Selected Podcast
Living In a COVID World
Let’s face it, everyone is tired of COVID. Many people have stopped wearing masks and are going about like normal. Yet, the U.S. is experiencing another coronavirus surge brought on by omicron subvariants. How can we protect ourselves and prepare for a third winter with COVID? Dr. Deepa Yerram, chief medical officer at International Community Health Services, is here to talk about steps we all can take to live our lives while minimizing COVID risks.
Featured Speaker:
Learn more about Lakshmi Deepa Yerram, MD, MHA
Lakshmi Deepa Yerram, MD, MHA
Dr. Deepa Yerram comes to ICHS with more than 12 years of practice in primary care, women’s health and obstetrics, community medicine and retail medicine. She is a firm proponent of affordable and accessible, high-quality health care for all. Dr. Yerram postulates that innovative system-wide partnerships along with digital technologies can support a sustainable transformation of primary care for all.Learn more about Lakshmi Deepa Yerram, MD, MHA
Transcription:
Living In a COVID World
Scott Webb: COVID-19 has affected all of our lives. And though we've all learned a lot over the past couple of years about viruses and COVID in particular, it's important that we continue to listen to experts like my guest today as it appears that we will continue to be living in a COVID world for the foreseeable future. And I'm joined today by Dr. Deepa Yerram. She's a physician and Chief Medical Officer at ICHS.
Welcome to Together We Rise Wellness Podcast from International Community Health Services. I'm Scott Webb. Dr. Yerram, thanks for your time today. We were just kind of talking about, you know, what we've all been through over the last three years or so, and sort of what it's going to be like for us moving forward living in this COVID world, if you will. So as we get rolling here, what can people do to reduce their risk of exposure to COVID-19, but also minimize the disruptions to our daily lives?
Dr. Deepa Yerram: We'd like to think that COVID-19 is over, but it is not. We still have cases kind of popping up, though it is way better than what it used to be during the Omicron or the Delta surge. But given the fact that we still have COVID around, we want to carry on with our daily lives. There are lots of things that we can do to reduce the risk of exposure.
Number one, ensuring that wherever you are there is adequate ventilation. Making sure that there is ample amount of air moving in and out of a room. And because proper ventilation and filtration can always help prevent virus particles from accumulating in the indoor air. Of course, avoid contact with anybody who looks sick or unwell or have been exposed to the virus even. Another subgroup of people that you should be careful around are those who have recently traveled to a high risk country. And conversely, if you yourself are sick or have symptoms, make sure that you get tested and stay home just to make sure that you're not putting other people at risk.
Another thing that we can do is to make sure that we are maxing out all of our vaccinations and boosters. If you have already gotten vaccinated, but have refrained from getting the bivalent booster, which is the most latest and current coverage for any kind of variant that we have out there, please make sure that you get it.
Always make sure that you are figuring out your community COVID-19 indicators, and I can talk more about it later on in the interview, but this is just a scale that each county or state puts up indicating their risk of COVID-19 transmission within that particular community.
The other thing to remember is masking, even though it is kind of getting out of vogue, is still helpful. And masking is just not recommended for indoor settings, sometimes it could be helpful in outdoor environments as well. Make sure that you have adequate amount of rapid tests on hand. And not only have them on hand, but also use them. You can still find rapid tests coming in. You can get it through free from the state, especially in Washington state. And the federal program is winding out, but the state program is still current or you can also purchase it from the local pharmacy.
Make sure that you're avoiding crowds and crowded areas. And this kind of goes in with ensuring that there is adequate ventilation, and also making sure that you're avoiding contact with people or unnecessary physical contact with people. Stay home as much as possible and avoid non-essential travel. And if you need and must travel, find out how you can get treatment if you test positive at any stage of your travel.
