The Long-Haul of COVID-19

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Dr. Mark Pundt, President and Chief Medical Officer

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The Long-Haulers of COVID-19

SYMPTOMS

PREVENTION AND VACCINATION

COVID-29 Loss of Smell

When COVID-19 entered the international spotlight at the start of 2020, there was much we didn’t know about the new virus. A little over one year out, we’ve learned a lot about how the virus is transmitted, who is at the highest risk for the most severe symptoms, and have even rolled out vaccinations, but we are still only at the very beginning of understanding the long-term effects the virus can have on patients.

While the majority of individuals who contract COVID-19 are able to recover without lasting symptoms, a recent article in the Journal of the American Medical Association estimated that roughly 10% will continue to experience ongoing symptoms even after they test negative for the virus. These lasting symptoms have been nicknamed “long COVID,” and the patients who deal with them have been deemed “long-haulers.”

Exactly why some people experience these long-term symptoms is unknown. There are theories that the virus somehow remains in certain individuals in an undetectable form, or that patients’ immune systems continue to respond with antibodies to fight the virus even after the infection has passed. There is no specific demographic that is more at-risk for developing long COVID — it affects people within all age groups, with or without high-risk factors, indiscriminately and without regard for how severe the patients’ initial symptoms of COVID-19 were.


SYMPTOMS

Because the majority of long-haulers test negative for COVID-19, there is no specific test that can be administered for long COVID. Diagnosis is made in the review of the patients’ symptoms and COVID-19 history. Individuals who had mild COVID-19 symptoms initially may experience new or exacerbated symptoms after infection. Long COVID can last for a couple of weeks, or for months, and it is not yet known whether some symptoms or issues may be permanent. Also important to know is that individuals with long COVID are not actually infected and are not transmitting the virus to others.

Symptoms are wide-ranging and include:

  • Ongoing fatigue
  • Shortness of breath
  • Joint pain
  • Chest paint
  • Coughing
  • Body aches
  • Loss of taste and smell
  • Difficulty sleeping
  • Dizziness on standing
  • Headaches
  • Impaired memory
  • Difficulty concentrating
  • Depression or anxiety

 

Some people have reported relapsing after periods of no symptoms, while others suffer from ongoing, persistent effects. These continued symptoms may be mild, or as severe as multi-organ effects which can involve the heart, lung, kidney, skin, or brain functions. These multi-organ effects can lead to conditions like organ inflammation or autoimmune conditions, and it is not yet known whether these conditions can be permanent.

If you are experiencing long COVID symptoms and they are impacting your day-to-day life, you can be evaluated at your nearest ConvenientMD location, or schedule a virtual urgent care appointment. Our clinicians can help determine whether you may be experiencing long COVID, and help treat and manage your symptoms or refer you to a specialist for follow-up care if warranted. Treatment is evolving with our understanding of long COVID, and you can rest assured that our staff is available to provide recommendations for care based on the most recent medical guidance.


PREVENTION AND VACCINATION

Especially because we don’t yet know whether these symptoms can be permanent, or are causing permanent damage to our systems, the best way to prevent these complications is to prevent COVID-19 infection altogether. The best way to do this, in addition to taking precautionary measures like wearing masks, socially distancing yourself from others, and washing your hands frequently, is, to get vaccinated.

CDC generally recommends that individuals be vaccinated regardless of whether they already had COVID-19, although if you are experiencing long COVID, you may wish to first speak to your physician before scheduling an appointment. Some anecdotal experiences suggest that people with long COVID experience improved symptoms following vaccination, but the causation has not been clinically identified.

Currently, ConvenientMD clinics in New Hampshire are providing COVID-19 vaccinations, by-appointment-only. Patients can register on the State’s VINI website, and select their nearest ConvenientMD as their preferred vaccination location to view available appointments.

Beyond COVID-19: How Urgent Care Has Changed, Virtually Forever

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Dr. Mark Pundt, President and Chief Medical Officer

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8am – 8pm, 7 days a week

Beyond COVID-19: How Urgent Care Has Changed, Virtually Forever

THE VALUE OF VIRTUAL URGENT CARE

WHEN SHOULD PATIENTS USE VIRTUAL URGENT CARE?

Over the last year, healthcare — particularly our urgent care sector — has seen rapid changes implemented in how we deliver care to patients with telemedicine, or virtual urgent care, becoming a mainstream option for many. But even as our communities are vaccinated against COVID-19 and life starts to resemble how we once knew it, there are many reasons why virtual urgent care is here to stay beyond the current pandemic.


