Plum Health Blog
Daily Detroit Podcast hits 1,000 Episodes
Daily Detroit Podcast hits 1,000 Episodes
This week, the Daily Detroit Podcast hits 1,000 episodes! That’s a lot of content! The team of Jer Staes, Randy Walker, and Shianne Nocerini are diligent and talented, and they put together insightful, informative, and entertaining shows each week day.
Over the years, I’ve been a guest a handful of times to discuss medical care issues, mostly relating to coronavirus and the COVID 19 pandemic.
Episode from April 5th 2021 on the big coronavirus spike in the spring
Episode from April 15th 2018 about our Plum Health DPC practice
I’m happy to contribute and very proud of what this podcast has accomplished!
Covid Testing in Detroit
Coronavirus PCR Testing in Detroit Michigan
At Plum Health DPC, we offer PCR Testing with results returning next day. We are testing folks at our office from 9 am to 5 pm each week day. We do not offer testing on the weekend as our laboratory is closed on those days.
If you would like to be tested, please bring a valid state or federal photo identification, along with a health insurance card if you have it. We are able to perform testing for insured or uninsured patients. Please arrive at our office and remain in your car. We charge $100 per test for non-members and $50 per test for members of our practice. If you’d like to learn more about our membership, it’s here on our FAQ page.
When you arrive for your COVID test at our office, please stay in your car and then call the office at 313.444.5630. We will come out and perform the swab curbside. We will also make a copy of your ID/insurance card to send to the laboratory.
Our office is located at 1620 Michigan Avenue, Suite 125, Detroit, MI 48216. We are at the corner of Michigan and Trumbull near the old Tiger’s Stadium site.
The labs are picked up around 5 pm and then we receive the results the next day. Once we have the results, we will email them to you. Please make sure that you print your email address clearly on our intake form so that we can send the results to the correct email address.
Either myself or our medical assistant, Chris Lake, will perform the test curbside. Curbside testing allows us to minimize exposure for ourselves or for the other patients that come to our office. Please wear a mask while testing you, leaving your nose uncovered and your mouth covered. Again, this helps us reduce exposure to the virus.
Thank you so much for reading and have a wonderful day.
-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
Plum Health DPC Offering the COVID 19 Vaccine
We are elated to be offering both the Pfizer and Johnson & Johnson vaccine to our patients at Plum Health DPC. If you haven't gotten your dose yet, please call our office at 313.444.5630. We are more than happy to give you the vaccine, for your health and the health of our community.
The Pfizer vaccine is a two dose series, with one dose being given now/at time zero and the second dose being given 3 weeks later.
The Johnson and Johnson vaccine is a one dose series and can be given at any time.
Thanks for reading, and have a great day.
- Dr. Paul Thomas with Plum Health DPC
Oakland County Vaccine Rollout Update
COVID-19 vaccine update in Oakland County: Save Your Spot Sign-up Available until Vaccine Supply Increases
Pontiac, Michigan – Oakland County Health Division (OCHD) is asking residents to remain patient during this time because of the overwhelming demand for the COVID-19 vaccine. The Health Division has received 7,800 doses, administered about 5,600 vaccines, and scheduled an estimated 17,000-plus first- and second-dose appointments through the end of February. Minimal vaccine supply, however, limits our ability to schedule appointments for the hundreds of thousands of eligible workers and Oakland County residents who are still waiting to be vaccinated. Use the newly launched Save Your Spot link on our website oaklandcountyvaccine.com to help us identify individuals who are eligible and interested in receiving the COVID-19 vaccine. For anyone unable to complete the form, call our upgraded health hotline at 800-848-5533.
"We are asking the community to help us plan for administering future doses of vaccine we receive by completing this new form," said County Executive David Coulter. "This will help us reach residents and workers who are eligible for vaccination when more doses become available. As we receive more vaccine, we will continue to administer them quickly and efficiently until everyone has the opportunity to receive the vaccine."
The Health Division is currently vaccinating individuals in phases 1A and 1B of the Michigan Department of Health and Human Services (MDHHS) COVID-19 vaccination plan who work or live in Oakland County.