And the simplest thing that you can do, which can have a big impact, not just for COVID, but also the other respiratory viruses transmitting around, is making sure that you're following adequate hand hygiene, something as simple as washing your hands with soap and water for 20 seconds. And if you don't have that immediately available, using an alcohol-based hand rub is always a good idea. It is definitely vital to wash your hands before eating or drinking. All of these things can help reduce the risk of exposure for COVID-19.
Scott Webb: Yeah, you're so right, if we've all learned to wash our hands and the importance of that and doing that properly. And you mentioned there about communities. I wanted to ask you how do we best sort of assess the risk level in our own communities? How do we, you know, assess that and then decide maybe, okay, it's time for some added levels or added layers of protection?
Dr. Deepa Yerram: So, we live in the era of online availability of any kind of information. And now thankfully, there are national, state and local public health district level data that is very easily available online. You can read about the changing risk level in your communities on news websites or listen to the information on news channels. And if you can't avail of information on any of those locations, you can also obtain it from your healthcare provider's office.
So, the community's risk level is based on certain parameters, such as number of hospital beds used, et cetera. It's important to know to not only keep an eye on the risk level, but also add layers of protection when the risk increases. So to decrease your own risk and the risk of communities, you might do things like delaying visits with people who are at higher risk of severe disease. And this is not just for COVID-19, but also the other viral illnesses that we kind of talked about previously. And if you must visit them, make sure that you add layers of protection such as masks and physical distance yourself when you are around them. If you have to hold gatherings, we are nearing the holiday season, this is the season of gathering with friends and relatives, make sure that you hold smaller, if possible, outdoor gatherings and wear a mask indoors or when you are in crowds. And of course, coming back to the ventilation aspect, that you must hold smaller gathering within closed confines, make sure that you're opening windows and doors and ensuring adequate ventilation whenever possible.
Scott Webb: Yeah, definitely. And you mentioned the rapid tests that we can buy or get for free depending on, you know, where we live and all of that. But also, you mentioned the importance of actually using them. So many of us have, you know, done our due diligence. We've been at the pharmacy and we've picked those things up, but then we actually have to use them. And I wanted to ask you, what's the proper way to use them? Do we only use them after potential exposure or do you recommend some other ways as well? We sort of never know because at one time they were so precious, just to even have them was so important. So it's like, "Well, should we use it this time? Or should we assume that it's just the cold?" You know, maybe you can give us a little bit of guidance on the correct way to use those in-home tests.
Dr. Deepa Yerram: Definitely. There are at least three major scenarios where you would consider using one of those rapid tests. And this is actually CDC's recommendation as well. You should definitely test yourself with a rapid COVID-19 test immediately if you have any COVID-19-like symptoms. Those are our fevers, chills, runny noses, sore throats, fatigue, et cetera. Also, if you were exposed to someone with COVID-19, then you would want to test yourself at least five days after your exposure. And if that test is negative, then definitely consider testing again in one to two days after the first test. And the third scenario where you would want to use that rapid home COVID test is immediately before the gathering, like if you're going to be getting together with family and such, or try to test as close to the time of the event as possible if you're going to an indoor event or a large gathering. And getting tested before the event is especially important when you are going to be gathering with individuals at risk of severe disease or older adults, such as grandmas and grandpas who might be immunocompromised or people who are not up-to-date on their COVID-19 vaccines. And remember that the youngest of the children that we have who are less than five years of age, they haven't been approved to receive the COVID-19 bivalent booster. So, they probably might not have asthma protection as we adults might. So, it is important to make sure that you're not carrying COVID-19 virus with you when you are meeting them.
Scott Webb: Yeah. And I'm sure there's a scenario where, you know, folks felt good and maybe tested negative before they traveled, but then maybe start not feeling well while they're traveling abroad or on a cruise ship or wherever it might be. What do you do if you're infected while you're traveling?
