March 9, 2020
By: Wendy Johnson MD, MPH,
We are fortunate so far that no one in New Mexico has yet tested positive for COVID-19, but it is likely just a matter of time before cases are identified.
At La Familia Medical Center, we are taking precautions to protect the most vulnerable in our community from becoming infected. Currently, we are working with the New Mexico Department of Health, our other local hospitals and healthcare facilities, and the City of Santa Fe coordinating a community-wide response. We are dedicated to providing our patients and community with the most up-to-date information about how to best protect yourself, your family and our entire community.
First, it’s important to know how Corona virus is transmitted:
Corona virus is respiratory disease transmitted by droplet transmission. This means that an infected person can only spread it by oral secretions in droplet form, someone who might cough or sneeze near you or directly on you (probably needs to be no more than 6 feet away) can transmit it to you only if their oral secretions come in contact with your mucous membranes. That can happen in a few ways: 1. They cough and their oral secretions land on your lips, mouth or nose. 2. They cough and their oral secretions land on your skin or clothes, you touch that area and then touch your mouth or nose. 3. They cough and their oral secretions land on another surface, then you touch the surface and then touch your face (this is the least likely method).
The most important factor for infection control is to identify the possible source of infections (a confirmed infected patient who is symptomatic) and minimize the risk that they will spread it to others. The sicker someone is with lots of coughing, sneezing and sniffles; the more likely they are to transmit the virus. Asymptomatic people may also spread the virus, but since they are not actively coughing or sneezing, it’s probably much less likely for them to spread it to casual contacts.
If you are exposed to coronavirus and become symptomatic, it will probably take about 5 days to start to feel ill, usually with a fever and dry cough first. But the onset of symptoms could be as little as 2 or as many as 14 days, which is why many states are quarantining people who have been exposed for 2 weeks.
Finally, it likely that when we have all the data, the fatality rate overall for COVID-19 will be less than 1%. The vast majority of those deaths will be in people over 70 or with weakened immune systems. For most of us, getting the virus will feel just like a bad cold. We don’t need to worry about ourselves too much if we get it, but we do need to make sure we don’t spread it to others. We all need to be very careful and protective of those in our community who are older, pregnant, or have other chronic illnesses.
What we are doing at La Familia Medical Center to reduce the risk of spreading the virus:
Keeping sick patients isolated – We are asking those who have symptoms to call first, and identify themselves at the front desk so we can make sure they get efficient care while exposing the fewest number of other people. We are not turning any of our established patients away, but we are advising those with milder cold symptoms, like cough and fever without shortness of breath, to call us before coming in so we can advise them on next steps. For most folks, there will be nothing additional we can do for them at the clinic, and keeping those who do not need clinical attention out of the clinic will better protect other vulnerable patients and staff.
Hand washing: Regular soap completely eliminates the virus and works even better than hand sanitizer. We are washing our hands frequently, especially before and after each patient encounter, before and after we touch patients, and before and after we touch any potentially contaminated surfaces. We Here are some good videos on hand washing technique: https://www.cdc.gov/handwashing/videos.html
Masks: Masks will only partially protect the one person wearing the mask for a short time. Also, they can also give you a false sense that you are protected when you really are not. If a sick person coughs on you, even if you have a mask on, and you touch the area where they coughed, and then touch your face, you may become infected EVEN IF YOU ARE WEARING A MASK. The mask itself can become a vector for illness if you wear it for too long or take it off incorrectly. The same mask on a symptomatic person however can protect all of the dozens of people they may come in contact with while in the clinic and prevent them from spreading the infection to other surfaces. If we have limited masks, we will use them for patients first.
Cleaning surfaces! We will have to give special, extra attention to this. Bonnie and the nursing staff are working to make sure everyone knows proper cleaning procedure and follows it. If we do get coronavirus in New Mexico, we might designate only certain rooms for those with symptoms and other rooms in a separate pod for patients more likely to have weakened immune systems.
What you can do:
Social Distancing: Refrain from shaking hands and keep some distance between you strangers in public places if you can.
Hand Washing: Remember that soap and water is the best way to eliminate the virus. Wash your hands for 20 seconds and make sure to rub all surfaces, including between fingers and
thumbs and the sides of your hands. Hand sanitizer is a good option if you don’t have access to water.
Be careful what you touch: Try to minimize touching your face, any surfaces in public places, and your phone! This is the perfect time to work on decreasing your phone use and be attentive to cleaning your phone periodically.
Stocking up on supplies: Remember that this is a pandemic, not a snow storm. If you are not ill, the risk of going to the grocery store is very low. When a few people hoard all the supplies, those who need them most have to do without, and that can endanger all of us. For example, the people who probably need hand sanitizer most are our home health aides, who go in and out of the homes of the most vulnerable every day. Health care workers really need to have access to masks. And if you’ve ever tried to change a messy diaper in public without baby wipes, you know how much parents of infants need those wipes more than you do! Please remember that for most people, all they need to stay safe is soap and water, and to remember these tips.
If you are ill, stay home. This is critical. Please do not expose others if you are ill, even if you are sure it’s not coronavirus. Especially stay away from those over 60, pregnant women, or anyone who may have a weakened immune system. Stay home from work, and if you live with others, try to sleep separately and use a separate bathroom. If that is not possible, do not share towels with others.
Get a flu shot! So far this year about 30 million people have gotten the flu and 17,000 have died. The large number of flu cases combined with coronavirus has the potential to seriously strain our healthcare system. By protecting yourself, you can
Helping the most vulnerable in our community: Check in with neighbors who live alone or are older, offer to help them with shopping or other errands. Ask if there’s anything they need.