The Health Division is following MDHHS and Centers for Disease Control and Prevention (CDC) recommendations for prioritizing distribution of COVID-19 vaccines to individuals. According to MDHHS, those now eligible to receive the vaccine include:
Healthcare workers
Residents 65 years and older
Frontline essential workers including police officers, first responders, frontline state and federal workers, jail, and prison staff; and preK-12 teachers and childcare providers (Phase 1B)
In addition to frontline essential workers, there are over 217,000 residents age 65 and older eligible to receive the vaccine in Oakland County. To receive updates on COVID-19 vaccine availability, register your email address at oaklandcountyvaccine.com or text OAKGOV COVID to 468311. The Health Division phone lines are very busy and sometimes Nurse on Call receives over 20,000 calls per day. Oakland County appreciates the public's patience. Nurse on Call is available at 800-848-5533 to answer health-related questions, make COVID-19 testing appointments, and assist those unable to complete the 'Save Your Spot' link.
Currently the COVID-19 vaccine is available through local health departments and local health systems. Residents are encouraged to check their health providers online medical chart or portal as all local health systems are going to start making appointments for their patients once they vaccinate their medical personnel.
Vaccine information can be found at:
Oakland County: https://oaklandcountyvaccine.com/
MDHHS: Michigan.gov/COVIDVaccine
CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
More information about COVID-19 can be found on the Health Division's website at www.oakgov.com/covid. For up-to-date public health information, follow @publichealthOC on Facebook and Twitter.
Dr. Raquel Orlich Featured on WDET's Detroit Today
This week, Dr. Raquel Orlich was featured on WDET’s Detroit Today radio program. Dr. Orlich answered many insightful questions from both the host Stephen Henderson and callers. To listen to the show, follow this link.
Raquel Orlich, DO is a board certified family physician. She has been with Plum Health since July 2019 and everyday she works to deliver affordable and accessible health care in Detroit. She is passionate about quality patient-centered care and establishing strong doctor-patient relationships. Her clinical interests include osteopathic manipulative medicine for chronic musculoskeletal issues, women’s health, and preventative health. She is a graduate of Michigan State University College of Osteopathic Medicine and completed her residency training at Ascension Macomb-Oakland Hospital.
Dr. Paul Thomas and Dr. Raquel Orlich are family medicine doctors with Plum Health DPC in Detroit Michigan. Recently, Dr. Raquel Orlich was featured on WDET to discuss Coronavirus.
Here’s the abbreviated transcript from WDET:
Guests
Dr. Anne Messman, emergency room doctor at a Detroit Hospital
Dr. Raquel Orlich, family doctor at Plum Health Direct Primary Care in Corktown, Detroit
I live alone and have been sheltering in place. Is it OK for me to visit other people who have also been sheltering in place by themselves?
No. The social distancing guideline still stands not to visit people. Until we know how to identify asymptomatic carriers, we must stay apart, unfortunately.
Do asymptomatic people ever show symptoms, or do they stay asymptomatic?
“Asymptomatic carriers, by definition, never get sick or show symptoms, but they can still pass on the virus,” says Dr. Messman.
Can COVID-19 survivors get infected by coronavirus after they have recovered?
We don’t know, yet. We do know the coronavirus has mutated several times, so, at this time, we believe it is possible that a survivor could get the virus again.
How long does it take for someone to shed the virus?
It varies greatly. Some people stopped shedding the virus soon after recovery, and for others, it took up to a month. We also don’t know yet if you can infect someone while you’re shedding the virus.
I was exposed to someone who later tested positive for coronavirus. I have had symptoms including a cough and low energy, and I passed out recently. What should I do?
Since there is still no treatment for COVID-19, if you are experiencing mild symptoms, it is best to stay home and recover. Do not take NSAID medications like ibuprofen or Motrin. It is okay to take Tylenol if you want to treat a fever. If your symptoms are severe and you need medical attention, you should go to the hospital.
I had a cold last month and some of those symptoms are still lingering. Is that a symptom of coronavirus?
