Considerations for Holiday Celebrations and Small Gatherings

The COVID-19 pandemic has been stressful and isolating for many people around the country. The upcoming holidays can be an opportunity to gather and reconnect with family and friends. This holiday season, consider how your plans can be modified to reduce the spread of COVID-19 to keep your loved ones and communities healthy and safe.

Unfortunately, COVID-19 activity is rising throughout the U.S. and gatherings are a significant contributor to the rise in cases. Please keep the following considerations in mind during small gatherings to slow the spread of COVID-19. These guidelines are meant to supplement, not replace, any state or local health and safety regulations, with which all gatherings must comply.

Celebrating with members of your own household, who are consistently taking measures to reduce the spread of COVID-19, poses the lowest risk. Members of your household is anyone who currently lives and shares common spaces in your housing unit, including family members and roommates. People who do not currently live in your housing unit, including college students who are returning home from school for the holidays, are considered part of different households. In-person gatherings that bring together individuals from different households, including students returning home, pose varying levels of risk based on several factors:

  • Community levels of COVID-19: High or increasing levels of COVID-19 cases in the gathering location, as well as in the areas where attendees are coming from, increase the risk of infection and spread among attendees. Family and friends should consider the number of COVID-19 cases in their community and in the community where they plan to gather. Information on the number of cases in an area can often be found on the local health department website.
  • Exposure during travel: Travelers can be exposed to the virus in the air and on surfaces in airports, bus stations, train stations, public transport, gas stations, and rest stops.
  • Location of gathering: Indoor gatherings, especially in areas that are small, enclosed, with no outside air, pose greater risk than outdoor gatherings. Increase ventilation by opening windows and doors to the extent it is safe and feasible based on the weather, or by placing continuous circulation of central air. Host outdoor rather than indoor gatherings as much as possible, and try to implement mask wearing when not eating or drinking.
  • Duration of the gathering: Gatherings that last longer post more risk than shorter gatherings. Being within 6 feet of someone who has COVID-19 for a cumulative total of 15 minutes or more greatly increases the risk of becoming sick and will require a 14-day quarantine.
  • Number and crowding of people at the gathering: The size of a holiday gathering should be determined based on the ability of attendees from different households to stay 6 feet apart, wear masks, maintain hand hygiene, and follow state and local regulations.
  • Behaviors of attendees prior to and during the gathering: Individuals who have consistently adhered to prevention behaviors (social distancing, mask wearing, handwashing, etc.) pose less risk than those who have been less consistent in practicing these safety measures. Gatherings with more safety measures in place pose less risk than gatherings with fewer or no preventive measures implemented. Attendees should avoid direct contact, including handshakes and hugs, with individuals not from their household. At gatherings that include people of different households, everyone should wear a mask that covers both the mouth and nose, except when eating or drinking. It is also important to stay at least 6 feet away from people who are not in your household at all times. Encourage attendees to wash their hands often with soap and water. If soap and water are not readily available, use hand sanitizer that contains at least 60% alcohol. Try to avoid singing or shouting, especially indoors.

Do not host or participate in any in-person gatherings if you or anyone in your household:

  • Has been diagnosed with COVID-19 and have not met the criteria for when it is safe to be around others
  • Has symptoms of COVID-19
  • Is waiting for COVID-19 test results
  • May have been exposed to someone with COVID-19 in the last 14 days
  • Is at increased risk of severe illness from COVID-19

Extra tips to ensure a safe and healthy gathering:

  • Limit contact with commonly touched surfaces or shared items such as serving utensils.
  • Clean and disinfect commonly touched surfaces and any shared items between use when feasible.
  • Use touchless garbage cans if available. Use gloves when removing garbage bags or handling and disposing of trash. Wash hands after removing gloves.
  • Plan ahead and ask guests to avoid contact with people outside of their households before the gathering.
  • Do not let pets interact with people outside of the household.
  • Bring extra supplies to contribute to the gathering if possible, such as extra masks, extra hand soap or hand sanitizer.
  • Get your flu vaccine, as it is an essential part of protecting your health and your family’s health this season. Gatherings can contribute to the spread of other infectious diseases.

