Happy 2023!

7 Tips for Covid-safe medical appointments

Hello and Happy, Healthy New Year!

2023 is off to a hair-raising start with infectious disease experts sounding the alarm on an uber-contagious, immune-evasive subvariant of Omicron (XBB.1.5 aka Kraken). A huge concern is LongCovid with persisent infection due to its ability to infect new cell types (ones that express lower levels of ACE2).

Prof. Akiko Iwasaki @VirusesImmunity

A very important and informative thread about why the Omicron XBB.1.5 subvariant is now dominating in the Northeast US and is expected to spread. Please protect yourselves and others by wearing N95 masks. I am truly concerned about the #longCOVID wave that follows this infection.

Yunlong Richard Cao @yunlong_cao

The superior growth advantage of XBB.1.5 has been well-documented by many colleagues @JPWeiland @LongDesertTrain @EricTopol. Here I'll add some experimental data: 1) XBB.1.5 is equally immune evasive as XBB.1, but 2) XBB.1.5 has a much higher hACE2 binding affinity. 1/ https://t.co/jsk7gcyfu4

Given this, I thought it may be helpful to address a question I'm often asked: How can I stay safe when seeking basic health care? After all, countless have been infected in medical settings, with reports pegging hospital-acquired infection at a whopping 12-15%.

This reality was recently brought home by seeing stroke-survivor, movie star Sharon Stone recount how she contracted COVID from an unmasked nurse at a doctor's appointment.

Dana Parish @danaparish

😭 Sharon Stone, still sick & testing + 16 days in: “I managed to not get Covid for so long, do you know how I got Covid - because they stopped wearing masks [at doc’s office]. And do you know where I got Covid, from a nurse!" 😡 hellomagazine.com/healthandbeaut…

hellomagazine.comSharon Stone reveals unlucky outcome following doctor’s visitSharon Stone took to Instagram to reveal an unfortunate outcome from her doctor’s visit involving her health

Since March 2020, I've labored over (and even tried to avoid) seeing a doctor in-person, and yet it’s unwise to skip necessary appointments out of fear of contracting Covid, flu, RSV etc.  So, I developed effective strategies that have worked for my family, friends, and me. To date, none of us have been infected at the doctor’s office.

Hope this helps make your life easier:

7 tips for safer medical visits:

1. CALL to find a practitioner that requires masks Even better if they also clean the air with portable HEPA filters /mechanical ventilation/ open doors & windows (when possible). 

2. N95 Mask INQUIRY Ask whether your practitioner will wear an N95 mask (aka respirator) during your appointment since they are excellent protection for both you and them. Bring extras in case they run out or forget.  Even better if support staff wears them, too. NOTE: Cloth and surgical masks (without a brace) don’t work well!

3. MAKE a first-morning appointment COVID is airborne and can linger in the air for hours (like smoke) in a poorly-ventilated space. The primary way people get infected is by breathing it in. So, fewer people in the office with/ before you is best. 

4. WEAR a well-fitted N95 (or better, like an elastomeric), and don’t take it off from the time you enter the building til you’re back outside. Not for a second. It only takes a single breath to catch Covid. At the bottom of this post, I’ll share a link on how to fit an N95 yourself.

5.  READIMASK (N95) or a metal-free elastomeric for MRI You can’t wear a regular N95 in an MRI machine because they contain metal, which can cause burns. Two metal-free options are Readimasks (N95) or an elastomeric with no metal (I have one made by 3M). It’s also possible to jimmy-rig a regular N95 by gently tearing or cutting off the nosewire/ staples attaching straps and using double-sided surgical tape (e.g. masktite) to tape mask to face. I had to do this for an emergency hand MRI last year and a kind 3M rep walked me through it.

6. WHEN you can’t wear a mask I went for yearly dermatology check and asked doc if he could examine my face outside so I didn’t have to remove my N95 indoors. He said yes. If that’s not possible, take a deep breath and hold it for a quick face-check. Exhale after re-sealing your mask. This is the same procedure to use in the airport when they ask you to pull down your mask for identification.

7. MOBILE Medical Services Some towns offer services that can come to your home, so the appointment can be conducted in a well-ventilated room or outside.  E.g. mobile phlebotomy, dental, or optometry. They may be more expensive and sometimes infeasible, but worth a mention.

Do you have other tips to share? Please post them in comments.

xx dp

PS. Here’s the link I promised, it’s worth watching!