Many of you have reached out offering different ways to help. You have provided us with personal protective equipment (PPE) which we, our families and our community appreciate immensely. Your assistance helps Carlos and Jose to continue to care for our hospitalized patients, provide home visits when necessary and perform testing in our own parking lot. Our office staff is committed to remaining as always available for you whenever you need us.

On Wednesday this week, there were 10 positive patients at Sarasota Memorial Hospital, half of those were severe enough to require intensive care. Let me repeat, 50% were critically ill. There were over 70 “persons under investigation or PUI” at the hospital as well. The number of positive cases continues to increase exponentially locally and nationally.

STATISTICS (according to Johns Hopkins and Fl Dept of Health as of 3/27/20 10 am)
• Total confirmed cases (worldwide): 553,244
• Total confirmed cases (US): 85,906
• Total deaths (U.S.): 1,307
• Total confirmed cases (Florida): 2,484
• Total deaths (Florida): 29

We continue to ask our patients to “stay home safely.” These orders have already been issued in neighboring counties including Tampa. You should connect with family and friends using technology. Leave home only for essential needs, such as groceries or medications.

We encourage you to remain active even at home. Be safe but get creative. Try to get your 30 minutes of daily exercise, which may be as simple as walking in your living room or lifting a 5 lb. bag of rice. Create safe activities adjusted for your own abilities.

In the event you do become ill, call us at Private Physician Services right away. Obtain your medical advice from us or from sources we select for you. Be wary of the many options being touted online, even those that may seem to come from health professionals. We remain up to date on any current therapeutic developments as they present on a constant basis.

Jose R. Santana Jr MD MPH FACP

Many of you have called us for guidance to protect yourselves from the virus causing COVID-19. Our nation is a week or two behind what has happened in Europe, particularly Italy. We now see the drastic steps several countries have taken. Sadly, the explosion in deaths seen demonstrates that pandemic management requires significant social distancing. While this may be uncomfortable and inconvenient, it must be widespread in order to flatten the curve so that our health care system is not overwhelmed. As physicians, we fear that any of our patients may succumb to this disease not just because of COVID-19, but due to a lack of access to proper services such as ventilators. If the healthcare system is overwhelmed because of COVID-19, there is still a need for patients who have any other medical condition, such as heart attacks, strokes, and so on.

Five states, (California, Ohio, Illinois, Massachusetts, and Washington) are reported to have closed bars and restaurants. New York City is closing movie theaters, gyms, small theater houses, restaurants, and concert venues.

We suggest that you cancel social public gatherings. Even if Florida has not closed restaurants, theaters, etc., now is the time for you to be Commander in Chief of your own health and take extreme steps by avoiding those venues. Of course, do your grocery shopping, but keep your distance. Even if one friend comes over for dinner, you are creating new opportunities for transmission. Avoid the gym. COVID-19 symptoms may take several days to manifest. A dinner guest, or someone sitting next to you at a theater or walking by you at a restaurant who looks extremely well if perfectly capable of transmitting the virus.

Take care of yourself and your loved ones. Sarasota is blessed right now with excellent weather. You can still exercise, go for a walk if able to do so, sit outside, but when possible, stay physically away from those, outside of your household. Avoid visiting nursing homes, to avoid exposing other elderly people who are the most vulnerable to complications and death from this virus. Stay in contact with loved ones via your phone and video chat.

Finally, again a reminder to frequently wash your hands for 20 seconds each time, particularly if you have gone out such as for groceries.
In the event you do become ill, call us at Private Physician Services right away, as Dr. Caballero, Dr. Santana, and our staff remains always available to guide you and provide care when you need us.

STATISTICS (according to Johns Hopkins, as of 5pm on 3/15/20}

• Total confirmed cases (worldwide): 162,687
• Total confirmed cases (US): 3,244
• Total deaths (U.S.): 62
• Total confirmed cases (Florida): 115

Two days ago, March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization (WHO). Prior pandemics have been due to influenza, but there has never been a pandemic by a new coronavirus. There is little or no immunity in Sarasota to this disease which spreads easily from person to person. Testing has been limited so we likely only know the tip of the iceberg as far as how many people are carrying this virus. There are likely hundreds of thousands of Floridians carrying the virus. Many have mild or no symptoms. However, the elderly and those with chronic health conditions are far more likely to develop severe symptoms (fever, shortness of breath, lung damage) and even death.
Both Dr. Caballero and Dr. Santana, want every single one of our patients to take steps to protect themselves and avoid contact with this virus. We believe now is the time to avoid gatherings whenever possible. Cancel optional activities, not only of large, but even small gatherings. We realize this may not always be possible but recommend it as an effort to avoid unnecessary contacts.

Many may not even be aware of having the virus, since the symptoms may not show even if the person is contagious. Shopping for your food is necessary, but shopping for non-essential items at stores should be avoided. Other public gatherings, such as movie theaters, shows, are also of concern and may put you at risk for exposure. Absolutely avoid getting on a cruise, not only is there risk of exposure, but the additional risk of confinement to the ship.

Frequently wash your hands with soap and water for at least 20 seconds.
For your protection, we are happy to provide a phone call for routine visits instead of an office visit.

