Hi everyone, I haven't had any real change to previously posted information until now. I am glad that the CDC has come out in favor of covering your nose and mouth with some sort of mask, bandanna, or scarf.
With the usual cold and flu, we don't recommend this measure unless you are the one who is sick.
The trouble is, this time up to 25% of estimated cases may be asymptomatic, just feel fine, but spread the virus all over the place. Also, some people take up to 7 days to get symptoms, but we don't know for sure how long they may be spreading the virus without realizing they are getting sick.
Don't let wearing a mask give you a false sense of security. You still need to be careful to clean your hands and avoid touching your face, including your eyes.
Continue to maintain social distancing habits and STAY HOME if you don't need to go to the grocery store or work where you are needed.
I continue to do video visits to try and keep up with our routine health care needs and to help you stay away from the urgent care or hospital unless really necessary. Please reach out if you need an appointment or have a concern.
Meanwhile, BE WELL, be kind, be thoughtful, be mindful.
Warmest regards, Dr Collins
Did you know that of the 48 positive test results to date in our Hawaiian Islands, 37 of them originated with Hawaii residents returning home?
In other words, the majority of our cases are residents who returned home from a trip. At this point, many students are and will continue to come home from schools across the US and abroad due to school closures.
There are others who will be returning from essential travel for the military or the government for example.
It is important for all travelers to monitor their health for 14 days after traveling and to avoid exposing others and stay at home.
Let's all do our part to stay calm and avoid fostering stigma and anger in our community. Just as it would be wrong to call this the "Chinese virus", it is wrong to blame travelers or tourists for all cases of Corona Virus.
Thank you for your assistance in increasing understanding during this rapidly changing situation.
Testing supplies, including the swabs used to collect specimens are in critically short supply nationwide.
Per the HI DOH and the CDC: "Mildly ill patients without risk factors for severe disease from COVID-19 infection should be encouraged to stay home and contact their PCP for guidance."
At this time, my guidance to you is:
social distancing and self isolation: if we all act as if we have this virus and do our best to minimize spread, this will minimize the spread.
if you have cold or flu symptoms: treat your cold and flu symptoms the way you normally would: fluids, rest, cough drops, Vitamin C, chicken soup.
Minimize contact with other people,
wipe down or spray with lysol: all surfaces you touch such as door knobs, sink taps and toilets, refrigerator and cabinet doors, and so on.
Reasons to call me or seek care at an Emergency Room:
Shortness of breath
extremely ill: too weak to care for yourself
If you are immunocompromised for some reason: cancer treatment, HIV positive, prolonged oral steroid use. Please contact me for an appointment
At this time, I am minimizing face to face appointments to only those that have to be in Person. Otherwise I am utilizing telemedicine.
COVID 19 UPDATE
Aloha to all my patients and future patients.
At this time, it is important to minimize unnecessary excursions and interactions with other people.
In order to help with slowing the spread of the COVID-19 virus, I would like to recommend the following:
If you are sick, stay home.
Monitor yourself and family for fever and other symptoms of COVID -19, remember that young people are less likely to show signs of illness and are more likely to have milder symptoms. This means that this demographic is more likely to be unknowingly spreading the infection.
If you are very sick, reach out to me, or consider a trip to the Urgent Care or the ED if necessary.
FAQ’S as of 3/17/2020
Those who are ill with a fever or cough, have recently left an area having widespread community transmission of COVID-19, or have had prolonged close contact with a person confirmed to have COVID-19 are encouraged to stay home and avoid contact with others except for seeking medical care. If they need medical care, they should call ahead to their doctor’s office or an emergency room to let them know about their travel history.
Note that it is not possible for us to test for COVID-19 just because you want to be tested, or even if we think it might be helpful. There are specific circumstances when the test is allowed to be done. Please do not go to the Emergency Department simply to request a test for COVID-19. The Emergency Department is for patients who are sick and in need of emergency medical care.