Dr. Deepa Yerram: The planning around COVID-19 or potentially contracting COVID-19 while on travel should actually start even before you travel, correct? And no matter where you're going, just make sure that you're up-to-date on your vaccines and your boosters. Ensure that you're packing a few COVID-19 test kits and potentially N95 masks in your luggage just in case. And while traveling, you can do certain things to actually reduce a chance of you coming down with COVID-19. And that includes social distancing as much as possible and continuing to wear high quality masks such as N95 or the KN95 that are so readily available everywhere to kind of make sure that you're staving off the infection.
Also, make sure before you travel to get updated information on COVID-19-related rules at your destination, and as well as making sure that there is adequate healthcare available at your destination if so it happens that you come down with COVID-19. You should have some kind of flexibility and leverage in your travel plan in case you have to extend your duration of your travel for quarantining purposes. And so, there should be adequate flexibility in not only your travel plans, but housing and other reservations.
But if you take care of all of these and you're traveling and you're being a good traveler and you still come down with COVID-19 symptoms, I will recommend that you will want to take a COVID-19 test as soon as possible. Isolate yourself from the rest of your party and try to extend your stay. So, the goal is to keep you from infecting others while you're still contagious. So, you will need to rearrange your trip and travel accommodation to accommodate the 10-day quarantine, unfortunately. And if you're at risk of severe disease, like if you're older or you have certain medical conditions, try to get medical care at the destination or wherever you're traveling because you may qualify to get the Paxlovid, the medication that can cut down the risk of you developing severe symptoms or having other morbidity or mortality issues from the COVID-19. And for that, you will need to see a healthcare provider wherever you are.
Scott Webb: I just want to finish up here today and ask you about the measures that ICHS has implemented to safeguard its patients and just the community in general.
Dr. Deepa Yerram: We have upped our communication strategy to ensure high-quality problem-specific information flows to our patients and the community at large. We have been the stewards of healthcare information to our community. And we do play a big role in how the community receives the information and how they process it.
Some of the steps that we have taken to ensure that this happens is we have made sure that we are doing outreach in the patient's spoken language, both on phone and in-person. Our community health workers are out in the community talking and providing information and vaccinating the patients whenever they're ready. We are doing several in-person outreach events such as fairs and popups. We have kind of made our communication strategy, especially the marketing strategy, more robust. And, as I said previously, that we are making sure that every piece of information that goes through the social media or radio networks or podcasts such as this, short videos, film and interviews, all of those are happening in various languages which are spoken by our patients.
We are ensuring that we are tailoring our messaging based on the audience segment. Say for example, for the youth groups, we have been doing more play-based and Minecraft, a video game-based messaging. And we definitely ensure that the patients and the community could avail of personal conversations with their trusted provider, be it primary care provider, their dental provider, their behavioral health provider or the pharmacy member.
On top of doing all of these, taking all of these steps to make sure that the patients has the most up-to-date information on hand. We have also stepped up ways to ensure that our patients and communities have easy access to the COVID-19 vaccines, and they can do this by getting vaccinated at their regular scheduled clinic visit. They don't need to have a separate visit for the COVID-19 vaccine. We have been running several high volume vaccination sites. Our pharmacy is open. And this is not just for our patients, but even non-patients who live near us. And if they want COVID-19 vaccines or any other vaccines such as influenza, they can walk into one of our pharmacies and get it. We are also running several pop-up clinics, which are organized by the community health worker teams at various community gathering places such as the grocery stores, religious institutions, some social and community centers such as senior centers and even at schools, ensuring and trying to cover as many places as we could, and we kind of try to brainstorm and figure out if our patient can go there, we should be present there to just make sure that they can get their vaccine whenever they are ready.
Scott Webb: Well, not surprising at all to hear that ICHS is on top of things. You may want to maybe consider TikToks. I know you said you were trying to reach out, you know, to the younger group, so maybe TikToks. That's where my 14-year-old would find the important information about vaccines and otherwise. But doctor, it's been so great to have your time today. We're all living in this COVID world and we're all trying to figure out, you know, because it is still around and it may be around for years, forever, who knows? You know, how can we do this but still live our lives? So, great advice from an expert today. Thank you so much. You stay well.
