Have Questions about Wildfire Smoke? Alicja Gonzales, PA-C, Has Answers.

ZOOM+Care provider offers tips on dealing with wildfire smoke.
Alicja Gonzales is PA-C at ZOOM+Care.

Maybe you don’t need us to tell you this, but: there’s a lot going in the world right now.

While our country grapples with COVID-19, the Pacific Coast is on fire, its residents cocooned in a thick blanket of smoke under an eerie red sky. Air Quality Index numbers are—quite literally—off the charts in both rural and major cities across the west. 

With smoke levels at hazardous levels, you’re bound to have questions about how air quality affects your health. To answer your q’s, give you some peace of mind, and get tips on reducing exposure risk, we sat down with ZOOM+Care provider Alicja Gonzales.

Hi Alijica! First of all, what are the symptoms of wildfire smoke exposure? 

Symptom severity can vary, but common symptoms include a scratchy throat, nasal and eye irritation, fatigue, headache, dizziness, nausea, cough, wheezing, shortness of breath, rapid heart rate, and chest pain. 

Who is most likely to experience health effects from wildfire smoke exposure? Who is THE most vulnerable?

Individuals with preexisting lung and heart conditions, the elderly, and pregnant women are at higher risk for complications. Children are also at a higher risk because they breathe more air per pound of bodyweight than adults. 

Finally, the longer you are exposed to pollutants from smoke, the higher your risk of developing smoke-related illnesses.

What can I do to protect myself from the smoke?  

Avoid outdoor exposure as much as possible. Exercise indoors when possible. Keep all doors and windows closed, and consider applying weather sealing if you detect smoke leaking in. 

Do not add to indoor air pollution. Avoid lighting candles, smoking, vacuuming, and using your fireplace.

 As a last resort, consider seeking shelter elsewhere—especially if you are at high risk for complications. 

Are there any effective home remedies to cleanse the air? We’ve heard a lot of talk about boiling herbs, wet towels and bandanas, etc. 

The above remedies are unlikely to improve actual air quality, but they may temporarily alleviate minor smoke exposure symptoms. 

To improve the air quality in your home, try these tips:

  1. Change home air filters to high-efficiency ones. 
  2. Use a portable air cleaner/purifier.
  3. Again, do not add to indoor air pollution. Your house might feel stuff from being shut up, but avoid lighting candles or using scented air fresheners. They do nothing to improve air quality, and can actually make it worse.

How can I tell if wildfire smoke is affecting my family or me? 

If you’re told to stay indoors, do so! Stay informed and monitor air quality indexes closely in your area. Know the symptoms of wildfire smoke exposure, and seek care if you’re concerned. 

If I’m experiencing side effects from wildfire smoke, when do I need to see a doctor?  

Minor symptoms such as fatigue, headaches, throat, nasal and eye irritation should gradually resolve as air quality improves.

If you have severe chest pain symptoms, shortness of breath, cough, rapid heart rate, or dizziness, you should immediately call 911 or the nearest emergency facility.

If you’re feeling off, or just worried, there is no harm in consulting your healthcare provider. Often, evaluation and medical guidance can bring much-needed reassurance. 

Should I be worried about long-term effects from wildfire smoke?  

It’s natural to feel worried, but the wildfires in our region will only temporarily affect the air quality. Long-term physical effects are unlikely.

Many of us feel really anxious right now. Is this normal?

Feeling anxious is a normal human reaction. Even in stressful situations, it’s important to try to find the positive in any situation. Consider turning anxious energy into ways to connect and help others in your community who are likely to be feeling the same way. 

Like Alicja said, it’s normal to off right now. Whether you need help coping with anxiety or processing what’s happening in the world right now, our Mental Health Specialists are here to help.

Do Face Masks Cause CO2 Poisoning? And Other Questions, Answered.

Face masks are an important part of curbing the spread of COVID-19.

As coronavirus cases surge in the U.S., lawmakers and public health officials are urging Americans to wear face masks in public. And despite some confusion early on when officials were advising against mask use, the scientific community has reached a consensus: Covering your mouth and nose in public is a safe, easy way to reduce coronavirus transmission.

So, with the science clear, why do some Americans refuse to wear a face mask? The answer is, in part, because the issue is steeped in myth and misinformation. For example, many believe that masks limit their oxygen intake and expose them to harmful levels of CO2.

To address some common concerns about the safety and efficacy of masks, we had a socially distanced sit-down with Dr. Mark Zeitzer, our Medical Director of Acute Care Services. 

Dr. Mark Zeizter, pictured above, is ZOOM+Care’s Medical Director of Acute Care Services. 

Hi Mark! Thanks for taking time out of your busy schedule to talk masks. First of all: is there any evidence to suggest that wearing a mask could cause CO2 poisoning?

Simply put, no. The use of cloth and paper masks can be uncomfortable or feel foreign. However, it does not cause CO2 intoxication or oxygen deficiency. There is simply no scientific evidence stating that there is any danger of CO2 poisoning created by temporary or prolonged mask use.  

Are masks even capable of catching or keeping unhealthy amounts of CO2 within the mask itself?

No, they aren’t. We’re lucky, because we’re not wearing masks that form a tight seal. Only an airtight face-covering could possibly cause carbon dioxide to build up to dangerous levels. Cloth and paper masks, which allow for a certain amount of breathability, are perfectly safe.

The biggest thing to remember is that masks create a barrier between your germs and other people. They catch things in our expired air, and respiratory droplets that come out of our noses and mouths. This helps decrease the spread of the virus.

Can regular or frequent mask-wearing deplete oxygen levels? 

There is no evidence that mask-wearing decreases oxygen levels or increases CO2 levels. It may feel like it, however, because wearing a mask can be uncomfortable. Most of us aren’t used to having our mouths and noses covered for long periods of time. 

But no, masks do not deplete oxygen levels. If you want to find out for yourself, you can do the simple experiment of putting a pulse oximeter (pulse ox) on your finger and wearing a mask for a few hours. You’ll find there is no correlation between decreased pulse ox levels and wearing a mask. You can even exercise with a mask on, and you will not see reduced pulse-ox levels.

