Has anyone had luck with this recently? I need to take my mask off for an appointment at a new doctor and I’m not sure how well my request is going to go over. I’m traveling from another state for surgery that requires some tests beforehand.

Our insurance wouldn't cover the shots at first. I know a lot of people have been experiencing this. Try again! My wife and I just got Pfizer jabs at CVS and it was covered. Glad I didn't pay for one a couple weeks ago.
Anyone else having better luck getting the shots covered now that its been several weeks?
Very happy to have these jabs with the holidays coming. Happy to report the Pfizer dose seems VERY mild this round. My arm isn't even sore just a bit of a stiffness where the injection was done.

Whelp, it looks like we may have a situation on our hands. Northern Hospitals will probably go back to OLMC (Online Medical Command) shortly, given the number of diverts.

I have been monitoring the hospitals all weekend long, and it really wasn't bad. For some reason Monday turned into a sh*t show.

Having worked the weekend, I was surprised at the lack of injuries (chainsaw and whatnot from trying to clear debris), and lack of rashes, cuts and bruises from walking through flood water.

My guess is that everyone hunkered down till the waters subsided and then dove in head first into their damaged homes today.

.......................................

Just to inform briefly: COVID is absolutely quieting down. The vast majority of cases are amongst the elderly population, who are socializing as usual, sans masks.

I have noticed an increase in ear infections among children and middle aged adults. This is concerning - none mentioned using the pool or swimming. Many had sinus pain/headache as a secondary symptom. None wished to test for COVID, though our providers may have run a few of their swabs through the paces anyway. Very few tested positive, but most were early (1-5 days) I to their symptoms.

The hospital data is encouraging:

09/06: 10,182

09/13: 7,026

09/20: 5,333

Wastewater testing has also shown very good reduction, though it has bobbing a tiny bit recently. Even Tampa looks good.

.............................................

A word on the hurricane and help available: if you go to my profile and check my posts there is one in the r/Florida sub for help with everything from hot showers to food, to finding a place to stay. If anyone needs help and cannot find the post, DM me. I will help you get the links.

At the moment I am still reeling from the devistation in FL, GA, NC and SC. I had to cut myself from it at one point, because diving into it head first searching for info about missing friends has made me a bit sick.

I truly hope everyone here in Florida is cared for in the aftermath of Helene. Please be careful and do not take on more work than you can handle. Clearing out a flooded home is dreadful work. I know, I did it on LI after Irene in 2011, and it was horrendous.

A reminder: the silt, mud, and mold you will encounter as well as the insects are not good for your health. Wear appropriate garments to safeguard yourself (good boots, jeans, and at least long sleeves rolled up). If in a moldy house, wear a mask. Handling moldy objects? Wear gloves. Drink plenty of water and take frequent breaks. Wear bug repellent if possible and do not work past sundown. Wait till dawn to start working, also...gottah avoid mosquitoes.

If you scratch yourself on something dirty, clean the wound well, and consider your last tetanus shot - if you can't remember when - get another. All Urgent Cares carry them.

Please Be Safe out there.

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URL to use: https://covidtests.gov/

I just ordered for myself, and it worked. They will begin shipping on Sept. 30th.

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It's been a bit rough lately due to a dreadful lack of staff, both in īreception and clinical. Lack enough that we are unable to provide some services. Some staff were out sick recently. To soften the blow in administration I've worked everyday for a week, filling in as much as possible. Being home is a luxury.

Nevermind the staff; we have begun seeing near 70 patients a day, often seen by just one practitioner.

The pace on some days has increased way beyond our staff's ability to handle, often resulting in long wait times during hours of high traffic, like mid-morning and after school. 2 hours at those times is typical.

We're seeing the usual ear infections in kids, followed by the same for them with parasites and lacerations.

The young Moms and Dads are catching stuff from their kids. We had one adult flu case, possibly the first in a long time. They've also got Strep, and COVID. Surprisingly few norovirus cases for this time in the school year.

The middle aged to young seniors are developing COVID + Community Spread Pneumonia at a shocking rate. Several arrived complaining of coughs that have gotten progressively worse over the course of 2 - 4 months. X-rays reveal scarring and fluid in the lungs often, resulting in some ED transfers. Complaints of sleepiness, fatigue and dizziness caused by Low O2 are becoming more frequent.

Interestingly, a practitioner wrote a few Paxlovid RXs and a lesser-known antiviral, Molnupiravir (Lagevrio). It's for mild symptoms of COVID in people with underlying conditions. The side effects seem quite similar to Paxlovid, including bitter aftertaste. Claims during studies and in advertising state that it reduces the chance of developing Long-Covid. I'll have to look into that.