If you are exposed to COVID-19 during a holiday gathering, while traveling, or at any time, quarantine yourself to protect others and follow these guidelines.

Thanksgiving may look different this year, but we encourage approaching the holidays with an open mind. Consider the above guidelines to protect your families and friends, and to ensure a season of good health. Thank you to all of our patients for their continued cooperation in slowing the spread of COVID-19.

Embrace your Eyes Event featuring Dr. Tanya Khan

I am excited to offer an exclusive virtual event presented by Dr. Tanya Khan, one of the top Oculoplastic Surgeons in Austin. Dr. Khan will be offering an informational about eyelid surgery and non-surgical options this Thursday, August 27th via Zoom.

ZOOM ID: 830 9022 5650

Dr. Khan trained at Duke University and currently practices at Tru-Skin Dermatology in Austin. She specializes in the clinical and surgical management of eyelid and orbit disorders, including blepharoplasty, repair of blepharoptosis, ectropion, entropion, trichiasis, epiphora, hemifacial spasms, and thyroid eye disease.  She performs surgeries to correct excess tearing due to nasolacrimal obstruction, complex oculofacial reconstruction to repair defects from trauma or cancer excision, and removal of orbital tumors.

As a board-certified ophthalmologist and fellowship-trained oculoplastic surgeon, her goal is to help people see better and feel more confident by sculpting their eyelids to better frame their faces. Often times eyelid surgeries can be covered by your medical insurance plan and would be considered upon consultation. She also offers many services that extend beyond the scalpel, such as facial fillers, neuromodulators, lasers, and skincare.

Join us virtually at the time of the event to enter to win a FREE virtual consultation with Dr. Tanya Khan! Winner will be announced following the event!

Thursday, August 27th at 4:30 PM

Click here to join the live event

Updated Guidelines for COVID-19 Antibody Testing

As the number of COVID-19 cases continues to rise in the U.S., the number of serology (antibody) tests aimed at identifying those with prior exposure to COVID-19 have made their way into the market. These tests are regulated by the U.S. Food and Drug Administration (FDA), which requires all commercially marketed serological tests to apply for and receive an Emergency Use Authorization (EUA) in order to market these tests to the public. The FDA also provides recommended performance standards that these tests should meet. As of June 17, approximately 18 commercial serological tests have been granted EUAs, while over 120 tests are currently on the market.

Serology tests have several limitations that make correct interpretation of the results critical. There is still so much unknown about immune status for the novel virus. Limitations to be aware of include:

  • False positive results: Serological testing for disease with a low prevalence in the population (such as the case in the U.S. and Travis county) present inherent challenges with interpretation of positive results. Even high performing tests with high sensitivity and specificity will return false positive results when disease prevalence is low, as is currently the case with COVID-19. Let’s take for example, a community of 100 individuals with a disease prevalence of 5%. If a test with a specificity of 95% was used in this population, it would be expected to return 5% false positives, so 5 out of the population of 100. 5 true positives would also be expected, as the disease prevalence is 5%. Overall, this test would return 10 positive results. However, only half of those results would be accurate, which shows the inherent limitation of these tests in low disease prevalence states. Once the disease prevalence is higher, the concern about false positives becomes somewhat mitigated, however, this is not the current reality with COVID-19.
  • Cross-reactivity: Cross-reactivity occurs when a test for antibodies for SARS-CoV-2 identifies not only antibodies for this virus, but also for other coronaviruses, such as those that cause the common cold. For tests where cross-reactivity is possible, antibodies for other coronaviruses may result in a positive result even when the patient was not infected with COVID-19.
  • Immune status: Given that COVID-19 is a novel virus, there is much that we don’t know about what, if any, immunity it may confer to those exposed and recovered from the infection. According to the FDA and the CDC, there is currently no available evidence showing immunity to COVID-19 after infection. While individuals typically develop some type of immune response after exposure to most viruses, it is not yet clear when an immune response develops after COVID-19 infection, how strong this immune response may be, and how long the immune response may last.