Can regular mask-wearing compromise one’s immune system?

Interestingly, I haven’t heard this angle before. No, wearing a mask does not inhibit the use of our immune systems in any way. If anything, a mask acts as an ally to our immune system, because it protects the wearer from receiving particles from others. 

But really, what masks do best is protect other people. By serving as a barrier, they block what we’re breathing out. When we wear a mask, it decreases droplet and aerosol transmission tremendously, and it’s not inhibiting our immune system from working well. 

Should individuals with asthma or similar other pre-existing respiratory issues approach mask-wearing any differently?

You know, I can only encourage people with asthma to wear masks more frequently. That’s because asthma patients are at an increased risk to COVID-19, since their lungs don’t work as well. They could have broncho-spasm or things like that.  Actually, wearing a mask can help them. Asthma is a form of allergy, and if they’re wearing a mask over their nose and mouth, they will bring in fewer allergens. So, in reality, their asthma will be more well-controlled. 

Can wearing a mask cause or induce anxiety?

Not for someone who doesn’t already have anxiety. 

For those with anxiety, wearing a mask can get to their psyche—they may feel like they can’t breathe as well. It can make some people feel like they’re suffocating.  

This is a very stressful time for all of us, and everyone’s anxiety has increased. However, it can be reassuring to look at the facts. Masks are not harmful. When you wear a mask, CO2 is not retained, and oxygen levels are not decreased. It may feel uncomfortable to wear one for long periods of time, but it’s not detrimental to your health. 

If you’re anxious about wearing a mask, practicing wearing one at home, in an environment where you feel comfortable. It will help you get used to the sensation. 

“Really, what masks do best is protect other people.”

Dr. Mark Zeitzer

What sources can we trust when seeking information about the safety and risks of regular mask use? Doctors or social media investigators?

It’s a difficult question. We’re supposed to be in the information age, but the truth has become deceptive. I think you have to be exceptionally careful about what you’re reading online and seeing on social media. Social media posts aren’t editorialized. They’re just put there—anyone can say anything!  

When looking for information, you want to find things that are peer-reviewed. Pay attention to organizations whose statements are reviewed by multiple people. You also want to check to see if there’s a political or financial bend coming from that organization. Organizations like the CDC, the WHO, the Washington State Department of Health and the Oregon Department of Health provide useful information that is well-vetted. But again, you have to be very careful about what’s on social media. 

Is it safe for young children to wear masks? 

That’s a great question. The CDC recommends that anyone over two years old wear a mask when they’re out in public. However, mask-wearing is not indicated for kids less than two years old, and for kids while they’re sleeping. Those are two big things to remember. 

Because children don’t tend to get as sick with COVID, parents might be lax about having them wear masks. However, kids can certainly spread it. Also, we just don’t know enough about the virus at this time. There could be side effects that we see further down the road. 

It’s important to remember that children are amazingly resilient and adaptable. I see them wearing masks comfortably and getting used to it, which is really wonderful to see. 

Anything else you’d like to add? 

This week, the CDC released more information about a situation in Missouri, where two hair stylists learned they had COVID-19 after they had interacted with 139 clients. An investigation found that none of these clients were known to be infected with COVID-19. The hair stylists and clients wore face coverings, which likely helped prevent the spread of COVID-19.

In other words—masks work. Wearing a mask is a selfless act that protects those around you, including your loved ones.

Interested in COVID-19 testing? ZOOM+Care offers both viral and antibody testing options. Learn more about the benefits and limitations, and get tested today.

Direct Admit: Another Way ZOOM+Super Helps You Avoid Cost and Hassle of the ER

There are three inevitable truths about going to the Emergency Room:

  1. You’re going to be waiting to see a doctor. And waiting. And waiting. Possibly for a very long time. 
  2. You’re not getting out of there without a hefty bill and a paperwork-induced headache. 
  3. Nine times out of ten, the ER experience is more painful than the injury that sent you there.

Luckily, the Emergency Room isn’t your only option for serious care. Enter ZOOM+Super: ZOOM+Care’s ER alternative. Staffed with board-certified emergency physicians, Super can handle many of the reasons folks go to the Emergency Room: broken bones, x-rays, severe abdominal pain, and much more. 

Compared with a typical Emergency Room, ZOOM+Super is affordable, fast, and stress-free. In most cases, patients can get in and out in 60 minutes or less. (Stack that against the 2 hours and 16 minutes it takes for a typical ER visit.) Even better? The average cost of a Super visit is $410—a whole lot less than the $2,096 they can expect to pay elsewhere.

While ZOOM+Super can treat 80% of the reasons that adults and kids go to the ER, sometimes, patients do need to go to the hospital—typically for procedures like appendectomies. When that happens, we can help them avoid the high cost and hassle of the ER by arranging a direct admission to the facility of their choice.

Our direct admit program helps patients bypass the hospital Emergency Room altogether, and can make a painful situation a lot less stressful.

To highlight this unique benefit of ZOOM+Super, we had a socially-distanced sitdown with Dr. Daniel Tseng, a leading Portland surgeon who frequently operates on Super patients at Legacy Good Samaritan Medical Center.

Dr. Daniel Tseng

1. HI, DR. TSENG. THANKS FOR TAKING THE TIME TO SPEAK WITH US. COULD YOU TELL US A BIT ABOUT YOURSELF AND YOUR MEDICAL PRACTICE? 

I completed my training at OHSU in 2006. I did a two-year fellowship in minimally invasive surgery. I’ve been in practice for 14 years. My specialty group practice is called Northwest Minimally Invasive Surgery, and we are affiliated with Legacy Good Sam and Providence St. Vincent. Our objective is to serve our local community by providing minimally invasive surgery to patients in the Portland area.

