The 2020 Pandemic
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Wednesday July 8
Posted By: Aubrey Smith

"Individual commitment to a group effort-that is what makes a team work, a company work, a society work, a civilization work."  Vince Lombardi

     So many opinions.  So much controversy.  The Governor has made a mandate and then got on television and scolded the local authorities for not enforcing the law.  Judges calling him wrong.  Social media gone wild.  News not trustworthy and filled with political agendas and bias.  Wow.  It's no wonder everyone's sick of it.  

     What is going on?  Why is there so much controversy.  Well, first of all it's been going on a long time and what most of us are hearing is "I'm so over corona".  I agree, we are all growing weary of the endless talk.

     So today, a video and a piece of advice.  First, the advice.  The CDC put out a warning on hand sanitizers with methanol.  Methanol is wood alcohol, toxic when absorbed.  Most hand sanitizers are either isopropyl alcohol (71% hopefully) or ethyl alcohol (like from grain alcohol, like one you get in the store for cocktails).  So check your labels.

       We need you to think about why the Governor has mandated their usage when you are deciding on whether or not you want to have an ICU bed and ventilator available when you get it.  Here's the kicker.  When you get it, you will get it from someone not wearing a mask.  Here's two great videos to help you decide.

                  https://youtu.be/zOub_oMD0cc

                  https://youtu.be/sIpHCptKZUg


Monday July 6
Posted By: Aubrey Smith

"We don't know what we've got til it's gone, like it or not"  Lance's song by Zac Brown

     It's about time.  The Governor mandated masks across the state.  If we had done this in March all across the country it would be over.  The choices we make change the future.  Don't be like Lance's Song, you don't have to lose a parent or spouse over this.  Just put on the mask.  It's not that hard.  I had some business in the city at lunch and I went out.  Everywhere I went, almost no one had on a mask.  I can say this for sure.  When I visited my kid in Katy a week ago we quarantined in his house except when my son and I went to the grocery.  In Houston the hospitals are full, the ICU's are overrun, and elective surgery is shut down.  

     Everyone, every single person, has on a mask in Katy.  Why?  The business owners care enough to enforce the rules.  The incidence in Katy is low.  In Houston, very few masks. No enforcement.   In Houston the outbreak is out of control.  So which group do you think Amarillo is in?  You tell me, take a look around.  

     Here's the link: https://gov.texas.gov/uploads/files/press/EO-GA-29-use-of-face-coverings-during-COVID-19-IMAGE-07-02-2020.pdf

    

 


Wednesday July 1
Posted By: Aubrey Smith

"It is literally true that you can succeed best and quickest by helping others to succeed."  Napolean Hill

     The map of the country is red.  Cases are on the rise all over again.  Amarillo is behind the curve just like always.  I thought you might like a video today.  These researchers studied how the virus gets around and infects others.  As the data on mask usage becomes very convincing, it's time to show you why. Don't worry, 90% in English they just interviewed directly the Japanese Doctor briefly. 

     Take a look:  https://youtu.be/H2azcn7MqOU

 


Monday June 29
Posted By: Aubrey Smith

"Talent wins games, but teamwork and intelligence win championships"   Michael Jordan

 

     So the ICU's are full in Houston.  Everyone is required to wear a mask.  People go on and do their work, they just have on a mask.  The cases in Houston are out of control.  That had to have a crisis to mandate the masks.  Why masks?  Because it works.  How hard is it?  Sooooooooo simple.  

     So much political debate.   "It's my right to do what I want".  "It's a conspiracy".   "It's all Trumps fault".  You have heard it over and over.  The pundits won't leave it alone.  

     Arizona is the epicenter of the entire pandemic right now.  Case numbers are higher than any country in Europe ever.  Cases now are higher than any day in New York.  In fact, higher than the entire country of Brazil, one of the most affected countries on Earth.  Local ordinances written by council members in Arizona banning  required masks are to blame.  Now it's a crisis.  Now it's out of control.  And now, finally, Gov Doug Ducey reverses those ridiculous local laws but it's too late.  Earlier action  could have saved hundreds of thousands of people from the misery, disease, and unbelievable financial strife.  Over 1000 doctors signed a petition and sent the Governor the recommendation to mandate masks long before he intervened.  But what do doctors know?  Remember on the news, the local Scottsdale Councilman Guy Phillips shouting the words "I can't breath" and then ripping his mask off?  To the local government that decided masks were stupid, you voters in Arizona should boot them right on out of there.  

