A better approach to medicine that puts the patient first.

Dear Patient of Lynch Primary Care:
Over the past several weeks, we have had numerous conversations with many of you regarding the coronavirus pandemic and all that it has entailed. We would not have thought that 2 or 3 months ago anyone could have predicted what a profound and all-encompassing impact this virus would have on all of our lives, in addition to the impact on the global financial markets.

Below we have listed some of the more common questions of the past 2 weeks along with the best answers that we can give at this time, with the understanding that we are dealing with a constantly changing situation which makes timelines and outcomes hard to predict.

Should I go to work?

There is no clear “yes” or “no” answer to this one. If working from home makes you stir crazy and going to work represents a low risk for coronavirus exposure, it makes sense for you to go in to work. If you have significant lung disease, heart disease, immune deficiency or other illnesses that put you at high risk for complications from Covid-19, it is probably best to stay home. There are many variables at play in each situation. If you are just not sure, feel free to contact us and we will help you with the decision. In general, we recommend that you err on the side of caution.

Is it okay to go outside?

In general, yes. Getting out for fresh air, exercise and maybe a little sunshine is a good thing. It is important to maintain “social distancing”, avoiding crowds and close contact with others, but this is generally easy to do in your yard or on a sidewalk or on a walking trail. Spending time outdoors ultimately helps our overall health, as long as it is done responsibly.

Should I wear a mask in public?

Surgical masks are useful in 2 settings. First, patients with symptoms of viral respiratory infection should wear a mask in public to minimize the spread of viral particles that come with sneezing or coughing (of course, if you are symptomatic, you should self-quarantine). Secondly, healthcare providers and caregivers who are in frequent, close contact with infected or possibly infected individuals probably benefit from wearing surgical masks. There has been no documented benefit for healthy individuals wearing surgical masks out in public places such as parks, grocery stores or even airplanes. This is why you generally do not see “wearing surgical mask” on the list of ways to prevent Covid-19.

Should I get a prescription for Plaquenil and azithromycin  just in case I get the virus?

There are several reasons not to do this. Number one is that it is not absolutely proven to work for Covid-19. Secondly, and more importantly, if the general public starts stockpiling this medication, it will not be available for those people who use it routinely to keep their autoimmune disease at bay or for those people who might need it as a last ditch effort if their symptoms from coronavirus were getting more severe. And lastly, remember that the majority of people that get this virus have either no symptoms or just symptoms of a cold. For 80% of people it is just a cold and approximately 98-99% of people survive this virus without these medications.

Is loss of smell or taste a sign that I have Covid-19?

Loss of smell or taste is a very nonspecific finding that happens to be a very common occurrence with just about any virus or allergen that causes congestion in the sinus passages. So, while it is not unexpected to experience loss of sense or smell with coronavirus, it is not specific to coronavirus.

My anxiety and depression have spiked and I am having trouble with sleep as a result of the changes that have occurred over the past month. What can I do?

This has been a fairly common complaint which we believe to be the result of the 24/7 news cycle, social distancing and fear of the unknown. In general, we recommend the following:

  • Avoid “over watching” the news.
  • Get outside if you can.
  • Focus on helping others and/or doing some projects and/or just catching up on your reading or letter writing. In other words , try to stay busy in a constructive way.
  • Try to maintain some form of exercise.
  •  Do your best to get 7-9 hours of sleep nightly.
  •  Stick to a generally healthy diet as much as possible.
  •  Keep in touch with family/friends/neighbors (while maintaining social distance).
  •  Call us. We can often help come up with simple solutions over the phone.
  •  Consider adjusting medication for a few months. (Done with our input of course!)

What if I am exposed to coronavirus?

The first most important steps are:

  •  Do not panic.
  • Self-quarantine for 2 weeks keeping your close contacts (family, friends, coworkers) informed.
  • Touch base with us. If you develop any signs or symptoms that suggest Covid-19, we will do our best to arrange for you to get tested.

Will I get coronavirus if I go to the emergency department?

The local hospitals are doing a great job of keeping people with upper respiratory symptoms separated from those without respiratory symptoms. While we cannot say it is “no risk”, it remains relatively low risk. We do our best to keep our patients away from the emergency department, but there are times when it is clearly the best course of action (as with acute chest pain, stroke symptoms, respiratory distress, trauma, etc.)

Should I get tested for coronavirus?

Unfortunately, coronavirus testing is still in short supply and must be ordered by a primary care provider. Testing is done via a nasal swab at an offsite location performed in a drive-through arrangement where the individual does not even have to get out of the car. The turnaround time for test results is typically in the 4 day range. In this current environment, the following factors are triggers which make it appropriate for testing:

  • Fever above 100.5
  • Dry cough
  • Sore throat
  • Shortness of breath
  • Generalized muscle and joint pain
  • Recent travel to an area such as New York with a heavy burden of coronavirus
  • Exposure to someone with known Covid-19 or suspected Covid-19

Is it safe to go to the doctor’s office?

One of the many benefits of being in a smaller, lower volume practice is having much greater access to your primary care provider. Our waiting room is rarely crowded and, in order to minimize our patients’ risk for Covid-19, we are generally dealing with our patients with respiratory infections over the phone. As a result, being seen at the Lynch Primary Care office is a low risk proposition in regards to the coronavirus. During the time of this pandemic, we do ask that you refrain from coming to the office unless you have a scheduled appointment. Please call the office first before coming over. As many of you are already aware, we have embraced “telemedicine” as part of our medical care model for many years and there are many things that we can handle over the phone for you very easily, thereby keeping your potential exposure to a minimum.

When will this end?

While no one can have a definitive answer to this one, if this coronavirus follows the typical 16-20 week course of other influenza-like illnesses, we may start to see the rate of new cases begin to decline in the next 1-2 weeks. In addition, overall recovered cases should start to out pace new cases in another 4-6 weeks, following which life should slowly start going back to normal again. There is light at the end of the tunnel!

There has been speculation that this virus will likely cycle through again in the fall and possibly again in 2021. As a result of social distancing and our efforts to keep this initial blast from overwhelming the health care system (clearly the right thing to do!), we will not have developed the typical widespread “herd immunity” that we usually get with milder viruses that go unchecked as they sweep across the country from around the globe. As a result of not having broader herd immunity, we are susceptible to these second and third waves of coronavirus, but we will be much better prepared for these next rounds which will likely not be as devastating as round 1 of the novel coronavirus.

Where can I get the best up-to-date information on the pandemic?

CDC.gov/coronavirus/2019–ncov (the ultimate resource)
Bing.com/covid (Global-to-local data.)
phpa.health.Maryland.gov (Great FAQ section)
Governor.Maryland.gov/coronavirus (Hogan’s updates)

We hope that this information will help keep you informed as well as quell the fear and anxiety that this pandemic has created for many. Please let us know if you have any further questions.

The Lynch Primary Care Team