2. THAT’S INTERESTING. WHAT IS MINIMALLY INVASIVE SURGERY? WHAT’S THE BENEFIT TO PATIENTS?

It’s when you do traditional general surgery through a very small incision. I can do 95% of surgeries through incisions that are less than ½ inch in size. There are several incisions that I use; a lot are done through the belly button. The main benefits to minimally invasive surgery are less pain associated with the smaller incision, very small scars, a shorter hospitalization, less risk for infection, and a faster recovery and return to work. It’s done often as an outpatient surgery, meaning you don’t have to spend the night in the hospital.

3. HOW OFTEN DO YOU SEE SUPER PATIENTS AND WHAT FOR?

Gallbladders and appendixes are the two most common surgeries we do for Super patients. We’re also seeing more hernias, which could be work related or due to heavy activity and lifting. I see about one or two Super patients per week. I share a call schedule with my partner, Dr. Jeff Watkins, and some other general surgeons at Legacy Good Sam, and so whoever is “on call” will see the patients referred from Super.

4. HOW DOES IT WORK WHEN SUPER SENDS A PATIENT TO YOU FOR SURGERY?

The patient is seen by the Super provider, who takes the patient’s history, does a physical exam, and orders any lab tests or imaging (ultrasound or CT are commonly done to diagnose appendicitis). Once the diagnosis is confirmed, then the Super provider either calls our office or sends us the patient through the Legacy transfer center. We try to do the surgery as an outpatient procedure and send the patient home on the same day. Depending on the time of the day and the operating room schedule at Legacy Good Sam, it can take as little as one hour or up to half a day. The last patient that Super sent me – I took the patient into the OR within an hour.

5. WHAT DO YOU LIKE ABOUT SUPER’S CARE MODEL? HOW DOES IT HELP PATIENTS?

There’s a convenience factor. It’s more convenient for these patients to be seen at ZOOM+Care. They can be seen the same day vs. having to wait weeks to see their primary care doctor. From my perspective being able to skip the Emergency Room is the biggest benefit of Super. Having all the patient’s labs and imaging already completed is really helpful as the accepting surgeon.

6. THANKS, DR. TSENG. WE’RE GRATEFUL TO PARTNER WITH GREAT DOCTORS LIKE YOU. 

You’re welcome!

We hope you never need ZOOM+Super, we’re here for you if you do. A visit is just a few clicks away, always

Virtual Orthopedics? Here’s What Using VideoCare™ for Specialists Is *Actually* Like.

If there’s one sentiment we hear a lot lately, it’s “Thank God for the internet.” Whether it’s keeping us connected or keeping us sane, tech is truly the hero of quarantine.

Thanks to apps like Facetime and Zoom Conferencing (we call it “the other Zoom” around here), we’re able to see the smiles of our family, friends, and co-workers. Video games allow us to escape reality and explore new worlds from our couch. And while we highly recommend non-virtual activities such as reading a book or going for a jog, platforms like Netflix give us instant access to a lifetime’s worth of entertainment.

That said, even the internet has its limits. Certain things—such as seeing your orthopedist—are impossible to do virtually.

Or are they?

While telehealth can’t replace physical exams and necessary testing, you’d be surprised by what ZOOM+Care specialists can diagnose and treat virtually, through VideoCare™. We offer several specialist services online, including dermatology, women’s health and gynecology, mental health, podiatry, orthopedics, and more.

As with anything new, we realize that “virtual orthopedics” sounds a little (er, totally) odd at first. To give you a better understanding of what seeing a specialist through VideoCare™ is like, we sat down with two ZOOM+Care providers: Shannon O’Brien, an MD on our Orthopedic team, and Lisa Taulbee, an ND on our Women’s Health team. Read on for some A’s to your most burning virtual care Q’s:

Hi Shannon and Lisa! Many are familiar with the use of telemedicine for common medical issues such as fevers and sore throats. However, few know that specialty care, including gynecology and orthopedics, can be delivered virtually. Can you give us a few examples of reproductive health and orthotropic concerns that can be addressed and monitored through telemedicine?

LISA: There are several concerns related specifically to women’s health that are well-suited to telemedicine. Patients can obtain refills of birth control pills quickly through this route. We can also safely treat a few infections that are common for patients, including yeast infections and urinary tract infections. Telemedicine is also a great way to discuss any questions someone might have about starting contraception like IUDs, or to address health conditions such as endometriosis or PCOS that they may have already been diagnosed with.

SHANNON: Video visits are best utilized (at least so far) to do follow up checks, like range of motion, progress with therapy. It is not good for initial visits for back pain, knee, or shoulder complaints. For those, I need to palpate and feel things.  

Dr. Shannon O’Brien

Gynecological and Ortho concerns often require in-office exams. What happens if a concern can’t be addressed virtually?

 LISA: If a provider feels that a patient requires additional evaluation, say for someone who is experiencing pelvic pain, we can refer them to the clinic for an exam with one of our women’s health providers.

SHANNON: I have asked patients to come in for an in-person visit, and so far have not had anyone refuse.

Outside of keeping people safe during COVID-19, what are some advantages of virtual care? Is there anything that excites you about this brave new world of telemedicine? 

LISA: I think the biggest advantage of virtual care is its convenience. It is so easy to make an appointment and then be “seen” in the comfort of your own home—no need to battle traffic or even change out of your pajamas to access care.

SHANNON: I think it would be a good way to connect people who live remotely to doctors. I lived in Alaska, and there are remote communities that do not have a licensed practitioner at any level for hundreds of miles. I think it would be a good option for people who cannot come in for in-person visits.  

Dr. Lisa Taulbee

A lot of people hear “virtual gynecology” or “virtual orthopedics” and think, “Huh? How on earth does that even work?” What is one thing that might surprise people about the experience?  

LISA: Gynecology is about so much more than just a pelvic exam! Our Women’s Health providers can address many areas of health with their patients. We discuss contraception, sexual health, chronic conditions that may benefit from lifestyle changes, preventative health measures, in addition to any pelvic concerns that a woman may have. And many of these issues can be addressed through telemedicine alone.