     What are you seeing in Amarillo?  Look around you'll see everyone is doing life as usual.  July 4th is coming.  Travel again will resume.  Cases that are asymptomatic will travel here and there.  Should we wait until we are Houston?  Should we wait until it's Arizona all over again?  How long do we wait?  And what are we waiting on?  Look around people.  

      The literature is clear.  There isn't any controversy.  There is only scientific fact.  People that wear masks get fewer cases, and if everyone in the US would wear a mask for a month, everywhere they go, this would all go away, just like that.  In fact, there is one researcher in Germany that says a regular mask may be just as good as an N95.  So what's it going to be?  Sounds more like the Spanish Flu every day.  See what I said about that under "Updates Spanish Flu all over?"        

      Be safe this holiday season.  Enjoy your family.  For now I'm still healthy and alive and taking care of you.  Let's try and take care of each other.  


Thursday June 25
Posted By: Aubrey Smith

"Life isn't about waiting for the storm to pass.  It's about learning how to dance in the rain."   Vivian Greene

     Five pro golfers have withdrawn from this weeks tournament because of the corona.  Only one has it but the others that withdrew did it because they were exposed.  One caddie has it.  Out of respect for the other golfers they withdrew.  And then there is Novak Djokovic who organized a series of exhibition matches in Serbia and Croatia with zero social distancing.  He and his wife both have it now.  Word on the street is he wouldn't take a vaccine if there was one.  Some postulate it's on purpose?  Who's to say?

     So the governor says its unacceptable now.  So here's my question for today.  Who's right- the golfers that are acting out of respect for their competitors, or tennis man that boldly goes on with the game? 

     The TMA president just sent us all a message.  Do something about this now or face the consequences.  I'm not seeing a lot of masks out there...…..


Monday June 22
Posted By: Aubrey Smith

"Often when you think you are at the end of something, you're at the beginning of something else"    Fred Rogers    

 

     We are seeing lots of patients in the office.  If you need to be seen then just call and we will get you in.  If you can or want to do telemedicine then it really helps spread out the patients so social distancing is possible.  

     The Texas Tribune reported on June 18 that Texas had the record number of coronavirus cases ever making June 18 the 7th consecutive day in a row for this new high and rising number of hospitalized cases.  If you haven't read my blog under updates on the Spanish Flu, it may be time for you to read it.  Right now, in the State of Texas, there are twice as many people in the hospital from the pandemic as there were on memorial day.  

     I think it's far from finished.  We still wear a mask in the office and probably will for a good while to come.  



Thursday June 18
Posted By: Aubrey Smith

"Out of difficulties grow miracles"  Jean de la Bruyere

     The office is open.  We have a plan for your safety and it seems to be working.  New patients are all coming to the office and follow up appointments for review of tests that need a shot or patients needing in person re-evaluation are all able to come in for a visit.  It's great to be back to work; however, we still do some telemedicine.  My thinking is that lots of patients actually like telemedicine and for those of you that are far away or need to be at home now it is working great. 

     The hospital is back to business as usual and at Physicians Surgical Hospital they are allowing a visitor.  This is a huge improvement.

     Is it over?  No, but there is a low incidence right now.  The CDC has made some observations that are important. The most likely way to get it is being close to another person that has it that doesn't have a mask on. It conveys through droplets from one pulmonary system directly to another.    So, there's that to still ponder. 