Recommendations from the Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA):

  • Serology tests should not be used as the sole basis of diagnosis of COVID-19 infection.
  • Use of serology tests should currently be limited to population-level seroprevalence study, evaluation of recovered individuals for convalescent plasma donations, and in other situations where they are used as part of a well-defined testing plan and in concert with other clinical information by physicians well-versed in interpretation of serology test results.
  • Serology tests should not be offered to individuals as a method of determining immune status. Individuals receiving positive test results may falsely assume it is safe to discontinue physical distancing. The AMA and CDC recommend all individuals to continue to abide by physical distancing recommendations, and face covering and shelter in place requirements.
  • Serology tests should not currently be used as the basis for any “immune certificates.”
  • Serology tests should not be used to inform decisions to return to work, or to otherwise inform physical distancing decisions. Doing so may put individuals, their household and their community at risk.
  • Serology tests should not be used to make decisions about grouping persons residing in or being admitted to congregate settings, such as school, dormitories, or correctional facilities.

Currently, the prevalence in Travis County is less than 1%. Because of this low prevalence, the serology antibody test will yield a high percentage of false positives. At this time, we are not recommending routine serology testing. These tests may play an important role in determining the overall prevalence of COVID-19 in the U.S. population, and may also be important in determining the prevalence of asymptomatic infections. While these tests will undoubtedly play an important role in population-level studies going forward, they are not without limitation and we must be well-versed in these limitations in our current environment and have a strong understanding of both the test and the potential results.

Free Skin Cancer Screening with Dr. Tyler Hollmig

I am excited to announce that I have partnered with Dr. Tyler Hollmig, one of the top dermatological specialists in Austin. Dr. Hollmig will be offering free skin checks to my concierge members as a special, added value service on Wednesday, June 10th at our office. When caught early, skin cancer is highly treatable. Routine skin cancer exams are extremely important in detecting abnormal skin lesions early. Our skin is constantly evolving as we age, and extrinsic factors such as the sun can have a detrimental effect on our skin. Studies show that early exposure to excessive sun at a young age can potentially cause skin cancer later in life. To protect your skin against the sun’s harmful rays, wear a broad-spectrum 30 SPF or higher sunscreen every day. Seek shade as often as possible and wear clothing that shields the sun’s rays as often as possible. 

Skin exams are recommended at a minimum of once a year, but with a personal for family history of skin cancer, skin checks are recommended more frequently. If you notice any suspicious spots on your skin or your partner’s skin, or anything that is changing, itching or bleeding, see a board-certified dermatologist.

Dr. Hollmig trained at Stanford University and is currently the Director of Dermatology Surgery and Laser and Cosmetic Dermatology at UT Dell Austin. He offers advanced, highly aesthetic and surgical reconstructions, along with Laser and Cosmetic Dermatology, including treatment of wrinkles, sun damage, red and brown spots, scars, unwanted skin lesions, birthmarks, unwanted hair, and other aesthetic therapies. 

For the patients who were previously scheduled in March, our office will be contacting you personally by phone. If you were not able to sign up in March, we will be scheduling more throughout the year. Please check our blog regularly for future dates.

Wednesday, June 10th 5:30 – 8 PM

*Offer for current concierge members of Dr. Roxana Rhodes only*

Phase Two To Open Texas

Phase II of Open Texas Began Monday, May 18, 2020

Governor Greg Abbott issued Executive Order GA-23, relating to the expanded opening of Texas in response to the COVID-19 disaster.

By way of Executive Order No. GA-23, restaurants that opened under Phase I may expand their occupancy to 50% beginning May 22. Bars—including wine tasting rooms, craft breweries, and similar businesses—may open at 25% occupancy but like restaurants, these occupancy limits do not apply to outdoor areas that maintain safe distancing among parties. The following services and activities may open under Phase II:

  • Child Care Centers (May 18)
  • Gyms (May 18)
  • Massage and Personal-Care Centers (May 18)
  • Youth Clubs (May 18)
  • Rodeo and Equestrian Events (May 22)
  • Bowling Alleys, Bingo Halls, Simulcast Racing, and Skating Rinks (May 22)
  • Bars (May 22)
  • Aquariums and Natural Caverns (May 22)
  • Zoos (May 29)
  • Day Youth Camps (May 31)
  • Overnight Youth Camps (May 31)
  • Youth Sports (May 31)
  • Certain professional sports without in-person spectators (May 31)

All sporting and camp activities are required to adhere by special safety standards, and minimum standard health protocols have been established for all newly-announced opened services and activities. Businesses located in office buildings may also open but must limit their occupancy to the greater of 10 employees or 25% of their workforce.