Additional Information from Wilcox and Kauai Medical Clinic
(which I am applying to my own practice):
Guidance for Patients with Clinic Appointments
If you are sick but have an appointment to see a doctor for something else (like a check-up) we will need to change your visit for a time when you are feeling better. Please call us so we can make a new appointment for you.
If you’d like us to check you because you are sick, call your primary care provider. You may be able to get checked by phone, or get advice through MyChart: create an e-visit.
We are following the advice of the experts at the CDC and the Hawaii Department of Health who tell us that people who are mildly ill should stay home unless they need help for that illness.
FYI: Visitor Restrictions
Starting at 8 a.m. on Friday, March 13, all HPH medical centers will implement visitor restrictions for all inpatient areas. These restrictions are the same at all 4 medical centers and include the following:
With confirmed cases of COVID-19 now identified in Hawaii, we are taking measures to monitor visitors to our facilities and ensure appropriate infection control measures are followed upon entry.
Effective Tuesday, March 10, access to Wilcox Medical Center:
Stay healthier and follow the prevention tips recommended by the Hawaii Department of Health and Centers for Disease Control and Prevention listed below to help protect yourself and our community.
For additional information, there are resources available at https://www.hawaiipacifichealth.org/coronavirus
Hawaii Department of Health
Centers for Disease Control and Prevention
Photo accessed on Google
As you know, we are having the largest measles outbreak in many years in the US. Several patients have asked me if they are protected and should get an MMR booster vaccine. Here is a useful 3 minute video which tells us if you should get the vaccine. I have tried to summarize the video points below:
1. Born before 1957 - most like had the disease as it was so endemic
2. Vaccinated with FIRST VERSION 2 DOSES (INACTIVATED, available between 1963-1968)
3. VACCINATED WITH SECOND VERSION x 2 DOSES (ATTENUATED, available after 1968)
4. VACCINATED WITH 1 DOSE INACTIVATED (1963-1968) AND 1 DOSE ATTENUATED (1969 ONWARD)
2. ONE DOSE INACTIVATED (1963-1968) WITH NO FURTHER DOSES
3. ONE DOSE OF ATTENUATED (1969 ONWARDS) WITH NO BOOSTER
If you fit any of these criteria or are unsure if you received a second dose - please consider having an MMR booster vaccine. Most commercial insurances cover the vaccine 100% and you can get it at any retail pharmacy.
Thank you for doing your best to take care of yourself!
Oh my goodness. I am so sick.
I haven't been this sick in YEARS!
What happened you ask? I thought Doctors were Superhuman!! They don't get sick. Well, usually I don't, not really, not enough to take a "gasp" day off from seeing patients. But this time I did. I think I caught influenza although I don't have proof because since "I don't get sick" I didn't go to the doctor to get checked, I figured I would be fine the next day.
However, most cold viruses don't put me in bed for 3-4 days.
Didn't you get your flu shot you ask?
Why yes, yes I did.
It did not make me sick either, I got it in the fall.
However, it is still possible to get other viruses, other strains of influenza even when vaccinated. I mainly get the influenza vaccine to protect others: my patients, and the kapuna in general with some amount of a buffer from infectious people.
I think I got this plague when travelling to Oahu for a robotics tournament.
I forgot to sanitize my hands every 45 seconds while on the plane. Also the Stan Sheriff center is probably not a germ free zone. To say nothing of travelling with teenagers... I do give them credit, they are less infectious to adults than children under 10. Oh yes, about 8 of the teams were from overseas: Taipei, China, Japan!
Next time HAND SANITIZER!!!!!
Late post: as of 4/1/19, Dr Splittstoesser and I are in Lihue in a wonderful office on Elua Street!
Neither of us was planning to move again but this opportunity came up and I still really like working with Dr Lisa so I moved with her.
I still see patients on Tuesdays and Thursdays and Dr Lisa is there on Monday, Wednesday, and Friday.
All my contact info is the same.
If you have questions please feel free to comment here or call.
Dr. Collins is interested in the health and well being of the individual, community, and planet.