e are now offering online visits to non-members for a limited time for acute illnesses to try and provide high quality medical care while preventing patients from being exposed to (or exposing others to) coronavirus or other illnesses.

Update - 3/25/20 - Stay at home order has been issued for our county, currently 912 cases with the case rate doubling every 3-4 days. Check out Dr. Bub's FB live chat she did today on the virus.

Update - 3/11/20 - Since initially posting this article around a week ago, there are now 33 positive/presumptive-positive cases in Colorado. Expect this number to rise drastically as the state's capacity to test improves.

For guidelines on getting tested and info on Colorado's (just opened) drive-through coronavirus testing location, check out the Colorado Department of Public Health's coronavirus site.

Update - 3/6/20 - See Dr. Bub's video on coronavirus for more info.

Original Article

New cases of coronavirus have been announced in various cities across the US, with the disturbing information that heath officials are unable to determine a source of infection. A lot has changed since our last piece on coronavirus, so we wanted to provide a level-headed update on what's new, what you should do to stay protected, and what we are seeing on the front-lines of healthcare.

COVID-19 in the US

Until relatively recently, all coronavirus cases in the US could be traced to an initial infection in another country. The identification of cases in the US with an unknown source of infection tells us that it is spreading in certain communities. Even though we have not identified community spread in Colorado, it is a matter of when and not if at this point. In particular, the newer cases in Washington State have been shown to be nearly genetically identical to a case identified over 6 weeks ago, which tells us that coronavirus has been spreading in the community this whole time.

A Clinician's Perspective on Coronavirus

In our office, it has been an unusual cold and flu season. Notably in the last month we have seen a high number of respiratory illnesses that have seemed unusual - longer courses than normal, more severe symptoms, and flu tests we were convinced would be positive ending up negative. It's certainly possible that these are just any of the number of respiratory viruses that circulate this time of year, but my colleagues are also reporting a similarly "weird" flu season.

Now that our suspicion is elevated for COVID-19 in the US, ideally we would test everyone with these symptoms for coronavirus, but the word in the medical community is that is difficult if not impossible to actually have a patient tested for COVID-19 due to the limited supply of tests. (update - the State of Colorado can now run it's own tests, but to qualify for testing a patient must have contact with someone diagnosed with COVID-19, have traveled to an area with an outbreak, or be hospitalized with severe respiratory illness), however It's not unreasonable to think that COVID-19 has been spreading in multiple communities to this point, because we have limited ability to diagnose people who are not critically ill.

Add in the fact that there is increasingly evidence that it can be spread asymptomatically, and also before and after a course of illness and my personal take is that it is already widespread in the US. Many other family medicine physicians have the same suspicion. All this to say - don't be alarmed when this disease pops up in Denver, and it's wise to take precautions like it is already here (because it probably is).

Keeping Level Headed

Evidence is showing that coronavirus may be less deadly than initially predicted. This holds especially true if there have been a number of milder cases that have not been diagnosed (which again, is likely a LOT higher than the officially reported number). The reality is, many people who contract coronavirus will not be able to distinguish it from a bad cold or flu.

However, if you are over the age of 60, or have underlying cardiovascular or respiratory disease or diabetes, it is prudent to take precautions now. COVID-19 attacks the alveoli (air sacks) in the lungs and causes pneumonia which can be deadly in some patients, so if you are experiencing respiratory illness with high fevers, cough, and shortness of breath, call your doctor for advice.

Take Precautions Now

The best way to keep you and your family safe, is to wash your hands, and avoid touching your mouth, face, and eyes. If you are sick, stay home and isolate yourself from family members and others as best as you can. These simple measures will decrease community spread a ton, and you should not wait until you are sick to do this.

Eat healthy, exercise, get sleep, and take care of yourself. If you are anxious about COVID-19 (or anything else), practice meditation, and stay away from the 24 hour news cycle. Take the steps you can to keep healthy and protect your family, and try to stop worrying about things that are beyond your control. Make sure you have a reliable doctor that you can trust to see you or provide advice if you do get sick.

If you are at high risk, avoid public gatherings if possible, and definitely avoid travel to regions with known reported outbreaks of COVID-19.

*DISCLAIMER: The information in this article is not intended and should not be construed as medical advice and is not a substitute for professional medical care. If you or someone you know has a medical concern, please contact your physician or healthcare provider. Do not delay care because of something you may have read on this website. If you think you are having a medical emergency, call 911 right away.