THE VALUE OF VIRTUAL URGENT CARE

During a time when minimizing contact has been crucial to slowing the spread of COVID-19, virtual urgent care offers patients a safe solution for urgent medical needs that do not require direct, physical treatment. Folks with symptoms for such illnesses as cold and flu, rashes, ear infections, sore throats, headaches, allergies and more have been seen and treated remotely, from the safety of their own homes. This protects the patient, the healthcare staff, and other patients who require in-person treatment by reducing exposure. Even when COVID-19 is under control, other communicable diseases will remain. Virtual urgent care will continue to mitigate disease transmission of these illnesses, just as it has with the novel coronavirus.

Virtual urgent care has also improved the accessibility of care for patients. At ConvenientMD, we recently expanded our virtual urgent care hours to 6:00am – 8:00pm, 7 days a week. With enhanced hours for treatment, more patients can take advantage of virtual urgent care. Patients who are located in remote areas are also able to access care much more easily and more quickly with this service. Time constraints are reduced and scheduling is simplified, with the patient not having to spend time traveling, arranging childcare, or waiting for their appointments.

While urgent care has always served as a more affordable alternative to an emergency department visit, affordable care can now be provided to patients with increased convenience and efficiency.  Virtual urgent care, eliminates the need for transportation and associated costs and it even reduces or eliminates the need for some patients to take time off from work to seek treatment. With virtual urgent care, more people seek initial treatment for injuries or illnesses than they would otherwise, preventing more expensive, in-depth treatment of progressed illness later on.

In short, virtual urgent care at ConvenientMD offers patients advantages including:

  • Reduced time cost
  • Increased availability and accessibility of care
  • Additional comfort and convenience
  • Reduced exposure to others
  • No risk of additional cost if a subsequent in-person evaluation is necessary

WHEN SHOULD PATIENTS USE VIRTUAL URGENT CARE

While patients seeking treatment for more severe injuries such as open wounds or broken bones should continue to visit our ConvenientMD clinics for in-person care, our virtual services offer treatment for a broad range of illnesses and injuries, including but not limited to:

  • COVID-19 evaluation
  • Cold, cough and flu
  • Strep throat
  • Allergies and asthma
  • Sinus infections
  • Headaches and migraines
  • Urinary tract infections
  • Gout
  • Rash, poison ivy, skin conditions
  • Arthritic pain
  • Pink eye/conjunctivitis
  • And more!

If an in-person follow-up is required, patients will not be billed for a second visit.

We encourage all of our patients to continue to access virtual services from the comfort and safety of their own homes when appropriate to do so. Patients receive the same high-quality care delivered in our clinics through virtual video visits with our providers.

ConvenientMD’s virtual urgent care services are available to patients in Maine, New Hampshire and Massachusetts, 6:00am-8:00pm, 7 days a week. Patients may be any age; however, if under 18, a legal guardian must be present. Most insurance is accepted, and is not required to be seen.

To be evaluated via virtual urgent care, enroll at 1-833-263-0131 or complete our online patient pre-registration form.

The Importance of Continued COVID-19 Testing

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Dr. Mark Pundt, President and Chief Medical Officer

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The Importance of Continued COVID-19 Testing

COMMUNITY SPREAD

NEW VARIANTS

CONTINUED COVID-19 TESTING

Over the past few months, we’ve been met with inspiring news from the scientific community in regard to our fight against COVID-19. Thanks to the rollout of vaccines developed in record-setting time, the United States has been able to vaccinate over 56 million people in a matter of weeks. This is an exciting and promising first step, but the importance of continued, widespread testing and other preventative measures cannot be understated.


COMMUNITY SPREAD

As of mid-February, new daily reported COVID-19 cases in the US have dropped to below 75,000. However, this number is still incredibly high – higher than what we saw during either of the peaks of the first two waves the pandemic.

As Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC), recently stated during an interview with NBC, “We are still at around 1,500 to 3,500 deaths per day. The cases are more than two-and-a-half-fold what we saw over the summer. It’s encouraging to see these trends coming down, but they’re coming down from an extraordinarily high place.” Context is vital to understanding the trends in our data.

The verdict is still unclear as to if those who are vaccinated have the ability to spread the virus to others. Until researchers know more about whether vaccines prevent asymptomatic transmission, for the safety of our communities we must assume that we can unknowingly spread the virus even once vaccinated.

We must continue with wearing masks, social distancing, hand washing and large-scale testing within our communities to continue to track the spread of the virus. Testing of as many people as possible for COVID-19, whether or not they have symptoms, helps to prevent the spread by isolating positive patients more quickly, reducing the chances that they will infect others. Testing saves lives.


NEW VARIANTS

As we’ve seen on national news, new variants of COVID-19 have been identified and are spreading. The variant from the United Kingdom – which is more easily and quickly transmitted – has already been found in more than 30 states and will likely become the dominant variant by the end of March. The CDC and other experts predict that these new variants may lead to more cases of COVID-19 in March.

