program that your PCP has been urging you to consider? This is the time to start. Remember the diet you promised to start? Now is a good time. And what about the colonoscopy or mammogram that you have been postponing—this is the time to schedule for the summer or fall, when hopefully this will be behind us. If it’s time for a preventative health visit—do it by telehealth now, and if needed, complete your evaluation with a physical exam, lab tests and vaccinations in the summer or fall. Speaking of vaccinations—please don’t give your provider a hard time when she or he tells you about the flu or pneumonia vaccine in the fall—or the COVID-19 vaccine when and if it becomes available—the current pandemic should convince everyone that vaccination is vital. We know that those with underlying medical conditions, even obesity, are at higher risk from COVID-19; now is the time to start lowering your risk!

Finally, I want to highlight the work that many of our physicians and advanced practice providers (APPs) have been performing in hospitals during this most difficult of times. Many of our physicians and APPs, including our hospitalists, medical and surgical specialists, ob-gyns and others, regularly provide services in hospitals and continue to do so—but their work has become much more intense and challenging. In addition, approximately 100 of our physicians and APPs have volunteered to provide additional services in local and regional hospitals in order to help out during the pandemic. I thank all of them, as well as others working on the front lines of this pandemic, for their selfless service, and hope you will join me.

Thank you for reading, and thank you, again, for trusting us with your care. And remember, we are here when you need us!

Dr T

Hal Teitelbaum, MD, JD, MBA

Managing Partner & CEO