PLEASE READ.  IMPORTANT UPDATE REGARDING THE COVID-19 PANDEMIC.  THIS EMAIL IS LENGTHY BUT CONTAINS IMPORTANT INFORMATION YOU NEED TO UNDERSTAND FOR THE HEALTH AND SAFETY OF YOU AND YOUR FAMILY.Dear Patients,

The physicians and staff of Placer Private Physicians have been doing our utmost to stay current with the ever-changing coronavirus outbreak.  This includes regular reviews of the recommendations put forth by the Center for Disease Prevention and Control (CDC), Placer County Health, and other healthcare organizations such as Sutter Health and Kaiser Permanente.  This COVID-19 pandemic is unprecedented, and we understand this has led to both fear and confusion for many of our patients.  The purpose of this email is to educate our patients so they can better understand the situation, and thus, better protect themselves and their families.

We do not want to panic our patients; however, we do want you all to understand the seriousness of the COVID-19 pandemic.  As your primary care physicians, our greatest concern is the health and safety of you and your family.  We urge you to follow the recommendations made by the CDC and other government health agencies.  Simple changes in your daily activities such as social distancing, limiting travel, and staying at home as much as possible can help limit the spread of COVID-19 and protect your loved ones from a potentially serious infection.  We are also making some temporary changes to our office visit protocol here at P3 to limit patient and staff exposure.  Please see below for details.

According to the latest update from the Placer County Health website (3/14/20), there has only been 8 documented cases of COVID-19 infections and 1 death in Placer County.  However, many experts suspect (and we agree) these numbers vastly underestimate the true number of active cases in our community.  The CDC data is showing 1600 total cases of COVID-19 in the US with 41 deaths, but again due to delays in testing, the actual number of infected persons is likely much higher.  While the current number of COVID-19 cases in the US may not be seem alarming to some, we only need to look at other places around the world to see how things may unfold in the days and weeks ahead.  (Please see our list of recommended websites below for more information on COVID-19).

The COVID-19 infection can be difficult to diagnosis as it has symptoms similar to the “common cold” and “flu” viruses.  The symptoms start gradually in most patients and are usually mild for the first 3 to 5 days.  These early symptoms may include sore throat, runny nose, and body aches.  About 5 to 8 days into the infection one may experience fevers and cough.  The rare but serious respiratory complications of COVID-19 usually manifest in the second week – pneumonia, respiratory failure, and possible death.  The time between exposure and symptoms is typically 4 to 5 days.  Finally, it is very important to realize that COVID-19 infected persons may have very mild or even no symptoms at all but are still contagious.

The COVID-19 virus is highly infectious and is most likely spread by nasal or oral secretions getting onto your hands and then passed to your face.  You can also get the infection from droplets coughed or sneezed into the air; however, this mode of transmission now seems to be less likely.  According to the CDC, the COVID-19 virus can remain active on hard surfaces for up to 9 days.  This means you should regularly wash your hands, keep your hands off your face as much as possible, and clean potentially contaminated surfaces.

The COVID-19 viral infection is mild in many cases and often does not lead to serious complications.  However, the infection can be very serious in people with chronic health conditions such as heart disease, lung disease, diabetes, obesity, and compromised immune systems (including medications that increase the risk of infection).  The risk for serious complications and death from COVID-19 are higher for those over 50 years old, and highest for those 65 years and older.  This is especially true for those in these older age groups who also have the above-mentioned chronic health conditions.

The CDC and California health officials are now recommending that all people over the age of 65 (and we would include any patients younger than 65 with chronic health conditions) stay at home.  Avoid public exposure and only go out if absolutely necessary.  Please postpone visits with friends and family, cancel group activities, and avoid traveling at this time.  Sutter Health has instituted a no visitor policy (with certain exceptions) at its hospitals to limit the spread of COVID-19.  Kaiser has cancelled elective procedures and limited office visits in preparation of a likely surge of COVID-19 cases.

THE GOOD NEWS:

Pediatric patients seem to have exceptionally mild symptoms and are extremely unlikely to have severe cases or complications.  HOWEVER, asymptomatic children can easily be spreading the infection to older, high risk individuals.  We recommend postponing visits to at risk family and friends including grandparents, older relatives, and those with chronic health conditions mentioned above.

Social distancing, canceling group activities, and avoiding travel have curbed the spread of the COVID-19 and limited the number of severe cases in places across the globe that have implemented these measures.  Unfortunately, this plan only works if the majority of the population follows these recommendations.  This is especially true for the young and healthy who do not feel threatened by the virus but unknowing spread the infection.  Again, we recommend following the guidance coming from the CDC, state, and local health officials.