The good news is that so far, all new variants can still be detected by current COVID-19 tests, and it is highly likely that this will continue to be true as other strains emerge. Additionally, vaccination should not interfere with the accuracy of diagnostic. The CDC is increasing surveillance of COVID-19 samples to understand the spread of the current variants as well as future variants. Continued testing will be vital to understanding where the virus is, how it’s moving, and how to protect our communities against spread.


CONTINUED COVID-19 TESTING

So, as more of us become vaccinated and we look towards eventually returning to some normalcy, how do we safely move forward?

Continue to wear a mask, maintain social distancing, and of course wash your hands – even if you’ve been vaccinated. It will limit your exposure to the virus, greatly lower your chances of becoming ill, and reduce your risk of spreading the virus to others.

Limit the time you spend indoors, especially in poorly ventilated spaces. The good news is that spring is coming, and this will become easier as the hard New England winter leaves us!

Continue to get tested. While highly successful, the vaccine doesn’t guarantee complete immunity, and as mentioned before, testing is vital to stopping the spread.

ConvenientMD will continue to offer fast, easy and accurate COVID-19 testing at all of our 25+ locations in New Hampshire, Maine and Massachusetts. Same day testing is available, with no appointment needed. Results are delivered quickly and efficiently; rapid test results are reported within 15 minutes and PCR test results are reported in under 48 hours. To ensure you receive the highest quality care and most accurate testing, all patients must first be briefly evaluated by a ConvenientMD provider. Call 1-833-263-0131 or click here to get started.

COVID-19 Testing Guidelines

ConvenientMD offers COVID-19 testing across all clinic locations in New Hampshire, Massachusetts and Maine. All ConvenientMD locations are closely following CDC and state guidelines in regards to COVID-19 testing protocols, which are constantly changing. We know it can be tough to keep up. In this blog post our Vice President of Medical Directorship, Dr. Debra Margolis addresses the most common COVID-19 testing scenarios and ConvenientMD’s current testing guidelines for each.

NOTE: This information is current as of 12/17/2020


I am experiencing symptoms possibly related to COVID-19

A ConvenientMD provider will evaluate you and decide which COVID-19 testing method is recommended. Rapid COVID-19 testing is only accurate in certain cases. If you are experiencing coronavirus symptoms, we encourage you to complete your evaluation with a virtual visit by calling 1-833-263-0131.


I need a COVID-19 test for work, travel or some other reason

A ConvenientMD provider will evaluate you and order COVID-19 testing if indicated. In most cases, a PCR test will be ordered. Results are typically returned in up to 5 days. All results for PCR testing can be found online.


I have had close contact with someone who tested positive for COVID-19

In this circumstance, it is important to understand what is considered close contact and the safest and most accurate time to get tested.

Close contact is being less than 6 feet apart for a total of 15 minutes or more over a 24 hour period, starting from 2 days before this individual’s symptom onset or the test collection date that was positive for COVID-19.

Per CDC guidelines, you must quarantine for 10 days from your last known exposure and monitor your symptoms for the full 14 days. Specific COVID-19 testing guidelines vary by state.

  • In Maine and New Hampshire, you cannot test out of quarantine.
  • In Massachusetts, you should test on day 8 of quarantine or later, using a PCR test. If the PCR test is negative and you remain symptom free, you can end quarantine on day 10.  You should monitor your symptoms for the full 14 days.  If you do not receive a PCR test you must quarantine for the full 14 days.

Please note, if you are a healthcare or critical infrastructure worker, quarantine guidelines and recommendations may vary. Please discuss this with your ConvenientMD provider.


I recently tested positive for COVID-19 and want a repeat test

The CDC does not recommend repeat testing as results may remain positive for up to 3 months. Quarantine may end when all 3 criteria listed below have been met:

  • It has been more than 10 days since symptoms first appeared
  • 24 hours with no fever without the use of fever-reducing medications
  • Other symptoms of COVID-19 are improving (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation)

How to Get Tested For COVID-19 at ConvenientMD

For COVID-19 testing at ConvenientMD, a brief evaluation by a ConvenientMD provider is first required. There are two options to complete this evaluation, virtually or in-clinic.

OPTION 1: Virtual Evaluation (recommended)

  1. Start with a virtual visit by calling 1-833-263-0131 to register. At the end of your visit, the provider will give you an estimated time for testing at your nearest clinic.
  2. When you arrive for testing, please enter the clinic and complete the check-in form provided appropriately.
  3. Bring the completed check-in form to the Medical Receptionist, who will then give further direction and next steps.

NOTE: If you are directed to the external testing site in Manchester, New Hampshire simply remain in your vehicle for drive-thru testing.

OPTION 2: In-Clinic Evaluation

  1. Visit your nearest clinic, when you arrive enter the clinic and complete the check-in form provided appropriately.
  2. Bring the completed check-in form to the Medical Receptionist, who will then provide further direction and next steps. Depending on availability, you may be asked to return at a later time for testing.
  3. After a brief evaluation, the indicated COVID-19 test will be ordered and completed.

