It’s been quite a while since I sent an “Update” email, and this one is going to be brief. You are all aware of the alarming increase in the number of Covid -19 cases around the country. Unfortunately, this trend is now occurring in Maryland.

Maryland statistics show a rather sudden increase in cases, hospitalizations including critical care utilization, case positivity rates, and percentage of the population infected as follows:

Deaths in Maryland have risen somewhat, from around 7 per day to about 14 per day. Death numbers will likely lag the increase in critical care bed utilization by about 2 weeks.

The rather sudden increase in Covid disease severity in Maryland has prompted us to reevaluate our protocols in the practice to keep everyone as safe as possible. We have seen an increase in patients with Covid over the last 3 weeks.  (We saw no cases between June and September, and in the last 3 weeks we know of at least 8 positive cases and one death in our patients, between all of the providers here)

So here’s the deal:

1)      We will continue to perform physicals on our regular schedule. If anyone scheduled for a physical has concerns about coming in under the current circumstances, we will be happy to reschedule your appointment until after the storm has passed.

2)     If you have a routine appointment for follow up and feel comfortable changing this to telehealth (video) or telephone visit, call and let us know.

3)     We encourage you to postpone routine lab work that you would normally get in November or December until after the first of the year. This can include the lab work for your physical, even if you plan to come in for your physical now. (We can call you with these results in January) Our lab facilities will remain open, but postponing lab work will decrease the traffic in our office by about 40%.

We will continue to monitor the situation in Maryland and Anne Arundel County and make adjustments in our protocols as the situation demands.

On to the Holidays. This season will be tough on everyone. We all need to consider how to keep Holiday gatherings as safe as possible and you have probably heard all of the leading recommendations. My suggestions:

1)      Limit the number of guests for indoor gatherings, 8-10 or less

2)     If your guests (or you) have significant risk factors for developing a serious case of Covid (age over 75, obesity, diabetes, lung issues, or a compromised immune system) consider not including them in the festivities. These risk factors add up, so an otherwise healthy 75-year-old may not be at high risk.

3)     If any celebrations can be held outdoors, these are pretty safe, especially if you keep your distance

4)     Consider having everyone get tested, within a few days of the event. This is not foolproof but lowers the risk of infection considerably.

5)     For kids returning from college – many of them have already had Covid and recovered. They should get tested before coming home

6)     Flying is fairly safe with a KN95 or N95 mask. High risk people should stay home.

7)     Avoid having guests from current high-risk areas including the Dakotas, Iowa, Wisconsin, and Illinois. Positivity rates there are as high as 40%.

Expect that restrictions in Maryland and other states which have managed the Pandemic successfully to be ramped up over the next several weeks. Experts are predicting a peak disease level around Christmas with gradual decrease after that.  We expect that a vaccine will be available on a limited basis in early January and availability will expand progressively through the spring. The Pfizer and Moderna vaccine studies look great, and FDA approval looks likely.

So with all that happy news, have a great Thanksgiving.