Practice Updates
Periodic Updates will be posted here to keep you informed during the pandemic.
If it appears that the update is "old" it's because things haven't changed.
July 21, 2022
The metrics I use emphasize transmission. According to those, we're in the RED.
We will not move back to ORANGE until the numbers go back down and are stable for 7 days.
This worksheet tells you where we are on any given date. It's updated about once a week.
Masks are still required, and if you are a new client, you must wait for at least 10 days to come in if you are doing any high risk activity (eating out, etc.).
Implementation guidelines are below.
This worksheet overviews the restriction levels and includes the county numbers crunched in a way that makes sense for tracking when we can add to or substract restrictions. At the top of the worksheet is a brief explanation of what restrictions are followed in each category.
As I mentioned in previous updates, I'm not following the CDC's new guidelines - I left the info on that decision below my signature. Instead I'm using a modified metric based on Katelyn Jetelina, writer of the Your Local Epidemiologist blog. And I'm monitoring the trends (going up, going down, and by how much), which includes case numbers, test positivity rates, hospitalizations and wastewater surveillance.
Even so, using the CDC metrics, Missoula county is at HIGH risk, which means masking up.
If you'd like to make an appointment, please contact me:
text/phone: 406-544-4704
email: deb@debkimmet.com
In the meantime, until we are all back to "normal," let's all stay safe!
Deb
*****************
Current Practice Guidelines: RED category
1. Masks are still required. No cloth masks. If you do not have a high quality mask, Deb will provide one.
2. Risky Behaviors: Wait 14 days before coming in for an appointment.
*****************
Why I’m not following the CDC Community Guidelines (masking guidelines)
The scheme I use leans toward the more restrictive side because it’s based on the vulnerability of the clients in my practice and my family. It focuses more on transmission rates and case numbers (1). The CDC guidelines don’t really do that. Yes, they are based a bit on case numbers, but hospitalizations and hospital utilization take center stage.
Yes, I’m sick of the restrictions and want them to go away and want to get back to normal quickly too – but basing restrictions on whether there’s room in the hospital isn’t a good way to go. And that’s the message that the CDC is sending: We have room in the hospital now for you, so have at it, do what you want!
More opposition to the CDC’s guidelines are coming out:
The overarching theme of these articles is that the CDC guidelines will leave a lot of people behind, cause more strain on our healthcare system, could potentially put kids under 5 and the immunocompromised in more danger, and don’t take the impacts of Long Covid on public health into consideration. 31% of those who get Covid can develop Long Covid, including those who got a mild case of Covid (6).
And that’s why I’m not following the CDC guidelines in my practice. I work with the severely compromised and I live with and interact with those who are at high risk for Long Covid (6). The scheme I’ve chosen is not perfect, no scheme is, but I think it’s the right choice for now.
References
(1) Jetelina, K. et al. (2022, Feb 7). Riding the waves: A framework for the future of SARS-CoV-2. Your Local Epidemiologist. Retrieved from https://yourlocalepidemiologist.substack.com/p/riding-the-waves-a-framework-for
(2) Mandavilli, A. (2022, Feb 25). New C.D.C. guidelines suggest 70 percent of americans can stop wearing masks. The New York Times. Retrieved from https://www.nytimes.com/2022/02/25/health/cdc-mask-guidance.html
(3) Fisher, A. (2022, Mar 8). The map colors changed, but did the risk? Source NM. Retrieved from https://sourcenm.com/2022/03/08/the-map-colors-changed-but-did-the-risk/
(4) Nurses union urges CDC to reverse updated COVID-19 guidance (2022, Mar 1). Safety & Health. Retrieved from https://www.safetyandhealthmagazine.com/articles/22341-nurses-union-urges-cdc-to-reverse-updated-covid-19-guidance
(5) Diament, M. (2022, Mar 7). Disability Advocates Want CDC To Reinstate Indoor Mask Guidelines. Disability Scoop. Retrieved from https://www.disabilityscoop.com/2022/03/07/disability-advocates-want-cdc-to-reinstate-indoor-mask-guidelines/29738/
(6) I developed a presentation for Long Covid with stats, risk factors, and other information. That video can be found here: https://youtu.be/s_iliB070_U
If it appears that the update is "old" it's because things haven't changed.
July 21, 2022
The metrics I use emphasize transmission. According to those, we're in the RED.
We will not move back to ORANGE until the numbers go back down and are stable for 7 days.
This worksheet tells you where we are on any given date. It's updated about once a week.
Masks are still required, and if you are a new client, you must wait for at least 10 days to come in if you are doing any high risk activity (eating out, etc.).
