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Coronavirus: (COVID-19) UPDATED Sunday March 22, 2020

Bradley Berryhill, MD

Bradley Berryhill, MD
Community Health Chief Medical Officer

Message to Our Community Health Patients

From Bradley Berryhill, MD, Chief Medical Officer

This is a historic moment in time for our world and no less true for everyone who lives here in central Vermont. There exists a level of stress and anxiety which is uniquely representative of this moment in time. Even in these trying times, our mission at Community Health remains unchanged. We are here to care for you and your family in the most equitable, highest quality and safest manner possible.

The coronavirus pandemic confronts us all with new and significant challenges. To accommodate and meet these challenges, we will be implementing new processes in order to meet your health care needs.

Coronavirus has now reached every country in the world. It has a demonstrated prevalence here in central Vermont. You and your family should have that understanding.

Most patients who have contracted the coronavirus have mild disease. Also, most do not have a known travel or exposure history.

Please be aware of the importance for social distancing, practicing cough etiquette and hand hygiene, restricting non-essential travel and avoiding groups of people. These public health practices will be critical to modifying our health burden over the next coming weeks.

In order to accommodate your health care need in a manner that is safe for all, Community Health will be changing our delivery of services. Each of our facilities will be setting a workflow that is both sensitive to your needs and sensible for their resources.

For our patients with chronic and non-urgent conditions, we still want to care for your needs. This may occur over the telephone, may occur via a video Telemedicine encounter (using your home computer of mobile device) or possibly you will need to be seen in the office. Your Primary Care Provider (PCP) staff will be reaching out to you and together we will decide how best to meet your needs.

If you have an acute or urgent health concern, then we will work with you and direct you to the most appropriate care environment. If possible, please try to call ahead. This will give us the best opportunity to ensure that your experience is both safe and satisfying.

We want you to know that we will remain open and ready to assist you. If you do come into the office, you will be screened for the coronavirus in a safe and confidential manner.

While physically at your provider’s office, your safety is a priority. We will need your cooperation and understanding for implementing new processes to meet our mutual goals.  Our goals remain the same. We will provide you the quality care that you deserve, in a manner that is meaningful and helpful to you, while protecting your and our staff’s safety.

Dr. Brad Berryhill
Community Health
Chief Medical Officer

Patient and Family FAQ’s and COVID-19

Many of our patient and families have legitimate questions regarding their care, safety and appropriate activities moving forward into the COVID-19 pandemic. Here are some fundamental questions and answers.

This is a respiratory virus transmitted via infected airborne secretion droplets (sneeze or cough). Importantly cough hygiene is critically important (covering a sneeze with a hand, arm, elbow or shoulder followed by a 20 second hand washing and then application of hand sanitizer).

Yes absolutely. This may be the most common route of infection. A patient touches a surface followed by touching their eye, nose or mouth. If this occurs, simply wash your hands with soap and water for 20 seconds and use hand sanitizer if available. Try to avoid these surfaces or any suspected contaminated area. Do not touch your face with your hands.

We believe about 2-3 days. If disinfecting a surface, use only those products that are labeled as EPA-registered for the human coronavirus. Simple bleach will not be effective.

We suggest using gloves to handle the mail and packages. Hand transmission is the concerning issue.

The Governor has issued  a Stay Home, Stay Safe Order period throughout Vermont. This means people should only leave home for essential reasons. If your are sick, stay home to protect others. You CAN go to the grocery store/pharmacy. Continue to go outside, take walks, and get groceries and medicines as needed while practicing social distancing and proper hygiene.

Social distancing is important. This is not the same as social isolation or being placed under quarantine. Social distancing means that we avoid a crowd, avoid close contact and eliminate much of our travel. All sporting events are now closed and many schools are closed or closing.

Typically, these are respiratory symptoms with a fever. These include a deep cough, shortness of breath and a fever. Occasionally, a patient will experience significant diarrhea. This can be difficult to assess, especially as we are in the middle of cold and flu season. We believe that four out of five patients with COVID-19 will have mild disease and that one out of five will have severe disease requiring a medical intervention.

The elderly, age 65 and above, most particularly anyone who has functional or structural heart and/or lung disease. Most very severe case occurs in patients in their 70’s and 80’s. Lastly, patients who are immunosuppressed or immunocompromised are at some increased risks. That includes patients with diabetes, patients with a cancer diagnosis and those receiving medications to alter their immune systems.

In the future (not now) we may be asking healthy patients and patients with non-urgent medical concerns to postpone their doctor visit. We will communicate more about that in the near future.

If a person is experiencing a fever with a deep cough and shortness of breath, or if the feel that they may be dehydrated then they should come to the doctor. Try to call ahead and realize that you will be screened and triaged to an appropriate care environment upon arrival. Also, those patients with chronic illness and who may not be stable, or have legitimate concern for such, will need to be seen.