Dr. Deepa Yerram: Thank you very much for having me.
Scott Webb: And for more information, go to ichs.com. This has been the Together We Rise Wellness Podcast from International Community Health Services. If you enjoyed what you heard, please be sure to share in your social media channels and check out our entire podcast library for additional topics of interest. I'm Scott Webb. Stay well, and we'll talk again next time.
Living In a COVID World
Scott Webb: COVID-19 has affected all of our lives. And though we've all learned a lot over the past couple of years about viruses and COVID in particular, it's important that we continue to listen to experts like my guest today as it appears that we will continue to be living in a COVID world for the foreseeable future. And I'm joined today by Dr. Deepa Yerram. She's a physician and Chief Medical Officer at ICHS.
Welcome to Together We Rise Wellness Podcast from International Community Health Services. I'm Scott Webb. Dr. Yerram, thanks for your time today. We were just kind of talking about, you know, what we've all been through over the last three years or so, and sort of what it's going to be like for us moving forward living in this COVID world, if you will. So as we get rolling here, what can people do to reduce their risk of exposure to COVID-19, but also minimize the disruptions to our daily lives?
Dr. Deepa Yerram: We'd like to think that COVID-19 is over, but it is not. We still have cases kind of popping up, though it is way better than what it used to be during the Omicron or the Delta surge. But given the fact that we still have COVID around, we want to carry on with our daily lives. There are lots of things that we can do to reduce the risk of exposure.
Number one, ensuring that wherever you are there is adequate ventilation. Making sure that there is ample amount of air moving in and out of a room. And because proper ventilation and filtration can always help prevent virus particles from accumulating in the indoor air. Of course, avoid contact with anybody who looks sick or unwell or have been exposed to the virus even. Another subgroup of people that you should be careful around are those who have recently traveled to a high risk country. And conversely, if you yourself are sick or have symptoms, make sure that you get tested and stay home just to make sure that you're not putting other people at risk.
Another thing that we can do is to make sure that we are maxing out all of our vaccinations and boosters. If you have already gotten vaccinated, but have refrained from getting the bivalent booster, which is the most latest and current coverage for any kind of variant that we have out there, please make sure that you get it.
Always make sure that you are figuring out your community COVID-19 indicators, and I can talk more about it later on in the interview, but this is just a scale that each county or state puts up indicating their risk of COVID-19 transmission within that particular community.
The other thing to remember is masking, even though it is kind of getting out of vogue, is still helpful. And masking is just not recommended for indoor settings, sometimes it could be helpful in outdoor environments as well. Make sure that you have adequate amount of rapid tests on hand. And not only have them on hand, but also use them. You can still find rapid tests coming in. You can get it through free from the state, especially in Washington state. And the federal program is winding out, but the state program is still current or you can also purchase it from the local pharmacy.
Make sure that you're avoiding crowds and crowded areas. And this kind of goes in with ensuring that there is adequate ventilation, and also making sure that you're avoiding contact with people or unnecessary physical contact with people. Stay home as much as possible and avoid non-essential travel. And if you need and must travel, find out how you can get treatment if you test positive at any stage of your travel.
And the simplest thing that you can do, which can have a big impact, not just for COVID, but also the other respiratory viruses transmitting around, is making sure that you're following adequate hand hygiene, something as simple as washing your hands with soap and water for 20 seconds. And if you don't have that immediately available, using an alcohol-based hand rub is always a good idea. It is definitely vital to wash your hands before eating or drinking. All of these things can help reduce the risk of exposure for COVID-19.
Scott Webb: Yeah, you're so right, if we've all learned to wash our hands and the importance of that and doing that properly. And you mentioned there about communities. I wanted to ask you how do we best sort of assess the risk level in our own communities? How do we, you know, assess that and then decide maybe, okay, it's time for some added levels or added layers of protection?
