Selected Podcast
Summer Activities and the Risk of COVID-19
Dr. Anna Ferwerda discusses safe summer activities and the risk of COVID-19.
Featuring:
Anna Ferwerda, MD serves as the Medical Director of the ten C. L. Brumback Primary Care Clinics, Federally Qualified Health Centers owned and operated by the Health Care District of Palm Beach County. Dr. Ferwerda joined the Health Care District in 2016 and developed the OB/GYN program. She served as Director of Women’s Health and was instrumental in increasing access to Women’s Health Services for the C. L. Brumback patients.
Dr. Ferwerda earned her Doctor of Medicine from Ponce Health Sciences University in Ponce, Puerto Rico. She completed her residency at Allegheny Health Network in Pittsburgh, PA where she served as Chief Resident in her final year. Before moving to Florida, she practiced general OB/GYN at MetroHealth Medical Center in Cleveland, OH and was an instructor for Case Western Reserve University.
Dr. Ferwerda is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the American Association of Gynecologic Laparoscopists and the Florida Medical Association. Her areas of interest include disparities surrounding contraception and sterilization, improving access to prenatal care and patient-centered quality of care. She is committed to providing every patient the highest quality of care.
The Brumback Clinics provide medical, dental, pharmacy and behavioral health services for adult and pediatric patients, regardless of their ability to pay, and offer a sliding fee scale. A Mobile Health Clinic provides medical care and behavioral health services to the homeless and underserved patients. The Brumback Clinics also provide a Medication Assisted Treatment (MAT) program for patients with substance use disorders and play a lead role in the county’s new and innovative Addiction Stabilization Center. Over 46,000 clinic patients across the county received care at the clinics last year.
Thanks to the efforts of Dr. Ferwerda and the medical team, the Brumback Clinics were honored in 2019 as a gold-level Health Center Quality Leader, ranked among the top 10% of health centers nationally for clinical quality. In 2017, the Brumback Clinics received an “80% by 2018 National Achievement Award” from the National Colorectal Cancer Roundtable (NCCRT) for achieving a colorectal cancer-screening rate that is twice the national average for community clinics and one of the highest in the country. In 2016, the clinics received NCQA Patient-Centered Medical Home (PCMH) recognition.
Anna Ferwerda, MD, FACOG
Anna Ferwerda, MD serves as the Medical Director of the ten C. L. Brumback Primary Care Clinics, Federally Qualified Health Centers owned and operated by the Health Care District of Palm Beach County. Dr. Ferwerda joined the Health Care District in 2016 and developed the OB/GYN program. She served as Director of Women’s Health and was instrumental in increasing access to Women’s Health Services for the C. L. Brumback patients.
Dr. Ferwerda earned her Doctor of Medicine from Ponce Health Sciences University in Ponce, Puerto Rico. She completed her residency at Allegheny Health Network in Pittsburgh, PA where she served as Chief Resident in her final year. Before moving to Florida, she practiced general OB/GYN at MetroHealth Medical Center in Cleveland, OH and was an instructor for Case Western Reserve University.
Dr. Ferwerda is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the American Association of Gynecologic Laparoscopists and the Florida Medical Association. Her areas of interest include disparities surrounding contraception and sterilization, improving access to prenatal care and patient-centered quality of care. She is committed to providing every patient the highest quality of care.
The Brumback Clinics provide medical, dental, pharmacy and behavioral health services for adult and pediatric patients, regardless of their ability to pay, and offer a sliding fee scale. A Mobile Health Clinic provides medical care and behavioral health services to the homeless and underserved patients. The Brumback Clinics also provide a Medication Assisted Treatment (MAT) program for patients with substance use disorders and play a lead role in the county’s new and innovative Addiction Stabilization Center. Over 46,000 clinic patients across the county received care at the clinics last year.
Thanks to the efforts of Dr. Ferwerda and the medical team, the Brumback Clinics were honored in 2019 as a gold-level Health Center Quality Leader, ranked among the top 10% of health centers nationally for clinical quality. In 2017, the Brumback Clinics received an “80% by 2018 National Achievement Award” from the National Colorectal Cancer Roundtable (NCCRT) for achieving a colorectal cancer-screening rate that is twice the national average for community clinics and one of the highest in the country. In 2016, the clinics received NCQA Patient-Centered Medical Home (PCMH) recognition.
