Don’t worry. This pic of myself and two of my 5 partners, Dr Elmore and Dr Shumaster was from Halloween. No one is hugging at the office now. 😞

So ‘social distancing’ has been converted to ‘shelter in place’. School closures extended another week. Unprecedented times— I don’t think any of us really could have predicted this 2 weeks ago, though maybe we should have.
Despite these measures we still don’t know how well all of this is going to work. We know it will help, because in China, Hong Kong, Taiwan and South Korea it mostly did. In Italy and Spain they didn’t and, well, they’ve got a horrible mess.
In Cadillac, this is going to complete a pretty extensive shut down already in place, adding retail and manufacturing to the list of closures.
The medical and public health aspects of this have been the focus, rightly so. But the social and economic aspects will be felt very deeply for a long long time. For small businesses especially. Unemployment benefits are supposed to be expanded. But the federal government is again in gridlock with the proposed bailout.
I think Governor Whitmer did a good job today. She has really enormous life changing, momentous decisions to make and she is showing more leadership than anyone in Washington. Finding out today that her main medical advisor is a practicing ER physician also gave me a large sense of comfort—that doctor does NOT look like she takes any crap and I think her motives will be more about results than politics.

We are scaling things back in the office. Hours are cut. Closing on Sundays now, just open For Saturday mornings on the weekend. But that will likely change as we ramp up again presuming the demand will at some point go flying up.
Do you remember the scene in the movie ‘Deep Impact’ when the couple was standing on the beach, waiting while watching the tidal wave coming? That’s a bit like what I feel like. Just reading about what other hospitals and clinics are seeing and what we have potentially coming in the ensuing weeks is scary, as we do everything we can to get our little clinic and our little hospital ready.

The State of Michigan now has 1328 cases. 15 deaths due to Covid. As of today Wexford still only has the 1 case confirmed and TC only 2. They’ve had a couple hundred negative tests (combined) come back with a couple hundred more still pending. Some of these though are highly suspicious cases so I expect that number to pop up soon. The state has improved testing turn around times but it’s still slow. And the health department is still limiting testing to the same restricted criteria we’ve had because the promised test kits are only slowly becoming available. Nothing has changed there.

If you have a fever or a cough the recommendations haven’t changed. Self quarantine, try and treat your symptoms as well as you can, and stay home. If things are worsening then let us know. It’s not that no one cares—sometimes we get that accusation—it’s just there isn’t much we can do and coming to the office to have us tell you that in person isn’t going to change much, except potentially expose a bunch of people.
We do however want you to make sure you get any care you need. All of the million things we treated before we still need to treat. Chronic diseases still need management—even more so, now. Don’t forego that. If you wait on something that may worsen it may make it harder to treat. And if you wait until we are swamped it’ll be harder to get in. Call and we will triage you the best we can. I can assure you that my office, and all the local offices, are maximizing what we can do to maintain distancing between pts and ourselves, though we are starting to recycle and conserve PPE.
On that note we’ve had a lot of generous offers for home made masks. We aren’t there yet but we will let you know. We really aren’t sure how well they’ll work. I’m sincerely hoping it doesn’t get to that point. A buddy of mine posted an idea of using a full face mask snorkeling setup—I think it’s great a idea. I bought 3 of those for Mexico. So if you see me and I look like Scuba Steve you’ll know why.

On the medical front they are now starting to actively treat known cases with plaquenil (hydroxychloroquine) and azithromycin. That’s what’s in the good ol’ Zpack, btw, an antibiotic we use a lot for bacterial infections. It doesn’t kill viruses but has a pretty strong anti inflammatory effect that combined with the autoimmune suppression of the plaquenil MIGHT help. Do not try this combo on your own, btw, if you somehow can get your hands on it. Combined together they can create a fatal cardiac arrhythmia called torsades. So people will have to have multiple EKGs to monitor this if they are on it.
Bottom line is that this still hasn’t been proven. It is potentially helpful. But it likely isn’t the magic bullet they want it to be and it’s potentially harmful.

My biggest fear going forward is that people in this county are going to get sick of this and stop doing it. Or the economic hit is big enough they just say ‘screw it’ and reopen. And then this thing comes at us in waves. In China, they locked people up. Chased em around with drones to enforce quarantines and isolation. Forcible detention—-you try that here in some places and there’s going to be open gunfights.
Americans love their freedom and what we are now faced with is the ‘freedom to stay home’ and that’s about it. That’s going to be hard to sustain for the time it’s going to take.
Sorry if today the humor and snark is more subdued. It’s sobering to be on lock down, knowing what this is going to mean to people. I’m probably not going to be able to maintain daily posts. I’ve posted more on Facebook in 1 week than I have in an entire year. But I’ll try and interpret things as they occur, though, and post when I can.
Keep your head up. Stay positive. Stay busy. This sh*t is getting real, though, and we’ve got a bit of a test in front of us. I’m fully confident we will get thru it but it ain’t gonna be much fun.
Take care, God bless, and stay home.

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