To our Patients and the North Cypress community:

As most of you are aware, many Texas businesses have reopened over the past several weeks, an important step for the economy. You may have also noticed that many people are choosing to not wear masks and social distancing has seemingly become less important to much of the population. This is increasing concerns about our community’s health.

The current situation

In the past four weeks, COVID-19 hospitalizations in the Houston area have increased by 150%. It is important to understand that this is not a rise in CASES, which will naturally increase as community testing increases; this is a 150% increase in HOSPITALIZATIONS! Many ICUs are full and have long waiting lists for admission. It is expected that this trend will continue over the next few weeks.

Please know that we understand the difficulties of remaining relatively isolated in your homes for the past several months. As you see your neighbors resuming their previous activities, it is tempting to venture out to restaurants and shops and to your physicians’ offices. However, the prospect of a second wave in COVID-19 cases makes this very risky.

Staying safe

We are deeply committed to your health and wellness, and for that reason, we want you to be aware that the more closely you interact with others and the longer that interaction, the higher the risk of COVID-19 spread. While it may be safer to stay home, we realize it's not always possible. When you do go out, take every precaution. Wash your hands often and liberally use hand sanitizer and soap and water. Continue to practice social distancing by staying at least 6 feet apart from other people.

We also strongly recommend wearing face masks in public. This continues to be a best practice of the medical community nationwide, as it protects not only you, the wearer, but those around you. While wearing a mask may seem cumbersome at times, we believe the added safety it provides for all is well worth any inconvenience. Most importantly, be especially cautious about going out if you are older than 65 or have an underlying medical condition (diabetes, asthma, COPD, heart disease) that puts you at a higher risk for serious illness from COVID-19.

Please read our latest recommendations for testing, self-quarantining and office appointments for our patients, detailed below:

If you have symptoms of COVID-19:

• Please note that not everyone who has symptoms needs to be tested.
• If you are otherwise healthy and contract COVID-19, you are most likely to experience only mild symptoms (fever, cough, fatigue, muscle aches, headache, loose stool, loss of taste or smell) that begin 2-5 days after being infected with the virus. It can sometimes take up to 2 weeks for symptoms to appear; some infected persons may never show symptoms at all.
• If you think you are infected but have only mild symptoms, please self-isolate at home until your symptoms have resolved. You may come out of isolation when it’s been at least 10 days since your symptoms first appeared, and you have been fever-free for three days. If you have family members or close contacts who are considered high-risk, we advise you to continue avoiding close contact with them for at least 14 days and maybe more (out of an abundance of caution). 
• If you have access to a portable (fingertip) pulse oximeter, it would be helpful to monitor your oxygen saturation. If your saturation drops below 90%, be sure to call our office as soon as possible.
• There is no specific treatment for COVID-19. Outpatient treatment consists of supportive care, such as maintaining adequate fluid intake and taking Tylenol for the headache and muscle aches. For most people, the symptoms will resolve within 2 weeks.
• If your symptoms are severe (such as trouble breathing, low oxygen, or high fever), please go to the nearest ER for testing and treatment. 

If you’ve been exposed to someone with positive or presumed COVID-19, but have no symptoms:

• You do not necessarily need testing.
• Please continue to practice social distancing and wear a mask when you are in public.
• Monitor yourself for symptoms for the next 14 days and avoid close contact with others, especially those who are over 65 or who have underlying medical conditions.
• If you do subsequently develop symptoms, please refer to the guidelines above.

COVID-19 testing availability:

If you have symptoms but don’t feel ill enough to potentially require hospitalization, or have no symptoms but would still like to be tested for COVID-19, the easiest way is to schedule an appointment with a participating Houston-area CVS or Walgreens pharmacy.

• Outpatient pharmacy testing is done in the pharmacies’ drive-through lanes and is contact-free, which means you must be able to do the nasal swab on yourself or bring someone who can do it for you (the swab only needs to be inserted about an inch into the nostrils).
• Test supplies are limited and you must submit information and schedule an appointment online at CVS or Walgreens.
• According to their websites, most insured patients will be able to receive this test at no cost, but please check with your individual insurance carrier to be certain.
• Although Walgreens has some rapid test kits available, most results at both CVS and Walgreens will take 2 to 4 days to be emailed to the patient.
• Other Houston-area test sites may be found on the Houston Emergency Center site at http://www.houstonemergency.org/covid-19-testing or the Texas Department of Health Services at www.dshs.state.tx.us/coronavirus/testing.aspx

It's important to recognize that no test is perfect. If you’ve been exposed to COVID-19 and are experiencing most of the symptoms of the virus, you should assume you have it, even if your swab is negative. In such cases, this would be considered a false negative and you should self-isolate for 14 days and treat yourself with rest, fluids and Tylenol as noted above.

If you are a patient at North Cypress Internal Medicine & Wellness and are planning an appointment or to have blood work done at the lab:

• For routine issues, we strongly encourage you to take advantage of our virtual visits. While we continue to take heightened precautions at the office to keep our environment as safe as possible, please understand that any visit still carries some risk of exposure and future illness. At this point, we are recommending in-person visits only if absolutely necessary.  
• For urgent or acute concerns, please call us to determine the best course of action. Please do not 'walk in.'
• If an in-person visit is deemed necessary, we'll contact you with screening questions beforehand. When you arrive, we ask that you call our concierge office line and wait in the car for instructions from our staff. Respectfully, we request that no visitors accompany you unless needed for your safety due to a disability.
• For routine lab draws, we suggest these be postponed until later in the summer if possible. When a lab draw is necessary now, we will direct you to labs that have strategies in place to safely minimize patient contact.

Finally, please understand that our intent in sharing this message is not to unduly alarm you, but to share information based on our current knowledge of a situation that is ever-evolving. Don't let your guard down and continue to take all precautions possible to stay safe and healthy. As always, please don’t hesitate to contact us if you have any questions or concerns.

We will get through this together!

Dr. Dorothy Serna and Dr. Kelly Englund