Transcription:
Robin Kish: How safe is going to the beach? Letting your children play with friends or seeing a doctor? What are the risks of family activities this summer? Staying healthy and active in the midst of the Coronavirus Pandemic is a huge challenge. We'll run it by a medical expert to get her take on summer do's and don'ts on this edition of Here for Your Health. Welcome to the Health Care District of Palm Beach County's podcast, Here for Your Health. I'm your host Robin Kish. The Health Care District is a unique healthcare system located in Palm Beach County, Florida. The Health Care District provides County residents access to primary care, skilled nursing, hospital care, and school health, where the District staffs registered nurses in nearly all of the county’s public schools. The Health Care District also flies, maintains, and operates the county’s two lifesaving Trauma Hawk air ambulances. Through all of these programs, the Health Care District serves as the county’s healthcare safety net. On this edition of Here for Your Health, we'll discuss some family activities you may be considering this summer and the possible risks they present, as we navigate the threat of COVID-19. Our guest today is Dr. Anna Ferwerda, Medical Director of the C. L. Brumback Primary Care Clinics operated by the Health Care District of Palm Beach County. Welcome Dr. Ferwerda.
Dr. Ferwerda: Hi Robin. Thanks for having me
Host: Dr. Ferwerda, the risks of COVID-19 make this the time like no other that we've experienced. The State of Florida has surpassed 100,000 cases of the novel Coronavirus and Palm Beach County’s cases have hit over 11,000 with nearly 500 deaths. Wearing face masks in public places in the County is now required, yet businesses and recreational activities have been reopening for the summer. Your background as a medical doctor is in women's health and you currently provide care at the Brumback Clinics for women, many of them expectant moms. In your professional opinion, how risky is it to go see a doctor this summer?
Dr. Ferwerda: I'd say it's low risk for our patients. First, like other clinics and physicians, we offer telemedicine appointments. So patients can be seen by a doctor virtually on their smart device without visiting the office. If they're unable to do that, they can also speak to a doctor on the phone and have their visit via telephone. The Brumback Clinics reopened in their full capacity in late April to safely serve our patients with clinical safeguards in place. We're following very rigorous CDC screening and CDC infection control guidelines for healthcare settings. And we've decreased the provider and patient density in the clinics with fewer providers per day providing face-to-face services. And we've modified our schedules to provide more telehealth in those situations. So if you are a patient who is coming to one of our sites, you might notice emptier waiting rooms that allow more social distancing and a more streamlined check-in process experience.
We also implemented new software to provide electronic check-in processes. So you don't have to necessarily check in at the desk or spend as long face to face with registration as you would have in the past. And patients are also in many scenarios waiting in their cars until we are ready to see them in the office. So it is really important for any patient who has an urgent healthcare need, or even a chronic medical condition to come back and see their doctor to avoid staying out of the hospital long-term. So any patients who need vaccinations should also be coming into the clinics just to make sure that we're preventing other diseases that could be potentially more dangerous as well.
Host: And the summertime is a great time for parents to bring their children in, to make sure they're updated on their childhood vaccines.
Dr. Ferwerda: Correct. And that's something really important because even though it's a preventive service, it's not an acute service, children can become infected with other viruses during this time. And it's very important for them to stay on schedule with their routine childhood vaccinations.
Host: So summertime it's hot everywhere, especially here in South Florida, a lot of families want to take their kids swimming and they themselves want to jump in the pool. How safe is that? What are the risks of swimming in a pool or going to the beach right now?
Dr. Ferwerda: Yeah, so swimming and going to the pool can really be, to the pool or the beach, can really be considered as low risk, as long as you continue to social distance and stay more than six feet away from other people who are not in your immediate family or group of people that you live with. So the more spread out you are at a location, the better it will be and the safer it would be. So you could stagger your time, like go early in the morning or late in the afternoon to try to avoid the crowds if possible.
Host: Okay. How safe is having guests or adult guests or your child's friends over to your house for a get together? I'm thinking outdoors is the key.
