Here is some powerful advice from a physician who is also the block captain of our neighborhood. She's my hero right now. We need leaders like her who can mobilize our communities and neighborhoods to take care of each other. Feel free to copy and paste parts of this letter she sent around our neighborhood and take ideas from it to share with your neighbors. Stay safe!

— Patrice, NIOT

Hello Neighbors,

As your Neighborhood Block Captain and as a Family Physician, I recommend the following.

Check the CDC site for updates once a day: https://www.cdc.gov/coronavirus/2019-nCoV/index.html [1]

TIMING is crucial. We need to lockdown NOW. The next 3 weeks will make the difference between being overwhelmed with a huge number of infections all at once versus spreading out the same number of infections slowly over the next 2 to 3 months. We need to help each other as a community to get through this. If we successfully lockdown, the infection will not only spread more slowly but will stop spreading and disappear.

STAY HOME

(except for absolutely necessary trips for groceries or for work. NO movie theaters, NO restaurants, NO take out food from restaurants, no group game nights, NO workouts at the gym, NOTHING ELSE. Telecommute for work if possible.)

• Just 1 person in each household should go to the store for the groceries or other necessities and should wipe purchases down with a mild bleach solution or Lysol or alcohol wipe before your purchase enters the home (see recipe below). The person who goes to the store should preferably have no Risk Factors for complications;
• Risk Factors: age 60 or older, having Diabetes, having pre-existing health issues (severe kidney disease, chronic respiratory conditions, immunocompromise, etc);
• We need to set up support system for households in our neighborhood. Please send me a personal email if you are under 45 years old and are already going to the store for items and could also pick up items for people who should not go out because they have risk factors: I will put you together with a buddy who needs a shopper;
• Please send me and my son a personal email if you have any risk factors and need groceries or other items and we will find you a "buddy" who can shop for you.

If you start to develop symptoms: fever & cough, quarantine yourself in ONE ROOM of your home and have food brought to you. Do not share the bathroom with others once you become ill. If you need food delivered to you, let me know: we need to set up a buddy system for our neighborhood. Call your own doctor or your local ER for instructions if you feel you are developing respiratory distress. DO NOT go to the medical clinic or ER if you do not have actual respiratory distress, you will only increase the risk of spreading your infection to others and you do not need any treatment if you have no respiratory distress / shortness of breath / wheezing / difficulty breathing.

We only have a very limited ability to test outpatients for SARS-CoV-2. Only ill patients who actually have fever and respiratory distress can be tested, and not even all of them can be tested. We just do not have the test materials to run the tests. In addition, it currently takes 2 to 3 days to get the results so it is not that helpful in deciding if you need to fully self quarantine or not. (Example: A caretaker/spouse who is taking care of a person who has documented test-positive but non-hospitalized Covid-19 illness does not qualify for SARS-CoV-2 testing if the caretaker has no fever and no respiratory distress.)

We do not have any effective treatments for Covid-19. We do not have anti-viral nor antibiotics for Covid-19. We only have supplemental oxygen and ventilator machines in the ICU to help people breathe if they need it.

Check in on your neighbors on each side of you: Get their email and phone number and give them yours. Check in with each other daily (via phone or FaceTime or Skype). Provide social support and contact electronically for those who live alone.

I have a healthy 23-year-old son living with me who has volunteered to shop for those who need groceries. He has been trained in sanitizing techniques (see details below) to use both while shopping and for delivery of foods. He will not be delivering fresh foods, only canned or bottled or frozen items. on your porch. (He has been sent home from work / school for the next 3 weeks and is telecommuting from home.)

I will be at work all day — seeing patients. Taking calls from patients. Returning calls from my patients. Triaging patients. I was on the phone today for a conference call for emergency coordination of care plans along with 100 other local physicians.

Since I will be unavailable tomorrow, and probably becoming more busy with work, please feel free to send an email to my son with your questions.

If no one in our neighborhood becomes severely ill, I will have done my job.

Warm Regards,
Block Captain/ Physician

How to keep your immune system strong?

• get enough sleep each night
• exercise daily, at least 30 minutes (you can still walk outdoors for exercise...)
• eat a healthy diet rich in vegetables and fruits
• laugh and play with family & friends daily: you can still touch the ones you love in your home if you are all well. FaceTime and Skype with family & friends.
• avoid anger, stress, panic as the high cortisol levels involved in these emotions tear down the immune system. read some good books, watch comedies. limit the amount of time you spend reading about Covid-19.
• vitamin supplements have never been shown to give any boost to the immune system
• avoid getting drunk: excess alcohol tears down the immune system
• this is a good time to stop smoking, of any kind, including inhalation of MJ. Particulate matter of any kind in the lungs is damaging.

How to make a sanitizing bleach solution at home?
(to clean purchased store items, grocery cart, door handles and other surfaces)

• mix 1 part bleach with 10 parts water in a spray bottle
• surface of item to be sanitized needs to be free of dirt and dust and also already dry before you apply the bleach solution
• spray the diluted bleach solution on the surface to be cleaned, spread it evenly with a paper towel moistened with the bleach solution or gloved hand and let it air dry (it must AIR DRY to be fully effective: wiping it dry defeats the killing properties of the solution)

Feel free to cut and paste this to your neighbors!