As always, call us for symptoms and we will be happy to guide you.

The Centers for Disease Control has excellent guidelines www.cdc.gov

Coronavirus disease 2019 (COVID-19) is caused by a virus named SARS-CoV-2 which has now been detected in many locations including right here in Sarasota. The CDC believes that more cases will be identified in the United States as we see more communities spread from person to person. At Private Physician Services we will continue to provide you with excellent care taking measures to ensure your safety.

The majority of coronavirus cases (81%) are mild, but there is a serious risk of complications particularly in the elderly and those with underlying medical issues. 

Those affected may have symptoms ranging from mild to severe, resulting in death in the more severe cases.  Symptoms of fever, cough, chest congestion and shortness of breath may appear 2-14 days after exposure in someone with COVID-19. The common cold, on the other hand, often includes sneezing, stuffy and/or runny nose, sore throat, watery eyes.  If you have these symptoms, please call us so that we may guide you properly.  We can help you distinguish between the causes of these symptoms. When necessary, we can arrange for further testing such as to determine if you have the flu and need treatment.

The most important step right now is taking preventive measures for yourself and other members of your household.

1.  Avoid close contact with people who are sick.
2. Stay home when you are sick, except to get medical care.
3. Cover your coughs and sneezes with a tissue.  If you do not have a tissue, use your elbow, not your hand when able to do so to cover the mouth.
4. Frequently washing your hands with soap and water for at least 20 seconds, particularly before eating.
5. Avoid public gatherings that are optional when possible.

So why is high blood pressure called the silent killer?

In some ways, high blood pressure has earned its’ nickname well as a “silent killer.” After all thousands of unsuspecting people become disabled or die from its consequences every year. By the time most people get symptoms of high blood pressure, such as headaches or nosebleeds just to name a couple, the blood pressure is dangerously high.  On its way there, that pressure has been damaging our kidneys, heart, brain, and other organs. Having high blood pressure puts you at risk for heart disease and stroke. The killer may be silent, but the damage caused and the lives impacted are far from that.

How does high blood pressure affect us?

According to the CDC, about 75 million United States adults (32%) have high blood pressure and just slightly over half of those (54%) have it under control.  It takes a daily toll killing what averages out to 1,100 Americans dying each day.

So what can we do about high blood pressure?

Fortunately, there is much we can each do:

1. Lower your sodium intake (no more than 1500 mg daily)
2. Avoid smoking and using tobacco products.
3. Be physically active daily
4. Eat a heart-healthy diet
5. Keep a healthy weight
6. Limit alcohol consumption

A good start is looking at our sodium intake.  The American Heart Association (AHA) recommends up to 1500mg of sodium for ideal cardiovascular health. 90% of Americans consume more than 1500mg (average consumption is 3400mg) and about 90% of Americans are expected to develop high blood pressure in their lifetimes. According to the AHA less sodium in the diet can help to blunt the rise in blood pressure that occurs as we age.

Most of our dietary sodium comes not from the salt-shaker, but from processed foods.  Always try to consume lower-sodium versions of any of your foods, in particular, bread, soups, and cold cuts. Select fresh or frozen poultry that hasn’t been injected with sodium (i.e. broth).

A good source for information on sodium is at www.heart.org/sodium

Resources: https://www.cdc.gov/bloodpressure/facts.htm

Jose R Santana Jr MD MPH FACP

The flu once again is upon us.  Many will become ill, some will die from it.

As an internist, I have cared for flu patients every single year for over 25 years. I witnessed first-hand the weakness, aches, fever, headache and other symptoms knock so many I care about off their feet, causing them to miss work, school, family events and more. Too often loved ones are then exposed and become ill as well. According to the CDC, during 2017-18, just over a year ago, the flu broke records for deaths and illnesses, killing nearly 80,000 people. That would be a Jumbo 747 jet with 500 passengers going down every day for nearly 6 months!

Who is at highest risk of flu complications?

Pregnant women and those over the age of 65, as well as those with chronic conditions such as diabetes, asthma, and other conditions are at the highest risk of more severe flu complications. Our immune systems weaken as we age.  In the United States, people over 65 account for 70-85% of flu-related deaths. But keep in mind that over 10,000 adults aged 18-64 died last season in the United States from flu complications, along with nearly 180 children. We are all at risk, so we must take steps to protect ourselves.

How to protect ourselves and our loved ones from the flu.

Annual flu vaccination is recommended for all people ages 6 months and older unless you have a contraindication to influenza vaccine. Even if you had the flu this season, you should still get vaccinated since the vaccine contains 3-4 different influenza strains. Rarely people who get the vaccine may have mild flu-like symptoms, but they will not get the flu from the vaccine. It takes 1-2 weeks to develop immunity after the vaccine, so there are some people who may be exposed to the flu before they have immunity and become ill with the flu, but this did not come from the vaccine.

The flu vaccine is the best way to prevent the flu.  Speak to one of our physicians on how to best avoid this all too common illness.

For more information go to www.cdc.gov/flu

https://www.immunize.org/vis/flu_inactive.pdf

Author: Jose R Santana Jr MD MPH FACP

Dr Santana is a Board-Certified Internist with Private Physician Services, PLLC in Sarasota Florida.