COVID-19 Update Archive

COVID Update

12/20/2021

It has been a while since I have provided an update. Things are changing again, and it is important to give you the current status of COVID.

There are two variants of the virus. The delta variant has been with us since early summer and has been responsible for the increase in numbers of infections, hospitalizations, and deaths. The new variant, omicron, is just starting and its impact is just beginning.

Why has the delta variant been so problematic?

It is more contagious and infective then the previous variants. One year ago, if 2 people were together unmasked and one was going to break out with symptoms tomorrow, it would take at least 15 minutes of exposure to breathe in enough virus to potentially get the infection. People most affected were over the age of 55, with the highest number of deaths in individuals over 70. It caused a much milder infection in people under the age of 50, very infrequent in people under the age of 20, and rarely resulted in hospitalizations or death.

The delta variant is much different. It takes less than 5 minutes of exposure to cause an infection. This makes it much more contagious. Researchers have shown on average when one person has the delta variant, they can infect 6 people. Each of these 6 will infect 6 more people and on and on it goes. Therefore, the numbers continue to grow at a rapid pace. Once the virus is inside the nose and/or mouth it replicates much faster than previous variants. People over the age of 55 are still at risk, but with so many of them vaccinated very few are getting it. The problem is under the age of 55. This variant is more aggressive with this age group. The number of hospitalizations and deaths in people under age 50 is markedly higher than a year ago. In talking with our colleagues in the hospitals they are seeing more and more healthy people in their 20s, 30s, and 40s on ventilators and dying. It is just not an infection of older adults anymore.

What is driving this? The unvaccinated. Any of us who work in healthcare have seen this for months. Our patients who consistently say they do not want the vaccine are the ones calling us day after day saying they now have COVID. Why? Because it so contagious as described above. The number one source of spread is being inside and unvaccinated. Therefore, the numbers have been going up in Michigan and now so many of the other northern states since November. Hospitalizations consistently are 70-80% unvaccinated. Those dying are consistently 90% unvaccinated. Look at the daily number of deaths in our state, in our nation. It is amazing that 90% or more of these could be prevented. Our colleagues in intensive care units have yet to hear someone say “I am sure glad I did not get the vaccine” as they are being placed on a ventilator. What is ironic we never see anyone in the hospital or in the intensive care unit because they had side effects from the vaccine.

Yet every day we hear the same comments by those who are not vaccinated. The reasons are almost word for word from everyone who do not believe in them or fear them. Why is this? The answer is anti-vaccination organizations. People do not realize that probably 90-95% of the information which is negative towards vaccines has been generated by the anti-vaccination organizations. These organizations are very clever, they don’t hesitate to lie, they know how to get the message out, and they do not care about your well-being. They are winning the battle. So many people today would rather believe things off social media which is fabricated data and false claims than experts that have dedicated their lives for our safety and well-being. If you get on an airplane tomorrow, you trust the science that it will fly and not crash. If you have a heart attack tonight you trust the science for the treatments to save your life. If you get cancer, you trust the science despite the complications and side effects that occur from the treatments. Yet the most effective tool we have against COVID so many people still refuse.

What about the 10-20% of people testing positive with delta variant who had vaccines? It is simple. After 6 months the effectiveness of the Pfizer and Moderna vaccines diminish, and we become more susceptible. The effectiveness of the Johnson & Johnson vaccine is worse. It diminishes after 2 months from receiving it. Getting a booster puts the protection back to 90-100%. Those getting the infection who are vaccinated are individuals who have not received the booster. You rarely see individuals with 3 shots getting it. The other factor involved are people over the age of 80. Their immune systems are weakened because of age. People getting chemotherapy are at risk because of their immune systems are suppressed.

Now we have the omicron variant. Trying to separate the hysteria in the media from fact right now is difficult. The scientific community does not have a lot of information on what is going to occur. Much of the information that is available is early and over the next 1-2 weeks a better understanding of it will be available. This is what we know as of December 19

1) It appears to be highly contagious. Early data suggests it may be 2-3 times more contagious than the delta variant.
2) It may only cause a mild infection. Information from South Africa and several European countries suggest this. It is still too early to know if this will continue or not.
3) Previous mild infections of COVID from other variants may not protect against the omicron variant. Therefore, avoiding gatherings and wearing a mask is now being reemphasized.
4) Early data suggests being fully vaccinated plus a booster shot is providing strong protection against this variant. Having 2 doses of the Pfizer or Moderna vaccine provides less protection but protects against severe disease. Having a Johnson & Johnson shot does not provide much protection.

This information is going to be changing day to day. How this is going to play out is too early to tell. the best defense is the vaccine. If you have had 2 shots and it has been 6 months, you need to get the booster. Many people are questioning whether they need the booster or not. You definitely need it. For those who are not vaccinated it is time to move forward and start the process. If not, because of the contagious nature of both variants- there is a very high probability you will get the infection.

Dr. Bonema

FLU SHOTS ARE HERE!!!!

9/10/2021

Flu shots will be available at Troy Internal Medicine starting Friday, SEPTEMBER 17, 2021. If you would like to receive a flu shot, please respond with a NEW FOLLOW MY HEALTH message that includes your: name, date of birth, and telephone number. You may also choose to call 248-267-5000, ext. 3007, and leave the same information (You do not need to wait for a representative to dial this extension.). An office representative will reach out to you and schedule an appointment for a flu shot. These flu shots will be given in our Walk-in Lab.