Monday June 15
Posted By: Aubrey Smith
  • Monday, June 15

       “Sometimes there’s not a better way. Sometimes there’s only the hard way.”          Mary Pearson

  •      In the June edition of Science magazine Alexis Madrigal and Robinson Meyer wrote the   article “America’s giving up on the pandemic”
  •      Standing in a crowd for a long period of time raises the risk of increased transmission of the coronavirus. There’s no doubt about it. It’s obvious to all of us that there have been a large number of crowds lately.
  •      People in America as well as health officials are taking into account with what the New York Times called growing consensus “that being outdoors may mitigate some of the risk of transmission”. The virus appears to survive less in the sun and outside and survive less time in heat and humidity.  Americans are growing in their belief that they are immune to the effects of the virus if they are outside.  The governor and our local leaders have opened up the state and the city for business.
  •       January 20 was the first case of the coronavirus in the United States. A man in Washington state had returned from Wuhan China. We are now five months into the pandemic. America is growing tired of the restrictions and the discussion regarding the virus. People are impatient and have grown weary with the entire concept of COVID-19. I hear many of my patients and friends say the famous words that you all hear all the time these days, “I am totally over coronavirus”.  Ask anyone in Houston if it’s over.  
  •       Wishing for it to be gone doesn’t make it gone. Hoping for it to be gone doesn’t make it gone. Whatever you think about the survivability, the coronavirus is a very inconvenient thing to get. It affects some of us severely. I can think of one particular patient that experienced the infection. All of the members of his family got the virus when he brought it home from work. His wife was very very sick with the pulmonary symptoms. She got a terrible case of pneumonia and it one point in time told her husband that if she was going to die, she would just die at home.  She was sick for five or six weeks and in bed most of that time. At one point her oxygen saturation was below 80. The husband was less sick but his case lasted many weeks and he had more of the G.I. symptoms. The children all got it as well. However the oldest was the one that was the most ill and she was only sick for a few days and had a mild case. The middle child never had any symptoms but tested positive and the baby only had pinkeye. So it’s true what you hear, some people won’t be very sick but some will.  I have had the opportunity to discuss what the experience has been like for some other patients as well.  A few of them have been to the hospital and describe the illness as the worst they have ever experienced.  Some have had mental confusion, some have had moments when the symptoms went away and they thought is was over only to come back for another week or more. All of the patients that had severe symptoms had those symptoms for many weeks.  I know a doctor or two that has had it.  They would recommend you try and avoid getting it.  
  •      A few things are true. Social distancing does work. Masks do work. Taking some precautions increases your chances of avoiding it.
  •      In our office I believe it’s important for us to continue to space things out so the waiting room will be sparsely populated.  We will wear masks and those of you that can do telemedicine will continue to do that. We shall press on for now...


Wednesday June 10
Posted By: Aubrey Smith

       "Ignorance might be bliss, but it also has teeth"  Craig Lounsbrough

 

     Some countries are opening up and not seeing a rise in cases.  That's really great news.  In Europe the average cases are down 80%.  In Europe they are practicing social distancing and wearing masks. In New Zealand they have effectively eliminated the virus from their country.  Their borders are locked.  

     However, some countries are opening back up and seeing a massive rise in cases.  That is terrible news.  In Iran no one is following any social distancing rules, no one is wearing a mask, no one is following any recommendations in spite of the constant warnings to the people.  In Iran cases are surging to the highest levels since it all started.  

     So which model would you say Amarillo is more like?  I'll let you decide the answer to that.  

     We are open.  Telemedicine still is helping all of us stay socially distanced.  Thanks for your understanding.  


Sunday June 7
Posted By: Aubrey Smith

                "Reality is that which, when you stop believing in it, doesn't go away"                                                   Philip K Dick

 

     NIH director, Dr Francis Collins, says we have about 10 vaccine candidates globally and that testing may begin on a larger scale as soon as July.  He hopes there is an actual vaccine by the end of the year.  This brings up a lot of questions about availability and efficacy.  

     With all the distractions on the news we seem to be forgetting we are in a pandemic.  However, the cases are down for now and the risks seem smaller.  Friends gather with other friends that have been socially distancing with relative success so far.  It helps that it is summer and we are outside.  In 1918, it was the second wave that was highly fatal and responsible for the majority of the deaths during the Spanish Flu epidemic.  It's not over.  See my blog on Spanish Flu from today under "Updates".

