You’re a health-conscious person. You are diligent about monitoring your progress and you care deeply about your wellbeing and performance…

… And this year, Covid has thrown a total wrench in the works.

Since the pandemic started, people — maybe yourself included — have been putting off non-urgent health-related concerns, screenings, tests, and exams.

And while this may have been necessary early in the year, when we didn’t know the extent of the risks and the burden on the healthcare system, we’re now at a point where it’s really important not to delay these appointments any further.

That’s because diseases diagnosed at later stages are typically harder and more expensive to treat, and have worse outcomes.

Around the world, we are already seeing major ripple effects of these delays.

For example, in the UK, it’s estimated that about a million women have missed breast scans since the onset of Covid — of whom about 8,600 are likely to have undetected breast cancer.

This is a complex topic, but it’s critically important. Please take some time to read through it all.

Your Concerns About Appointments

After speaking to dozens of patients each month, there are a few main concerns people seem to have, so let’s break them down here.

  • Taking up valuable health resources when they are needed for the critically ill.

This is a positive, community-minded attitude, but it is now more important than ever that you take care of your own health. People with poorly controlled chronic disease pose a public health risk right now, and you risk placing a higher burden on your community if you don’t get timely treatment.

  • Catching Covid-19 from the doctor’s office, going to a facility where Covid is being tested or treated.

Healthcare facilities, in general, have really stepped it up to prevent the transmission of COVID. It’s not in their interest at all to allow patients to become infected at their facility.

I recently went to the dentist, so let me share what that experience was like: they had staggered appointment times so that there are never more than two people in the waiting room. When I entered the front door, a nurse met me to disinfect my hands, do a temperature check, and to put all my belongings in a plastic bag.

They gave me a new mask, hair net, hospital gown, and foot coverings to put on, and the dentist and all the staff were also in head-to-toe personal protective equipment. I felt very secure!

  • Not being able to maintain social distance in the doctor’s office.

Many offices are doing away with the waiting rooms altogether or at least reducing the number of people allowed in at one time. For example, my sister’s pediatrician has closed the waiting room and people wait in their cars until it’s time for their appointment. They also have different days of the week for well-child visits vs. sick child visits.

However, if the location you are visiting does not have this level of precaution, you can instruct the staff that you are present and will wait outside or in an area that you feel comfortable until they are ready for you.

  • Disinfection of rooms and equipment

Most governments are mandating a higher level of disinfection to all healthcare facilities and public spaces. Elevators and seating are regularly being wiped down, all equipment disinfected between appointments, and the staff taking additional precautions with disinfecting their hands and using PPE.

However, I understand that you may still have reservations about going into a clinic or hospital, so let’s talk through some options for managing that.

How To Approach Medical Care

These recommendations hold whether there is mild, moderate, or large-scale community transmission in your area.

  • Call ahead and if the facility you are going to is actively treating or testing Covid patients. Many facilities have moved all things Covid related to separate areas to prevent transmission. Get familiar with the new policies they have in place for social distancing, disinfection, etc.
  • Utilize telemedicine when it’s possible: most doctors are now using telemedicine for many types of visits. They will be able to let you know if it’s necessary to come in for a face-to-face visit.
  • If you are experiencing any possible symptoms of Covid-19 (fever, cough, shortness of breath, headache, loss of taste or smell, sore throat, diarrhea), contact your doctor or health authority, and determine the next steps with testing and treatment. Do not go to non-Covid-related medical appointments while symptomatic, unless it is by telemedicine.

Urgent Care Vs Important Care

There is a difference between acute, urgent medical situations and important, but less time-pressured situations.