Dr. Deepa Yerram: So, we live in the era of online availability of any kind of information. And now thankfully, there are national, state and local public health district level data that is very easily available online. You can read about the changing risk level in your communities on news websites or listen to the information on news channels. And if you can't avail of information on any of those locations, you can also obtain it from your healthcare provider's office.
So, the community's risk level is based on certain parameters, such as number of hospital beds used, et cetera. It's important to know to not only keep an eye on the risk level, but also add layers of protection when the risk increases. So to decrease your own risk and the risk of communities, you might do things like delaying visits with people who are at higher risk of severe disease. And this is not just for COVID-19, but also the other viral illnesses that we kind of talked about previously. And if you must visit them, make sure that you add layers of protection such as masks and physical distance yourself when you are around them. If you have to hold gatherings, we are nearing the holiday season, this is the season of gathering with friends and relatives, make sure that you hold smaller, if possible, outdoor gatherings and wear a mask indoors or when you are in crowds. And of course, coming back to the ventilation aspect, that you must hold smaller gathering within closed confines, make sure that you're opening windows and doors and ensuring adequate ventilation whenever possible.
Scott Webb: Yeah, definitely. And you mentioned the rapid tests that we can buy or get for free depending on, you know, where we live and all of that. But also, you mentioned the importance of actually using them. So many of us have, you know, done our due diligence. We've been at the pharmacy and we've picked those things up, but then we actually have to use them. And I wanted to ask you, what's the proper way to use them? Do we only use them after potential exposure or do you recommend some other ways as well? We sort of never know because at one time they were so precious, just to even have them was so important. So it's like, "Well, should we use it this time? Or should we assume that it's just the cold?" You know, maybe you can give us a little bit of guidance on the correct way to use those in-home tests.
Dr. Deepa Yerram: Definitely. There are at least three major scenarios where you would consider using one of those rapid tests. And this is actually CDC's recommendation as well. You should definitely test yourself with a rapid COVID-19 test immediately if you have any COVID-19-like symptoms. Those are our fevers, chills, runny noses, sore throats, fatigue, et cetera. Also, if you were exposed to someone with COVID-19, then you would want to test yourself at least five days after your exposure. And if that test is negative, then definitely consider testing again in one to two days after the first test. And the third scenario where you would want to use that rapid home COVID test is immediately before the gathering, like if you're going to be getting together with family and such, or try to test as close to the time of the event as possible if you're going to an indoor event or a large gathering. And getting tested before the event is especially important when you are going to be gathering with individuals at risk of severe disease or older adults, such as grandmas and grandpas who might be immunocompromised or people who are not up-to-date on their COVID-19 vaccines. And remember that the youngest of the children that we have who are less than five years of age, they haven't been approved to receive the COVID-19 bivalent booster. So, they probably might not have asthma protection as we adults might. So, it is important to make sure that you're not carrying COVID-19 virus with you when you are meeting them.
Scott Webb: Yeah. And I'm sure there's a scenario where, you know, folks felt good and maybe tested negative before they traveled, but then maybe start not feeling well while they're traveling abroad or on a cruise ship or wherever it might be. What do you do if you're infected while you're traveling?
Dr. Deepa Yerram: The planning around COVID-19 or potentially contracting COVID-19 while on travel should actually start even before you travel, correct? And no matter where you're going, just make sure that you're up-to-date on your vaccines and your boosters. Ensure that you're packing a few COVID-19 test kits and potentially N95 masks in your luggage just in case. And while traveling, you can do certain things to actually reduce a chance of you coming down with COVID-19. And that includes social distancing as much as possible and continuing to wear high quality masks such as N95 or the KN95 that are so readily available everywhere to kind of make sure that you're staving off the infection.
