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Working Safely- An Interview

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Want to protect your company when returning to work?
Read this interview featuring our own Dr. Scott Conard

From an interview with Western Medical Consulting and Dr. Scott Conard:

While COVID-19 cases continue to rise throughout most of the United States, most companies and businesses have “reopened” or are making plans to resume operations as soon as they can.  Particularly for businesses in which on-site attendance in either required or critically important, they face unique challenges.  Everything is about mitigating risk so that operations can resume while protecting staff and customers/clients and avoiding massively disruptive shutdowns.

Western Medical finds itself in the middle of many of these conversations as we provide critical supplies ranging from testing kits to university hospitals; face shields to clinics; and respirator masks and 3 ply masks to businesses (and their employees), home health agencies, and hospitals.   To aid our clients we are bringing in leading experts to offer advice and tips on responding intelligently and responsibly to the pandemic.

We are starting with Dr. Scott Conard. 

Dr. Conard is a practicing family physician, long time Professor, and chief medical officer and a leading consultant to several companies that are “reopening”. We spoke to him regarding his advice to companies on coming back to work during COVID-19:

Importantly, we are referring to “return to office or plant” as most of these workers have never stopped working and in fact, many have been working harder than ever.  While most of these companies that have remained partially or completely shut were planning on returning on July 1, due to the virus surge being experienced in many parts of the US, many re-openings were delayed or canceled, and are slow in moving ahead.

We have deployed different strategies for the different type of companies but there are certain commonalities:

In all cases the foundation of the return to office strategy is based upon “the big 3”:

  • Social distancing
  • Using PPE appropriately
  • Careful hygienic standards

 

Social Distancing:

There’s a lot of information out there on basic common-sense strategies (do not have workers on top of each other, install plexiglass separating cashiers from customers, etc…) but we have been working on deeper strategies.  For example, our companies have told us that while people are working hard remotely what has suffered most is collaboration which is critical in certain industries.  How do you allow the resumption of collaboration and working in teams while mitigating risk?  

 Some of our companies wanted to divide up the staff and have them come in on different days (for example divide into 5 “teams” and have everyone start in the office one day a week) but that’s not a COVID-19 compatible strategy for several reasons.  Instead, we suggested a different strategy — divide into teams by what they do and who needs to be there for teams to function best for collaboration — for example, suppose a drafting/design team needs an architect, engineer, draftsman, marketing person, and finance support. Create 3 “teams” and bring them back together at the office for one week at a time (Team A is in during week one then Team B comes next week then team C) and of course monitor everyone.  If there is exposure during the week the worst-case scenario is only one entire team is exposed BUT by the time they are due to come back they can have treatment (86% of people who get COVID-19 experience low impact) and by the time their “turn comes up” to come back to the office they will have effectively served a full 14 day quarantine period — thus mitigating risk to the company at large but allowing teams to function properly.

 Another strategy that clinically makes sense is to risk stratify those returning to work (remember this is just from the medical perspective and is not legal advice — must work with HR and legal team) 

 Divide the entire staff into 4 groups:

  • Low risk — personally, low risk and no contact with vulnerable people regularly
  • Low risk but contact with high-risk people at home (elderly or high risk)
  • High risk
  • COVID-19 impacted — in some type of protocol
 

The idea is not to treat all employees the same with respect to COVID-19 mitigation strategies and have more stringent precautions in place for the latter 3 groups that require more protection.  Again, it is important to work with legal counsel due to ADA and EEOC concerns. This usually requires companies to come up with ways to voluntarily obtain this information and to then educate the staff. 

 The challenge with COVID-19 is this virus turns people into weapons to spread itself and we do not know who these people are until too late.

 Thus the importance of foundational practices 2 and 3 — it is vital to have and use PPE and to have policies and procedures in place to ensure hygienic conditions in the workplace — but these policies and procedures must not only be established but followed as well.

 Wrongful death suits have begun to appear with the claim that employees went to work, got sick, and died because while the companies had policies and procedures, the managers were not consistently educating and enforcing them.  Companies must have complete alignment throughout their business:

  1. C suite completely educated, knowledgeable, and aligned with policies and procedures
  2. Managers/director level educated and enforcing procedures
  3. Staff Returning to work understanding how COVID-19 works and their responsibility to stop the spread

Training/education is super important, lip service is not enough.  For example, one company had very strict policies in place on the use of masks and face shields (due to the vulnerability of eyes we recommend both masks and face shields or goggles to employees that come in regular contact with people and social distancing is not feasible at all times) and regular use of hand sanitizer but the company didn’t provide any! Cannot just be words must be supported through action.