Opened services and activities under Phase II are subject to certain occupancy limits and health and safety protocols. For more information, please refer to the governor’s Open Texas page. All services, businesses, and activities that open under Phase I and Phase II may open with restricted occupancy levels and minimum standard health protocols laid out by the Texas Department of State Health Services (DSHS).

Things to Keep in Mind

As businesses, services, and activities begin to resume with minimum standards recommended by the DSHS, it remains vital to practice social distancing, proper hand hygiene, and to wear a face covering when in the public. Studies have shown that almost half of infections occur from carriers before they develop symptoms. In other words, almost half of infections occur from individuals who are not yet aware that they have COVID-19 (see graph below). The covering of one’s nose and mouth when outside their home or residence is necessary to help prevent the spread of COVID-19. When you wear your face covering, you are protecting other individuals. When others wear their face coverings, they are protecting you. This, along with maintaining the 6-feet social distancing guidelines and hand washing remain crucial steps to slow the spread of the virus.

Travis County Medical Society also recommends cocooning for people who are over 70 years of age and those who are medically vulnerable to COVID-19, by minimizing all interaction. This safety measure was established to protect people who could become very ill if they are infected with COVID-19. We recommend all patients who fall under this vulnerable population to practice cocooning.

We urge our patients to remain vigilant and to make their best judgments as more places begin to open and resume operation. Everyone has a role to play to maintain the slow spread of COVID-19 and to prevent hospitals from becoming overwhelmed. With the economy slowly re-opening, this is more important than ever. We want to remind our patients that at this time, there is no FDA-approved treatment or vaccine for COVID-19. Presently, clinical trials are underway. If patients have any questions on safe and preventive practice, please refer to our blog or contact our office and we would be happy to assist.

Introducing Relaxation Sundays: Yoga at 10AM!

Start your Mother’s Day with a relaxing and restorative Yoga Session on ZOOM. Download the app for free on any web browser or mobile device and click the link here at 10 AM on Sunday, March 10th to join the movement.

 

Yoga improves flexibility and posture and helps to prevent injuries by strengthening core muscles used for support and weight-bearing. Yoga’s ultimate contribution to our wellbeing is the unification of body and mind into a state of flexible and activated focus.

Some other proven benefits of yoga include: 

  • decreased stress
  • increased blood circulation
  • lower blood pressure
  • improved respiration and vitality
  • protection from injury
  • increased muscle tone
  • relief of anxiety
  • reduction of inflammation
  • improved sleep quality

Do not feel pressure to turn your microphone or video options on, as this is all about your health and healing during this time. If you have a question during the workout, please feel free to speak up! Please listen to your body and alter any pose as needed. If you need any personalized advice on how to change a position after the session, please contact me directly at info@partners-in-health.com.

Stay healthy and keep active everyone! 

Your personal fitness coach,

Alyssa

Stay Home – Work Safe Order to Expire Today

Governor Abbott Announces Phase One To Open Texas

On April 27, 2020, Governor Greg Abbott issued Executive Orders No. GA-18 and No. GA-20, relating to the expanded reopening of services and relating to expanding travel without restrictions as part of the safe, strategic plan to Open Texas in response to the COVID-19 disaster. This executive order supersedes any conflicting order issued by local officials, which means the Stay Home – Work Safe Order issued by Mayor Steve Adler is set to expire today, April 30, 2020.

