3/23/20 | UPDATE ON COVID-19
David Z. Tusek, MD
Dear Cloud Members,
In the past week, the pandemic has claimed over 16,000 lives, wiped $6 trillion in value from the global markets, shut down most international and intranational travel, and generally thrown our world into chaos.
Here is our fourth newsletter about this emerging crisis, with answers to some of the most common and most important questions that you are asking us, in our efforts to keep you informed. We hope you find these updates informative and relevant, as we believe transparency and honesty are always high value commodities.
Does Cloud Medical offer COVID19 testing?
Yes. A month ago we expended a great deal of resources to identify and procure supply chains for testing kits in anticipation of the crisis that is now here. But we don’t have enough for all of our 1000 members, so we are testing on a case by base basis. As you can imagine, our team is extremely busy caring for everyone to the very best of our ability, so we are extremely grateful for your understanding and patience as we get back to every one of you that needs our help as soon as we can.
Have some Cloud Medical patients already tested positive for COVID19?
Yes. Most of the positives have been in individuals with recent international travel history. But it is clear that community spread is now occurring in Boulder County. Currently as of today (Monday 3/23/20) there are a total of 39 positive cases in Boulder County, a total of 720 in Colorado, and approximately 10% of those are sick enough to be hospitalized. Of all Coloradans with flu-like symptoms who have been tested thus far 11.6% have tested positive for COVID19.
What are the testing criteria for Cloud Members?
Ideally we would be testing all Cloud Members (and everyone else in our community for that matter) once a week, every week (like Telluride). That would be by far the most effective and efficient way to end this pandemic, and it’s really where the greater system has failed us here in the US. The problem is we don’t have nearly enough testing capacity and our supplies are so limited.
So, our recommendations are the following:
For anyone with cold or flu symptoms, we ask that you conduct your life as though you were actually positive for COVID19. Despite the harrowing statistics that we read, the vast majority of infected individuals still only have mild symptoms, so if you have any runny nose, fever, cough, sore throat, a belly ache, body aches…etc, then just please assume you may be one of the lucky ones with good immune resilience who can withstand the virus without too much trouble and then becomes immune to it (from what we can tell the convalescent immunity to COVID19 is likely durable and long lasting). If your symptoms start getting more serious: if your temp is over 100.5, or you experience shortness of breath, or if your pulse oximeter (hopefully you bought one as suggested in our first newsletter, if not get one now) drops below 92 or 93%, please let us know. It is for folks like you that we are currently prioritizing testing.
What if am sick with mild or moderate symptoms right now?
This means that you isolate yourself as strictly as possible, and avoid spreading your illness to anyone as much as you can. Isolate yourself spatially and physically, but not socially! Make extra efforts to “keep in touch” with friends and family—safely, at a distance. One of our patients who tested positive for the virus had dinner with her dad after he moved his table next to a sliding glass door which safely separated them but still allowed them to enjoy one another’s company. It’s not going to last forever, but for now these are exactly the kind of steps we need to be taking.
What if my symptoms become more severe?
Call us. We are here for you.
Can I still pick up supplements or medications from your offices?
Yes. We prefer that you call ahead with payment so that we don’t need to handle your credit card or cash, and we’ll meet you at the door with your order in a bag.
Are there any other less typical symptoms which seem to be associated with COVID19?
Yes, there have been increasing reports about alterations in the sense of smell and taste.
How do we technically define a high-risk “exposure” or “contact”?
According to our best knowledge, being within 5 feet of someone for more than 15 minutes, even when there is no direct physical contact qualifies as a high risk encounter. Obviously any skin contact at all is automatically high risk.
Can the corona virus survive on surfaces and clothing?
Yes. It appears that it can survive on countertops and cardboard for 1- 3 days. It is likely that the same goes for clothing. It’s always best (if you must go out) to take off your clothes and wash them right away and take a quick shower after returning home. If you receive a package, make sure to thoroughly wash your hands after unpacking it and recycle the cardboard right away.
One of our patients texted the following question on Sunday: “I want to know what you are doing regarding the virus? What will you do if we come down with this? I’m surprised you haven’t addressed your patients about this. Can you get us a ventilator if needed?”