If you’ve had a cold, or have had seasonal allergies in the past, don’t worry. A tickle in the throat can last weeks after having a cold. However, if you have symptoms that are unusual for you, pay attention for symptoms of COVID-19 and take extra care. If you experience sever symptoms, go to a hospital.
Does using Tylenol to treat a fever negatively impact my immune response? Should I just leave the fever untreated?
Healthcare providers have differing opinions on this question, but if you have a fever and want to treat it, Tylenol is OK. A very high fever can be very dangerous and should not go untreated.
Does wearing a mask protect me, or other people?
Wearing a mask protects both you and other people. The main function of the mask is to catch droplets from someone coughing or sneezing before they get in the air. It is best to wear a mask if you need to go out.
I had a stomach virus recently. Is that a symptom of COVID-19?
Some patients who tested positive have experienced symptoms like diarrhea or vomiting. There are other reasons you might experience gastrointestinal issues including influenza or food poisoning.
I may have been exposed to someone with COVID-19, but I’m showing no symptoms. Can I get an antibody test to find out if am an asymptomatic carrier?
We do not have an antibody test, yet.
This week, Dr. Raquel Orlich was featured on Detroit Today with Stephen Henderson. She was able to answer many listener’s questions about Coronavirus and Covid-19
Single Largest Jump in Coronavirus Cases in a 24 Hour Period
Coronavirus Update: United States sees the single biggest increase in cases in a 24 hour period
Unfortunately, the United States has just witnessed the single largest increase in Coronavirus cases of any country in a 24 hour period. Over the last 24 hours, there have been 14,550 new cases reported in the United States according to this website.
Why is the Coronavirus Spreading so quickly in the United States?
It comes down to the concept of R⌀.
R⌀ is the average number of people that an infected person transmits the virus to.
If R⌀ is <1, the epidemic will burn out.
If R⌀ = 1, then epidemic will continue at a steady pace.
If R⌀ >1, the epidemic will increase exponentially.
Current estimates put R⌀ at about 2.5 to 2.9 (Peng PWH et al, 2/28). In plain English, this means that the average person with the Coronavirus will give the virus to 2.5 to 2.9 other people. This transmission rate is a bit higher than seasonal influenza. R⌀ is a reflection of both the virus and also human behavior. Interventions such as social distancing and improved hygiene will decrease R⌀.
Control of spread of COVID-19 in China proves that R⌀ is a modifiable number that can be reduced by effective public health interventions. The R⌀ on board the Diamond Princess cruise ship was 15 – illustrating that cramped quarters with inadequate hygiene will increase R⌀ (Rocklov 2/28).
The Coronavirus started with a single infected person, and it spread to roughly 2.5 to 2.9 other people. Once infected, those people passed the Coronavirus to another 2.5 to 2.9 people each. This is how a virus can exponentially spread. The Coronavirus spread has been hard to diminish because people have a relatively long incubation period or they have the virus and they don’t show symptoms of having the virus for a relatively long period of time, like 5 days to 10 days.
What should I be doing during the Coronavirus pandemic?
Definitely stay at home as much as possible. If you must go outside your home, practice social distancing and act as though you have the virus. Essential tasks done outside the home include buying groceries, making visits to the doctor, and picking up medications from the pharmacy.
How do I protect myself when I go outside?
First, avoid going outside unless you’re going for a walk or otherwise exercising in your neighborhood. If you must go outside, wear disposable latex gloves when you touch high-risk surfaces. For example, when you pump gas at the gas station, put on a pair of latex gloves during the credit card use, key pad entry, and handling the gas pump. Then, dispose of the gloves responsibly in a nearby trash can. Use hand sanitizer once you’re back in your car. Don’t touch your eyes, nose, or mouth after touching potentially contaminated surfaces. You can also use this routine of wearing latex gloves when grocery shopping or when handling a grocery cart.
Is it safe to get food delivered?
Yes, it’s safe to have food delivered and it’s safe to get take-out food. The best practice is to wash your hands after touching any packaging and to wash your hands again before eating. For instance, if you get your food in a brown paper bag, take your food out of the brown paper bag, recycle or discard the brown paper bag, and wash your hands before touching the food or individually wrapped food. Then, transfer the food to a plate or glass bowl and microwave the food for 30 seconds. This will kill any germs or bacteria in or on the food. Wash your hands again prior to eating.
