Subject: Coronavirus Update

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Coronavirus update
Sunday, March 01, 2020

By now you are likely aware that the flu-like respiratory virus called COVID-19 or Coronavirus has arrived on the west coast, with cases reported in California,Washington and Oregon. I wanted to write and give you my take on the virus, preparations, office procedures, and some links to helpful information. It appears that this virus is spread very easily by respiratory secretions both airborne and on surfaces touched by hands, and perhaps is more easily transmitted than seasonal influenza. 

 A majority of patients will have a fairly mild course with low grade fever, cough, etc. like many other seasonal colds. Perhaps 1 or 2 in 10 will have more severe disease with higher fever and more severe lung disease, and 1 or 2 in 100 may require hospitalization. This usually occurs because of an over-reactive immune system that causes inflammation and damage to the lungs while trying to fight it. Most of those who have died have been elderly or sick already, though a few have been apparently healthy. It appears likely now that we will have some spread of this virus through our community in the coming months.

We hope that it will follow seasonal flu pattern and taper off as the weather warms, and clinical trials of a vaccine are as close as 2 months away. In the mean time we will have to be smart and cope as best we can. If it becomes widespread in our area, avoiding large gatherings of people in contained areas will be an important avoidance strategy, as will usual hand hygiene practices. This link from the Multnomah County Health Department has updates and FAQ's for our local scene If you want to dig deeper and get information about travel your best advice will be from the Center for Disease Control here

A few words about our office: I will be closely monitoring the outbreak as well as the Providence health system's responses and capabilities for treatment. At this time, there is no specific treatment for the virus (for example, Tamiflu which is used for influenza is not effective) and we do not have testing capability in our office. Symptomatic treatment with tylenol/advil for fever or headache, cough medicine etc. may still be helpful. I will likely need to see a few patients in the office still to determine if they have pneumonia, or to exclude other conditions that look similar. I would like everyone who has cough or fever and contacts the office to talk with Dr. Biemer or Julia Jones before making an appointment, and PLEASE DON'T JUST WALK IN WITH YOUR COUGH WITHOUT AN APPOINTMENT! This puts our staff and other patients at unnecessary risk. Thank you and please reach out if you have questions - I'll do the best I can to get you answers and keep you up to date as we learn more. 

James Biemer, 9135 SW Barnes Rd, Suite 863, Portland, OR 97225, United States
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