Dr. Ferwerda: Yeah. And that really depends on how you have your get together. Outdoors is always going to be safer than indoors, just because you have more air circulating and generally more space. It's easier to stay six feet apart to allow social distancing. You can't really share food utensils or drinks. So I know that creates a lot of stress for hostesses. So common chips with dips or trays are generally not a good idea where there could be a lot of people touching their mouths and then touching the food that would be in those, in those trays. And that's important to think about when you're eating and drinking, you really can't do that with a mask on. So you really should do it in smaller groups and attempt social distancing as much as possible. And you can expect that if you're having a get together, that people will be using your restroom at some point. And that is actually okay. You can provide things like cleaning wipes and those kinds of things within your bathroom and ask people to just wipe down the surfaces before they leave and just ask people to wipe off the door knobs if they've touched them. And so, it really, this can be done safely, as long as you keep in mind that you should still be social distancing and not sharing things, especially that might be transmitting any body fluids like saliva.
Host: I heard it's also helpful to put out paper towels and don't share a common hand towel.
Dr. Ferwerda: That's actually a common question. I've gotten from a lot of my patients. Can I share a hand towel with my husband? You can share it with your immediate family, people you live with. Yes. But if you are having a get together with people who are not your immediate family, it's better to use something that is individual or disposable. People have their own cloth napkin. If you are going to use cloth or have their own paper napkin and avoid sharing those items.
Host: And we're talking a few people, maybe no more than five?
Dr. Ferwerda: Yeah. Five to 10 would definitely be your maximum. And then obviously it depends on what your space provides in terms of how easily, how large your space is and how easily you could social distance.
Host: Yeah. You need a lot of room outdoors to spread out if you're six feet apart. Dr. Ferwerda, what about getting your hair cut? So many people have their hair growing out and they really need to get a cut. Is that considered a high risk?
Dr. Ferwerda: Yes. Unfortunately for most people, because I think this is a big concern. So it does involve close contact with someone for a prolonged period of time, especially for people who are getting color services, right. You could be there for up to two hours. So it's a medium to high risk because you're very close to that person for quite some time. And the safest way to really do it is to make sure that you're both using a mask appropriately. And that means that the mask is covering your nose and your mouth the whole time you're with that other person. And that will decrease your risk pretty significantly, but you still, there's no way to get a haircut at six feet apart. So it really is unfortunately, one of the more difficult or risky things to do.
Host: We almost have to become our own barber, get virtual instruction. I actually saw some hairstylists out there who are really revitalizing their...
Dr. Ferwerda: Home hair color and home haircut. Yeah.
Host: Yeah. There were really guiding everyone. Now malls have reopened that's somewhere. Families typically go during the summer to cool off and shop. How safe is it to go to the mall now?
Dr. Ferwerda: So it depends on how crowded the mall is. How if it's an open space or if it's a closed mall, so indoors or outdoors, outdoor malls and outdoor activities are safer than indoor malls and indoor activities and the emptier they are, the safer it will be. So the risk varies. Typically if you go during peak hours in a closed space, you're going to be at higher risk than if you go to an open airspace that is relatively empty. So try to go in off-peak hours, make sure to wear your mask and use your hand sanitizerif you touch shared surfaces, and remember door handles are shared surfaces, and elevator buttons as well.
Host: Maybe limit the time you're indoors.
Dr. Ferwerda: Yeah, exactly. That definitely would be helpful.
Host: Many people like to travel over the summer. How risky is it to go on a trip?
Dr. Ferwerda: Unfortunately, it is still risky at this time. So, if you're flying, it involves a long period of time in very close quarters with a lot of people in a closed environment. Airlines are taking a lot of precautions and passengers are wearing masks during the flights, but it still is much higher risk to travel than it would be for you to stay home. There are security lines at the airport, crowded airplanes, buses, trains. It's very difficult to stay six feet away from each other on those. So it's, I've noticed a lot of people taking road trips or doing more local trips just within their family, family units. So that's been a popular idea this summer and it's a great opportunity to see local sites and take advantage of things that we maybe wouldn't have done before.