Testing

We advise our companies to employ a testing protocol based on the conditions (that is, what is the prevalence of COVID-19 on the worksite and in the community).  Testing is costly, disruptive, stressful, and challenging logistically. At this time, based on the data we only recommend the use of PCR testing as the rapid antigen testing is simply not accurate enough at this time. For example a sample strategy developed for a company in a moderately affected community is:

  • With low prevalence (less than 5%) we recommend a symptom-based testing strategy however if the rate goes up in the community and workplace be more aggressive.
  • At 10% more aggressive — we are tracking people that may have been exposed to any outbreak.
  • At 15% random testing and testing entire departments that may have been exposed even if no direct contact/exposure
  • Above 20% — global testing for the entire workplace.

 

Case study:

Logistics warehouse: Manufacturers bring products a warehouse where it is unloaded, is gets taken into the facility, sorted, redistributed and taken back out to the retail outlets.

One of the drivers from the manufacturer had COVID-19 — infected the person receiving the inventory, who then infects his coworkers on the dock before he developed any symptoms – so 7% of the facility had COVID-19 by the time the first person was diagnosed.  We advised that the company test everyone within the “next ring” – regardless of symptoms.  When  half of them were positive we immediately advised the company to test and monitor everyone in the facility, implemented very strict “big 3” protocols -ensuring that all protocols re PPE and hygiene were being strictly followed, and thus we were able to contain COVID-19, and keep the warehouse open with only 14% of the Employees being affected.

  

In summary, following the 3 critical points (effective social distancing; use of PPE; and proper hygienic practices), ensuring that the policies and procedures in effect for these requirements are understood by everyone from entry-level workers to executives, supporting and empowering managers to strictly follow the protocols, and scaling testing based upon a high risk situation resulted in a successful health and business win for the company.

 

For more information on how your company can mitigate risks associated with COVID-19 contact Dr. Conard directly at Scott@scottconard.com.

 For assistance with any medical supplies contact us at Randy@westernsurg.com.


Dr. Conard Interview with Family Medicine Consortium

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Our Medical Director Dr. Scott Conard sat down for an interview with the Family Medicine Education Consortium. Have a listen to learn more about Dr. Conard and his journey in medicine.


Flu and COVID – Winter 2020

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Flu and Covid – Preparing for Winter 2020

As everyone is trying to manage the spread of COVID-19, we are quickly approaching the fall and winter months. This year, and every year, we want you to be protected against the flu.  Here are some comparisons between the Flu and COVID this fall. 

Flu Shot FAQ

Will there be changes in how and where flu vaccine is given this fall and winter?

How and where people get a flu vaccine may need to change due to the COVID-19 pandemic. CDC is working with healthcare providers and state and local health departments to develop contingency plans on how to vaccinate people against flu without increasing their risk of exposure to respiratory germs, like the virus that causes COVID-19.

Some settings that usually provide flu vaccine, like workplaces, may not offer vaccination this upcoming season, because of the challenges with maintaining social distancing. For more information on where you can get a flu vaccine, visit www.vaccinefinder.orgexternal icon.

 

Will there be flu along with COVID-19 in the fall and winter?

While it’s not possible to say with certainty what will happen in the fall and winter, CDC believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading. In this context, getting a flu vaccine will be more important than ever. CDC recommends that all people 6 months and older get a yearly flu vaccine.

Can I have flu and COVID-19 at the same time?

Yes. It is possible have flu, as well as other respiratory illnesses, and COVID-19 at the same time. Health experts are still studying how common this can be.

Some of the symptoms of flu and COVID-19 are similar, making it hard to tell the difference between them based on symptoms alone. Diagnostic testing can help determine if you are sick with flu or COVID-19.

 

Will a flu vaccine protect me against COVID-19?

Getting a flu vaccine will not protect against COVID-19, however flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources.

What is CDC doing to promote flu vaccination during the COVID-19 pandemic?

To address the importance of influenza vaccination, especially during the COVID-19 pandemic, CDC will maximize flu vaccination by increasing availability of vaccine, including purchasing an additional 2 million doses of pediatric flu vaccine and 9.3 million doses of adult flu vaccine, by emphasizing the importance of flu vaccination for the entire flu season, and by conducting targeted communication outreach to specific groups who are at higher risk for complications from flu. These same groups are often at higher risk for COVID-19 too, so protecting them from influenza is important to decrease their risk of co-infection. 

 
 This information was provided by the CDC. 


Covid-19 Testing FAQs

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COVID-19 Testing FAQs

We at GOH Medical are your North Dallas Premier COVID Testing site.

In a world of uncertainty, one thing you can be certain about is knowing what the COVID-19 entails for you.

Here are some common questions we receive regarding COVID-19 testing.

Do you offer COVID-19 testing?