If you have an upcoming scheduled office visit you will be able to have a flu shot at that time. There is no need to call or send a Follow My Health message to schedule an appointment to receive a flu shot in this case.

Walk-In Lab Flu Shot Hours:
Monday-Friday: 9:00 a.m. – 4:00 p.m.
We will be offering some Saturday hours, as well.

During this time of Covid-19 it is especially important that you get your flu vaccine as influenza symptoms mimic Covid-19. By reducing influenza, this will also reduce the risk of high impact hospitalizations as well as improve your health.

So, in closing, get your flu shot! Do this preferably in October, and at least by the end of October; but anytime is better than none. In addition, our physicians request that if you have not yet received your Covid-19 vaccinations, you should go to your nearest Health Department or pharmacy to do so.

Look for influenza and Covid-19 updates on our website at: www.troyinternalmedicine.com

COVID Vaccine Myths, Part 1

8/25/2021

This message provides an update regarding the COVID-19 vaccines and the myths surrounding them. The majority of our patients are vaccinated, and we thank you. There remains hesitancy and concerns from those who have chosen not to be vaccinated. In the next three portal messages, we will provide the latest evidence-based information to address the concerns patients still have.

Immunizations represent the most significant life-saving measures in all of medicine. One example is the meningitis vaccine. Prior to the meningitis vaccines in the early 2000’s every winter a number of high school and college students would die from bacterial meningitis. Since the advent of these vaccines, deaths are a rare occurrence. Parents of high school and college aged students do not hesitate to request this vaccination for their children. Another example of life saving vaccines are those which prevent bacterial pneumonia. Pneumonia in older adults has dropped significantly since the introduction of the pneumonia vaccine in the late 1980’s. A more recent example is the vaccine to prevent shingles, Shingrix. We see far fewer cases of shingles and the often, longstanding, debilitating pain associated with this because of this effective vaccine. Ironically patients rarely question receiving these effective vaccines.

Why is there such hesitancy and resistance to receive the COVID-19 vaccine? Our experience over the last 18 months has been an ever-changing barrage of recommendations and information. There has been a lack of a unified, clear, and understandable messaging from the medical community, often because the information and recommendations are evolving so rapidly. Additionally, misinformation about the vaccine is plentiful in the news and social media. Unfortunately, much of it is spread by unqualified medical persons who are advancing their personal opinions, agendas, or ignorance. The result is people are getting sick and dying because of this misinformation.

We know that patients trust their physicians’ opinions. We therefore believe we have a duty to provide up-to-date information for you. This information does not reflect our personal opinions. It reflects accurate, evidence-based research and medical information.

Why has the virus not gone away? It needs to live in humans. The only way to prevent infection is having immunity. This is achieved only by getting the infection or getting the vaccine. There is no medication available which will prevent the infection. As new variants develop, the virus has become more contagious and infective than previous versions. A year ago, it would take 10-15 minutes of exposure to someone with the infection to transmit the infection to someone else. Now the Delta variant takes no more than 5 minutes of exposure to infect someone. It is 60% more contagious than the United Kingdom variant from this past winter and spring. The main source of infection remains in people’s homes. Viruses like to spread in environments which are enclosed, have very little air circulation, and with people in close contact with one another.

The increase of COVID-19 infections in the southern states is due to the heat of the summer, where people spend much of their time indoors. Higher numbers are occurring in regions with lower vaccinations. Current data has approximately 95% of the new infections in unvaccinated people, with ~98% of the hospitalizations and deaths occurring in unvaccinated people. Prior to the vaccine hospitals were filled with older patients. Now this group is highly vaccinated. Since the Delta variant is more contagious and aggressive, it is infecting children and younger adults (18-40-year-olds) more than previous variants.

Two positive trends have recently been observed in Michigan. First, because of the vaccine, the number of infections and hospitalizations are less than the three previous spikes. Second, over the past several weeks, as the Delta variant infections have increased, many have become motivated to receive the vaccine. The concern will be when the weather gets cold, and we spend more time inside will this change because of the aggressiveness of the Delta variant and the numbers of unvaccinated people.

Myth #1: Children and young adults are rarely infected and have mild infections.
I was going to make this one of the last, but data published this past week has moved it first. Southern states from Georgia through Texas are experiencing the worst COVID outbreak since the pandemic began. The biggest reason is the low vaccination rates (as discussed above). The American Academy of Pediatrics reported in the beginning of July 12,000 new infections in children. At the beginning of August, the number was 94,000. The Dallas-Fort Worth area has 300 pediatric intensive care beds through the area hospitals. Last week they ran out of available intensive care beds due to COVID-19 infected kids filling most of them. Many of these kids are on ventilators. This is all due to the aggressiveness of the Delta variant. These are in kids under the age of 18 including 4 and 5 years old. Again, these are kids. They should not be in the hospital. They should be enjoying their summers and going back to school.

Most concerning is data out of these states show the number one cause of infection for children is unvaccinated parents. I will repeat unvaccinated parents (remember the #1 spread of COVID is in family homes). Imagine being in an intensive care room right now and your child is on a ventilator, critically ill, and the child caught it from a parent or grandparent who chose not to be vaccinated. As a doctor there is no worse feeling than being in a situation like this, knowing a vaccine could have prevented this. This information is not from social media, the government conspirators, FOX News, or CNN. This is REALITY!

