Subject: Labor Day Weekend Update

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Labor Day Weekend Update
Hello Patients and friends! 

Apologies, as it's been a while since I've written. This pandemic has gone on longer than most of us had hoped (though infectious disease specialists had predicted just this for years) and there's a certain amount of fatigue that creeps in. I do hope those of you who I haven't seen in a while are doing well. We are aware of the very real mental health toll that Covid and the associated isolation has taken on many. More on this below. 

A brief update first, on our office, Providence, and the state:
We have continued both virtual visits and seeing patients in the office in person since the beginning of June. The summer schedule has been busier than most, likely both from patients catching up on routine health appointments missed in March through May and also in anticipation probably of a rougher fall. Our office staff has remained healthy and for the most part, so have our patients with respect to Covid. 

The hospital is on the whole a very safe place to visit. There is screening all day at every door, mandatory mask use, and lots of stations for hand washing. As you're aware the emergency department is at the far end of the hospital and we've continued to have only a few active Covid patients in the hospital. Our ER and ICU's, staffing and PPE supplies are in great shape, should we have another surge later in the year. 

Statewide Covid cases have continued to decline week by week over the past month or so and the percentage of tests that are returned positive is down below 5% which is a very good gauge of disease activity. New cases have been seen mostly in the 20 to 29 age group with decreasing numbers in subsequently older decades, likely as result of very responsible behavior! At the same time we've seen more hospital deaths which usually follows a surge in cases by a few months, and at St Vincent we've seen several patients under the age of 50 with no clear underlying conditions die from the disease, a reminder to take this virus very seriously. 

Regarding mental health concerns:
With regard to mental health concerns, there is no question that pandemics are stressful. And that's even before a presidential election year that has huge implications no matter which side you inhabit, protests erupting into violence on our streets, and an economy that has left tens of millions unemployed and shuttered countless businesses. Please know that feeling stress, depression, suffering insomnia, having increased relationship issues, and enjoying your cocktails just a little too much are all common reactions. Below is a summary from the Center for Disease Control, please look to it for suggestions and please reach out to us if we can assist in any way. Don't suffer in silence.

If you have already had a positive experience with mental health professionals in our community, please consider sending us a note or sharing their contact information. We are constantly working to improve our network for your benefit, and our most reliable source is patient experience. 

On the status of Covid testing:
We have seen slow evolution in the availability and turn around times for testing. Many urgent cares are testing, though most require a pre-test virtual visit or online survey. We have also had a number of patients report success in getting quick tests through Rite Aid and Walgreens pharmacies. There are still few recommendations for asymptomatic testing, though it is not unreasonable before travel, before mingling with vulnerable family members, or after a known exposure. Specifically, we are aware that some Legacy GoHealth Urgent care locations offer a 15 minute rapid test for asymptomatic patients (by appointment only).

As much as I'd love to give you a clear set of guidelines for all this, it turns out the variety of scenarios are endless and I or Julia will often need to hear the details to help you make decisions. 

Here is a testing resource we have found useful. Although it is provided  by Washington County, most of the listed sites are scattered throughout the greater Portland area. 

Vaccines in a time of Covid:
Looking ahead, some of you have already been asking me about the Covid-19 vaccine that may be available later this year. I'll send out more info as it comes. Suffice it to say now, that I do not expect a vaccine to be widely available before 2021, and would be very reluctant to advise folks to get a vaccine that has been approved without Phase 3 clinical trials being completed. This is where usually tens of thousands of volunteers get the vaccine or placebo, then wait several months until some have become sick with Covid, to measure both effectiveness and adverse effects. 

I would advise you go ahead and get the flu vaccine as soon as it's available. We have regular seasonal flu shot available now, but do not yet have high dose for seniors.

Some infectious disease experts are predicting a very light flu season as it has been light in the southern hemisphere this past season and we have so little travel and enhanced personal protection with distance, masks, hand washing etc. We will see!

And finally:
Oregon Health Authority's most recent letter with guidance about staying safe over the Labor Day Holiday

On that note, have a fun, safe, happy Labor Day weekend.

Jim Biemer, Julia Jones, and the team

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