Yes! We offer two different COVID-19 tests.  The first one looks for active virus, and the second one looks for antibodies. Click here to learn more about antibody testing.

How much does it cost to get a COVID-19 tests?

Test are billed to your insurance with no copay to the individual. If you do not have insurance, your cost would be $150 for active infection or $60 for antibody testing.

What are the requirements to get tested for COVID-19?

All patients requesting a COVID-19 test must first have either a virtual or in person visit with a GOH Medical provider.  If you are experiencing symptoms such as cough or a fever, please call us and we will schedule a telemedicine visit.  (972) 292-7158 x2

What can I expect during my Telemedicine/Virtual visit?

Please click here to learn more about telemedicine visits at GOH Medical.

What can I expect on the day of my COVID-19 test?

Once you arrive at our building for your appointment, please call us when you arrive. We will run through a few questions with you on the phone, then one of our medical assistants will meet you at your car to perform the test. Please stay in your car with the window rolled up until the medical assistant arrives. 

Where do I go to get tested?

You will be coming to our office located at 12810 Hillcrest Road, Suite B209, Dallas, TX 75230 .

How soon can I be seen?

Although we are experiencing high demand for our COVID testing, if you call before 11am, we will be able to schedule you either that current day or the following day. Click here to Schedule Now

How long does it take to receive results?

Results are available within 1-3 days.  We are receiving most tests around 2-3 days after sending them to the lab.

How will I receive my results?

You will receive a call on the number of your choosing. In addition, your results will be uploaded to the patient portal.

What happens if my results are positive?

If you test positive for an active COVID-19 infection, we will guide you along your path to recovery. If you receive a positive result, we recommend that all household members get tested as well. We will guide them through this process as well.

Are you concerned about COVID-19 symptoms? Click below to schedule a virtual  appointment.







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7 Key Factors in Building Your COVID Resistance

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Building your COVID Resistance

You have more influence over your risk of getting COVID than you realize! Although the Coronavirus can infect those that are otherwise healthy, how fast you recover back to health is based on how… your health! 

There are seven key factors, seven healers, that you need to be conscious of. By pulling the seven healers into your life, you decrease your chances of becoming ill. 

The Seven Healers Are:​

1. Air 

Shifting your breathing from rapid, shallow breaths to deep, slower breaths changes your body dramatically. With only three minutes of deep breathing, your body’s stress hormone balance and calm can be restored. By becoming aware of your breathing, you will be able to maximize the function of your lungs.


2. Water 

Staying hydrated is extremely important. In addition to nourishing your cells, water is a major detoxifying and cleansing agent in your body. Without adequate amounts of fresh water, your body cannot operate at its required levels. Don’t wait till you’re thirsty to drink- keep yourself hydrated.


3. Sleep

People who do not get enough sleep are three times more likely to become ill. Make sure to get 7.5 -9 hours per night for optimal health. When you sleep, you cycle through different stages through the night. Each stage allows your body and mind to repair and heal itself.  Adequate sleep also brings hormonal balance, stronger mind and immune system, and reduce fatigue and irritability. 


4. Food

Food is the strongest drug you put in your body. While making unhealthy food choices will diminish the quality and quantity of your health, choosing the right foods will enhance it. There are many foods that boost your immune (infection-fighting) system and build healthy gut bacteria when you incorporate them into your diet. Focusing on “living foods” such as fresh fruits and vegetables, minimize or eliminate processed foods, and skip the added sugar.  An easy way to simplify what to buy at the grocery store is called “Perimeter Shopping” where you stick to the outside and minimize trips down the aisles.


5. Play

Just because we are adults doesn’t mean we have to stop playing! If athletics or freeze-tag aren’t your thing, even 20-30 minutes of walking every day boosts your immune system and protects you from infection. Exercise doesn’t have to be strenuous to be beneficial. Regular activity can reduce toxicity in your lymphatic system, reduces anxiety & depression, decreases stress hormones, improves blood circulation and refreshes your body with rich oxygenated blood.  We could go on and on, but aim for at least 20 minutes per day.


6.      Relationships 

Without healthy, loving relationships, we will not have a meaningful life. Learning to effectively manage the stress in your relationships, in and out of the workplace, is important. Keep in mind that in order to improve your relationships, you have to first improve your relationship with yourself.  No more talking down about yourself. “Good Vibes Only”


7.      Purpose

Evidence is accumulating that a sense of positive well-being boosts your immune system and its ability to help you avoid getting sick. Having purpose is the “why” behind what we do.  This is what makes you wake up in the morning and look forward to tackling the next day. A lack of purpose can cause apathy, which can easily affect these other factors. 

If you want to ensure you are properly incorporating these factors into your life, and you would like a physician to guide you, I would encourage you to participate in a course I lead called “Game of Health”. It focuses on these seven key factors in your health, and helping you overcome whatever is holding you back. 