The COVID vaccines are some of the safest products medical science has ever produced. Hundreds of millions of doses have been given to support this. Yet it is mind boggling the opinions people have by relying on Dr. GOOGLE and not their doctor. Over the next week there will be two more updates going over all the myths related to the vaccine. Hopefully this will help many of you to move forward and get the vaccine.

COVID-19 Vaccine Booster Shots

8/20/2021

There have been several important developments this week in respect to the vaccines. We would like to provide you with the current recommendations.

Starting immediately any individuals who have an underlying problem with their immune system and have received the 2 dose vaccine series from Pfizer or Moderna, should receive a booster vaccine. The following criteria constitutes who should do this:

Any person who is actively getting treatment for cancer. This includes solid organ cancers, blood cancers such as lymphomas, leukemias, multiple myeloma, etc. and melanoma.
Any person who has had a solid-organ transplant and is on medications which suppress the immune system.
Any person who has had a bone marrow stem cell transplant in the past 2 years.
Persons with advanced or untreated HIV infection.
Persons who have an underlying disease which weakens the immune system and require medications to strengthen and support the immune system. These are rare conditions. Two examples are DiGeorge syndrome and Wiskott-Aldrich syndrome.
Persons on medications which can affect the immune system. Examples of this include the following: high dose corticosteroids which include prednisone at doses of 20 mg or more daily; anyone receiving cancer chemotherapy drugs; transplant related immune suppression drugs; or anyone receiving a category of medicines called Biologics. These are commonly used in people with autoimmune conditions including rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis to give a few examples. Common medicines in these categories include methotrexate, Humira, Enbrel, Remicade, Simponi, Stelara, and Taltz.

We recommend if you are unsure if a medication you take is part of these medications which affect the immune system, you should call the doctor who is treating you for the specific condition. Please do not call us if we are not prescribing the specific medicine. We may not be able to give you the correct answer.

The booster shot only pertains to Pfizer and Moderna. You must have completed the 2-shot series at least 28 days before you can get the booster shot. If you received the Janssen vaccine (Johnson & Johnson), the booster does not apply to this. Currently there is not enough evidence that a 2nd shot is necessary. This may change in the future.

It is well documented that individuals in these categories have a weaker immune response to the vaccines. Recent studies show that with a booster shot the immunity can exceed 80%. It is very important that you receive this booster if you are a part of these groups. This will have a significant impact on reducing the risk of you getting COVID. If you need any additional information, please refer to the CDC website.

As for the rest of us, it appears a booster shot will begin the week of September 20. Today the US Department of Health Human Services in conjunction with the CDC and other national health organizations put forth this recommendation. It is for the Moderna and Pfizer vaccines. It will start for individuals who are 8 months past their 2nd dose of vaccine. It still must get authorization from the FDA and CDC. They anticipate the Johnson & Johnson vaccine will require a booster at some time in the future.

Studies over the past several weeks have shown at 8 months the immunity given by these 2 vaccines begins to reduce. All along we anticipated a booster shot was going to be needed. We will give more guidance as more information becomes available. The COVID vaccines still provide very good protection, including against the Delta variant. The risk of getting infected when fully immunized remains less than 10% and the infection is mild. The chance of hospitalization remains very rare when being fully vaccinated.

COVID-19 Vaccination Update

4/6/2021

As of 4/5/2021, all residents of Michigan 16 and older are eligible to receive a COVID-19 vaccination. To find a location to sign up, please see the resources below.

Local health department
Local Pharmacies such as Meijer, RiteAid, Kroger, CVS, Walmart, and Snyder Drugs
Ford Field Vaccination Site
West Michigan Vaccine Clinic
Michigan residents without internet service. or residents who need assistance scheduling a vaccination appointment, can call the COVID-19 Hotline at: 888-535-6136 and press option 1. Hours for the hotline are Monday – Friday 8:00 AM – 5:00 PM and Saturday – Sunday 8:00 AM – 1:00 PM.

For more information, please visit Michigan.gov/COVIDvaccine

COVID-19 UPDATE

4/5/2021

It has been a while since we have provided an update. Today I would like to give a brief update on the status of the COVID-19 pandemic.

The biggest news are the vaccines are working great. Over the course of the past 8 weeks there has been a dramatic drop in the number of infections, hospitalizations, and deaths. This has been greatest in people over the age of 65 because of the large numbers receiving the vaccine. The initial goal with vaccination was to reduce hospitalizations and deaths. This is being achieved. The other benefit of the vaccination has allowed many of these people to start leaving their homes and being with their kids and grandchildren again. The psychological impact for them has been huge. The fear of contracting the infection and possibly dying is receding for many of these people. This will only continue to get better now that 16-year-old and up can receive the vaccine. The initial response to this is looking very good. The wait time to get a vaccine is still several weeks. Over the course of the next month this should shorten as the number of vaccines become more available.

So why are we starting to see an increase in the number of new cases and hospitalizations? There are 2 causes. First, lack of wearing masks. People continue to do a good job in public areas where they are required. The main problem remains in small gatherings, especially in people’s homes. A recent report in the Journal of American Medical Association showed mask use was low when visiting a friend’s home or hosting visitors inside their homes. Most of the time people were less than 6 feet from one another. It was also high in people who believe masks are ineffective. Many of these people in the study had medical risk factors. Consistently this is occurring in people under the age of 55. Every day when we speak to people who have contracted the virus this is the typical scenario.