     The office is open and we are seeing new patients.  Telemedicine continues for follow ups and discussion of tests mostly very smoothly.  Surgery continues on a completely normal schedule.  For the moment, the sea is calming.  


Sunday May 31
Posted By: Aubrey Smith

 

     "Yea, all things live forever, though at times they sleep and are forgotten" HR Haggard

 

     While the cases continue to drop, life returns to the community and medicine gets back underway.

     Summer is almost here.  Seems like it already is summer.  We are outside.  Golf carts are rolling, boats are out, stuff is growing.  But the coronavirus isn't gone.  Ignoring it doesn't make it disappear.  The Texas Medical Board hasn't forgotten either and we are still following all the protocols in the office and at the hospital.  

     We appreciate your understanding and patience with the telemedicine visits and the protocol in the office.  I think we will all be glad when it gets cold again and we see the incidence go back up again when we all go back inside.  If we stay vigilant now, that next peak could be a small one.  Stay positive........


Thursday May 28
Posted By: Aubrey Smith

     "A man on a thousand mile walk has to forget his goal and say to himself every morning, 'Today I'm going to cover 25 miles and then rest up and sleep' "

          Leo Tolstoy, War and Peace

 

     The Governor was here.  His plans have been announced.  The numbers are down. Is it safe to come outside yet?

     In a very recent article in the New England Journal of Medicine Dr Marc Larochelle suggests an idea worthy of your consideration.  He describes 3 groups of people: Low risk younger healthy patients, Medium risk Middle Aged or younger with high risk conditions, and Older age or middle aged with high risk conditions.  He suggests the younger group just go back out there.  If you have a high risk condition or are older, still take precautions, and if you are older or have a high risk condition, just do everything you can to avoid any possibility of contact with persons who may have coronavirus. 

     We appreciate your patience with telemedicine.  It really works pretty well.  It makes room for those of you that need to come in. 

     We press on...….


Tuesday May 26
Posted By: Aubrey Smith

"Be patient, everything is coming together"  Anonymous

     Clinic seems to be working just fine with new patients coming in while follow up patients and test results can do telemedicine.  This makes it possible to keep the waiting room empty for the most part.  We still have the no visitor policy in place and will take your temperature in the entry.  If you pull up keep your air conditioner on, if your temp is over 100 you can't have a visit. 

     Surgery is back on track.  The hospitals are both open.  Now let's just see what memorial day weekend did to us over the next couple of weeks. 


May 13, Wednesday
Posted By: Aubrey Smith

“ To lose patience is to lose the battle“

                                   Mahatma Gandhi

     It appears as though telemedicine and traditional medicine in combination are our new normal for now. I believe this will go on for quite some lengthy period of time. Most patients are handling telemedicine very well. I think the convenience of discussing things on the phone for test results and quick follow ups to make sure things are going well is the way medicine will be practiced for a long period of time.  

     Thinking about your mental health right now is more than likely a wise choice. Being isolated and at home constantly leads to a whole different set of stressors. Take some time to go for a walk and be outside.

     Although it would appear as though the numbers are going way up remember that we’re doing a whole lot more testing. It does appear that the curve is flattening in spite of the increased number of cases that are being reported. Moving on to a more regular schedule at the hospital hopefully will occur in the next couple of weeks.  Thanks for your patience.

 


May 12, Tuesday
Posted By: Aubrey Smith

‘ Thought is the only thing that can cause humans to deviate from their inevitable path”.     
                        Modified from Christophe Finipolscie’s original quote

     As we embark into the seventh week of this crisis in the Amarillo and Panhandle region, I encourage you to remain vigilant. I’m getting used to wearing a mask although I must say it’s not near as much fun as it was without a mask. Clinic seems to be working very well with the telemedicine visits allowing for the spacing out in office visits.

     One thing that will help us so much to stay on better time is to fill out the forms on the Internet prior to your arrival in the office. If this is all done we have a much better chance to stay on time. In order to be fair to everyone and space our patients appropriately all of us are trying to be much more conscious of the timing of your visit to the office. We are trying our very hardest to stay as close to on time as possible. We appreciate your help regarding this issue.

