Most healthcare organizations try very hard to control the flow of patients through their facilities to minimize risk to staff and fellow patients and many are moving more or less completely to telemedicine.
Triage protocols like ours generally say something like this:
A) If you have what feels like a bad cold or bronchitis, stay home and take care of yourself, because most cases really don’t require antibiotics or professional medical care.
B) If you think you have been exposed to coronavirus but don’t feel all that bad, stay home and take care of yourself, because there is no treatment and there aren’t enough test kits right now to test you just for your own curiosity.
C) If you have severe symptoms but are not in distress or think you ONLY MIGHT need to be hospitalized, please call and we will direct you there our to designated clinic area at a specific time so you can be evaluated and tested.
D) If you have serious trouble breathing and feel like you absolutely will need help breathing and need an ambulance, ONLY then call 911.
Still, we have people in category C who call and deny their high fever plus recent travel to a high risk area plus severe symptoms until they are all the way inside the clinic, having exposed staff and fellow patients because there isn’t enough personal protective equipment to use for every staff member for every patient encounter in a state with one million people and only 250 cases so far.
At our stage in the pandemic, we need patients to be honest with us, so we can direct clinic flow and allocate our resources in a responsible manner.
A Country Doctor Writes: 
It’s hard for people, patients and health professionals, who are skeptical. But nobody has the right to endanger others by their own skepticism.
Welcome to a country where there isn’t a lot of faith in our medical system to begin with…
It’s even goes beyond the general public. I personally will screen all patients with colds via phone before they walk through the door, as prescreening has failed at several levels before this (i.e. front desk, medical assistants, and and nursing staff; as they cannot be expected to have the level of training comparable to a physician). I was stunned when one day the local hospital/ER refused to screen health care workers with colds that have travelled through tier 2 regions or had contact with those that were in quarantine. I was told by the ER Covid Response team, “If they are walky or talky then they will be sent home to quarantine; and if they are dying or look like they will be hospitalized or intubated then they will swab these patients.” When the death rates are reaching >3.6% in the United States, the local health care workers in conjunction with the government needs to conduct widespread community nasal/oral swabs and or finger prick IgM/IgG testing to get control of this pandemic. It’s not just the one patient or HCWorker that can take out an entire office or pharmacy with a single exposure, long term there is potential to take out entire adult populations with comorbidities that help sustain these practices. If the risk is not mitigated soon, there will be a large number of physicians that will be looking towards retirement rather than continuing practice under these conditions.
Which is why we are 100% telehealth right now. My and my staff’s health cannot rely on trustworthy people. The reimbursement is the same now and I can keep myself, my family and my staff healthy.
My grandson recently had HI fever, myalgias, no appetite for a few days. My daughter is a nurse @ an SNF, I am their medical director and sole admitting doc, also med director of local Hospice branch, plus part-time employee @ our small town office, and 68 y.o.. Well, @ our office he tested negative for flu + Strep, so my daughter took him to ER @ our recommendation – guess what? DESPITE close family ties (we all live in 1 big house) to health care workers, his negative tests @ our office, and symptoms – they declined to test him as he “didn’t meet their screening criteria”!!!! So we isolated him to one room, gave him Tamiflu + Zpk, fluids, chicken noodle soup, and rest…..After about 6 days he was up, eating, lost about 7#, but feeling “75%” he said….HOPEFULLY it was NOT COVID-19!!!!
My opinion is that this Sars2 Corona will make it’s way through the community despite our efforts to contain it. That does not mean we give up on our patients and loved ones. It means that we give them the medications and treatments we can and keep in contact with them while they are at home. Speaking for myself, at 72 yrs old I plan to treat myself with the blessing of my doctor friend with Zithromax and Quinine derivatives. Right now I have a fever, cough and symptoms of a mild cold.
God Bless us all, everyone this Passover and Easter. LRB
What is your opinion on the deadly QTC prolongation drug interaction of quinine and zpak?
Have you already considered this?