The virus is spread through the air from our mouths and nose. To become infected, all it takes is for individuals who are unmasked, and one person has the virus who is within 6 feet for no more than 10-15 minutes. In that short amount of time, you can breathe in enough virus to get infected. If you are wearing a mask the chance is very low. Therefore, there is such a renewed emphasis by our public health leaders to wear masks. They really work.

The second reason for the increase in cases has to do with the presence of new variants of the virus. What is a variant of the COVID-19 virus? It is the same virus but there has been a change or mutation of its genetic material, which changes its ability to infect. The virus becomes more, or less contagious. This commonly occurs in the influenza virus which causes the seasonal flu. It regularly mutates and is the reason why we need a new flu shot yearly. What conditions are needed for them to mutate? Basically, the longer the virus is around, its continued growth and reproduction, the greater the chance it can mutate. If you slow the spread and growth of the virus down, such as receiving a vaccine, the chances of mutating are reduced or eliminated.

Currently there are 3 strains present of concern. They are the United Kingdom, the South African, and the Brazilian. The United Kingdom strain is now the most common form of the virus occurring in the United States and Europe. The other 2 strains have affected their respective countries but have very little presence in the United States. The problem with United Kingdom strain it is at least 50% more contagious. If it is 50% more contagious it means the virus spreads much easier and faster. Therefore, our numbers are going up again. The virus is more contagious; thus, it is easier to spread. Fortunately, this variant is not causing a more severe infection, and the vaccines have an excellent response to it. The best way to prevent and eliminate the virus and its variants is to keep it from spreading. Therefore, masks and the vaccine are so important.

We are winning the battle. If everyone does their part, we will get back to normal. Next week I will discuss myths of the vaccine.

COVID Vaccine Update

1/7/2021

It was announced on Wednesday the State of Michigan will start vaccinating people 65 years of age and older and those in certain risk groups. They will be administered through the County Health Departments. You must make an appointment with the health department. Walk-ins will be turned away. There is a limited supply of vaccines. This is going to be a slow process.

As for our office, we will not be providing vaccinations anytime soon. We applied to the State two weeks ago and there has been no response from them. Speaking with a colleague who is familiar with the process, the State will provide preferential vaccine distribution to hospital systems, health departments, and major drugstore chains. It appears private offices will be low priority. We are actively trying to change this situation. Please do not call the office to get an update. As soon as we have information it will be released on the portal and our website. As a reminder once we have the vaccine, we will not be doing any type of waiting list. We will have a plan set up which will be fair, addressing those who are highest risk first.

Oakland County Health Department click here

Macomb County Health Department click here

Wayne Count Health Department click here

COVID Vaccine Update

12/23/2020

The news on COVID-19 is starting to turn positive. Over the past 2 weeks our practice has been getting fewer calls on people infected with the virus. This is very good news. We have not seen a spike in cases following Thanksgiving. With the Holidays, please stay diligent and do not let your guard down. A recent study out of the United Kingdom estimates people under the age of 35 years of age as 35-40 percent of the infections are asymptomatic. These individuals can spread the virus just as easily as those who have symptoms.

With Moderna receiving emergency approval on Friday, the supply of vaccines will start increasing on a weekly basis with two companies having approval. First responders and hospitals are currently being vaccinated. This week, and next, will begin nursing homes and extended care facilities staff. They will be followed by residents of those facilities. Lastly, will be doctors and employees of outpatient medical facilities such as ours.

Once these above groups have received vaccinations, then begins the first phase to the general population: people 65 years and older and individuals with medical conditions which puts them at high risk for severe COVID-19. This phase (referred to as phase 1B by the State) will be a big challenge. There are probably 80 – 100 million Americans who qualify. This is what we know so far:

If the current phase goes as planned, it could be late January or early February when the next phase begins. The determining factor will be how many vaccines are available. Both companies are increasing production every week.

Which vaccine should you get? It will be determined by where the Michigan Department of Health distributes them. We will have no control over which one will come to us. Fortunately, they work the same. The response rate is 95 percent in both vaccines after 2 weeks, following the second shot. Moderna’s vaccine has a higher amount of side effects, but they are all minor.

We are submitting our application for the vaccine. We need to see how many we will receive, and then we will start making plans on how it will be distributed. There are a lot of logistics which need to be addressed before we have a formal plan. We will send out updates every 1-2 weeks, both on the portal and the website. We will keep you well informed.

What about side effects? Will there be any surprises and/or problems we are not aware of? The simple answer, it is possible. Over the next 6 weeks 25-30 million people will receive the vaccine. We will see if there is something, we are unaware of. With vaccines, side effects occur within 6 weeks of receiving the vaccine. Anything after that time frame is not related to the vaccine. Another point we want to emphasize is every side effect and/or adverse event must be reported to the FDA. Please rely only on information coming out of the FDA. Anything else cannot be accepted as reliable and accurate. There are already several things on social media which are wrong. There are groups and individuals who are anti-vaccine. They utilize the Internet and social media to spread false information.

In the next several weeks we will send out in an update with a complete overview of the side effects, so that you will have a clear understanding of what to expect. Many people are hesitant to take the vaccine. Going forward, we plan on keeping you well informed about all aspects of the vaccine to assure your safety.