Host: The CDC has a comprehensive list of recommendations to help guide families on making decisions to stay safe this summer, you can visit www.cdc.gov/coronavirus. And the website addresses daily life and coping at home, as well as going out. Dr. Ferwerda, any final suggestions for staying safe over the summer.
Dr. Ferwerda: I definitely have some of those. So it's very important for everyone to stay up to date because the information is changing quickly. The CDC is definitely one of the best places for you to get your information. And, and it has very accessible and easy to understand information for everyone. I would definitely encourage people to wear their masks appropriately, always covering your nose and mouth wherever you are. If that is at a mall, at any location where you're around many people and then proper glove wearing, if you are going to wear gloves is really essential. Something I've really noticed when I'm out in the community is when you're wearing gloves, you really need to make sure that if you're going to wear them, you change them before you touch your person.
So, if you touch your face with the gloves on, or if you're touching your phone that you're touching to your face, you're really increasing your risk of transmission to yourself. Because you're much less likely to wash your gloves or to use hand sanitizer on your gloves than you would be just to wash your hands or put hand sanitizer on your hands. So, I would actually encourage people instead of wearing gloves to more focus on being very, very aware of what you're touching with your hands and being very aware of when was the last time you washed your hands or when was the last time you used hand sanitizer? Because it really is much safer to have clean hands if you're going to touch your face than to have dirty gloves, really. It can be much more dangerous to have that if you're touching, you know, your children or your face or whatever else you might be doing.
Host: That's great advice, Dr. Ferwerda, thanks so much for joining us today. You provided some really helpful information to keep us all healthy over the summer and beyond.
Dr. Ferwerda: Yeah. Thanks for having me, Robin.
Host: Thank you to all of our listeners. If you find this podcast helpful, share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcasts.org. Let us know what you think. Your review helps us reach more people just like you. And if you have a suggestion about a future podcast topic, have any questions or just some feedback. Call (561) 804-4111. Today's podcast is brought to you by the Health Care District’s Federally Qualified Health Centers, the C. L. Brumback Primary Care Clinics. If you are someone you know could benefit from having a medical home, please call the Brumback clinics at (561) 642-1000 to make an appointment for a medical visit, testing, medication assisted treatment, or other services, or you can visit www.brumbackclinics.org.
Robin Kish: How safe is going to the beach? Letting your children play with friends or seeing a doctor? What are the risks of family activities this summer? Staying healthy and active in the midst of the Coronavirus Pandemic is a huge challenge. We'll run it by a medical expert to get her take on summer do's and don'ts on this edition of Here for Your Health. Welcome to the Health Care District of Palm Beach County's podcast, Here for Your Health. I'm your host Robin Kish. The Health Care District is a unique healthcare system located in Palm Beach County, Florida. The Health Care District provides County residents access to primary care, skilled nursing, hospital care, and school health, where the District staffs registered nurses in nearly all of the county’s public schools. The Health Care District also flies, maintains, and operates the county’s two lifesaving Trauma Hawk air ambulances. Through all of these programs, the Health Care District serves as the county’s healthcare safety net. On this edition of Here for Your Health, we'll discuss some family activities you may be considering this summer and the possible risks they present, as we navigate the threat of COVID-19. Our guest today is Dr. Anna Ferwerda, Medical Director of the C. L. Brumback Primary Care Clinics operated by the Health Care District of Palm Beach County. Welcome Dr. Ferwerda.
Dr. Ferwerda: Hi Robin. Thanks for having me
Host: Dr. Ferwerda, the risks of COVID-19 make this the time like no other that we've experienced. The State of Florida has surpassed 100,000 cases of the novel Coronavirus and Palm Beach County’s cases have hit over 11,000 with nearly 500 deaths. Wearing face masks in public places in the County is now required, yet businesses and recreational activities have been reopening for the summer. Your background as a medical doctor is in women's health and you currently provide care at the Brumback Clinics for women, many of them expectant moms. In your professional opinion, how risky is it to go see a doctor this summer?