As befits the oncoming season, the waiting room echoed with coughing for nearly the whole day, every day.

Many patients missed their target day testing for COVID and insisted that the test they took a day after being exposed was gospel. "It was negative. I don't have COVID." Sometimes I try to explain testing, sometimes I can't get a word in edgewise. Frankly my dears - I just barely care anymore if they want to live in a fantasy.

For your sake: I really hope I don't see you in my clinic. Wear a good mask, (yes, wash your hands), get vaccinated, and please:

Be safe.

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In 2023, the Florida Legislature passed Title XXXII Chapter 456.62 into law. It's titled "Communication of COVID-19 treatment alternatives."

(3) In determining which alternative medications to present to a patient for purposes of obtaining informed consent, the health care practitioner must include any medications currently authorized or approved by the United States Food and Drug Administration for the treatment of COVID-19 and use his or her best clinical judgment to identify any alternative medications that could reasonably be expected to benefit the patient.

The legislature added a number of anti-mask, anti-vax, and pro-horse paste provisions as part of this bill.

381.00316 Discrimination by governmental and business entities based on health care choices; prohibition.—(1)(a) It is the intent of the Legislature that Floridians be free from mandated facial coverings, mandates of any kind relating to vaccines as provided in this section, and discrimination based on such vaccination status.

Depending on the interpretation of the law by the provider's organization, this can have a chilling effect on effective FDA-approved treatments where they have the provider ask for a waiver before prescribing treatments.

I may have heard about this news last year, but it's just shocking to personally see some of the effects a year later.

I checked with a local chain pharmacy and a Covid vaccine without insurance is $200. I just quit my job so I don’t have insurance at the moment and I certainly can’t afford that. I checked vaccines.gov and they had no information on affordable shots anywhere. I live in Florida so I’m not expecting much from our county health department as our state Surgeon General is against Covid vaccines. Does anyone have any information on how or where to acquire an affordable Covid booster? Thank you.

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Novavax available at many CVS locations. They want you to schedule appt online.

Frustrated: It's the only word I can think of to sum up my thoughts, the general atmosphere at the clinic, and the attitude of our providers.

We are suffering another year and another prolonged season of habitual denial and ignorance of SARS-CoV-2, on the part of the DOH, patients, businesses, corporations, caretakers, nurses, and medical doctors.

The clinic is full of sniffling, coughing, extremely fatigued and annoyed children and adults. Occasionally one of them walks in wearing an adequate mask, sometimes worn correctly, but often unsealed and donned incorrectly. These are usually the home-tested, positive result cases. The rest walk in, seemingly oblivious to the fact that they harbor a deadly infectious disease.

When prompted to take a mostly inadequate surgical mask, they guffaw at themselves for forgetting and make a million excuses for their behaviour, look at me with consternation, sigh, or do as they are told without a blink.

Everyone is sick with something. If they aren't, they are in clinic for a laceration, an infected wound, abdominal pain, or a fall. The rest are job testing - and they rarely wear masks while waiting, but they do grab masks when the room is full of uncontrollably coughing patients.

I am astounded at the number of ER transfers I am getting per day. People arriving so sick that they cannot stand up, seniors with fall injuries, persons bleeding excessively from orifices, you name it. The fear of the ER continues, despite that fact that our clinic is just as risky.

Our providers and nurses are sometimes out for weeks at a time. They return with chronic coughs that they can barely rid themselves of before succombing to another infection. The young ones bounce back faster than the older clinicians, of course.

Whether or not our providers and nurses are aware of the cumulative effects of numerous COVID infections per year remains mirky. As a person "untrained" in medical science, one cannot just ask them this without a verbal altercation and a writeup. It's practically against policy.

A momentary lapse in my control happened when my coworker insisted that a patient was told that it was okay to return to work the same day that she was diagnosed with COVID. The patient was still feverish. I absentmindedly reminded my coworker that CDC recommendations were not what she just spewed, and was met with an "I know what the CDC rules are, and so does the provider! Don't lecture me!"

My retort was silence. I knew I'd be written up. My coworker then quietly crawled from her seat to secretly discuss the situation with the provider (both are the office tattletales), who informed her that his orders were not what she thought, and informed her of the correct CDC regulations for infectious disease exposure and prevention.

Did I get an "I'm sorry, I was wrong. I will call the patient back to correct my disinformation,"? Nope. Not one word, from either the provider or my coworker. No writeup, either. I still want to post the recommendations prominently in my area, but know if I do, I may risk a writeup. "No unofficial signage," is the order from on high. The best we have is "Cover your cough and wash your hands," which has been the mantra of infectious respiratory disease since Spanish Flu.