What can you do to boost your immune system?
Many people want to know what they can do to boost their immune system to protect themselves from the Coronavirus. You can do the following to boost your immune system:
Sleep 7 to 9 hours each nigh
Eat nutritious and healthy foods
Drink plenty of fluids, mostly water
Exercise for 1 hour each day
Meditate to keep your stress levels low
When we’re stressed out, we tend to produce more cortisol, a steroid hormone that can weaken our immune system. That’s why it’s important to meditate, sleep well, and exercise.
What are good exercises during the Coronavirus quarantine?
You definitely want to exercise every day during the Coronavirus quarantine. Exercise will be good for your physical health, immune system, and emotional wellbeing. The best exercises will be to go outside of your house for a walk, jog, run, or bike ride. This is one of the few exceptions to the “stay at home” rule above. When you exercise, make sure that you’re keeping your distance from other people by at least 6 feet. You can exercise in your neighborhood or a nearby park. Avoid mall walking or any exercise where you’ll have to open a door/use a door handle for entry. That’s why we recommend folks avoid gyms and pools because there are just too many surfaces that could harbor the Coronavirus and potentially spread the infection. Therefore, exercise at home: lift weights, do floor exercises, do yoga or pilates. Fortunately, several health and fitness companies are giving free 30 day trials of home exercises - take advantage of these programs.
What can you do to slow down the Spread of Coronavirus?
Stay at home.
Act as though you have the virus and any interaction is a potential to spread the virus to a vulnerable person. People who are the most vulnerable are older adults or those with pre-existing medical conditions like lung diseases or cardiovascular diseases.
Do not visit nursing homes or elderly relatives, even if you feel well. You could be an asymptomatic carrier of the coronavirus and you could potentially endanger or kill the older adults that you visit.
Should you be sitting on a stockpile of extra medical supplies and equipment, please donate it to your nearest hospital or primary care physician office. If you have new and unused N95 masks or gloves, please donate them to these healthcare facilities.
Thanks for reading and watching, and have a wonderful day.
-Dr. Paul Thomas with Plum Health DPC
Coronavirus Update for Detroit Michigan March 2020
Coronavirus Update for Detroit, Michigan for March 2020
I’m a Family Doctor in Detroit, and today I’ve gotten a ton of questions about the Coronavirus - ask me anything!
For starters, here’s what I sent out to all of my Plum Health DPC (https://www.plumhealthdpc.com/) patients earlier today and I thought everyone should know these things as well. Beyond what’s written below, ask me anything:
Plum Pack!
The Coronavirus is causing concern at this time - the President spoke last night about closing access to the USA from Europe, the NBA, NHL, and NCAA have cancelled/postponed all of their games, and other major events have been cancelled - but do not panic.
People Will Become Sick This Spring
Many people will get sick and have upper respiratory symptoms over the next few days and weeks. Most of these will be from the common cold, many of these symptoms will be from seasonal allergies, some will be the flu, and some may be due to the Coronavirus.
What I can do for you is to help you triage - I can help you determine if you're sick with the flu, a cold, or having an allergy flare up. I can help you determine if you have symptoms that are concerning for the Coronavirus.
If you contact me and I'm concerned, I may send you to the emergency department for further testing. As of now, Coronavirus testing is not available at our clinic.
Here are some algorithms about how I approach caring for our patients, caring for all of you.