Do not come to the doctor for minor cough or cold symptoms. That is for a runny nose, scratchy throat and upper airway congestion without a fever. If those symptoms occur, then please stay home, do not go to work, practice good personal and cough hygiene to protect your family members and self-monitor for advancing symptoms. Should they develop then contact your doctor.

Any person who has traveled anywhere internationally, or to a U.S. hotspot, within the past 15 days and has no symptoms. Those people should strongly consider self- isolating and self-monitoring for symptoms for a period of 14 days. The CDC has advised all people who have traveled from a designated level III country within the past two weeks to be quarantined at home for 14 days. There is no need for a doctor visit in this circumstance unless concerning symptoms develop or if an unrelated and serious medical condition occurs.

Additionally, any person with no symptoms, no known exposure and no high risk travel history should not come to the doctor asking for COVID-19 evaluation and testing. This advice may change over the next few days or weeks, however at this moment in time, this is the most prudent advice for our healthy patients.

Please have at least 30 days of your prescription medications. If you are running low, then call your doctor and we will ensure an appropriate prescription refill. Important items to have at home include bathroom cleaning material, hand sanitizer with at least 60-70% alcohol (if you can find it), soap and a water supply. We do not anticipate a legitimate shortage of food for our population, though it appears that fresh meat and produce may have some limited access at this moment in time.

Remember, the most effective maneuver for protection is avoiding droplet contact and washing your hands with soap and warm water for at least 20 seconds.

This is an unprecedented moment in history and by necessity Community Health will be making unprecedented adjustments to the way we deliver care. Our goal is to get the appropriate care to any and all who need that care and to protect our staff from harm. This is a shared responsibility for which we are asking for your understanding and cooperation.

Hand-Sewn Mask Donations

Many of you in our community have asked about sewing and donating fabric masks to help supplement our inventory of Personal Protective Equipment (PPE). Per guidance from the Centers for Disease Control and Prevention stating that fabric masks are a crisis response option when other supplies have been exhausted, we welcome these donations.

Below is some general guidance for those who wish to help by sewing masks for donation.

Important Infection Prevention

Before starting this project, please ask yourself the following questions:

  1. Have you been in contact with anyone suspected or confirmed to have COVID-19 in the past 14 days?
  2. Do you have fever, cough or shortness of breath?

If you answer “NO” to both questions, thank you for making masks.

If you answer “YES” to either or both questions, please DO NOT make masks.

If you are experiencing cough, fever, or shortness of breath and have a concern that you may have COVID-19 please contact your primary care provider for a risk assessment.

How Do I Get Finished Masks to Community Health?

  • Download and fill out the COVID-19 Donation Form
  • Place fabric masks in sealed plastic bags in quantities of 15-20 per bag. Attach filled out COVID-19 Donation Form to the outside of the bag.
  • Donations can be made on Mondays from 9am-4pm to the foyer at Community Health Administration, 71 Allen Street, Suite 101, Rutland.
  • Contact Jill Jesso-White at jjwhite@chcrr.org to coordinate the drop off of all donations.

Materials & Downloadable Directions

  • Front piece: 100% unused cotton fabric – no metallic fabrics
  • Back piece: tightly woven unused cotton, like a tea towel or cotton flannel
  • 1/4″ or 3/8″ flat elastic (to make with ear loops) OR 3/8″ or 1/2″ ribbon (to make with ties)

For Public Information and Safety

The Vermont Department of Health (VDH) is working closely with the state’s health care providers and hospitals, local governments, and across state programs and agencies. They are working to identify people who may have been exposed to coronavirus. They assess their exposure risk and provide them with guidance for their health and recommendations for self-isolation or other measures.

They also work hard to keep the public up to date with current information through their website and other communication methods. It is important that the Rutland community know about this virus and how to protect themselves, and each other from contracting it.

Symptoms

  • Fever, cough, and shortness of breath. Also, chills, body aches, sore throat, headache, diarrhea, nausea/vomiting and runny nose. The severity of these symptoms are similar to those of influenza virus.
  • Symptoms of COVID-19 may appear in as few as 2 days or as long as 14 after exposure.
  • If you have traveled to any affected areas or have been exposed to a patient under investigation and develop the above symptoms:
    • Do not go to work, school, or daycare
    • Contact your health care provider
    • Contact the Vermont Department of Health at 2-1-1

Prevention

There is currently no vaccine to prevent the COVID-19 infection. The best way to prevent infection is to follow the CDC travel advisories.

https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

The CDC recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

Centers for Disease Control and Prevention (CDC) Links

This is an emerging, rapidly evolving situation and CDC will provide updated information as it becomes available, in addition to updated guidance.

The Vermont Department of Health website is updated daily by 1:00 pm.

Updates • Current Status of COVID-19 in Vermont • Latest Guidance for Travelers Returning from an Affected Area

Visit the World Health Organization for rolling updates on Coronavirus disease (COVID-19)

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