Latest CIMA news on Covid-19 / Coronavirus

While this virus affects the world, your INDIVIDUAL needs are cared for by your PERSONAL PHYSICIAN and local health care team. Medical conditions will not wait for the pandemic to end, so we have made our office safer for you to see us and get treatment. See this page for updates and how this affects you locally.

Update: March 27th, 2020, 5:00 pm                                                                                                              From: Dr. McDowell

TELEMEDICINE started this week with good success as an OPTION for those needing health care visits.   We know this is an odd time but life, as well as medical conditions, marches on and need attention.  For those reluctant to come in, or better kept out of the office due to risk, we are offering state of the art encrypted video medical visits. 

 

  • This is for patients who are ill with respiratory symptoms of the sinus, face or chest with or without fever who need evaluation and treatment. 
  • Patients who are high risk of exposure such as immune compromised conditions like our cancer patients and prefer to have a video visit in leu of coming in.
  • Our providers will see you via ENCRYPTED video using Zoom and evaluate your condition, order testing and medication if needed and advance your care instead of having you sit at home ill without help. 
  • For those who are NOT high risk of the virus and for those who are not ill with a respiratory illness we strongly advise you come to the office for your visit as this is still the most controlled environment to be seen by a clinician with all our diagnostics to best assess and treat your conditions.   The office is quite sanitary as it always has been for both your safety and ours. 
  • For those patients who are delaying chronic medical visits for their conditions please do not cancel your visit.   Our physicians are very concerned delayed visits are going to cause a back log in treatment and services and our office will not be able to accommodate the need and the Fredericksburg area’s health facilities will become back logged as well.  You now have all the options to keep your appointment with in-person visits and with Video Telemedicine. 
  • Continued work on updating our providers on local area testing has been going on and we are hopeful that next week we may have some better ideas on the local testing capabilities near our area.   At this time, we are still not directly testing patients but this may change so stay tuned. 
  • Our office has continued our phone triage (illustrated in an email coming out this weekend from Dr. Marrow) which keeps sick patients with suspected disease at home but still gets them needed treatment.  This is working very well and the office has been able to continue helping many patients this week both in the office and on Telemedicine. 

 

UPDATEMarch 20, 2020,  5:00 PM                                                                                                                     From:  Dr. McDowell 

  • All of our providers participated in a high-level briefing with the senior leadership of Mary Washington Health Care including Dr. McDermott the CEO and Dr. Newman the Chief Medical Officer.   Questions were asked by our physicians and our doctors and PAs were able to receive a real time update on the readiness and processes at the area’s largest medical center and how we are serving our patients as a team both here in the office and our patients who we feel require hospital inpatient care. 
  • Testing is even more limited in our area due to shortages and those lacking fever and significant symptoms should NOT seek testing. 
  • We are staying abreast of the news there may be some degree of treatment for this virus.   The medication in the news widely reported (Hydroxychloroquine and Azithromycin) are common internal Medicine drugs we have experience with already.   While the news of this is exciting there is lots of caution to their use as we are watching U.S. information as well as credible medical information from Italy, South Korea, England, France and Spain all dealing with this crisis and coming up with treatment recommendations. 
  • Hydroxychloroquine as a preventative has a very interesting prospect we are also looking at and awaiting treatment recommendations.   This is of special concern for many of us healthcare professionals and staff who are very high risk for exposure. 
  • This week we have perfected our Phone Triage and new office waiting room procedures to much success and huge praise by our patients.  While not a perfect situation this has been a VITAL step to ensure a safe office environment. 
  • Most of our patients continue to come in for their scheduled medical services which, with a few exceptions, our physicians are encouraging patients continue to keep up with.   
  •  There will be a huge back up and limited services to try and reschedule everyone after this pandemic has resolved.  
  • Health conditions important when we don’t have a viral outbreak are still important today. 

 

Updated: March 20, 2020,   2:10 pm                                                                                                                             From: Dr. Jordan        

Managing Emotional Health in the World With Coronavirus

In light of all the recent changes and inconveniences that have developed over the past week, Dr. McDowell asked me to write a response from the psychological health perspective to address the wave of anxiety and uncertainty people are experiencing and to provide some sound advice for coping with its impacts.

Coping with the risks and realities of the Coronavirus on a daily basis may seem like an overwhelming task in the midst of your already stressful life. As a result, you and your family members may be experiencing increased feelings of fear, anxiety, or even panic. To help you manage your anxiety during this stressful time, I would like to offer some useful tips and strategies to keep you psychologically and emotionally healthy.