Visit Game of Health for more information.

To be sent more information to your email, please fill out the form below:








Balancing Carbs in Your Diet

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Balancing Carbs in your Diet

For a diabetic, balancing carbohydrates is critical. See the chart below for important information on the basics of diabetes and carbohydrate management.


Covid Testing

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Antibody testing will show you if you have had exposure to the Coronavirus. You may have antibodies even if you had zero symptoms after being exposed.

Schedule your appointment and learn if you have been exposed today!

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Frequently Asked Questions

  1. Does this test for active infection or only Antibody? There are two different tests relating to Covid-19. The PCR tests the status of active virus in your body. The Antibody tests (IgG, IgM) test the status of your body’s reaction to the virus. It is possible to be positive for active virus, but negative for antibodies; or negative for active virus, and positive for antibodies.  After a virtual visit with one of our providers, we will help you get the test or tests you need. 
  2. Does the test detect both IgG and IgM?  Starting May 4th, the antibody test will detect IgG, IgM, and IgA antibodies. For more information on the different antibodies, see the graph below. 
  3. I understand that a telehealth visit must be completed first. Is there criteria that the provider is looking for in order to perform the test? The current testing criteria we have received is still mostly revolving around PCR testing. The guidance we were given was to screen for PCR testing based on CDC guidelines. If the patient doesn’t meet criteria for High Priority or Priority PCR testing but there is still a concern of possible infection (current or past) or exposure then they are eligible for antibody testing IF they have been asymptomatic for more than 3 days after exposure or if they did experience symptoms it has been more than 7 days since onset.
  4. What is the cost? Is there criteria that must be met for insurance to cover at 100%? The cash price for antibody testing is $100. It was reiterated May 1st that any COVID-19 related treatment or testing fees will be at no cost to the patient if they have insurance.
  5. When and how will the patient receive the results? The turn around time is 24-48 hours and results will be faxed to our office directly and sent to the provider for review. We will notify the patient based on the provider’s instructions and will post a copy to the patient’s secure portal in Athena.

For Up-To-Date tracking of Covid-19 cases in Dallas, Click Below


Supporting the Community through the Covid-19 Pandemic

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Supporting the Community through the Covid-19 Pandemic

During this time, GOH Medical is offering 50% off medical services for those that are now without medical insurance.


Discounted Service Options

Fee-for-Service

This type of service is what most people are used to; pay for treatment at your appointment time. Prices are based upon level and complexity of visit.

  • Typical cost for acute visits (Example: common cold, flu symptoms, recent injury, etc.) $167. Currently $84 for 1st visit, $58 after that.*
  • Typical cost for Chronic conditions or complex issue visits (Example: Diabetes Management, Hypertension, Heart Disease, etc.) $255. Currently $128 for 1st visit, $85 after that.

Direct Primary Care

Subscription based medicine. A flat fee charged each month, with no additional cost of medical services at appointment time. With DPC, you get quality time with your doctor. During your 30 minute appointments, you and your doctor are able to work together to address all health concerns and to customize a plan of action.

 

We know that there have been a lot of changes during the time of this global pandemic. We are here for our Dallas community. This offer of 50% off medical services is good until June 1, 2020. If you are in need of medical services, but do not have insurance, we can help. Contact us today for more information. 


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Telemedicine and Virtual Visits

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Tracking the Cases of Covid-19 in Dallas County

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Updated as new information is released regarding the number of cases in Dallas County specifically.

 7/16: 1,058 New Cases 37,996 Total Cases, 501 Deaths

The chart above tracks the daily number of new positive COVID-19 tests.  This is important to track in order to determine how quickly the virus is spreading. The flatter the orange line, the slower the rate of transmission.

An increasing proportion of COVID-19 cases in Dallas County are being diagnosed in young adults between 18 to 39 years of age, such that of all cases reported after June 1st, more than half have been in this age group.

Of cases requiring hospitalization, more than two-thirds have been under 65 years of age, and about half do not have any high-risk chronic health conditions. Diabetes has been an underlying high-risk health condition reported in about a third of all hospitalized patients with COVID-19.

Increasing outbreaks of cases are continuing to be reported from multiple large social gatherings since the beginning of June.

The age-adjusted rates of confirmed COVID-19 cases in non-hospitalized patients have been highest among Hispanics (667.4 per 100,000), Asians (187.4 per 100,000) and Blacks (136.4 per 100,000). These rates have been higher than Whites (43.8 per 100,000).   Over 60% of overall COVID-19 cases to date have been Hispanic.

Dallas County website updated at 12:30 PM daily: https://www.dallascounty.org/departments/dchhs/2019-novel-coronavirus.php


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