By way of Executive Order No. GA-18, all retail stores, restaurants, movie theaters, malls, museums, and libraries are permitted to reopen on Friday, May 1, 2020, but must limit their capacity to 25% of their listed occupancy, and must operate under certain restrictions. The Department of State Health Services (DSHS) has recommended minimum standard health protocols for all individuals, all employers and employees, as well as industry specific protocols for retailers, retail customers, restaurants, restaurant patrons, movie theaters, motive theater customers, museums and libraries, and museum and library visitors, which can be found in the governor’s Open Texas report.

Under Executive Order No. GA-20, the mandatory 14-day quarantine period for individuals traveling from Louisiana has been eliminated. Under GA-20, the mandated 14-day quarantine for travelers from the following areas remains in place: California; Connecticut; New York; New Jersey; Washington; Atlanta, Georgia; Chicago, Illinois; Detroit, Michigan, and Miami, Florida.

Update from Partners in Health

The safety and well-being of our patients, staff, and the general public remain our highest priority. We are committed to doing everything we can to continue providing quality care to our patients while taking every precaution to limit the exposure of our patients and staff to COVID-19. We will continue to follow recommendations from the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), public health authorities, and federal, state, and local orders. Under the new orders issued by Governor Abbott, our schedule is now open for routine appointments. All routine appointments previously scheduled will proceed. Our appointments will be staggered to allow for time to thoroughly disinfect and sanitize each exam room. We encourage our patients to schedule and stay up to date with their annual wellness exams, as it remains a vital part of reducing your risk of getting sick and living a longer, healthier life. All patients will still be required to wear a face covering when entering our facility and temperature screening will be done upon entry. Visitor access will remain restricted. For your safety and ours, we ask that all caregivers, family members, and friends of our patients wait in their cars during the appointments. All consultations and illnesses will still be evaluated first through telehealth or other forms of virtual visits (Zoom, FaceTime, phone call, text, email, etc.) to minimize exposure to the public.

We are in the process of scheduling events for after the month of May. Please check our website regularly for events held through our online meeting platform, Zoom. Please keep in mind that we must all keep doing our part to help prevent the spread of COVID-19 by practicing social distancing and proper hand-washing hygiene. We highly recommend everyone to stay at home as much as possible, especially for those at higher risk, and to only leave their residences for essential and individual outdoor activities. To protect others around you, wear your face covering when you have to leave your home. Please check our blog and our COVID-19 page regularly for updates.

 

 

Workout Wednesday: Yoga on the Beach at 6PM!

Visualize yourself tomorrow on the beach reflecting on your inner self. 

Transform with us this week by joining our free yoga session on ZOOM. Download the app for free on any web browser or mobile device and click the link here at 6 PM tomorrow to join the workout.

Yoga improves flexibility and posture and helps to prevent injuries by strengthening core muscles used for support and weight-bearing. Yoga’s ultimate contribution to our wellbeing is the unification of body and mind into a state of flexible and activated focus.

Some other proven benefits of yoga include: 

  • decreased stress
  • increased blood circulation
  • lower blood pressure
  • improved respiration and vitality
  • protection from injury
  • increased muscle tone
  • relief of anxiety
  • reduction of inflammation
  • improved sleep quality

Do not feel pressure to turn your microphone or video options on, as this is all about your health and healing during this time. If you have a question during the workout, please feel free to speak up! Please listen to your body and alter any pose as needed. If you need any personalized advice on how to change a position after the session, please contact me directly at info@partners-in-health.com.

If you are unable to join us for this workout, there are many free online resources available! Yoga instructor, Adriene, hosts a YouTube channel called Yoga with Adriene that offers an online community of over 6 million subscribers. She publishes free Yoga Videos and has a library of over 500 free videos and growing. Click here to access her website for more information!

Stay healthy and keep active everyone! 

Your personal fitness coach,

Alyssa

Why is your body composition so important?

A healthy balance between fat and muscle is vital for health and wellness throughout life. Scientific evidence shows that a healthy body composition will increase your lifespan by reducing the risk of heart disease, cancer, diabetes, insulin resistance, etc., increase energy levels, and improve self-esteem.

A healthy body composition is one that includes a lower percentage of body fat and a higher percentage of non-fat mass, which includes muscle, bones, and organs. Knowing your body composition can help you assess your health and fitness level.