Dr. Ferwerda: I'd say it's low risk for our patients. First, like other clinics and physicians, we offer telemedicine appointments. So patients can be seen by a doctor virtually on their smart device without visiting the office. If they're unable to do that, they can also speak to a doctor on the phone and have their visit via telephone. The Brumback Clinics reopened in their full capacity in late April to safely serve our patients with clinical safeguards in place. We're following very rigorous CDC screening and CDC infection control guidelines for healthcare settings. And we've decreased the provider and patient density in the clinics with fewer providers per day providing face-to-face services. And we've modified our schedules to provide more telehealth in those situations. So if you are a patient who is coming to one of our sites, you might notice emptier waiting rooms that allow more social distancing and a more streamlined check-in process experience.
We also implemented new software to provide electronic check-in processes. So you don't have to necessarily check in at the desk or spend as long face to face with registration as you would have in the past. And patients are also in many scenarios waiting in their cars until we are ready to see them in the office. So it is really important for any patient who has an urgent healthcare need, or even a chronic medical condition to come back and see their doctor to avoid staying out of the hospital long-term. So any patients who need vaccinations should also be coming into the clinics just to make sure that we're preventing other diseases that could be potentially more dangerous as well.
Host: And the summertime is a great time for parents to bring their children in, to make sure they're updated on their childhood vaccines.
Dr. Ferwerda: Correct. And that's something really important because even though it's a preventive service, it's not an acute service, children can become infected with other viruses during this time. And it's very important for them to stay on schedule with their routine childhood vaccinations.
Host: So summertime it's hot everywhere, especially here in South Florida, a lot of families want to take their kids swimming and they themselves want to jump in the pool. How safe is that? What are the risks of swimming in a pool or going to the beach right now?
Dr. Ferwerda: Yeah, so swimming and going to the pool can really be, to the pool or the beach, can really be considered as low risk, as long as you continue to social distance and stay more than six feet away from other people who are not in your immediate family or group of people that you live with. So the more spread out you are at a location, the better it will be and the safer it would be. So you could stagger your time, like go early in the morning or late in the afternoon to try to avoid the crowds if possible.
Host: Okay. How safe is having guests or adult guests or your child's friends over to your house for a get together? I'm thinking outdoors is the key.
Dr. Ferwerda: Yeah. And that really depends on how you have your get together. Outdoors is always going to be safer than indoors, just because you have more air circulating and generally more space. It's easier to stay six feet apart to allow social distancing. You can't really share food utensils or drinks. So I know that creates a lot of stress for hostesses. So common chips with dips or trays are generally not a good idea where there could be a lot of people touching their mouths and then touching the food that would be in those, in those trays. And that's important to think about when you're eating and drinking, you really can't do that with a mask on. So you really should do it in smaller groups and attempt social distancing as much as possible. And you can expect that if you're having a get together, that people will be using your restroom at some point. And that is actually okay. You can provide things like cleaning wipes and those kinds of things within your bathroom and ask people to just wipe down the surfaces before they leave and just ask people to wipe off the door knobs if they've touched them. And so, it really, this can be done safely, as long as you keep in mind that you should still be social distancing and not sharing things, especially that might be transmitting any body fluids like saliva.
Host: I heard it's also helpful to put out paper towels and don't share a common hand towel.
Dr. Ferwerda: That's actually a common question. I've gotten from a lot of my patients. Can I share a hand towel with my husband? You can share it with your immediate family, people you live with. Yes. But if you are having a get together with people who are not your immediate family, it's better to use something that is individual or disposable. People have their own cloth napkin. If you are going to use cloth or have their own paper napkin and avoid sharing those items.
Host: And we're talking a few people, maybe no more than five?
Dr. Ferwerda: Yeah. Five to 10 would definitely be your maximum. And then obviously it depends on what your space provides in terms of how easily, how large your space is and how easily you could social distance.
Host: Yeah. You need a lot of room outdoors to spread out if you're six feet apart. Dr. Ferwerda, what about getting your hair cut? So many people have their hair growing out and they really need to get a cut. Is that considered a high risk?
Dr. Ferwerda: Yes. Unfortunately for most people, because I think this is a big concern. So it does involve close contact with someone for a prolonged period of time, especially for people who are getting color services, right. You could be there for up to two hours. So it's a medium to high risk because you're very close to that person for quite some time. And the safest way to really do it is to make sure that you're both using a mask appropriately. And that means that the mask is covering your nose and your mouth the whole time you're with that other person. And that will decrease your risk pretty significantly, but you still, there's no way to get a haircut at six feet apart. So it really is unfortunately, one of the more difficult or risky things to do.