What are some differences between an in-person visit and a virtual visit at ZOOM+Care? What are some similarities? 

LISA: These types of visits are identical to each other other than the ability to perform physical exams. Even if a patient really does require an in-person visit, we can significantly decrease the amount of time that they need to be in the clinic by collecting all of the relevant information before a patient leaves their home.

SHANNON: Both visits allow one on one attention, and the history portion is no different. The differences come with the physical exam component. Virtual care is good for patient teaching, but it’s difficult to replicate a good knee or shoulder exam. I can’t get x-rays, put on or remove a cast, fit cam boots or braces, either. 

Meds Delivered to Your Door? Meet the Team That Makes It Happen.

At ZOOM+Care, we want to meet people where they are—which, given the current moment, can be kind of tricky. Luckily, we have ways of putting the care (and the prescriptions) you need in the palm of your hand. Enter ZOOM+Care’s Pharmacy delivery program: If you can’t make it to us, we can fill your prescription at our central pharmacy, then ship the meds directly to your door. Easy, right?

But, like most things that look simple from the outside, putting them into practice is another thing altogether. A lot of hard work goes into making our pharmacy program feel frictionless for our patients—especially right now. 

The COVID-19 pandemic has put enormous strain on our nation’s healthcare system, ZOOM+Care included. While the most immediate impact is on our clinics, our pharmacy and delivery programs are feeling it, too. Our pharmacy team is on the front line every day, working hard to keep these essential services up and running.

As part of our continuing series on ZOOM+Care’s frontline workers, we sat down (virtually) with our three members of our fabulous pharmacy team: Lisa Willinger, Mallory Kempton-Hein, and Megan Sorenson. Read on to learn more about ZOOM+Care’s Pharmacy and its Delivery program, the new challenges the organization faces due to COVID-19, and how they’re adjusting to pharmacy life during the pandemic.

Hey ladies! So, before we get into it—how are you holding up?

MALLORY: I am doing good, all things considering! Besides the drastic increase in doing puzzles, I am trying to keep my routine as close to normal as possible.

ZOOM+Care pharmacist
Mallory Kempton-Hein, Pharmacist

For those who don’t know, can you tell us a little bit about ZOOM+Care’s pharmacy and home delivery service? 

LISA: ZOOM+Care Pharmacy serves two distinct functions. We pre-pack medications in unit-dose bottles for all of our clinics and serve as consultant medication experts for our providers. We also have a fully-functional retail pharmacy with home delivery service available to all patients, including employees. We take most insurances and offer low cash prices to those patients who either do not have prescription insurance or are out of network. Most prescriptions are filled and shipped within one business day, offering a very convenient service to patients!

What, if any, new challenges do you and pharmacy staff face due to COVID-19?

MEGAN: One challenge the pharmacy staff is facing is to make sure we are keeping a 6 feet distance from one another while continuing to serve our patients and support our providers and crew out in the clinics.

What role does Zoom’s Pharmacy Home Delivery play in the COVID-19 outbreak? 

MALLORY: Zoom Pharmacy is trying to support our patients by encouraging social distancing and delivering her prescriptions directly to her home. This way, our patients can stay home and prevent the spread of COVID.

Do you think the pandemic will change the way we get our medications in the future? 

MALLORY: I think this pandemic has changed how we think about using delivery for all items, including medication. This pandemic has pushed people to move to a home delivery method, but being able to avoid long lines and waiting at the pharmacy is a convenience for our patients now and in the future.

ZOOM+Care pharmacist
Lisa Willinger, Pharmacist

 What is a typical day for you like before coronavirus? What are your days like now?

 MEGAN: For us, our workdays are very similar—except there’s no traffic to and from work. 

Unlike many ZOOM+Care employee’s, the pharmacy staff is unable to work from home. Can you describe the mood amongst your team?

LISA: There are definitely days we wish we could work from home, but overall the team’s morale has been great. My coworkers have really stepped up to take on extra projects and tasks to support each other during this time. 

What’s your favorite activity or practice to keep the COVID blues at bay?

 MEGAN: I’ve been walking my dog while listening to some podcasts, watching shows/movies, and catching up with family and friends via FaceTime. 

What are you doing to cope with stress and anxiety right now?

MEGAN: I’ve been running outside to cope with my stress and remind myself this won’t last forever.

Any advice on how to help/support medical and pharmacy workers during this time?

MALLORY: We are here to help you, and with healthcare stretched thin right now, please be patient and understanding. Also, please stay home!

If you could tell the general public one thing right now, what would it be?

LISA: I would like to say thank you to everyone out there who has continued to be patient and kind despite the stress and uncertainty of COVID. I have seen so much compassion in the world the past few months that it makes me very optimistic for the future. 

ZOOM+Care pharmacy tech
Megan Sorenson, Pharmacy Technician

ZOOM+Care is doing a lot to fight COVID-19 in our community. What’s been your proudest moment on the job since the pandemic hit?

MALLORY: My proudest moment has been seeing Emma’s on the frontlines. It has been so inspiring to see them put their own needs and concerns about COVID aside to take care of our patients. 

My favorite question: What’s the first thing you’re going to do when all of this is over?

LISA: My fiance and I had one of the many wedding casualties of the season, so we are definitely going to have a big wedding reception when this all blows over! I am also itching to go to an outside concert or festival. Oh, and karaoke. Definitely karaoke.

ZOOM+Care home delivery

WE KNOW THINGS AREN’T NORMAL RIGHT NOW, BUT WE’RE STILL HERE DOING WHAT WE NORMALLY DO: PROVIDING YOU WITH BETTER CARE, FASTER. (WHETHER IT’S THROUGH VIDEO, CHAT, PHONE, OR AT OUR CLINICS.) GET CARE NOW. 

Hey Zoom: I Feel so Helpless during the COVID-19 Pandemic. What Can I Do to Help?

ZOOM+Care Covid 19 anxiety

Great question.

