The last two weeks have felt like a daily mental whiplash, adapting day by day to a new life and work environment.  I have had just enough time and energy to update the blog and social media sites with a few blurbs as we go. Today is offering me an opportunity to finally put some linear thoughts together.

I am blessed to report that our household is doing fine, with no illnesses and no urgent unmet needs (stocked up on TP 3 weeks ago during a routine trip to the store).  Through a stroke of good luck, Kim also routinely stocked up on hand sanitizer and office TP about 5 weeks ago. Bleach goes a long way (1 gallon makes 15 gallons of strong sanitizer spray!). Disposable gloves by the thousands were readily available from restaurant supply stores, and somehow, we had stocked up on surgical masks in December. The staff has made themselves a little “COVID fortress” at the front desk to keep a 6 foot distance during interactions with patients. They have instructed more people to immediately wash and sanitize their hands upon arrival than a seasoned kindergarten teacher.

Like all health care offices, we have been reassessing daily what we should do, if we should do it, and how to do it safely. After much deliberation and informed by recommendations of various public health agencies, we decided to remain open with restricted hours and strict new infection mitigation procedures (posted on website ).  It is certainly not business as usual but it is services nonetheless. Patients with absolute contraindications to travel outside the home are rescheduled to mid April, patients with wellness concerns mostly opt to defer to April as well. This allows us to maintain staggered appointment times for folks who need to be seen in the next two weeks.

As I constantly second guess myself about any decision I have made in the past two weeks, daily life at the office seems to keep me on track.  Governor Walz’s stay at home order that went into effect on Friday included chiropractic services in the list of essential health care services.  It reminded me that a week ago, I stayed at the  office until 8  pm to treat a PCA who works with disabled young adults and was hurt pulling a double shift since other PCAs were out on quarantine. Her next step was probably the ER or urgent care, and she had nobody to cover her next shift.  Thankfully most appointments last week were not that kind of nail biters, but I have come to realize that for many folks coming in, deferring treatment for a couple of weeks will result in non-regainable deterioration of their condition, difficulty keeping up with their job (think grocery stockers, delivery drivers, and young parents), and increased risk for ending up in an overloaded acute care health system. So for now we plod along with a lot of bleach, and a willingness to adapt every day. 

Before parting, please allow me to share a few insights. The bad: the reality of the situation is that life will not just go back to normal magically after April 10th.  The two week sheltering order is time to plan the next phase, in particular how we emerge from the shutdown to a safe “new normal”.  There is a breadth of non-acute health care services that need to resume (think dental, optometry, addiction treatment, preventive care), before they turn into a heap of acute and late stage problems.  Some of the patients we are deferring now fall in that category and we need to find a way to expand access to those folks before too long.  The good: folks out there (or more accurately in there), seem to finally take the social distancing recommendations to heart and this will pay off in a couple of weeks.  There is more information coming out about what truly transmits COVID in asymptomatic and presymptomatic patients (will post link on site tomorrow) suggesting that outside of aerosol droplets from coughing or sneezing, normal breathing is much less of a vector than contact/touch. So being ruthless about what your hands touch and how diligent you are to keep your hands clean before you touch your face is a great way to prevent infection.  I started wearing disposable gloves anytime I enter a store and discard in the trash as I exit. I wipe down everything I bring in from the store with the 1:10 bleach solution before bringing them in the house.  These measures are annoying and time consuming, but in the scheme of things, a small investment for a great return. 

Many blessings and virtual hugs to all. Know that behind my surgical masks, I am still smiling at all of you. 

Fiona Demel DC