COVID Vaccine Update

12/14/2020

With the COVID-19 vaccine release, we want to keep you informed on the latest status. Currently in Phase 1 the vaccine will be going to hospitals. As the supply builds up it will then go to the rest of the health care community, first responders, and assisted living and nursing home residents and staff. Next, it will go to the general public starting with those over 65 of age, and with those having chronic conditions which increases the risk for infection. When this process begins will depend on how quickly the first phase goes. It could be as early as this February.

COVID Vaccine and Gatherings Update

12/8/2020

Within the next one to two weeks, one or two vaccines should be available. They are from Pfizer and Moderna. Both vaccines work the same way to give protection. Here is what we know so far.

Both vaccines require 2 shots. Pfizer’s 3 weeks apart, Moderna 4 weeks apart. One is not superior to the other, they work in the same mechanism.
Two weeks after the second shot there is a 95 percent response rate. This is outstanding. There may need to be another booster shot. Right now, the estimate may be 1-2 years after the second. This will be determined as time goes on.
The vaccine cannot give someone COVID-19, it is impossible.
Side effect information will be released when the vaccine is approved. We will provide more information on this in future updates.
Supplies will be limited in the first several weeks. Hospitals will receive the first shipments from the CDC. The next shipments will go to health departments. They will then distribute it for medical workers outside of hospitals, first responders, nursing homes and assisted living facilities. Once these groups receive their immunizations, Phase 2 will begin.
Phase 2 will be a much larger roll out. When it will begin depends on supply and how quickly phase I concludes. Optimistically it could be late January or February. This group will include people 65 years of age and older, people with underlying medical conditions at risk for severe COVID-19, people from racial and ethnic minority groups, and a number of other smaller groups.

With more information is coming out, we are just beginning to assess whether we will be giving out the vaccine. There are a lot of logistics which must be addressed including the ability to get proper supply of the vaccine and the storage and preparation of the vaccine. I will give you timely updates through the portal and our website. I assure you this is a top priority of ours and we are assessing the information as soon as it is available.

With the cold weather here, the home environment is still the common source of COVID-19 spread. What should you do if someone in your home tests positive and/or becomes ill?

Persons who suspect they may have COVID-19 should isolate (same as quarantine). This means stay at home, use a separate bedroom and bathroom if possible. Stay away from others in the house.
Isolation must start before seeking testing if ill because one is contagious at that point. Isolation must continue while awaiting test results.
If ill and test results are negative, you must talk to your doctor before stopping isolation. There are many instances where the test is negative, but the virus is truly present causing COVID-19.
All household members including the patient should wear a mask if they cannot socially distance, especially if they share a common space such as a bathroom or kitchen.
Household members exposed to the patient and not wearing a mask must stay home and isolate. They should obtain testing usually 5-6 days after the exposure. It usually takes this amount of time to get a positive test.
Why the emphasis on household members? Data from several studies have shown roughly half of household members with confirmed COVID-19 infections had no symptoms. They are actively spreading the infection while unaware of having it. This holds true if you have visitors in your home. So often someone may be asymptomatic but is actively spreading the virus.

Bottom line if someone in your home is sick, they need to isolate, and you stay away from them. If you must be near them, wear a mask and wash your hands regularly. If you have been with them without a mask you have to isolate and get tested as discussed above. Be safe and keep wearing your mask.

Thanksgiving 2020 and Family Gatherings

11/24/2020

Things are changing rapidly with this pandemic. Our position is to try to keep everyone informed now on a weekly basis. Today will be good news and bad news.

First the good news. We’re getting very close to having a vaccine. The first vaccine could be available in several weeks. This is the Pfizer vaccine. A second one from Moderna may be quickly behind it. The first phase will go to where the need will be the greatest: hospitals and healthcare workers. Nursing homes will probably be next. After that it will begin to roll out to the general public focusing on those at greatest risk. As it gets closer, we will know more. We do not have any idea when Troy Internal Medicine will receive the vaccine. Right now, the release of the vaccine will be coordinated nationally. When we have a better idea when we could have it, we let everyone know well in advance. The status of the vaccine will be part of every weekly update.

Now for the bad news. The number of cases continue to accelerate. It is becoming very troubling and frightening. We are now over 180,000 new cases a day. More than 2000 deaths are being reported daily. To put it into perspective, for the past 2 weeks, more people have died every 2 days in our country from COVID-19 then died in the 9/11 attacks. Soon it will be a daily number greater than 9/11.

Unfortunately, we are entering a holiday weekend and we need to be very careful. The reality remains this infection is easy to prevent. It’s done by people being responsible for themselves and those around them by wearing masks and social distance. This virus is highly contagious, more than anything we’ve seen in our lifetime. The ability to spread is similar to those who had childhood infections of measles, mumps and chickenpox. You can lack symptoms and still spread it.

The number one place of spread remains in small gatherings in people’s homes. This is why Thanksgiving could be a serious problem going forward. The best thing to do this year is keep it simple. We cannot tell you what to do but only make suggestions. Have your immediate family only. If people are coming from out of town or back from college, social distance and wear a mask. It may be inconvenient, but it beats getting sick. Asymptomatic spread remains a big problem. Make sure air is circulating in your home by running ceiling fans and floor fans. Crack windows to get some fresh air circulating.