Implementation guidelines are below.
This worksheet overviews the restriction levels and includes the county numbers crunched in a way that makes sense for tracking when we can add to or substract restrictions. At the top of the worksheet is a brief explanation of what restrictions are followed in each category.
As I mentioned in previous updates, I'm not following the CDC's new guidelines - I left the info on that decision below my signature. Instead I'm using a modified metric based on Katelyn Jetelina, writer of the Your Local Epidemiologist blog. And I'm monitoring the trends (going up, going down, and by how much), which includes case numbers, test positivity rates, hospitalizations and wastewater surveillance.
Even so, using the CDC metrics, Missoula county is at HIGH risk, which means masking up.
If you'd like to make an appointment, please contact me:
text/phone: 406-544-4704
email: deb@debkimmet.com
In the meantime, until we are all back to "normal," let's all stay safe!
Deb
*****************
Current Practice Guidelines: RED category
1. Masks are still required. No cloth masks. If you do not have a high quality mask, Deb will provide one.
2. Risky Behaviors: Wait 14 days before coming in for an appointment.
- Risky behaviors include but are not limited to:
- Eating/drinking at a bar or restaurant
- Going shopping or to the grocery store without properly masking
- Going to indoor events (basketball games, concerts, etc.)
- Without masking Or
- If you are wearing a mask, without proper physical distancing from anyone who is unmasked
- Going to outdoor events without physically distancing (even while masked)
*****************
Why I’m not following the CDC Community Guidelines (masking guidelines)
The scheme I use leans toward the more restrictive side because it’s based on the vulnerability of the clients in my practice and my family. It focuses more on transmission rates and case numbers (1). The CDC guidelines don’t really do that. Yes, they are based a bit on case numbers, but hospitalizations and hospital utilization take center stage.
Yes, I’m sick of the restrictions and want them to go away and want to get back to normal quickly too – but basing restrictions on whether there’s room in the hospital isn’t a good way to go. And that’s the message that the CDC is sending: We have room in the hospital now for you, so have at it, do what you want!
More opposition to the CDC’s guidelines are coming out:
- Over 400 experts in public health and education oppose them as premature (2).
- The director at the Public Health Foundation, Vanessa Lamers, believes it’s unethical to drop public health measures and rely on health care capacity. It doesn’t take into account all of the unvaccinated people, including kids who can’t get vaccinated (3).
- National Nurses United, the largest union of nurses, opposes the guidelines because they don’t provided “needed protections for the immunocompromised, young children or other vulnerable populations.” And there is concern regarding how it will impact frontline caregivers (4).
- Over 100 disability groups and advocates are concerned how the guidelines impact them (5).
The overarching theme of these articles is that the CDC guidelines will leave a lot of people behind, cause more strain on our healthcare system, could potentially put kids under 5 and the immunocompromised in more danger, and don’t take the impacts of Long Covid on public health into consideration. 31% of those who get Covid can develop Long Covid, including those who got a mild case of Covid (6).
And that’s why I’m not following the CDC guidelines in my practice. I work with the severely compromised and I live with and interact with those who are at high risk for Long Covid (6). The scheme I’ve chosen is not perfect, no scheme is, but I think it’s the right choice for now.
References
(1) Jetelina, K. et al. (2022, Feb 7). Riding the waves: A framework for the future of SARS-CoV-2. Your Local Epidemiologist. Retrieved from https://yourlocalepidemiologist.substack.com/p/riding-the-waves-a-framework-for
(2) Mandavilli, A. (2022, Feb 25). New C.D.C. guidelines suggest 70 percent of americans can stop wearing masks. The New York Times. Retrieved from https://www.nytimes.com/2022/02/25/health/cdc-mask-guidance.html
(3) Fisher, A. (2022, Mar 8). The map colors changed, but did the risk? Source NM. Retrieved from https://sourcenm.com/2022/03/08/the-map-colors-changed-but-did-the-risk/
(4) Nurses union urges CDC to reverse updated COVID-19 guidance (2022, Mar 1). Safety & Health. Retrieved from https://www.safetyandhealthmagazine.com/articles/22341-nurses-union-urges-cdc-to-reverse-updated-covid-19-guidance
(5) Diament, M. (2022, Mar 7). Disability Advocates Want CDC To Reinstate Indoor Mask Guidelines. Disability Scoop. Retrieved from https://www.disabilityscoop.com/2022/03/07/disability-advocates-want-cdc-to-reinstate-indoor-mask-guidelines/29738/
(6) I developed a presentation for Long Covid with stats, risk factors, and other information. That video can be found here: https://youtu.be/s_iliB070_U