Additionally, heres information from the State of Michigan regarding Coronavirus, released earlier today:
Finally, below is what we know and what you can do to protect yourself:
What You Can Do to Prepare for the Coronavirus
You can prepare for the Coronavirus by taking several actions and non-actions:
wash your hands thoroughly before eating
wash your hands thoroughly after using the bathroom
wash your hands thoroughly before touching your T-zone (eyes, nose, or mouth)
Cough or Sneeze into the crook of your arm/the bend in your elbow; again, wash your hands after coughing or sneezing
purchase food and supplies in case you need to be self-quarantined
if you become sick with a respiratory infection, but you’re not sick enough to require hospitalization, you may need to self-quarantine or stay at home to avoid infecting your neighbors and co-workers
if you become ill, call your doctor and discuss your symptoms. It may be better to call or text your physician, as going to the doctor’s office may
cancel any non-essential travel to areas where the virus is spreading like China, Iran, South Korea, and Italy
avoid large gatherings - parades, sporting events, campaign rallies - to avoid catching the virus or spreading the virus
What We Know About the Coronavirus or Covid-19
Here’s what we know thus far:
Every single one of us has had a coronavirus infection in the past — it’s one of the viruses (along with rhinovirus, adenovirus, etc.) that causes the common cold. This novel Coronavirus (COVID-19) is just a variation (or mutation).
This new coronavirus can cause anything from nothing to a mild cold to a potentially lethal viral pneumonia.
Those who seem to be most affected by COVID-19 thus far are those who are more at risk to begin with: those who are older, those with multiple chronic health conditions, etc.
The evidence out of the initial outbreak in Wuhan, China revealed:
Median age = 59 years of age
Estimated basic reproduction number (the number of people an infected person infects) is approximately 2.2
The average length of time from the onset of symptoms to hospitalization was 9.5 to 12.1 days
There have been new coronaviruses in the past — most notably the SARS (2002, 2003) and MERS (2012 – Present) epidemics; however, the mortality rate of COVID-19 (2.0% to 4.0% or below) is notably lower than SARS (9-10%) and MERS (36%).
From the WHO, they estimate that the mortality rate is somewhere around 3 - 4%. We are more concerned about this Coronavirus than the typical flu virus because of this higher mortality rate. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2
This virus spreads from person to person, though we aren’t exactly sure how. Our best hypothesis is that it is spread via bodily fluids and droplets from speaking, breathing, coughing, sneezing, etc (and potentially through the GI tract).
Children absolutely can get the Coronavirus that causes COVID-19. Two interesting points about pediatric patients: 1) there is early evidence that they carry a high “viral load” and — combined with the fact that they aren’t great at washing hands, not touching their face, etc. — because of this may be more likely to spread the illness and 2) children who do get COVID-19 seem to have a lower mortality rate than those who are older who contract the disease.
Here’s what we don’t know:
We don’t know if this virus will peter out as the warmer months kick in; we also don’t know if this is a one-season thing or if it will come back strong again next cold & flu season.
We don’t know when or if we’ll have a successful vaccine to prevent against this new virus. In a late February 2020 press conference, Dr. Anthony Fauci did a great job describing how a vaccine is created (starts at about 11:00 into the clip) and how far we are away from a successful vaccine.
How to Protect Yourself and Others from the Coronavirus
How to protect yourself & others:
Just like any other respiratory virus: stay home if you’re sick!
Just like preventing any other respiratory virus: take good care of yourself! Exercise regularly, eat nutritious, balanced meals, practice stress mitigation techniques, and get a solid 7-9 hours of sleep a night, etc.
Just like preventing any other respiratory virus: wash your hands! A lot!
Just like preventing any other respiratory virus: don’t touch your eyes, mouth, nose, etc., and get into the habit of washing your hands before eating.
If you can, avoid contact with those who are sick or are caring for the sick.
If you are not actively sick (or caring for someone who is), ear-loop/surgical masks are not likely helpful. Healthcare workers will wear masks (and often higher-rated ones than the ear-loop masks), as they have a much higher likelihood of caring for someone with the disease and are prioritizing mitigating the spread to others.
Those who are exposed to someone with COVID-19 or those who are being tested for COVID-19 will likely be asked to self-quarantine (currently not mandatory). If your job permits, start asking your employer about work-from-home opportunities; if your job doesn’t permit work-from-home, ask your employer what their plan is to keep you safe!
Because of the real possibility of a quarantine, stock a couple week’s worth of non-perishable foods items in a pantry. Also make sure you have the basics — like medications, OTCs like ibuprofen, acetaminophen, diphenhydramine, and pseudoephedrine, and (a rational amount of) toilet paper, facial tissues, etc.