COVID-19 has ushered in an era of uncertainty—uncertainty about the future, yes, but also about how to help each other during these unprecedented times.

Hands down, the best way to help is by practicing social distancing.

But as we all shelter in place, many of us are wondering, “What else can I do? How can I support frontline workers? Should I sign petitions? Organize a fundraiser to purchase personal protective gear for local hospitals?”

Our Chief Medical Officer, Dr. Erik Vanderlip, weighs in with some answers:

Be emotionally available.

“There are several things you can do to help others right now, beyond social distancing,” says Dr. Vanderlip.

“First and foremost, take care of yourself and those close to you. We need to be extra sensitive to the emotional needs of our loved ones during this time—especially older relatives, and vulnerable people in your community. Talk to your parents, call extended family members, and frequently check in on friends who are self-isolating at home. “

LIMIT UNNECESSARY TRIPS.

Vanderlip also suggests doing everything you can to avoid unnecessary trips.

“We’re still seeing a lot of people on the streets, packing into grocery stores, and even flocking to the coast for weekend getaways. We should only be leaving our homes for essential activities.”

When it comes to grocery stores, Vanderlip says, “While you shouldn’t stockpile groceries, having some necessities on hand in your home—if you’re in a financial position to buy them—is something that can help you and others. That way, you won’t have to take frequent trips to the grocery store.”

THINK LOCAL.

“When thinking of ways to help, many people overlook their immediate circle of influence—their friends, family, and neighbors,” Vanderlip reflects.

“Everyone is super focused on raising money for masks and personal protective equipment—but there are probably people in your building or on your street that could use help. Do you have an elderly neighbor, for example? See if you can pick up cleaning supplies, groceries, and other other necessities for them. Help keep them safe by wearing gloves and leaving their packages outside the door.”

CITE YOUR SOURCES.

“Finally, don’t contribute to the spread of rumors or misinformation,” says Dr. Vanderlip.

“Conspiracy theories catch faster than COVID-19, but truth takes longer to spread. Before you share the salacious rumor you heard, check your sources and pause. Fear and misinformation lead to panic, chaos, and poor decision-making. During this time, it’s essential to focus on what we each can control and what we can’t.”

Right now, social distancing is the most effective measure for containing the spread of the coronavirus. Check out our answers to your most burning social distancing questions. 

Your Biggest Social Distancing Questions, Answered

social distancing questions women in grocery store with mask covid-19

You know how when you hear a word over and over and over again, it begins to lose all meaning?

That’s probably how you feel about the term “social distancing” right now.  

But, despite everyone being tired of hearing (and reading, and talking) about social distancing, no two words better explain what we need to do to curb the spread of COVID-19.  

Social distancing is, perhaps, the most meaningful phrase of 2020. 

One more time for the people in the back: What is social distancing? 

As we’re sure you know by now, social distancing describes several precautions that can slow down the spread of COVID-19. These measures include staying home, avoiding crowds, and refraining from touching one another.

Why is social distancing so critical? 

If COVID-19 continues to spread, unchecked by social distancing, there might not be enough hospital beds or respirators for those in need.

According to burgeoning research, coronavirus may be transmitted by carriers who are still healthy. That means everyone must practice social distancing—not just those who are sick. Full compliance will help vulnerable populations, such as older adults and immunocompromised individuals, from getting the virus. 

We know that living like this is undeniably isolating and inconvenient, even if it’s for the greater good. To help you keep calm and social distance on that, we answered your most burning social distancing questions:

Can I leave my house during social distancing?

Yes. For sanity’s sake, it’s okay—and good—to go outdoors to get fresh air and exercise. The point is not to quarantine yourself, but to avoid close contact with others. 

What does “close contact” mean, exactly? Just keep a full six feet away from other people as much as you can.

However, there are a few precautions you should take to keep yourself and your loved ones safe. 

When you leave your home, avoid touching your face and wipe down any surfaces you come into contact with. If you’re out of your home for an extended period, periodically disinfect your hands with an alcohol-based sanitizer. 

And no matter what, practice impeccable hygiene: Wash your hands before you go out, while you’re out, and when you get home. 

Can I order takeout while social distancing? 

Yes! Currently, there is no evidence that COVID-19 can be transmitted through food—so ordering takeout should be safe.

That said, you should still be extremely careful. Disinfect takeout containers upon their delivery, and wash your hands before tucking in.

Ordering takeout helps restaurants and delivery drivers earn much-needed income during the pandemic, so don’t refrain from treating yourself.

Is it okay to use public transportation?

Crowded buses and trains, with their oft-touched poles and communal benches, are fertile breeding grounds for germs. To minimize your risk of infection, you should avoid using public transportation, ride-sharing, or taxis.

However, if you need to use public transportation to get to work, be sure to carry disinfecting wipes to clean seats and handles, and wash your hands as soon as your commute is over.

Can I go to the grocery store? 

Yes, and doing so is likely unavoidable. However, you should try to be strategic about your shopping trips. Pick a time when the store is least likely to be busy, such early morning or late at night. And—without giving in to the urge to panic buy— purchase as much as you’re able to at a time, to minimize your number of trips. 

While shopping, remember that surfaces in the store may be contaminated. If possible, use a disinfecting wipe to clean the handle of your grocery cart—and as always, keep your hands away from your face. When you get home, wash your hands immediately. 

If you buy fruits and veggies, be sure to wash them thoroughly before eating.

Are you over 60, or immunocompromised? You may want to try and avoid shopping trips altogether, if you can help it. Try shopping oline

What about going to the doctor?

Unless you have an urgent medical issue, you should probably avoid going into the doctor’s office. 

However, you can seek out virtual and telehealth options that don’t require an in-person appointment. 

At ZOOM+Care, we’re currently asking all patients to start their care by connecting with a provider through Phone or via ChatCare. We will treat what we can remotely, but—if our providers feel it’s medically necessary—can get you scheduled for in-person visit, as well. 

Phone and Chat visits will go a long way in minimizing the risk of exposing yourself or others through in-person contact. 