We admit it every day that we work: we are tired of dealing with unnecessary and avoidable sickness, yet no one cares discuss masking or vaccination unless the patient is the caretaker of someone who is immunocompromised or elderly, and asks the question specifically. Otherwise, masking is entirely ignored beyond the printed patient "return to work" instructions (which patients don't read), providers wearing their own choice of mask, and the surgical masks given out to obviously infectious patients.

Every day I hear or read of patients seeking medical advice and treatment in a safe and sterile atmosphere - and getting pushback for attempts to protect themselves. The situation appears to be getting worse, with more and more doctors ignoring infectious disease protocol, and more patients disregarding the same.

In Florida it is close to impossible to force a doctor to observe protocol. The best response might be to leave their office immediately and file a complaint with the American Board of Medicine; do not bother with the State Board; or file to both just to be thorough. This will not prompt swift action, but trying is better than allowing the possible outcome.

..................................................................

Please - if you can, get your updated vaccinations. Wear a good mask whenever possible and instruct yourself and others in correct donning and doffing of respirator-style masks.

...............................................................

Despite the lower numbers of hospital detected positive COVID patients (down to around 11,000 per week vs 13,000), the number of in-clinic positive patients is high. Respiratory emergencies involving middle aged to elderly patients is rampant.

Detection of COVID infection in-hospital is extremely high in the 64+ age group, lesser but equivalent (nearly the same) for 12-60 years, and thankfully much less amongst infants.

Deaths continue to mount up (in the hundreds - (08/09/24 showing 200 just that week), with the elderly 64+ being the most counted. Horrifying but not unexpected, the highest deaths were in Palm Beach. If you are a senior and value your life, avoid that county at all costs.

Second only to Palm Beach for senior deaths are Orange and Broward Counties, Miami-Dade, and even Hernando is topping the charts.

Do not discount deaths in the 40-49 year old, 50-59 year old, and 60-64 year old brackets. They are still happening - the older you are, the more at risk you are.

.................................................................

If you have any questions about exposure, risk, masking, vaccination, infectiousness, or treatment, please post them.

Be Safe.

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I'm posting today because it's been a while, but not because there's been any great change at the clinic.

It's been regular as clockwork. We get a positive COVID case every other hour.

Everyone comes in unmasked, and looks mildly surprised when I ask them to take a mask because they have respiratory symptoms.

Sometimes I get a quick quip: "But it's just my sinuses," or "But it's Strep," or the flash of a cranky frown, and then resignation. I've noticed that once they sit down most keep their masks on, but there's always one rotten apple who sits in an area where I have to crane my neck to see that they have doffed their mask in order to talk in the telephone.

Recently we've been given a directive to screen everyone (and I mean everyone) who walks in the clinic for potentially infectious disease. Frankly I wonder what prompted this sudden crackdown, but we are screening for: any respiratory symptoms, recent fever, exposures to COVID, TB, Monkey Pox, Chicken Pox, RSV, and recent travel outside the US as well as exposures to anyone who has the above criteria. It's a little bit scary. Anyone fitting this description is asked to mask, and in the cases of everything but COVID (unless the person is coughing uncontrollably) they are to be whisked to a back room and isolated immediately.

Sore throats, sinus pain, and trouble breathing with a cough are still a big thing. Fatigue is an amazing motivator! It still brings in the 20-somethings, the active 40 year olds, and the quizzical parents. The statement I hear most: "I just can't shake this feeling of tiredness. I spent the last two days in bed!"

Occasionally we see those who tested positive at home and are seeking guidance. They are scared. They need someone to talk to, and a doctor or nurse can help them navigate the symptoms. Not that any of our providers will just hand out RXs for Paxlovid - nope. Only the gravest of cases gets that. Instead they get symptomatic management prescriptions. It's better than nothing.

PS: If you are seeking a free Paxlovid Card, most clinics have them. A rep came in and gave us a pile of them. Chances are, if you whisper a request from the receptionist at your local Urgent Care, like "Pssst....do you have any of those free Paxlovid cards?" they will probably dig one out of a drawer for you. Just keep it on the down low. No need to alert the providers who would prefer you not know about the free card program. It's still available online, of course, but it's good to have one handy just in case. You'll still need to get a prescription to use it - but that can be had via telehealth or your local pharmacist if you really want it.

...........................................

The really troublesome thing happening in-clinic is the high number of emergency patients we're seeing. Some days I escort so many emergencies that the regular patients cannot be seen for hours. That causes problems, especially when we've made a job seeker hold his urine for 3 hours. Most come prepared to pee immediately. I marvel when some job testers sit patiently without even a peep.

The rest of our "not so sick" patients or people seeking physicals still harry us: "I saw three people go in ahead of me, and I was supposed to be next!" Ughhhh....sometimes it gets ugly.