What are common scenarios of a COVID-19 infection? The common symptoms are a combination of muscle aches, fatigue, fever, chills, nausea, cough, sinus congestion and drainage, loss of taste or smell, headaches, diarrhea, shortness of breath. I will give you some examples of things we are seeing.

Cough, fever, and shortness of breath actually make up the minority of patient’s we are speaking to. Actually, this is what most people are looking for.
Sinus congestion and stuffiness with clear drainage is a common example. They can have a low-grade sore throat that comes and goes. Sometimes individuals will feel tired or achy.
Intermittent episodes of fatigue where for a number of hours the individual feels exhausted then they feel fine. Frequently they will develop low grade fever and chills, muscle aches, stuffiness in the sinuses.
Complaints of fatigue, mild nausea and intermittent diarrhea.
Any presence of loss of smell or taste is COVID-19.
We are starting to see more headaches in conjunction with body aches, fatigue, and mild abdominal pain.

This is a general overview of scenarios we are seeing. What is also important there are few other infections going around. So, when we talk to patients with any of these symptoms, we approach it as COVID-19. Another important fact is if you have symptoms and test negative for the virus, there is a high probability it still is COVID-19. We see this a lot. Some people just test negative despite having the infection. We have the patient stay in self quarantine for the appropriate amount of time. Stay away from people if you’re not feeling well. Stay away from people if you’re awaiting the result of a COVID-19 test.

Finally, the biggest concern we are facing is running out of hospital capacity. This is affecting hospitals throughout the country from major cities to small towns. We are close to running out of beds because hospitals are overrun with COVID-19 patients. As the numbers continue to increase this will become a reality within one to 2 weeks. I am not exaggerating. What will happen if you or a family member has a heart attack, a stroke, a surgical emergency, a motor vehicle accident, and the list goes on. Then there is the medical work force. They are exposed daily and a number of them get sick or exposed and cannot work. They are exhausted and overwhelmed. Also, they are not replaceable. In the spring hospitals that were overwhelmed could get extra doctors and nurses from areas of the country which were not affected. That does not happen anymore for the whole country is affected.

This is a very serious problem which is only getting worse. Please listen to our health leaders and doctors. Wear your masks, social distance, and limit the size of gatherings. We say this because we truly care about your well-being. We do not want to see you sick or in the hospital. Let’s defeat this virus! Have a safe and Happy Thanksgiving.

The Importance of Masks

10/30/2020

It is time to discuss the importance of wearing a mask, above your mouth and nose in the presence of other people. The only reason more people are becoming infected with COVID-19 has to do with not being masked.

Why is it so important to wear a mask? COVID-19 spreads through the air through the nose and mouth. The virus is highly contagious. It spreads more efficiently then influenza, the virus which the flu shot protects against. With COVID-19 infection, whether you have symptoms or not, breathing, talking, coughing, sneezing, or singing respiratory droplets are released into the air. The virus is in these droplets. If individuals are unmasked and have close personal contact and/or are within 6 feet, they can breathe in enough respiratory droplets within 5-15 min. to become infected with the COVID-19 virus. The virus attaches to sites in the nose, mouth, and throat and begin the infection process. Beyond 6 feet the respiratory droplets have fallen to the ground and the risk drops significantly. Recently this has gained more attention as we now know it can be spread from what is known is airborne transmission. Some of the respiratory droplets are tiny, and can stay suspended in the air for minutes to hours after an infected person has left the area. These transmissions occur within enclosed spaces which typically have inadequate ventilation and air flow. The unmasked infected person has been shouting, singing, or exercising where they are releasing more particles into the air. Unmasked individuals who are in the room or come in up to several hours later can breath in enough of these tiny particles and get infected. This probably accounts for less than 5 percent of infections.

The risk increases within enclosed spaces. This is where almost all cases are originating from. The number one source of infection has been small gatherings of people who are indoors. The most common place is in the family home. Other sources include meetings, weddings, funerals, bars, and birthday parties. In all instances people are not wearing masks, are with people they know well or feel comfortable being around. If you do not know what their habits are in respect to where they go or who they are around, someone attending may have the virus but are asymptomatic. Everyone attending can get exposed and become infected. Amazingly people who are feeling sick still or have a fever still think it is fine to go out. Of those who become infected, many can remain asymptomatic or others may not break out with symptoms for 7-10 days. All the time this occurs they could be spreading the virus to others if they are not wearing a mask. Remember, if you have no symptoms YOU STILL SPREAD THE VIRUS!

Respiratory droplets can land on surfaces and objects. If you touch that surface and then touch your own mouth, nose, or eyes the virus could gain entry. Fortunately the amount of virus that is on surfaces is not enough to cause an infection. The more common scenario to cause an infection would be sharing a bathroom in your home with someone who is actively infected. In this setting the person who is sick is constantly releasing virus when they are in the bathroom. High amounts of viruses then contaminate the surfaces and air.