Can my friends come over?

We know it’s difficult, but visitors aren’t a great idea right now. This is especially important if you or someone you live with is at high risk, or you live in a communal setting like a nursing home or group home.

Social distancing can be lonely, so it’s important to maintain connections during this time. Try getting creative with technology: Schedule dinners parties via Skype, host a movie marathon on Zoom conferencing, or play games with friends online.  

If your mental health is suffering as a result of social distancing, consider consulting with our doctors via ChatCare or booking a Phone visit with one of our Mental Health providers. We can explore your options for treatment and guide you towards the best solution for your mental health.

When I leave the house, do I need to wear a face mask? Will it protect me from getting the virus?

Not necessarily—and unless you’re sick or caring for someone who is, you probably shouldn’t wear one. 

Masks are effective at capturing droplets, which are the main source of transmission for coronavirus. If you are in close contact with an infected person, a mask may reduce your chances of contracting the disease. If you’ve been diagnosed with COVID-19, or are showing symptoms, you should make every effort to isolate yourself from others who feel well.

However, masks don’t protect healthy people from coming into contact with those germs. Because COVID-19 can live on surfaces for days,  a mask will make little difference if going to the grocery store or taking a bus.  

What’s more, face masks are in short supply. We should save them for healthcare providers and people experiencing upper respiratory symptoms.

Do I need to stay six feet away from my spouse—or even my children?

Not unless either of you is showing symptoms of sickness.

Under most circumstances, if you and your loved ones are living in the same home, you don’t need to stay six feet away from them. (And let’s be real: doing so would be virtually impossible.) However, limit excessive physical contact as much as possible.

We’re practicing social distancing, too. If you or a loved one needs care during this turbulent time, please connect with us via Phone or via ChatCare before coming into a clinic. We appreciate your understanding as we all do our part to curb the spread of COVID-19.

Your HPV Vaccine Questions, Answered

test tube with the HPV vaccine in the hand with a glove on a blue background

If there were a vaccine that could ward off STIs and cancers, people would line up for it—right? 

You’d think the answer to that question would be, unequivocally, “yes!” And yet, plenty of folks say “no” to a vaccine that prevents the cancer-causing human papillomavirus, or HPV. 

HPV is the most common sexually transmitted infection in the United States. (It’s so prevalent, in fact, nearly 80% of people will get in their lifetimes.) Human papillomavirus is the cause of nearly all cervical cancers, and can also lead to cancers of the throat, vulva, vagina, penis or anus. 

Luckily, there’s a vaccine for that.

Gardasil 9, the HPV vaccine approved by the FDA in 2014, prevents infection from the HPV types that cause over 90% of these cancers. It also guards against two strains that are responsible for the majority of genital warts.

Since most adults have already been exposed to HPV, the vaccine is recommended for girls and boys ages 11 or 12. However, it can be given as early as age nine—and as late as 26. (Some doctors even recommend it for people as old as 45.)

HPV vaccination is preventing cancer-causing infections—so why aren’t more teens and children receiving them? 

Despite its overwhelming safety and efficacy, fewer than half of American adolescents have been fully vaccinated against HPV. And while adoption is low for a variety of reasons, myths, misinformation, lack of knowledge about the vaccine still are a huge contributing factor. 

To help clear the air about this important and potentially life-saving vaccination, we sat down with Dr. Lisa Taulbee, a member of Zoom’s Women’s Health Team. Read on to learn more about the vaccine, who it’s for (spoiler: it’s not just for girls!), and why you should consider it for yourself or your child.

ZOOM+Care women's health doctor
Dr. Lisa Taulbee

1. Hi Lisa! Thank you so much for taking the time to talk to us about HPV vaccinations today. CaN You Tell us WHAT HPV is?

Human papillomavirus, known as HPV, is the most commonly sexually transmitted infection (STI) in the United States. There are hundreds of different strains that infect different areas of the body—some may cause warts on the hands and feet, while others may infect the mucous membranes such as the genitals and cervix in women. The strains of HPV that are considered to be high-risk can cause certain types of cancer such as cervical cancer.

2. How common is the virus?

It’s estimated that about 80% of sexually active men and women will be exposed to HPV at some point in their lives—though many experts believe that all sexually active adults have been infected at some point in their lives

3. How does HPV spread?

HPV is sexually transmitted through intimate skin-to-skin contact—unprotected vaginal, anal, or oral sex.

4. What are the risk factors of HPV?

The risk factors of HPV are dependent upon a patient’s number of sexual partners, as well as their age. If they start having sex earlier, they’re more susceptible to infection.

5. What are some common misconceptions about HPV?

There’s a perception that men are not affected by (HPV) because they can be asymptomatic. The truth is, men and women alike can be exposed to the virus. Even though men might not show symptoms, they play a key role in the transmission of HPV to women.

It’s also important to note that there is no currently approved test for HPV in men.

7. What is the HPV vaccine?

The HPV vaccine is a series of three injections over the course of six months. At ZOOM+Care, we use a vaccine called Gardasil 9. It protects against nine strains of the virus, mostly targeting the high-risk strains that can cause certains types of cancer

8. Why are HPV vaccines important and what are the benefits?

To put it simply, HPV vaccination is cancer prevention. The HPV virus is estimated to cause nearly 35,000 cases of cancer in men and women every year in the U.S., and the vaccine can prevent more than 32,000 of these cancers from ever developing.

9.Who can benefit from the HPV vaccine? Is it just for women? 

The HPV vaccine benefits both males and females. It’s recommended to begin vaccination at age 11 or 12, but it’s approved through age 45.

11. Are there any side effects of the HPV vaccine?

The side effects associated with the HPV vaccination are injection site reactions, as well as possible headaches, nausea, fevers, and dizziness.

12. Are there any myths about the HPV vaccine?

There is a stigma surrounding the HPV vaccine because it targets an infection that is sexually transmitted—and it’s typically given to children who are not yet sexually active. Parents don’t like to think about the fact that their child will eventually be sexually active, but the point vaccinating early is to administer the vaccine well before sexual activity begins. It’s the best way to protect children from life-threatening cancers later on.