     It is hard to know the exact date but it looks like June 1 maybe the date for business as usual. That of course is subject to change. Looking at the news nationally, it would appear as though countries that are opening up aggressively or having a higher recurrence rate and new spikes. Will just have to see. Nevertheless we are trying to make your office visit and your hospital visit as safe as possible. Thanks for your patience.


Monday May 11, 2020
Posted By: Aubrey Smith

“ We need not so much to be taught as to be reminded“.   CS Lewis

The office is running smoothly using telemedicine and a combination of seeing patients in the office. It is making it possible to keep people separated and socially distanced. Surgery begins this week and may return to a more normal schedule next week and the week thereafter. All of these things depend on the number of cases and whether or not we see a resurgence of the outbreak. My quote from CS Lewis today is to remind you that we are still in a pandemic. It is advisable to continue to socially distance, wash your hands frequently, and continue with all precautions that we have come to learn to live with. This virus will be with us for a long time. It will be easy for us to forget and to lose our patience.


Thursday May 7 th
Posted By: Aubrey Smith
     The Office is open for new patients, postoperative patients, injections, and emergencies. We encourage telemedicine when possible. Telemedicine has made it possible to spread patients out safely at the office. After we see you as a new patient we more than likely will order either physical therapy, some kind of treatment plan, or order tests such as an MRI. The next visit can easily be a telemedicine visit because all we need to do is discuss the plan or how you’re doing with your current treatment. Most patients like telemedicine and if you have a good Internet connection it works just fine.

     This problem that we’re having with the COVID-19 is going to be with us for a long time. There are certain protocols at the office that you need to know about. The big thing is spreading patients out and wearing masks as required by the Texas Medical Board.  

     I posted a new video today that I think will be helpful for you to understand our current situation, what’s happening at the hospital, and what’s happening at the office. As always we appreciate your patience during this unusual time in history.


Sunday, May 3
Posted By: Aubrey Smith
  • Our medical and civic leaders have spoken with the governor of the state of Texas. Governor Abbot has spoken personally with the vice president United States of America. The centers for disease control is taking over Covid operations for Moore county and for Amarillo. They are bringing supplies and strategies to get the beef packing plants under control. Their strategies will encompass all of Amarillo to address our community spread issues. The centers for disease control will arrive today or tomorrow and implement the strategies they developed in addressing the Colorado packing plants. The governor has stressed that the vice President of the United States of America is actively involved in the management and that all our key state of Texas emergency management personnel are also engaged.
  • with an increased number of tests there will be more positive tests as a result of the increased testing. Don’t panic when you see the numbers rise. Will have to let a new curve develop.
  • we will have more tests more equipment and more things that we need very soon
  • The governor has personally stated that for our area people should stay indoors. What this means is that business is not back to usual. The law of the governor is for the rest of the state not here. He has personally suggested this is a different situation. You should strongly take that into consideration.
  • with regard to elective surgery outpatient’s that have followed the rules, have self Quarantined and can pass the screening test can have surgery if they are of a low risk group. Higher risk patients are going to be delayed because there’s no ICU transfer capabilities from Quail Creek hospital if there are no ICU beds. This is a very rare occurrence but it cannot happen.
  • Any patient that has had symptoms will be tested for Covid before they go to the hospital. This takes 3 to 5 days. If the test result is negative the patient may have surgery.
  • any patient that will be in the hospital on an admission must be tested 3 to 5 days before surgery.
  • The ASA classification system will be utilized to determine low risk patients
  • what do I think about all this? I think 70% of us are going to get the virus. I think half of us that get it will not even know that we have it. Of the half that gets sick only half of those will be really really sick.  So about 18.75% of us overall are going to be really sick.  18.75% will think they have a common cold. I think the mortality rate will be less than 2% and maybe even less than 1%.  We won’t know for years what this number is.  Probably similar to the flu.
  • However this is not like the flu at all. This is completely different. For those of you that believe that this is exactly like the flu please understand this is much more INFECTIVE THEREFORE IT IS MUCH EASIER TO SPREAD
  • If we all just go out and do whatever we want then we’ll all get it at once and hundreds if not thousands will not have an ICU bed and will die. Please understand the facts and accept that it is much easier to spread. 
  • The governor of the state of Texas has personally stated that the people of Amarillo should stay inside. What that means is it’s not back to business as usual.
  • The Texas state medical board has mandated the use of N 95 masks  for all physicians and healthcare workers that come within 6 feet of a patient whether they are symptomatic or not when they are seen in the office. The patient must wear a mask as well. This is not optional. This is the law for now
  • So we are going to be seeing some patients in the office and we will all be wearing masks.
  • we are all going to get through this together one way or another.