In some cases, there can be very serious consequences when medical attention is delayed or not sought at all. If you or someone you know falls into one of these categories, make sure immediate medical care is provided:

  • Signs or symptoms of heart attack or stroke
  • Dental emergencies
  • Recent onset abdominal pain
  • Cancer diagnoses
  • Well-child visits for newborns

Covid is impacting areas across the world very differently, so it’s key to call your health facility to inquire about the policies for scheduling the following important (but less urgent) appointments. Depending on your risk level, underlying health, and location, this list needs to be determined on a case-by-case basis:

  • Pediatric vaccinations
  • Change in symptoms for chronic conditions
  • Musculoskeletal injury
  • Planned surgical repairs
  • Physical or occupational therapy
  • Screening exams – mammograms, cervical cancer, skin cancer, colon cancer, lung cancer, osteoporosis, dental exams, and cleanings
  • Elective surgeries and procedures
  • Routine annual physical exams and blood tests
  • Well-controlled chronic conditions

If you have a pre-existing condition or are in a vulnerable category, it is more important than ever to make sure that your situation is well-managed and under control.

If possible, I recommend booking a telemedicine consultation with your doctor to determine if it’s necessary to have a face-to-face. It may be possible to properly manage it with minimal interaction.

This is also the case if you are among those most vulnerable to Covid complications.

This includes adults of any age who are obese (BMI >30), those who currently smoke or have a smoking history, have cancer, chronic kidney disease, COPD, heart disease, immunocompromised, sickle cell disease, or type 2 diabetes.

If you are part of these groups then it is critical that you contact your doctor to continue to manage your chronic underlying condition and overall health.

It may be necessary to delay the following if your health is otherwise good, your risk factors are low, and the Covid burden in your community and the healthcare system is currently high:

  • Elective surgeries and procedures
  • Routine annual physical exams
  • Well-controlled chronic conditions

When To Schedule A Routine Check-Up If You’re Healthy and Low-Risk

If you are not part of a high-risk group then it is important to resume medical appointments, screenings, tests, and exams, unless the healthcare system in your area is stressed and you are instructed to wait.

If you are experiencing new and persistent health issues then it is important to make an appointment with your doctor, however, it may be possible to do a telemedicine consultation to review your situation.

At this point in the pandemic, doctors are very good at determining which patients should be seen and which ones should wait based on the healthcare burden in that community.

If you just need a regular check-up but don’t expect anything to be wrong, then it really depends on the area that you live in and the current burden of cases on the healthcare system in that area.

Even if you don’t expect anything to be wrong you may have certain health risk factors that are only uncovered when you see the doctor for an annual check-up.

Remember: things like high blood pressure which put you at risk for heart disease and stroke are often silent and lack obvious symptoms.

To help you with this decision, I’ve put together a screening exam timeline guide.

This guide lays out a basic testing schedule for a low-risk, healthy person. It starts from early childhood and progresses all the way through to late life, and notes the frequency and type of testing you should be doing to screen for the most common health concerns of each age group.

*Note the recent change to the age that colon cancer screenings should be started. The age was changed from 50 to 45!

What Extra Precautions Can You Take?

If you go to an appointment it is, of course, important to follow the standard recommendations of hand disinfecting, social distancing, wearing personal protective equipment (a good mask!), and to avoid touching your face.

I also recommend that people take the following supplements to support their immune system in general, especially if they will be out of the house and in public areas:

  • Zinc 30mg
  • Vit C 1-2 grams daily
  • Vit D 2,000-10,000IU daily (depending on your Vit D blood levels)

(Click here for some of my favorites)

As we are going into the winter months and the holiday season, it’s even more important that you’re in the best physical health you can be.

You might be seeing family, traveling, and facing that end-of-year hit to your normal health routines.

And with Covid still raging, one of the best things you can do for yourself right now is to make sure your health is as dialed in as possible.

Many doctors in my network (who are mostly in private practice outside of hospitals) are commenting on the reduction in office visits even when their area is not hit hard by Covid.

They have the capacity and precautionary measures in place to continue providing non-Covid medical care, so if you require care or simply want to have a check-up to optimize your health, I highly recommend connecting with your doctor soon.

The most important thing that you can do right now for your community is to take care of your health and the health of your family.

Have you seen this fantastic visualization A room, a bar and a classroom: how the coronavirus is spread through the air?

It describes the likelihood of infection in three everyday scenarios and highlights the importance of wearing MASKS and proper VENTILATION of indoor spaces.

And also this visualization of how masks work by Joseph G. Allen the director of the Healthy Buildings program at Harvard.

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