Host: We almost have to become our own barber, get virtual instruction. I actually saw some hairstylists out there who are really revitalizing their...
Dr. Ferwerda: Home hair color and home haircut. Yeah.
Host: Yeah. There were really guiding everyone. Now malls have reopened that's somewhere. Families typically go during the summer to cool off and shop. How safe is it to go to the mall now?
Dr. Ferwerda: So it depends on how crowded the mall is. How if it's an open space or if it's a closed mall, so indoors or outdoors, outdoor malls and outdoor activities are safer than indoor malls and indoor activities and the emptier they are, the safer it will be. So the risk varies. Typically if you go during peak hours in a closed space, you're going to be at higher risk than if you go to an open airspace that is relatively empty. So try to go in off-peak hours, make sure to wear your mask and use your hand sanitizerif you touch shared surfaces, and remember door handles are shared surfaces, and elevator buttons as well.
Host: Maybe limit the time you're indoors.
Dr. Ferwerda: Yeah, exactly. That definitely would be helpful.
Host: Many people like to travel over the summer. How risky is it to go on a trip?
Dr. Ferwerda: Unfortunately, it is still risky at this time. So, if you're flying, it involves a long period of time in very close quarters with a lot of people in a closed environment. Airlines are taking a lot of precautions and passengers are wearing masks during the flights, but it still is much higher risk to travel than it would be for you to stay home. There are security lines at the airport, crowded airplanes, buses, trains. It's very difficult to stay six feet away from each other on those. So it's, I've noticed a lot of people taking road trips or doing more local trips just within their family, family units. So that's been a popular idea this summer and it's a great opportunity to see local sites and take advantage of things that we maybe wouldn't have done before.
Host: The CDC has a comprehensive list of recommendations to help guide families on making decisions to stay safe this summer, you can visit www.cdc.gov/coronavirus. And the website addresses daily life and coping at home, as well as going out. Dr. Ferwerda, any final suggestions for staying safe over the summer.
Dr. Ferwerda: I definitely have some of those. So it's very important for everyone to stay up to date because the information is changing quickly. The CDC is definitely one of the best places for you to get your information. And, and it has very accessible and easy to understand information for everyone. I would definitely encourage people to wear their masks appropriately, always covering your nose and mouth wherever you are. If that is at a mall, at any location where you're around many people and then proper glove wearing, if you are going to wear gloves is really essential. Something I've really noticed when I'm out in the community is when you're wearing gloves, you really need to make sure that if you're going to wear them, you change them before you touch your person.
So, if you touch your face with the gloves on, or if you're touching your phone that you're touching to your face, you're really increasing your risk of transmission to yourself. Because you're much less likely to wash your gloves or to use hand sanitizer on your gloves than you would be just to wash your hands or put hand sanitizer on your hands. So, I would actually encourage people instead of wearing gloves to more focus on being very, very aware of what you're touching with your hands and being very aware of when was the last time you washed your hands or when was the last time you used hand sanitizer? Because it really is much safer to have clean hands if you're going to touch your face than to have dirty gloves, really. It can be much more dangerous to have that if you're touching, you know, your children or your face or whatever else you might be doing.
Host: That's great advice, Dr. Ferwerda, thanks so much for joining us today. You provided some really helpful information to keep us all healthy over the summer and beyond.
Dr. Ferwerda: Yeah. Thanks for having me, Robin.
Host: Thank you to all of our listeners. If you find this podcast helpful, share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcasts.org. Let us know what you think. Your review helps us reach more people just like you. And if you have a suggestion about a future podcast topic, have any questions or just some feedback. Call (561) 804-4111. Today's podcast is brought to you by the Health Care District’s Federally Qualified Health Centers, the C. L. Brumback Primary Care Clinics. If you are someone you know could benefit from having a medical home, please call the Brumback clinics at (561) 642-1000 to make an appointment for a medical visit, testing, medication assisted treatment, or other services, or you can visit www.brumbackclinics.org.