We are in pandemic fatigue. Many people are letting their guard down because they are tired of everything. Others believe their personal rights are being violated by being told to wear a mask. Others just do not believe in a mask because of information they gathered through the media. Some think it is a conspiracy and will go away after the election. This is all irresponsibility. Unfortunately because of these attitudes the cases are rapidly increasing. They will continue to increase until everyone takes responsibility and wears a mask to protect themselves and those around them. Why is this is so important? We have abundant evidence masks work:

Since the end of March everyone at Troy Internal Medicine has been wearing a mask. We screen people daily for symptoms and fever. No one in our office has contracted COVID-19 from being in the office. Moreover there are times where we cannot social distance. With everyone wearing a mask that chance of contracting the virus is basically zero.
When we speak with patients who have the infection or have been exposed, consistently they were around other people and were not wearing a mask. Again almost all these patients were indoors at a family or social function. Those who were wearing masks and were exposed have consistently tested negative.
There are a number of private elementary, middle, and high schools which opened and are at full capacity since mid August, and have had no issues with outbreaks of COVID-19. The reason has to do with everyone wearing masks and are enforced by the teachers and administrators. It is tough to social distance this number of people, but wearing masks is preventing outbreaks.
Patient’s who are at highest risk consistently have been very careful. When around people, whether at home or away from home, they have always worn masks. These patients are not having any problems.

What is the best strategy moving forward? Please adhere to the guidelines. Protect yourself and others. We have a moral obligation to keep others safe. The best way to prevent illness is to avoid being exposed to this virus. Most importantly cover your mouth and nose with a mask when you are around others. It can take as little as 5 min. to get exposed to the virus and become infected. Stay at least 6 feet away from others if you or someone else is not wearing a mask. Avoid crowded indoor spaces. Make sure the indoor spaces are properly ventilated by bringing in outdoor air as much as possible. If you are around people indoors or at some type of function, wear a mask. If you do not know how careful those around you have been, you are putting yourself at risk.

If you are an individual at higher risk and you will be around people, you must wear a mask. This virus remains very aggressive in people who are at high risk. Most of the current infections are in people under the age of 45. We know the infections tend to be milder, and many get no symptoms at all. The amount of critical infections and deaths remain much lower than what they were in the spring. The main concern going forward is the spread to those who are older and at increased risk for the infection. People over the age of 50 makeup most of the hospitalizations and deaths.

Thanksgiving and the Holidays are approaching. With the number of infections going up, this could be a major problem. Everyone needs to be careful and think very carefully about how they get together with family and friends.

Where is everything going? For once the news is exciting and optimistic. There is a high probability the vaccine will be ready in December with at least 2 maybe 3 companies producing it. There will probably be 10-30 million doses ready to go at that time. The preliminary data is looking optimistic for its effectiveness and safety. In a recent podcast, Dr. Fauci estimates there may be 700 million doses available by April. A group of knowledgeable scientists and public health officials have worked out a 4 phase process to distribute the vaccine. I can reassure you none of this and I repeat none of this will be influenced politically by either of the political parties. The men and women involved in all aspects of research and development are dedicated, top-notch scientists and they follow strict protocols which cannot be changed or circumvented.

For hospitalized patients we are very close to having FDA approval of a monoclonal antibody treatment which kills the virus. One company applied for emergency approval 2 weeks ago and there are 2 companies which are in the final phase 3 studies, and they may be ready for approval in December. This is the antibody treatment which President Trump received, and it cleared the virus from his system within several days. Once available it will have a major impact on those who are most sick, speeding recovery and reducing the death rate.

Finally, a word on what we do everyday. Our care for you is not based on press releases or political opinions. It is based on sound evidence-based science for what we do and what we recommend. We want this over more than you can believe. We put ourselves at risk everyday coming to work to do what we do for you. Please wear your mask.

Influenza Vaccine

FLU SHOTS ARE HERE!!!!

Flu shots will be available at Troy Internal Medicine starting SEPTEMBER 8th, 2020. If you would like to receive a flu shot please send a message through the Follow My Health portal with your name, DOB, and telephone number. (Click here for FMH portal). You may also choose to call 248-267-5000, ext. 3007, and leave a voicemail with the same information (You do not need to wait for a representative to dial this extension.). An office representative will reach out to you and schedule an appointment for a flu shot. These flu shots will be given in our Walk-in Lab.

If you have an upcoming scheduled office visit you will be able to have a flu shot at that time. There is no need to call or email to schedule an appointment to receive a flu shot in this case.

Walk-In Lab Hours:

Monday-Friday: 9:00 a.m. – 4:00 p.m.

During this time of Covid-19 it is especially important that you get your flu vaccine as influenza symptoms mimic Covid-19. By reducing influenza this will also reduce the risk of high impact hospitalizations, as well as improve your health.

So, in closing, get your flu shot! Do this preferably in October, and at least by the end of October; but anytime is better than none.

Look for influenza and Covid-19 updates on our website soon.

Coronavirus Update

Our providers are currently scheduling Telehealth visits for our patients. Please follow the link below for more information on how to schedule a Telehealth appointment and how to connect to a Telehealth visit.

troyinternalmedicine.con/telehealth-visits/

We will no longer be providing urgent care hours Saturday mornings until further notice. If you would like a telehealth visit with your provider, please call our office at 248-267-5000 to request one.

Be sure to call us and schedule a Telemedicine visit or an in-office visit for any health concerns. Our office is currently seeing “Well” visits in the morning, cleaning the office mid-afternoon, and then scheduling non-Covid ill patients in the afternoon. We screen all patients during the phone call, as well as, prior to entering the waiting room. Our appointment process has been streamlined for patients to be roomed promptly. We ask that anyone accompanying you to your visit stay in the car. In the future we look forward to continuing your healthcare within the office.