The situation in Pasco is different from other areas in Florida. While the numbers have gone down significantly in Miami and Orlando, Pasco's numbers of positive cases In-hospital wavered briefly and then rose again. It could be the "back to school" effect, or a new variant has crept in.

North Tampa's wastewater detection revealed that COVID is still rising there. Samplings from other areas (South and East) are not showing the same levels. It's a head scratcher for sure.

.......................................

The news has been active: New COVID shots could be available by the end of September, and the COVID Test Program has been resurrected. In a couple of weeks we should be able to reorder 4 more FREE Rapid COVID tests via the mail. That's supposed to be in preparation for the Fall surge, but we really need at least 8 - unless they will offer 4 more for the Winter surge.

Underlying all of this is the death count, which is rising. When I know most of these COVID cases could have been avoided, it makes me sick. Recently about 450 deaths were counted. Most of them were seniors. As I have mentioned in the deaths post yesterday, I have to resist the urge to rush up to seniors in public to warn them and beg them to mask in public. I cannot harass them - it's their choice whether to live or die. It hurts me to see that almost no one in Pasco is masking despite the high hospital numbers.

I know that most people are "done" with COVID. They don't care if the levels are high, or are not informed because they do not know where or how to research it. Not seeing any masks, they assume that everything is okay.

Freedom is a powerful drug. The freedom to chose whether to mask and prevent sickness, or not to mask and transmit a deadly pathogen is a powerful right that we all possess. Please choose life. Mask up for your friends, family, for strangers, and coworkers. Mask for your health and for your possible future.

If you are sick, or know someone who is, please be forward enough to tell them to go home. Ask them to wear a mask if they must be out working or shopping. Let them know that their actions have consequences.

If you know someone who was recently exposed, ask them to mask, too. It doesn't matter if they have symptoms or not. Ask them to mask until the incubation period is over - till they exhibit symptoms and test positive (and should continue to mask) or at least 5 days after exposure.

What else can you do?

Warning: The following action could land you in hot water. Do not do this unless you are capable of running away quickly:

Carry a few sealed masks with you. If you see someone coughing, sneezing, or scraping a tissue across a red nose, offer a mask. You don't even need to say anything. Just surreptitiously hold it out for them to take. Smile so that they can see your eyes crinkle. Raise your eyebrows. Nod approvingly. If they take it, great! If not, move on quickly. Don't stick around for the angry retorts. Some people have COPD, and are not "sick", so expect that response from some seniors. Just apologize and be on your way.

And:

When it comes time to get vaccinated, please do. Get your Flu/COVID combo. Be prepared, and

BE SAFE.

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Our clinic numbers are at odds with what's being reported by the FLDOH.

For 07/19 they finally settled into this number: 23,789. It is just shy of the peak number in August of 2023.

For the week of 07/26, the highest number they've posted so far is: 18,710.

When comparing the numbers to the August 2023 peak, it's hauntingly familiar:

08/25/23: 23,976

09/01/23: 19,044

Tell me if you think I'm right or wrong, but...there's something strange about this.

My Spidey sense is tingling, especially when every other person who comes to my clinic has COVID.

We saw 50 patients. 25 of them came in with sniffles, coughs, sinus or ear pain....and they all tested positive. I haven't seen that level of positivity since 2022.

The others were there for back pain, urinary tract infections, gout, rashes, pink eye, falls, lacerations, and job testing.

If the general public is spreading it like wildfire, why isn't it showing up at the ERs? For one: we see travelers. We see visitors, and we see new Florida transplants from lots of states. The DOH weeds all of those out of their counts.

Yup, you've got to be a bonefide resident, living in Florida most of the year, , registered in Florida, and have a Florida ID or Driver's license. All the rest get thrown out.

Still, a good majority of our patients live here. They have Florida Medicaid cards, or Florida Blue insurance.

I'm at a loss here. I cannot figure it out. When conversing with Floridian ER and ICU personnel, they all say that they are seeing more COVID cases than they have in a long time.

Have we hit peak? Have we started dropping? Maybe. I am going to wait till next Friday's numbers come out and see if they adjust the July 27th number higher, and to see what the first week of August comes in at.

The fact is: there are still a lot of cases out there because stay at home restrictions have been pulled back, and more sick people just don't care if they spread it.

Most people don't understand the restrictions: "My boss says he needs me at work tomorrow, COVID or not." (Hopefully that person stayed home like they said they would), but people are not masking, roaming grocery stores, thrift shops, department stores, and restaurants.

Despite what the CDC and FLDOH say, COVID is still very active in Florida. Until the wastewater proves that we have hit bottom, I'd mask up and

Be Safe.

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