We are doing the very best we can to support all of you: anticipating your needs, stocking up on gear, offering the most updated guidelines via newsletters and blog posts, providing COVID19 testing for those who need them most when testing is virtually impossible to obtain anywhere else, returning every phone call and question as quickly as we can, moving all non-emergent visits to telemedicine (weeks before any other medical practice in our area), etc.
I honestly wish we had access to ventilators and dedicated ICU teams specially reserved for every one of our patient-members—just in case. If you develop worsening symptoms we will, as always, do everything possible to expedite your care to the most world-class treatment settings available.
Is there a silver lining to all of the madness, economic mayhem, and societal disruption?
Yes. This crisis is forcing all of us to slow way down and reflect on what matters most and is most important in life. While is it triggering panic in some, it is also demonstrating to us how much profound caring and love there is in our community and our planet as a whole. Below is a sample of many other messages I’ve received in the past week. We have frankly been overwhelmed by the incredible outpouring of kind, supportive, uplifting messages from so many of our Cloud members, and it is an absolute honor to serve you all!
“Hi DT. Im doing doorstep delivery of healthy organic food in jars for folks coming back from international travel and choosing to quarantine…I want to help them coordinate a soft landing with good food! Feel free to give them my contact.” —Maria
“Hi DrT. I have several N99 respirators wondering if you and your staff might need them, I’d be happy to donate them” —Yoshi
“Checking in with you. I have a box of N95 masks that I bought during H1N1…if your providers have a need.” —Seth
“Quick Q—do you have any idea how many masks are projected to be needed by our local hospital over next 10 days?…I’m working with philanthropists to help fill the need gap.” —Ali
“Greetings, I have been a convener, a community builder, and a conference creator. In doing so, I tend to scan a variety of sources for things I think are useful for others to know about. As we all scan the headlines and social feeds, grappling with the ongoing shifts to our world and dealing with the emotions they evoke, I thought I’d share some of the things I feel cut through the noise and provide some education and clarity on events. Because things are changing so rapidly some things may be outdated. But my hopes are to provide some basic resources so that you stay informed and updated for you and your loved one’s benefit.” —Ted
“DrT. We have drivers available for front door delivery of 6 rolls of toilet paper for anyone who is out. We are asking $20, all of which goes to the driver, if anyone is in need” —Simon
Are there any free resources we recommend to help manage life’s challenges during these hard times?
Yes. There is a profound difference between knowledge and wisdom. It is crucial to obtain the best scientifically updated information (knowledge) available, especially in times of a rapidly evolving crisis. But how we manage that information, and how skillful our “sensemaking” capacity is in order to lead us toward the best decision-making—that is reflective of wisdom.
One of the many wise voices emerging over the last few years is Thomas Hübl and he has posted exceptionally valuable insights, discussions, and tools on his website which I recommend to anyone who is looking for deeper and broader perspectives about the challenges we’re currently facing.
What else can I do to help?
In this pandemic no one will be immune from the economic impact, but certain sectors of our economy will be hit harder than most. This is related to a question that I’ve asked myself recently about what makes our community (or any community for that matter) such an outrageously awesome place to live. Certainly we have a spectacular landscape and great weather but that doesn’t define a thriving, vibrant community. What does? We all have our own opinions, but here is mine: I believe that what makes communities special are the extraordinary artists, musicians, and restauranteurs (especially those who support local farmers) who inspire and feed us. They also happen to be amongst the most vulnerable to the economic fallout of the pandemic.
So…if you happen to be fortunate enough to be able to afford it, I encourage you to buy a framed photo from your favorite photographer (like, Lisa Siciliano, who took the photo of BB King at the top of this blog), or an original painting from a local artist (like Nikita Coulomb), or reach out to your favorite local musicians (like the guys from Rosehill Drive) and download their music and kick in some extra love on their bandcamp page, or support brilliant multimedia artists who defy categorization (like Stuart Davis) on their Patreon page, or join an amazing CSA or slow food farm (like the Golden Hoof), or buy local CBD products like my favorite post-workout drink, and definitely keep supporting all of our amazing local restaurants, breweries, and bakeries by ordering lots of take-out and buying gift cards for your friends!
Be safe out there, and don’t forget to tell the people you love how much they mean to you (since you shouldn’t be smothering everyone with kisses), and like BB King is demonstrating in the photo, always be grateful for all that you have and all that you are.
Dr.T and your Cloud Medical Team