NOTE: Please be aware that occasionally in-clinic provider evaluations for COVID-19 may be booked prior to closing due to high volume.


All clinic locations have been experiencing extremely high volumes due to demand for COVID-19 testing. Unfortunately, wait times may be longer than normal. Our medical teams are working tirelessly to address all patient’s needs as quickly as they can. We appreciate your patience and understanding during this time.

Heat Exhaustion vs. Heat Stroke: The Important Differences

ConvenientMD provides water bottles to youth members of the Boys & Girls Club of the Lakes Region to stay hydrated and prevent heat related illnesses during hot summer months!

This summer, ConvenientMD collaborated with one of our local partners, the Boys and Girls Club of the Lakes Region. All youth members were given a 24 oz. water bottle to promote staying hydrated, and help prevent heat related illness while spending time outdoors during hot days at summer camp! Read on to learn more about heat exhaustion vs. heat stroke, and how to stay safe from the heat during New England’s hot summer months.


Summer time in New England means as much time as possible spent outdoors for many of us. Heat related illnesses such as heat exhaustion and heat stroke can be dangerous this time of year, but they are preventable. If you intend to spend time outdoors on a high temperature day, it’s important to know and understand how to identify heat related illness signs and symptoms, when to seek medical care, and what you can do prevent heat exhaustion and heat stroke altogether. Here’s what you need to know to keep you and your family safe from the heat through the rest of the summer.

Heat Exhaustion vs. Heat Stroke

Heat exhaustion and heat stroke are both illnesses that are the result of the body overheating. However while heat exhaustion and heat stroke occur under similar circumstances, the signs and symptoms are quite different.

One of the major differences between heat exhaustion and heat stroke is heavy sweating. Heat exhaustion happens as a result of physical activity in hot temperatures. The body begins to sweat heavily in an effort to cool itself, and heart rate slows due to exhaustion. Excessive sweating from heat exhaustion often leads to dehydration.

In some circumstances, heat exhaustion may develop into heat stroke. Unlike heat exhaustion, if suffering from heat stroke the body stops sweating, skin is dry, and heart rate will increase. Additionally, a change in mental status such as confusion is a sign of heat stroke. Heat stroke is considered a medical emergency, and treatment should not be delayed.

Here is a full list of signs and symptoms of each illness to look out for, as per the CDC.

Signs and Symptoms of Heat Exhaustion

  • Heavy sweating
  • Cold, pale, and clammy skin
  • Slow heart beat
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness and weakness
  • Dizziness
  • Headache
  • Fainting

Signs and Symptoms of Heat Stroke

  • High body temperature of 103 or higher
  • Hot, red, dry, or damp skin
  • Rapid heart rate
  • Headache
  • Dizziness
  • Nausea
  • Confusion
  • Losing consciousness

When to Seek Medical Care

For those experiencing signs and symptoms of heat exhaustion, it can usually be treated at home. Get out of the heat, rest in a cool place, and drink water. If you are experiencing nausea and vomiting and consuming fluids is made difficult then you may need to seek medical treatment. IV fluids may be necessary to re-hydrate the body.

If a person experiencing signs and symptoms of heat exhaustion begins to stop sweating, seems confused, and/or has a seizure, medical attention should be sought immediately. Please note that if severe symptoms such as seizure are present, it is time to call 911. Heat stroke has the potential to be life threatening.

Tips to Prevent Heat Related Illnesses

Before spending a day outside in the heat, especially if you plan to be physically active, it’s important to take precautions to prevent heat-related illness. Here are 5 things you can do to keep you and your family safe.

1. Wear appropriate clothing

Choose clothing that is lightweight, light colors and loose fitting to keep yourself cool.

2. Schedule outdoor activity thoughtfully & pace yourself

If you are going to be physically active outdoors, try to choose a time when the temperature is at its lowest point. For example, mornings and evenings tend to be cooler than midday. If you are unable to plan accordingly, be sure to pace yourself while in the heat. Slow down and take breaks as needed.

3. Wear sunscreen

Sunburns can affect your body’s ability to cool down, and cause dehydration. To protect yourself from a sunburn be sure to wear sunscreen, SPF 15 or higher is recommended.

4. Avoid hot and heavy meals

Hot meals add heat to your body, stay away from hot meals on a hot day!

5. Stay hydrated!

Drink water consistently, don’t wait until you are thirsty. Avoid sugary, alcoholic and caffeinated drinks as these will cause you to loose body fluid.

As you plan outdoor activities this summer, keep all of this information in mind. First, take the steps to prevent heat related illness, but also know the signs and symptoms to look out for and when you should seek medical treatment. Enjoy the beautiful summer weather, while also staying safe and healthy!


Reviewed by, Emily McCue, NP, Regional Advanced Practitioner Director