Also, make sure before you travel to get updated information on COVID-19-related rules at your destination, and as well as making sure that there is adequate healthcare available at your destination if so it happens that you come down with COVID-19. You should have some kind of flexibility and leverage in your travel plan in case you have to extend your duration of your travel for quarantining purposes. And so, there should be adequate flexibility in not only your travel plans, but housing and other reservations.
But if you take care of all of these and you're traveling and you're being a good traveler and you still come down with COVID-19 symptoms, I will recommend that you will want to take a COVID-19 test as soon as possible. Isolate yourself from the rest of your party and try to extend your stay. So, the goal is to keep you from infecting others while you're still contagious. So, you will need to rearrange your trip and travel accommodation to accommodate the 10-day quarantine, unfortunately. And if you're at risk of severe disease, like if you're older or you have certain medical conditions, try to get medical care at the destination or wherever you're traveling because you may qualify to get the Paxlovid, the medication that can cut down the risk of you developing severe symptoms or having other morbidity or mortality issues from the COVID-19. And for that, you will need to see a healthcare provider wherever you are.
Scott Webb: I just want to finish up here today and ask you about the measures that ICHS has implemented to safeguard its patients and just the community in general.
Dr. Deepa Yerram: We have upped our communication strategy to ensure high-quality problem-specific information flows to our patients and the community at large. We have been the stewards of healthcare information to our community. And we do play a big role in how the community receives the information and how they process it.
Some of the steps that we have taken to ensure that this happens is we have made sure that we are doing outreach in the patient's spoken language, both on phone and in-person. Our community health workers are out in the community talking and providing information and vaccinating the patients whenever they're ready. We are doing several in-person outreach events such as fairs and popups. We have kind of made our communication strategy, especially the marketing strategy, more robust. And, as I said previously, that we are making sure that every piece of information that goes through the social media or radio networks or podcasts such as this, short videos, film and interviews, all of those are happening in various languages which are spoken by our patients.
We are ensuring that we are tailoring our messaging based on the audience segment. Say for example, for the youth groups, we have been doing more play-based and Minecraft, a video game-based messaging. And we definitely ensure that the patients and the community could avail of personal conversations with their trusted provider, be it primary care provider, their dental provider, their behavioral health provider or the pharmacy member.
On top of doing all of these, taking all of these steps to make sure that the patients has the most up-to-date information on hand. We have also stepped up ways to ensure that our patients and communities have easy access to the COVID-19 vaccines, and they can do this by getting vaccinated at their regular scheduled clinic visit. They don't need to have a separate visit for the COVID-19 vaccine. We have been running several high volume vaccination sites. Our pharmacy is open. And this is not just for our patients, but even non-patients who live near us. And if they want COVID-19 vaccines or any other vaccines such as influenza, they can walk into one of our pharmacies and get it. We are also running several pop-up clinics, which are organized by the community health worker teams at various community gathering places such as the grocery stores, religious institutions, some social and community centers such as senior centers and even at schools, ensuring and trying to cover as many places as we could, and we kind of try to brainstorm and figure out if our patient can go there, we should be present there to just make sure that they can get their vaccine whenever they are ready.
Scott Webb: Well, not surprising at all to hear that ICHS is on top of things. You may want to maybe consider TikToks. I know you said you were trying to reach out, you know, to the younger group, so maybe TikToks. That's where my 14-year-old would find the important information about vaccines and otherwise. But doctor, it's been so great to have your time today. We're all living in this COVID world and we're all trying to figure out, you know, because it is still around and it may be around for years, forever, who knows? You know, how can we do this but still live our lives? So, great advice from an expert today. Thank you so much. You stay well.
Dr. Deepa Yerram: Thank you very much for having me.
Scott Webb: And for more information, go to ichs.com. This has been the Together We Rise Wellness Podcast from International Community Health Services. If you enjoyed what you heard, please be sure to share in your social media channels and check out our entire podcast library for additional topics of interest. I'm Scott Webb. Stay well, and we'll talk again next time.