Scales can be misleading as body weight is comprised of muscle, fat, and bone added all together. As part of your concierge membership, we provide the included service of performing a DEXA Body Composition scan to assess your health better. During your concierge wellness exam, we are promoting preventative health for a better you!

As we age, we begin to lose muscle mass and, in turn, end up with a higher body fat percentage %. We work towards keeping you on track with your fitness and nutrition goals to maintain healthy proportions of body mass. In addition to analyzing these results, the scan also provides an accurate depiction of your bone density. Your bone health is also essential in preventing bone loss through the years with the prevention of developing osteoporosis.

This image depicts a person as they age, remaining the same in weight and BMI, but their body fat percentage is increasing with time. As we age, the body tends to store more fat due to lowered metabolism and hormonal changes. As you can see in the example, her Resting Metabolism decreases proportionally as her body fat percentage increases.

One way to measure your health is by calculating your metabolic age. Your Basal Metabolic Rate is compared to your chronological age group to determine whether your metabolic age is lower or higher than your actual age. The science behind this measurement suggests that if the metabolic age is lower than your actual age, this indicates overall functional fitness and healthy metabolic activity. Body fat requires less energy than lean muscle, as lean muscle is much more metabolically active and therefore requires more energy expenditure to remain in homeostasis.

What is visceral fat?

Visceral fat is a type of body fat that is stored within the abdominal cavity. It is located near several vital organs, including the liver, stomach, and intestines. It can also build up in the arteries. Heart disease, Alzheimer’s, type 2 diabetesstroke, and high cholesterol are some of the conditions that are strongly linked to too much fat in your trunk.

Common myth: Muscle weighs more than fat – FALSE! They weigh the same.

The density of fat is less than muscle. Muscle takes up approximately four-fifths as much space as fat does.

Work towards a healthier you by joining the movement with us every week for Workout Wednesdays!

*Coming soon in May – Relaxation Sundays*

COVID-19 Updates

Austin Public Testing Enrollment Form Now Available

Austin Public Health launched the Austin Public Testing Enrollment Form, which allows the community to complete an online assessment for COVID-19. This new tool allows the public to be screened for COVID-19 symptoms without having to see their physician. Please be aware that criteria for testing must be met. Should any of our patients get tested, please notify our office. Please also notify our office with your results if you are tested.

Governor Abbott’s Strike Force to Open Texas

Governor Greg Abbott held a press conference on April 17, 2020 where he issued three new Executive Orders to begin the process of reopening the state of Texas while revising hospital capacity and certain social distancing guidelines. Within the orders, select activities and services that pose minimal to no threat of spreading COVID-19 are allowed to reopen beginning today, April 24, 2020, using a “Retail-To-Go” model. Certain restrictions on surgeries have been loosened, and schools will remain closed for the remainder of the 2019-2020 academic year. Within these orders, the Governor established the Strike Force to Open Texas – a team of nationally recognized medical experts and private and public leaders who will advise the Governor on safely and strategically reopening the state of Texas.

Texas State Parks Re-Open

Texas State Parks began reopening for day-use only on April 20, 2020 as part of a broader effort to begin reopening the state of Texas. New restrictions in effect include requiring visitors to make reservations and paying ahead of time, wearing face coverings, maintaining 6 feet distance from individuals outside of their party, and prohibiting the gathering of groups larger than five. Please see the Texas State Parks website for more information.

Reminder About Serology (Antibody) Testing for COVID-19

At this time, serology testing is not recommended. The majority of tests are still currently undergoing review by the FDA, and serology testing cannot be used to make a diagnosis of active COVID-19 since antibody production is not present at detectable levels until several days after symptom onset (see graph below). Only molecular testing should be used to make the diagnosis of active COVID-19. For more information, please see our blog post.

Please keep in mind that as the state of Texas slowly begins to reopen businesses, we still encourage our patients to stay home as much as possible, especially those who are over 70 and those with lung disease, heart disease, hypertension, and/or diabetes (also known as cocooning). Social distancing guidelines are still in place. Per city mandate, face coverings are required anytime an individual has to leave their residence. As the situation evolves, we will provide ongoing updates.