Physician and Patient.

I wear two hats. That of a physician and that of a patient. It’s a tall order, especially during this pandemic. The two roles often feel in opposition to each other. While the healer in me wants to be “out there” working in the front lines she also says the same thing she would say to another person in the same position: “No, don’t do that. You are part of the vulnerable group most likely to have a severe case of COVID-19. Do what you can from the sidelines. There is plenty of healing work to be done that doesn’t involve exposure.”

The Doctor

I became a doctor because I love helping people. I’m a healer at my core. The fact that there is no way to save people from the brutality of COVID-19 is a difficult one to accept. We are all dependent on our own immune systems to fight the battle and there is no treatment proven to be effective. Scientists are working faster than ever before but a solution is not there yet. Right now it is nature or nothing as a healing entity.

The Patient

So I do exactly what others are doing. I am sheltering and working from home. I am doing all I can to keep myself healthy and my immune system strong. That means good sleep, outdoor exercise daily (socially distanced of course), good nutrition, and recommended supplements such as Vitamin D, Vitamin C, and Zinc. I keep in touch with friends and family by Zoom, phone, and text. I listen to podcasts and I also participate in group therapy designed to help the group cope with the huge amount of grief and frustration that COVID-19 has brought to our world.

The Risk

The illness that puts me most at risk with COVID-19 is Sarcoidosis. Most people haven’t heard of it. It’s a chronic immune disorder that most frequently affects the lungs, as it does in my case. So I’m very careful about social distancing. Mask and gloves when going in stores. Social distancing outside. Lots of time at home. I GET that it sucks to withdraw from social occasions and the workplace. I’m frustrated like everyone else that we need to do this. But I also have confidence that we will get past it in time.

If I didn’t have an increased risk for this disease I might not understand the need for social distancing.  So if you are staying at home and don’t feel you need to I offer you a big THANK YOU for caring enough about others to respect the need for social distancing.  It might just be that you helped save some lives.

The world is changing dramatically, and we must change along with it.  Medicine has changed in two very important ways that reflect the demands nature and society have placed on it. 

TELEHEALTH IS NOW

First, Telemedicine is no longer the wave of the future.  It is NOW.  Like social relationships that have transitioned to online meetings, so have medical services.  Dr. Larson holds telemedicine appointments using a HIPAA compliant connection through her Electronic Health Portal.  She was a pioneer in telemedicine, having used teleconference technology for several years over several platforms. 

Not all video connections were created equal.  They each have their pros and cons.  Variations in connection reliability, portability, and security make the choice of platform important.  When considering what kind of connection you want to have with your provider remember that unless it is compliant with the Health Information Portability and Accountability Act (HIPAA) the privacy of your health information may be compromised. 

PERSONALIZED MEDICINE IS NOW

COVID-19 has brought to our attention in a dramatic way that while we are all the same, we are also different.  Our vulnerability to infection and severity of disease varies with age, health status, and variables we have not yet discovered.  People are aware of their individuality and want medicine that delivers to their unique needs.  This pattern has been developing for some time but is now a driving force for change. 

Dr Larson’s Functional Medicine practice offers a path to personalized care through cutting edge testing and attention to the specific needs of individuals.   Those needs are uniquely expressed in an individual’s DNA.  The new science of Genomic Medicine expands the opportunities for individualization in medical decision making beyond what can be accomplished with even the cutting edge Functional Medicine tests.  To learn more about Personalized Medicine and Genomic Medicine contact Dr. Larson.

Plans to reopen US economy
Plans to reopen US economy

On Thursday evening, April 16, 2020, a summary of the Federal government’s plan to reopen the U. S. Economy was shown on the San Francisco NBC evening news. While I watched I took screenshots of my TV.

There are 3 categories of Gating Criteria proposed to be met before proceeding to Phase I Opening.

State or Regional Gating Criteria

These criteria require not just a flattening of the curve. They propose to see a downward trend in reported symptoms and case reports. Hospitals need to be able to handle all non-crisis care and they should have in place a robust testing program for at risk healthcare workers, including new antibody testing.

These criteria make sure that our healthcare system is no longer overwhelmed with COVID illnesses. It’s good to see the call for a robust testing program for Healthcare Workers. How about adequate PPE?

The Phases to Reopen The Economy

Governors have discretion in when they feel their state is ready for Phase One.

Phase One

This is a huge step. It means many people back to work, many people going to public places, and an INCREASED need for each individual to protect themselves and others against exposure. It means: Keep wearing a mask and gloves. Keep social distancing in place. There is a lot of awareness required. MORE than is required now when so many people are out of circulation. If we don’t do well enough at this step the curve will turn upward again.

Returning to work in the age of Covid-19

What are the recommended health requirements for return to work? Temperature measurement is a poor screening measure. It will only capture those with active illness who have ignored the mandate to stay at home when sick.

It won’t capture those with lingering ability to spread the virus or who are in the incubation period after exposure but not yet sick. We need better guidelines here. Social distancing is completely appropriate but it can’t make up for screening errors. There are too many occasions where social distance is either ignored or not possible in the workplace.

Does this step allow for gyms and theaters to open? It appears so but Phase 3 mentions opening restaurants and theaters.

The bullet points are brief and consequently cannot include measures to ensure appropriate sanitation in public places. There also aren’t any guidelines for testing of the larger population, a measure clearly recommended by public health officials.

Phase Two
Phase Two

It’s hard to predict when this phase can be implemented. Already many schools are closed for the rest of this school year. Summer programs and vacations have been cancelled. State by state it will happen.

Phase Three
Phase Three

It’s time to consider how you will change your behavior as we move to more freedom to circulate. If you are a business owner forced to close during the shelter in place period how will you adapt your business practices when allowed to open?

We are all in this together. Please use caution and STAY WELL! Susie Larson, MD

Please watch as Dr. Emily London talks about what we all must do to protect ourselves and others from COVID-19. It’s about the value of doing nothing. Sound strange? Listen.