May 1st
Posted By: Jon Michael Jones

The Governor said: "We strongly suggest you wear a mask". Then he said, "if you don’t want to go out yet, stay at home". Dr Smith said: “we aren’t ready to open, if you go out wear a mask. Stay calm and wash your hands”.

We are going to see you in the office for a shot or for a new visit. Many precautions will be taken to help us all stay as safe as possible. There will be screening the day before and the day of your visit. We will take your temperature in the parking lot. Many of you are hurting and need some relief. Our goal is to make sure you are as safe as possible here. That's why all the precautions. 


April 30th
Posted By: Jon Michael Jones

April 30, Thursday, I’m hoping my hospital doesn’t turn into a Covid unit and you should too:  They ordered mandatory masks in Houston risking a fine, but the Governor said his authority overrules and there will be no fine.  He said "We strongly suggest you wear a mask". Then he said, "if you don’t want to go out yet, stay at home".  

     We are going to see  you in the office for a shot or for a new visit.  Many precautions will be taken to help us all stay as safe as possible.  There will be screening the day before and the day of  your visit.  We will take your temperature in the parking lot.  Many of you are hurting and need some relief.  Our goal is to make sure you are as safe as possible here.  That's why all the precautions. 


April 15th
Posted By: Jon Michael Jones

Texas Medical Association Urges Governor to ease restrictions on Surgery, City extends to April 30, Abbott extends to April 30, Surgeries still Scheduled for April 23 for us but that could change, our office gearing up for safely getting you in for a visit.

Tip for the day:  coronavirus lives on cardboard about 24 hours.  On plastic almost 72 hours...and 50% of health workers that are in the hotspot centers working around these patients have it on their shoes.  We need less plastic anyway. 


April 8th
Posted By: Jon Michael Jones

April 8, Wednesday  Still in the shelter in place

 

Check out this link on shopping

The video on how to safely get groceries

To all of our patients

     For most people it’s easy. Virtual continues.  We modernized it which I hope makes your experience easy and more efficient.  It works best if you are on a strong WiFi. Try and do the visit from a strong connection to the internet.  If you can’t get a connection to work we will just have a phone visit.  If you are worried about finances don’t worry we will figure it out.  Don’t get lost to follow up I don’t want you to get behind on your therapy and plan.

     We are still under restrictions for no non emergent use of Personal Protective Equipment.  That means no shots, no elective cases.  We can do emergencies so if you have a fracture or acute injury we can do it.  We can refill your prescription just like always.  We can do almost everything virtually it’s surprising.  

     Testing is in Amarillo.  If you have two of the three symptoms:  Cough, Shortness of Breath, Fever--- 2 of the 3, then call the Health Dept 378-6300 and they will screen you.  If you pass their screening they will arrange a drive through test.  Because most of my patients read this I want to make it easy.  If you have symptoms, stay at home and do the self quarantine.  Remember, you still can pass it on after it’s over. 

     Wash your hands thoroughly or sanitize all the time.  The virus dies with soap and water. Wash like you are prepping for surgery.  If you are wondering if you are doing enough then you probably aren’t. Clean all surfaces in your house frequently.  If you have to touch your face wash your hands first.  When you come in clean your keys, wallet, and anything else that went outside.  Talk to your Doctor if you are sick.  Use the phone or do it VIRTUAL. Avoid all vectors of transmission.  For the well being of all the wonderful brave front line health care workers in our city, stay home. Watch the video link I posted above.

Take care of each other.  Take care of yourself. 

If you have questions just call us....

Kindest regards, 

Dr Smith