A Q&A with Healdsburg health care providers

An interview with local healthcare experts as they prepare their patients, staff and community for the surge of COVID-19 patients in Sonoma County.
Misty Zelk, MD, Medical Director of Outpatient Services 
Q: Why are safety measures so important and do they work?
We all must take the shelter-in-place directive extremely seriously. This is the most effective tool we have to fight the spread of the novel coronavirus COVID-19. Designate one person to go grocery shopping and do not take the whole family because they are bored.
Another equally important safety measure is practicing a diligent personal hygiene routine that includes washing your hands and sanitizing objects and surfaces frequently touched throughout the day.

Take extra precautions if you are wearing face protection and/or gloves. Wash your hands before and after each use and sanitize or dispose of the protective gear every time you use them.
Do not view these items as replacements for social distancing or hand washing, but do use them in conjunction for an added level of protection. They can be helpful as a secondary line of defense against the spread of the virus. However, they must be used correctly.
Q: What age groups are contracting the virus?
COVID-19 has been found in all ages from children to the elderly. We are all at risk of getting this very contagious virus and it must be taken seriously to avoid spreading it throughout our community.
 
Q: Are there additional tips for our seniors?
Geriatric patients who are homebound can greatly benefit from maintaining a regular schedule that includes set times for sleeping, waking, eating and light exercise each day. I recommend that my patients start a hobby or project such as puzzles, journaling and listening to music. Another tip is to reduce the amount of time spent watching the news or scrolling through social media. Doing so can greatly reduce anxiety levels and stress, especially now.
Q: What are healthcare providers doing for their regular patients?
Information and protocols are changing rapidly as we learn more about this virus. We have found clever ways to adapt to make the most of the situation. Telemedicine is a fantastic tool that allows us to stay on schedule with our regular appointments, while we provide in-person care to patients that need to be seen in-person for evaluation and testing.
 
Q: What are you telling your patients who are expressing symptoms?
Our nurses are asking the protocol questions to evaluate each patient who calls in with concerns about their health. This process has not changed. There is no specific symptom that 100% identifies this virus and there are no current treatments to start just because a patient tests positive.
A general rule that I tell all of my patients is to follow the four basic pillars of health: hydrate, rest, eat and exercise. These are the fundamentals of good health, and now is a good time to be reminded of them.
In addition, there have been false claims reported in the news about including blood pressure medications and Ibuprofen. I recommend talking to your physician first before making changes to your medication regimen.
Gary M. LeKander, MD, Chief of Staff, Medical Director Intensive Care Unit and Respiratory Therapy Service.
Q: What have you learned about the COVID-19 virus that people should know?
This virus like many other viruses, is unpredictable and there are many ways a person may show signs of COVID-19 infection. Common symptoms include a fever (100°F+), coughing, fatigue, shortness of breath, headaches, sore throats, muscle aches, loss of taste and smell and even GI symptoms such as nausea and diarrhea. In fact, only 30-60% of those infected have a fever. So be aware of the other early signs of infection.

Q: What is the lifecycle of this virus?
The lifecycle of this virus is what makes it so challenging. You can be a carrier of the virus and not show symptoms for up to 10 days after becoming infected. This is why we have a strict shelter-in-place ordinance to stop the spread of the virus as people may not even know that they are infected with COVID-19.
Additionally, once a person is diagnosed with COVID-19, it usually takes one to three weeks before they begin to recover from the infection. Importantly, we also now realize that the patient can continue spreading the virus for an additional week after the symptoms have subsided and they are feeling back to normal. That means the virus has roughly a 30-day lifecycle with the ability to spread and infect others.
Q: What do you recommend if a patient has any of the symptoms?
 About 80% of those diagnosed with COVID-19 infection can be managed with home isolation and recover over several weeks. If you feel unwell, you should call your primary healthcare provider for advice just as you would with any other illness or concern.
If you are showing symptoms, self-isolate in a separate room and avoid contact with others in the house with you. Sanitize any shared surfaces such as door knobs, sink faucets and shared spaces such as bathrooms and kitchens. Stay hydrated, rest and share your progress with your doctor who can help you manage your symptoms.
Q: When does a patient confirmed to have the virus need to go to the hospital?
About 20% of those infected with COVID-19 may require hospitalization for treatment, with about 5% requiring ICU level of care. All hospitals in the county, including Healdsburg District Hospital, have active plans in place to treat COVID-19 patients — in addition to the usual patients requiring hospital care. Special precautions including visitation limitations and universal masking procedures are in place to help ensure the safety of our patients and our healthcare team. 
Joint message from Dr. Zelk and Dr. LeKander
Your healthcare providers and local, county and state government officials are excellent sources of reliable information that can help you navigate the daily changes surrounding COVID-19. They are doing their best to prepare for the potential surge of infected cases and together we are working with them to ensure we have enough beds, equipment and physicians to care for our community.
If your healthcare provider recommends that their patient comes into the office for an evaluation, please be reassured that we have taken every measure to ensure a sterile environment for both your health and ours. Your healthcare provider is one of the safest places to go outside of your home.
Keep up the great work!
People may be experiencing fatigue from these safety measures and becoming restless staying at home. It is understandable but we all, regardless of age or health, must take the shelter-in-place orders and social distancing protocols seriously and abide by the county regulations.
Everyone must do their part to keep our infected count low so that we do not over-tax the healthcare network and emergency resources. Flattening the curve starts with you and your family. The actions you take make a difference. You can help us saves lives by working together to flatten this curve and protect our community. 
Visit the Healdsburg District Hospital website and Facebook page to find up to date information on COVID-19 and the latest changes at the hospital at www.healdsburghospital.org.