* COVID-19 Testing update 4/22/2020 *

“First do no harm.” This is part of the oath a physician takes. This statement covers many aspects of the responsibility a physician has to their patients. The Covid-19 pandemic has given us challenges in healthcare we have never experienced. There are many unknowns facing us in the decisions we make daily. Patients face the same unknowns without the knowledge and understanding which we possess. It has generated a lot of anxiety and fear for you.

To practice medicine correctly and in your best interest, it needs to be done based on good scientific evidence supporting what we do and will not do. Many reports in the media advise recommendations when diagnosing and treating this virus. Unfortunately, a number of these recommendations have no evidence to support what is being done. They give you the impression go ahead and do these things because of the nature of the pandemic. Remember “first do no harm.”

There are two very important issues you need to be made aware of right now. Testing and treatment. There are two types of testing for Covid-19. The nasal or throat swab testing is to diagnosis or show you have the infection. The second test is the antibody testing which is being discussed more and more in the media. This test assesses the body’s immunity to the virus. The antibody test is a blood test. It is checking for antibodies to the virus. Antibodies are what your immune system produces to kill the virus and then provide immunity. Immunity is your body’s ability to prevent getting the infection again. If you have immunity theoretically you cannot get the infection again. Unfortunately, it does not always work that way. There are different levels of immunity. It may last only for several months or it can be permanent. The testing for antibodies is a very important test to have done if you had the infection , think you may have had it, or were exposed to someone who had it but you did not get sick.

We want to make you aware this antibody testing is being offered now by many different clinics and offices. Unfortunately, the testing materials available right now are not validated by the FDA. As a result, the accuracy and reliability of the testing has not been proven. The FDA validation is very important to have because it assures the accuracy and reliability of the test. This week the FDA validated the test kits for three companies. None of these tests are yet available. There are over 80 companies waiting for validation, yet many of their testing kits are being used right now to test people for the antibodies. Many people are seeking out this testing because of the multiple media reports on the need to determine if you have immunity to the virus. If the tests are not accurate, they may miss people who have immunity. Worse, it may falsely show they have immunity but never had the infection and are at risk of getting the virus. For example, in England, the National Health Services, the country’s health program, had been testing patients for 10 days to see if they had immunity. A week ago, they abruptly canceled the testing when they found out the testing kits being used were giving many wrong results for immunity. “First do no harm.”

At Troy Internal Medicine, we will be doing the testing for immunity, but are going to use testing which are validated by the FDA. Unfortunately, due to the high demand we will not be getting kits until sometime in May. We want to reassure you there is no rush to have this test done. If you are offered to have this blood test done elsewhere, insist on seeing documentation with a package insert showing validation by the FDA. If the facility cannot provide this, do not have the test done. This test is very important, and accuracy is key.

Next is treatment. We receive calls daily requesting chloroquine, hydroxychloroquine, and the Z-Pak for someone who has the infection and others who want to have it on hand in case they get the infection. Multiple media reports and physicians make claims that these drugs must be used. Unfortunately, to date, there is no evidence that these drugs have any benefit in patients unless they are in the hospital. This is based on good scientific studies. We rely on this. We do not rely on what the media says. We do not use treatments just because it might help. This is bad medical practice. These drugs have been studied in past outbreaks of the Covid virus, and there was never any benefit with them. Moreover, these drugs do have serious side effects. They increase the risk of heart rhythm problems which can be fatal without warning. They can cause damage to the liver and the bone marrow. Yet patients want these medicines and want to believe what the media promotes versus good science and medicine. Patients argue with us over the phone on why we will not prescribe them. “First do no harm.” We want to reassure we are following everything closely, and on a daily basis. We will continue to do the care, safety, and compassion at the highest level which you are used to getting from Troy Internal Medicine.

Stay healthy everyone.

Coronavirus Information

Troy Internal Medicine is monitoring the CDC guidelines daily. We are aware of the current situation regarding Coronavirus, and will update our website appropriately.

Our phone room has been screening patients for fever, cough, shortness of breath, travel within the last 14 days, and close contact with someone positive for the Coronavirus. We are not currently testing for the COVID-19 here at our office. We ask that if you have any of these symptoms, have had close contact with an affected patient, or have traveled to any of the affected areas in the past 14 days, that you CALL US FIRST to have a message directed to your physician.

In order to prevent the spread of the virus we are:

Changing our schedules to well visits in the morning. All well visits will be from 7:30 a.m. to 12:15 p.m. Between 12:30 and 1:30 p.m. we will break for lunch. In addition to our current process of cleaning patient rooms between each patient visit, we will be deep cleaning all patient rooms and departments during the lunch hour.
Our Walk-in-lab hours will temporarily change to 7:30 a.m to 12:15 p.m.

In order to prevent the spread of the virus everyone should:

Wash your hands and fingertips often with soap and warm water for at least 20 seconds. Use an alcohol based hand sanitizer with at least 60% alcohol if soap and warm water are not available.
Always cover any coughs or sneezes with a tissue or sleeve.
Avoid close contact with people who are sick.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Clean and disinfect frequently touched objects and surfaces (computers, keyboards, door knobs, etc.)
Get proper rest, nutrition, and exercise.

For more information, please visit the State of Michigan’s website regarding the Coronavirus at the link below.

https://www.michigan.gov/coronavirus

4600 Investment Dr

Open Mon - Sat

New Patient?

COVID-19 Update Archive