Many parents also have concerns that vaccination would encourage or support youth promiscuity, a belief which is not supported by data.

13. What else can you do to Prevent HPV?

Barrier methods, such as condoms, are a form of birth control that can prevent infection—though it isn’t 100% guaranteed to be effective. 1

Studies also show that having an IUD may lower person’s risk of cervical cancer by helping to fight off an HPV infection.

14. Can people already infected by HPV benefit from vaccination?

People already infected by HPV can still benefit from vaccination. There are several strains of the virus that this vaccine provides immunity against—so someone that’s been exposed to one strain can still prevent contraction of strains they have not yet been exposed to. 

More questions? We’re here. Schedule a Women’s Health visit today!


Your Intermittent Fasting Questions, Answered.

Is intermittent fasting right for you?

Unless you’ve been living under a rock for the past few years, you’ve probably heard of intermittent fasting: The latest ‘must-try’ diet trend that promises to curb hunger pangs and help you shed extra pounds.

Amid the deafening buzz of celebrity endorsements, it can be tempting to dismiss fasting as yet another ineffective fad. However, doing so might be a mistake.

Turns out, intermittent fasting is one fad diet that seems to be backed by real science. According to a review published by the New England Journal of Medicine, there are links between fasting and improvements in cognitive and physical performance, cardiovascular health, and symptoms of diabetes and obesity.

But—before you skip breakfast—it’s important to get the facts. We sat down with Zoom’s Doctor of Osteopathic Medicine, Dr. Benjamin Burton, to get some answers to your most burning intermittent fasting questions.  Read on to hear his take on the dietary trend.

1. Hey Dr. Burton! Thanks for taking the time to talk intermittent fasting with us. Let’s cover the basics first: what is intermittent fasting?

Intermittent fasting is a diet philosophy that entails scheduling specific periods where eating will be significantly limited or avoided all-together.  

Several different schedules can be incorporated with the intermittent fasting diet. One popular approach is to pick a couple of days a week where food is significantly restricted (something like eating only about ¼ of what you usually would need in a day) and then eating a normal, balanced diet the other days of the week.  

The other approach is to pick a specific period every day to abstain from eating. This is often done in 12 or 16 hour periods. For example, only eating from 7 am to 7 pm daily and fasting for the remaining 12 hours. Or fasting from 11 am to 7 pm and fasting the remaining 16 hours.  

2. Why is intermittent fasting so popular?

Dieting is intensely personal, and everyone has different needs. Making healthy food choices can be difficult, time-consuming, and exhausting for some. Sometimes, it’s just easier to decide to not eat at all for an extended period. This helps simplify things for a lot of people. For some people the eating pattern is much more intuitive and easier to follow. 

Fasting is gaining popularity in the medical field because there is some evidence that there are a number of health benefits beyond just weight loss. It seems to have additional value in preventing or treating diabetes. Most weight loss programs improve blood sugar, but intermittent fasting can potentially improve blood sugar before a significant amount of weight is lost. 

3. Is it safe?

Intermittent fasting, as it is laid out in most mainstream programs, is quite safe. As with anything, if taken to an extreme can become unhealthy. Generally, fasting for more than 24 hours should be done with caution, and fasting for more than 72 hours should be avoided. In any fasting scenario, it is important to stay hydrated. I recommend that most periods of fasting be a “water fast,” meaning abstaining from food but still drinking water. This allows for the benefits of a caloric restriction but protects against dehydration.  

4. Are there any myths about intermittent fasting? If so, what are they?

I’m not sure there are many myths, but there are some claims that are not fully scientifically validated yet. These include claims that intermittent fasting will improve sleep, prevent dementia, and prevent cancer. These claims may all be true, but we haven’t fully validated these claims in human research. 

5. Are there side effects?

Food provides essential glucose and electrolytes (like potassium and sodium) that we need on a daily basis. The human body has mechanisms that monitor and maintain normal levels of glucose and electrolytes even when a person isn’t eating. However, people that take medications that affect blood sugar (diabetes medication) or medications that affect electrolytes (mainly blood pressure medication) should discuss fasting with their doctor before starting. There are also rare diseases that would prohibit some people from fasting, but generally, these individuals are well aware they should avoid fasting.  

6. What are the benefits of intermittent fasting?

The biggest benefits that are currently well-validated are weight loss and improved blood sugar control.  

7. Will fasting improve overall health?

Intermittent fasting certainly has the potential to improve health. For many people, losing just 10% of their excess weight can result in significant health benefits.  

8. Is there a right or wrong way to intermittently fast?

Dieting is an incredibly personal thing. I recommend beginning with a well established intermittent fasting routine. Once a person is comfortable with that, they can try modifying it a little to suit their life situation better. I would discourage extreme fasting for most people. (e.g., fasting beyond 24 hours).  

9. Is intermittent fasting for everyone?

No, a hundred times no.

If anyone could find a diet that is safe and effective for the majority of the population, they should get a Noble Prize. Intermittent fasting requires a lot of meal planning and diverging from traditional mealtime routines. It is hard for some people to do this in a typical 8-hour workday if they don’t have a lot of flexibility regarding meal times. There are a lot of other barriers that can really make this program difficult.  

10. How many days, if any, are recommended to intermittently fast each week?

There are several different programs. The most popular one currently is a daily 16:8 routine where a person fasts for 16 hours and eats for 8.

11. Is intermittent fasting an effective form of dieting?

It can be. The value of any diet program is calorie restriction and food tracking. Intermittent fasting seems to really click for some people and help them control their food intake.

12. Will intermittent fasting promote weight and/or fat loss?

Intermittent fasting has been found to promote weight loss.  