The fewer people who become infected reduces the strain on the healthcare system and reduces the overall number of patients with complications and death.  Please change your behaviors and help our community prevent the spread of this disease.  The closing of schools, businesses, bars, events, etc. is not something we have ever experienced on this scale, but these measures are proving to have an impact on the number of new COVID-19 cases and mortality rates.

THE BAD NEWS:

Health experts are anticipating that the problems seen in other countries may affect us here in the United Sates – hospitals and medical personnel are being overwhelmed with large number of COVID-19 patients.  This is making it very difficult to care for all patients in need of health services including those with injuries and illnesses other than COVID-19.  Italy has been particularly hard hit by COVID-19.  They are literally running out of hospital beds, ventilators, and necessary medical staff to care for all their patients.  This is affecting people in both large cities and small towns.

Although COVID-19 testing is now more available, there is still limited availability.  If you are asymptomatic, there is no recommendations at this time for testing.   If you are having viral respiratory symptoms, please contact our office so our physicians can evaluate your case and help decide if you meet the criteria for testing.  We have already started testing at risk symptomatic patients and have the ability to test here at our office.

School closings are stressing families and making childcare more difficult.  This is making some parents have to choose between work or childcare.  We understand the difficulties this poses for our families and hope these closings end as soon as possible.

Many people are still not taking COVID-19 seriously and are going about life with a “business as usual” approach.  The more people that are out and about in the public the more we will see the accelerated spread of COVID-19.  This may lead to more aggressive quarantine rules, travel restrictions, as well as greater economic, social and healthcare strain.  We strongly urge you to make the appropriate changes in behavior and not consider things “business as usual”.
–Use phone, internet, and email communication as much as possible.
–Assume that all people you come in contact with are possibly contagious, even if they are not showing symptoms.
—Assume surfaces you touch are possibly contagious and use hand sanitizer, wash hands, and avoid touching your face as much as possible.
—Avoid domestic or international travel unless necessary, especially if you are traveling to an area that is more significantly affected by COVID-19.  If you do travel to an area less affected, consider that you may be the vector that ultimately spreads the infection to such an area.

Please understand, these are difficult times, there is a lot of uncertainty and fear surrounding this situation.  The best way to combat fear and uncertainty is with knowledge and appropriate action.  The information above is accurate to date and has been compiled from trusted healthcare sites and medical professionals.  While the next several weeks will be difficult for all of us, please understand we are doing everything we can to both protect and serve our patients to the best of our ability in this rapidly changing situation.

WHAT PLACER PRIVATE PHYSICIANS IS DOING:
— Our office is open during our normal business hours and we are available to address your medical needs and concerns.  This includes 24/7 access to a physician.
— We are working hard to be a resource for information and will continue to update our patients as new information comes are way.  We have been and continue to be on the forefront of this battle!
–Until further notice, we are seeing patients at the office for urgent care issues only.  This means we are postponing health and wellness visits until a later date.  Many health issues such as lab and medication reviews can be done over the phone or by electronic messaging.  This is to not only protect our physicians and staff, but to protect our patients and hopefully limit public exposure to COVID-19.
–If your medical situation requires you be seen at our office, we are here for you and will make the appropriate arrangements.  If you feel you need to be seen, please call ahead and get a scheduled appointment.  Please NO WALK-IN appointments.  All patient visits will be “pre-screened” by a physician for appropriateness and infection control.  So please call ahead if you feel the need to have an office appointment.

Finally, don’t panic!  Yes, the COVID-19 pandemic will be challenging for many reasons, but we will get through this as a community, a nation, and a world.  How we act during these times of stress and fear will determine the outcome.  By banding together as a community and following the public health guidelines, we can win the COVID-19 battle.  We are already learning how to better combat COVID-19 and potential future pandemics.  We will continue to update our patients as new information and recommendations are released.

Sincerely,

Dr. Hedman, Dr. Lichti, Dr. Brown and all the Placer Private Physicians staff

Recommended Websites for up to date and accurate COVID-19 information / recommendations:

General information on COVID-19 from the CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html

Information on preparing for the situation at hand:
https://www.cdc.gov/coronavirus/2019-ncov/prepare/index.html

Information on protecting yourself and family:
https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

Johns hopkins information on social distancing:
https://hub.jhu.edu/2020/03/13/what-is-social-distancing/