Are you aware of any cases of the coronavirus among your Malibu patients?

Not in Malibu but Ventura, where I am also based, had five cases quarantined; LA has several.

What is your best advice to Malibu residents?

First and foremost - learn from Korea, Israel and other nations that have had success in limiting transmission. They required citizens to avoid unnecessary contact with others and to stay home. 

When family or others enter your home, make sure they cleanse their hand with antibacterial wipes before touching any surfaces. Wipe off the doorknobs and leave shoes on the front porch. Avoid walking barefoot outside except at the beach. 

While we know there is not a vaccine available, what advice do you have for our readers regarding self-care and diet?

There are some readily available foods that will enhance your immune system and help your body defend against infection. They include local honey, kefir and yogurt which you can make at home. There are many easy-to-make yogurt recipes available online. I do not recommend most over-the-counter probiotics as they are not regulated and can even be dangerous to your system.  

Doesn’t stress also affect your immune system? 

Stress increases acidity which kills off our good gut bacteria whose role is to protect us against viruses. It is very important to manage your stress. Meditation is an excellent practice. Alejandra DeLuca, of Malibu Meditations Journey, is offering online streaming mediation sessions.  Reading, listening to music and online yoga and chat groups for sharing can also be helpful. Many religious organizations are offering online counseling, religious services and other support services.   

What precautions should we be taking when purchasing food from restaurants or grocery stores? 

For restaurants, it is important to know whether those providing your foodstuffs are fully compliant with safe food handling requirements. If they are not wearing masks or gloves and abiding by the strictest safe food handling requirements when preparing, packaging, serving, delivering or selling food products, you cannot assume that the food is safe. Always inquire before ordering. If you buy fruits and vegetables, clean [them] thoroughly with vinegar and water.  At times like this, I actually recommend canned or frozen fruits and vegetables and dried fruits.

Are test kits available locally? Who should be tested? 

There are a very limited number of test kits available locally and only individuals with symptoms or in high risk categories should be tested at this time.  

What is your procedure when a patient calls in requesting a test? 

When someone requests a test, I ask the person about his or her travel history, known contacts, health status and concern. Individuals who are particularly vulnerable include those with diabetes, heart conditions and receiving chemotherapy. If a caller does not have symptoms, I discourage the caller from going to a doctor’s office, emergency room or hospital. The best choice for this person (and for the community) is for that person to stay home and to monitor their condition. Individuals with mild or moderate symptoms can be treated by their doctor or health care provider via telemedicine. Most doctors are now setting up teleconference appointments. Patients can call their insurance to make sure they are covered, although the government may cover the test.  

Not going to a doctor’s office, clinic or other medical facility avoids spreading the disease to others, including medical personnel. Should serious symptoms develop, your physician can advise you of who to contact. 

Should individuals who suspect they are infected go to their doctor’s office? 

In most cases, a physician’s office is not prepared to deal with the virus. The staff usually does not have the protective apparel or equipment to keep themselves or the environment safe from infection. In addition, many offices are severely understaffed at this time as employees care for their families. However, your doctor can provide information and direct you to appropriate services. Also, medical providers can also provide treatment advice via telemedicine—online conferencing. 

What are the symptoms that indicate that one may be infected with the coronavirus?  

Commonly reported symptoms include fever, cough, difficulty breathing, runny nose—but diarrhea is also a symptom. This is why we are developing a stool test to see what makes some people more susceptible and with apparent symptoms, others asymptomatic.

What else do you want our readers to know? 

Our health services are under great strain as they provide care to seriously ill individuals. In addition, there are shortages of protective clothing, masks, supplies and ventilation equipment. It is up to all of us to be part of the effort to control the spread of this disease. The best way is to stay home and take care of yourself and your family. 

Specifics? 

• Wash and disinfect your hands often with soap and water for at least 20 seconds. Use an antibacterial solution or wipes if you have them, but handwashing with soap and hot water is very effective. Do this especially if you have been in a public space, and particularly after blowing your nose coughing or sneezing. 

• Avoid touching your face with unwashed hands, and surely after coughing or sneezing.

• Cover your mouth when you cough or sneeze—use a tissue and discard immediately.

• Avoid close contact with people who are ill. 

• Put a distance between you and others of at least six feet when in a public, social or work environment

• If you are feeling at all ill: stay home. If you are concerned that you might be infected with the virus, call for guidance and instructions—on the telephone—with your doctor, urgent care or local hospital, or even local health department. Try to avoid urgent care or the emergency room unless it is truly urgent or an emergency that requires intervention.

• You do not need to wear a mask unless you are sick. Facemasks are in short supply and must be retained for caregivers. 

• Clean and disinfect all surfaces throughout the day, this includes tables, light switches, doorknobs, countertops, handles, desks, phones, keyboards, sinks...

• Eat healthy foods, especially those that support your immune system. These include fruit and vegetables high in vitamin C, protein, Kefir milk, yogurt. Add supplements of zinc, vitamin C and vitamin D—after asking your doctor.

• As much as it is stressful being home, it is best to take the safe road and protect everyone than the bumpy road and crash. 

Lastly, remember to be kind and that every day is a blessing to be alive.

How can people reach you?

People can follow me at @SabineHazanMD on Twitter or go to my website progenabiome.com or venturaclinicaltrials.com 

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