Due to the widespread media coverage of the Coronavirus, people are becoming more anxious. The American Psychological Association (APA) has offered some advice for managing anxiety and putting news reports into perspective while maintaining a positive outlook.

1. Keep things in perspective. Perspective taking is critical for managing anxiety in this situation. The present reality is that most people who contract the virus will only experience mild symptoms. Some people are more vulnerable to the coronavirus, such as senior citizens, and those with underlying health conditions. However, most people will only develop mild symptoms.
2. Get the facts. When watching the news, it is helpful to use an analytical approach when viewing information regarding the coronavirus. Verify the information you receive is from credible sources such as the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO). Dr. Baruch Fischoff at Carnegie Mellon University suggests finding such credible sources that do not sensationalize the news.
3. Communicate with your children. Children often become distressed in response to a crisis. Keep them informed with honest, age-appropriate information. Keep children on their traditional routines and schedules to alleviate distress. Model appropriate rational thinking in regards to the situation and manage your own emotions as so they can observe how to react in this situation.
4. Keep connected. Try and keep a sense of connectedness by maintaining your social networks even while you practice social distancing. This can help to foster a sense of normalcy in your daily life and it can also provide an outlet for you and others to share your thoughts and feelings and process the whole experience.
5. Seek additional help. If you feel overwhelmed by nervousness, have lingering sadness, or prolonged reactions that affect your job performance or interpersonal relationships, consult with a trained mental health professional such as a psychologist or counselor who deal with extreme stress.
(Adapted from APA website https://www.apa.org/helpcenter/pandemics)

Other thoughts to consider include not ignoring other pre-existing medical conditions or being afraid to go to your doctor. Family practices and internal medicine facilities like Colonial Internal Medicine Associates are taking extra measures to ensure your safety such as increasing their pre-existing antiviral protocols by wiping down office surfaces every two hours, instituting phone triage for patients who may have symptoms of Coronavirus to treat them over the phone instead of in the office, practicing social distancing in the waiting room by rearranging seating, and allowing people to wait in their personal vehicles and be contacted by the front desk staff when their exam room is ready.

Remember to keep a level head during this turbulent time. Typically our natural response during times of crisis is for our emotional mind to take over and we often react impulsively without thinking. In those moments it is important to stop and take a deep breath and give yourself time to re-engage the rational-logical side of your mind. Our best decisions are often made when we are levelheaded or balanced between our logical/rational mind and our emotional mind.

When practicing social distancing, don’t alienate your neighbors. One of the negative effects of social distancing that psychologists are concerned about is its impact on social functioning because we know that socialization is a protective factor that increases positive health outcomes. Stay in touch with other people through telecommunications and social media. Reach out to others who may be at home by themselves. By focusing on someone else, it helps to take your mind off of your own anxieties and stresses. Remember to follow the Golden Rule. “Do unto others as you would have done to you.”

Finally, remember, while the Coronavirus might attack our bodies; let’s not let it take our minds and hearts.

Be Well,

Dr. William Travis Jordan, Licensed Clinical Psychologist
Head of the Psychology Department
Colonial Internal Medicine Associates

We recognize that there are many others out there with illnesses that need to be treated as well. We have patients with the greater likelihood that they have a viral upper respiratory infection, bronchitis or pneumonia or Influenza which still needs to be taken seriously and treated. We are a doctor’s office used to handling these sorts of illnesses and we do not want to prevent those who are ill and likely NOT to have Coronavirus from receiving needed medical care. So, in addition to having those patients at high risk for Coronavirus as stated above call into the office and stay at home until a physician can determine risk we have taken addition actions to prevent viral spread.

  • Patients in the waiting room are now seated father apart
  • Magazines and community materials have been removed
  • Chairs, counters, door handles and all common surfaces are now being cleaned with a medical grade disinfectant every 2 hours
  • Exam rooms as USUAL are being cleaned between patient visits with antibacterial and antiviral solutions
  • Patients may opt to wait outside or in their car and staff will let them know when they are called back to a private room
  • If a patient comes into the waiting area and is identified as a risk based on symptoms, they will be taken to the exam room immediately available rather than sitting in the waiting room.

We have implemented these temporary changes and phone triage for those who are ill because we also recognize that many people who see us have chronic and acute illness which can not wait until this short term viral threat is over and need to keep their appointments.