13. Will intermittent fasting put the body into starvation mode?

The “starvation mode” is an interesting theory, and maybe a myth in first world countries. There is an unhealthy starvation state that is achieved with extreme starvation. This requires a level of food deprivation that is generally only seen in severe poverty or inhumane treatment of prisoners. Some diet philosophies like frequent small meals to “keep the metabolism going” or restricting too much and putting the body in a “starvation mode” aren’t really well validated. More likely, people that over restrict put themselves into a restrict/binge pattern. While these people have periods of little food intake, they then slip and binge, thus overeating in the long run. Intermittent fasting directly challenges these “starvation mode” theories, and to some degree, seems to discredit them. Finding the right balance is tricky. It is important to monitor and be purposeful about eating. There is a difference between intermittent fasting and a binge/restrict pattern of eating.   

14. What is the protocol on exercise while intermittently fasting?

Exercise, like dieting, is intensely personal. Intermittent fasting is generally used to lose weight. Exercise programs targeted at weight loss would be congruent with intermittent fasting. If someone is exercising to train for an endurance activity or gain muscle mass, intermittent fasting can be used, but this would require a high level of planning and coordination. This would require a lot of individualized research and maybe coordination with health professionals like trainers and nutritionists.

WANT EXPERT GUIDANCE ON YOUR WELLNESS JOURNEY? ZOOM+CARE’S INTERNAL MEDICINE IS HERE TO HELP. SCHEDULE NOW. 

It’s World AIDS Day—Let’s Talk About PrEP!

Pills of prescription PrEP Pills for Pre-Exposure Prophylaxis to help protect people from HIV.

There are approximately 1.1 million people in the US living with HIV today. World AIDS Day, celebrated each December 1st, is an opportunity to increase awareness and knowledge about HIV, support those living with the virus, and champion efforts to prevent new infections.

One such effort? Pre-exposure prophylaxis, or PrEP: a once-a-day pill that prevents HIV-negative people from becoming infected.

PrEP is over 90% effective at preventing HIV infection. When used as directed, it’s one of the most powerful tools for stopping the spread of AIDS— and yet, the drug is largely underutilized.

A myriad of barriers drives low usage rates: cost, accessibility, and—perhaps most unfortunately—stigma.

Even today, HIV is unfairly stigmatized by homophobia. Many—especially those in the queer community—are hesitant to seek out drugs like PrEP for fear of feeling judged.

Moreover, when you talk about HIV prevention, you have to talk about sex—which, let’s face it, can be uncomfortable. Many doctors and patients shy away from discussing PrEP due to feelings of embarrassment.

At Zoom, we want to eliminate factors that prevent people from seeking care. We encourage open, honest discussions about HIV risk; we strive to create a stigma-free environment where people can access screening and prevention options that are safe, effective, and meet their needs.

Talking openly about HIV screening and prevention confronts the stigma associated with the virus. It also helps normalize drugs like PrEP as a routine part of preventive healthcare, just like birth control. That’s why— in anticipation of World AIDS Day—we sat down with one of our providers, Allison Ehrlich, for a frank discussion about this life-saving drug. Read on:

Hi Allison! Thank you so much for sitting down to talk PrEP with us. First things first: What is PrEP?

PrEP, Pre-Exposure Prophylaxis, is the act of taking daily medications, such as Truvada, that can help prevent contracting HIV through sexual activity and IV drug use in combination with safer sex practices including using condoms and lube, talking with your partner about HIV status, and getting tested regularly for STIs. 

Why do we need new HIV prevention tools like PrEP? Aren’t condoms enough?

We have come a long way in the medical field with testing, treating and preventing HIV with PrEP, Truvada being one of these medications. Condoms are a great tool when used with PrEP to help protect yourself from HIV in addition to other STIs, but are not enough alone. They can break, may not be used properly, or not provide adequate coverage to reduce the risk of transmission of an STI. 

Who is a good candidate for PrEP? How do I know if it’s right for me? 

PrEP is recommended for the following populations: men who have sex with men (MSM), sex with multiple partners, involved in an open relationship, engage in sexual activity with a partner who is HIV+, or uses IV drugs. 

PrEP might be right for you if you have the following risk factors:

  • Have one or more HIV+ or injection sexual partners
  • Having sex with someone in a sexual network where HIV is common
  • Having a prior STI
  • Participate in sex work
  • Using condoms inconsistently or never
  • Share injection equipment 

It is important to talk with your healthcare provider and be honest about your sexual and medical history and lifestyle risk factors. They can help determine if PrEP is right for you. 

How effective is PrEP, and how soon does PrEP become effective after you start it? 

Per the CDC: “Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily.”

PrEP when taken daily takes at least 7 days for maximum protection against HIV.

Are there any side effects?

Side effects in clinical trials included nausea or headaches, but usually subside over several weeks. 

If I’m taking PrEP, do I still need to get tested for STIs?

Yes, you need to get tested every 3 months for HIV, and every 6 months for other STIs—sooner if you have any concerns. 

I’m worried I’ve been exposed to HIV. Is PrEP a good option for me?

No, PrEP is pre-exposure prophylaxis and is used before you come into contact with HIV. If you are worried you have already been exposed to HIV, then you will need PEP, post-exposure prophylaxis. This is a month-long course of therapy that needs to be started within 72 hours of exposure. 

I’m nervous about talking to my doctor about PrEP. How should I bring it up?

ZOOM+Care is a great place to talk about PrEP, because we understand it can be a sensitive topic. It is important to be clear about wanting to start PrEP. We will need to discuss your medical and sexual history to help us determine your risk factors, if you are a good candidate for PrEP, and how to best assist you in getting Truvada.

Why does ZOOM+Care support the use of PrEP?

PrEP, in combination with safer sex practices and other prevention tools, is an amazing method to help protect yourself from becomming infected with HIV. ZOOM+Care is open 7 days a week, holidays, and have clinics open until midnight providing easy access to care. Our central pharmacy is happy to assist with Truvada for PrEP and discuss ways to reduce the monthly cost. You can go online at zoomcare.com or on the iOS app to schedule a visit.

Interested in HIV screening, education, or prevention? We’re here. Schedule an appointment today.