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Patient Communications

COVID Letter to Patients #3

Dear patients and fellow community members,

We hope you are feeling well and are comfortable at home with everything you need (food, medication, a phone connection to friends, family or support people) to be safe.

We at the Coastal Health Alliance are continuing to work to support your health, wellbeing and safety. We are writing to review essential health information during the pandemic, review ways we can help keep you safe, and ways for you to reach out for help if you need it.

As you know, the most essential thing you can do for yourself and your community right now is stay home as much as possible, and keep your distance (at least 6 feet) from people at all times.

Handwashing with soap and water, as often as you can and certainly after you touch doorknobs, counters, and surfaces, is very effective in killing this virus. Avoid touching your face as this is often the way the virus enters our body.

Many people want to know if masks are necessary. We are learning that when people wear masks, even cotton ones like handsewn masks (like the ones being sewn locally; see West Marin, Covered) or bandannas, not only does droplet transmission decrease, it also helps us not touch our mouth and nose. Until recently the CDC was not recommending people wear masks when out in public. However, new information is leading health officials to recommend people wear masks when out in public. You can reuse them by putting them in a paper bag for a day or out in the sunshine. N95 masks should be saved for medical professionals taking care of sick people or caregivers taking care of someone at home. There is a national shortage of these masks and unfortunately we cannot give these out.

We are reaching out to our patients with chronic health conditions to make sure they have medications and that their conditions are in good control. Please make a phone appointment with your primary care provider to adjust treatment if necessary, and to arrange for refills of medications. We also want to ensure people with chronic health conditions have had flu shots and pneumonia immunizations, in an effort to keep people out of the hospital. We will be reaching out to our highest risk patients to offer these immunizations starting next Monday.

During this challenging time, we are continuing to encourage all patients to think about what kind of care they would like to receive in case they become seriously ill. While this is always important, it is even more important during a pandemic for us to know your wishes, and for you to have an Advanced Medical Directive on file with us. It is also very helpful to have this information posted on your refrigerator (on a pink POLST form) so emergency responders also know how you’d like to be cared for. Please talk with your family and your primary care provider about your wishes, particularly if you know you would rather not receive care in a hospital.

We are also working with other local organizations to identify and support our most vulnerable and isolated patients and community members, particularly those who may not receive email, those who need help with picking up medications from the pharmacy, or who may live alone and are in need of more support. Our local fire departments are also interested in ensuring isolated people have someone checking in on them; if you or someone you know is isolated and needing this sort of help, please call the clinic at 415 663-8666 or your local fire department.

Now is the time for us to practice community resilience by reaching out to our neighbors in need, supporting each other, being kind, and staying separated physically but not emotionally. Each Wednesday evening from 6:30 to 7:30 pm Dr. Anna O’Malley will offer up-to-date informative sessions and answer questions, both from a public health and integrative medicine perspective. These will be on Zoom and limited to 100 participants each time; please RSVP to if you’d like to join and you’ll receive the call information. These calls are free and are open to all members of our community.

As we stay home, taking good care of ourselves and supporting our immune system is another way we can show care for our community. Now is the time to get a good night’s sleep, every night. Avoid sugar and processed foods whenever you can. Go for walks in this beautiful weather in this glorious spring. Breathe. Connect with loved ones by phone. Reach out to those who may be alone or in need.

We are here for you in this challenging time. Please reach out to us at 415-663-8666 if you need support in your medical care, in refilling medications, in accessing food, or in ensuring people are checking in on you. We will connect you to people who can help.

With care,

Anna O’Malley, MD

Frances Grau Brull, RN, Director of Clinical Operations

Steve Siegel, CEO

And the team at the Coastal Health Alliance

COVID Letter to Patients #2

Coastal Health Alliance

Coronavirus Update #2

March 23, 2020

Dear patients,

As the COVID-19 pandemic spreads, we at the Coastal Health Alliance are ramping up our support of our patients, our community, and our staff, and preparing for the possibility of a dramatic rise in cases here in West Marin, as has been seen elsewhere in our region and country.

Thank you for doing your part by strictly social distancing. Our ability to safely care for people as they become ill is greatly helped by everyone, young and old, staying home, taking walks locally, refraining from gathering with friends in person, and being vigilant when out on essential business or errands to stay separated by at least 6 feet.

We are putting procedures in place to support your health and safety and to prepare ourselves and our patients for the possibility of the virus spreading through West Marin. We appreciate your understanding.

We have:

  • Shifted all non-urgent appointments to telephone appointments. This protects you from potential exposure, and medical staff, too. In-person appointments are available in Point Reyes when needed.
  • Closed Bolinas temporarily to reduce the risk of community transmission and protect the health of medical staff. Having a rotating skeleton crew in one site (Point Reyes) allows us to ensure the healthiest workforce and your access to care.
  • Closed the dental office for now

This week we are:

  • Exploring alternative venues for care to ensure patients who are suspected of having COVID-19 remain separate from other patients.
  • Working closely with Marin County Department of Public Health to ensure testing can happen in West Marin as soon as possible.
  • Reaching out to our highest risk patients to encourage flu and pneumonia immunizations if needed. While not protective against COVID-19, these do decrease the risk of other serious respiratory illnesses and potentially keep people out of the hospital.
  • Reaching out to our patients with chronic conditions to get optimal control of blood sugar, blood pressure, and heart and lung conditions. Uncontrolled chronic conditions put people at greater risk of becoming critically ill from the virus.

Please help us help you by:

  • Strictly adhering to social distancing and handwashing.
  • Taking good care of yourself and your immune system: get good sleep, eat an anti-inflammatory diet, avoid sweets and processed food, practice relaxation, stay connected to friends and family over the phone or by email).
  • Calling your pharmacy or the clinic if you need refills on medications.
  • Making a phone appointment to discuss your diabetes, high blood pressure, or asthma if these conditions are not “in good control”.

We are all in this surreal and challenging situation together. Please remember the importance of kindness and compassion and take good care of yourself.

With care,

Steve Siegel, CEO

Frances Grau Brull, RN, Director of Clinical Operations

Anna O’Malley, MD

Coastal Health Alliance

COVID Letter to Patients #1

Dear ones,

As you know, the Coronavirus is spreading throughout the Bay Area, and our country. The situation is developing rapidly, and we would like to do all that we can to keep the community informed, safe, and well-cared for.

We will be sending out weekly updates to keep you informed about what you can do to help slow the spread of this virus, and how you can support your body in being as strong as possible in case you do catch it.

The Coastal Health Alliance is currently working on a strategy to address as many of our most vulnerable patient’s needs over the phone, in support of recommendations for those over age 60 to stay at home as much as possible. Stay tuned for more information on this.

Here is what we know:

  • This virus is very contagious. It is anticipated that between 40 and 70% of people in our country will become infected in the coming months.
  • Most people will only have a mild illness.
  • Some people, particularly those over age 60 and with chronic health conditions like diabetes, heart disease, high blood pressure or lung disease, can become very sick, and a many could die. There is an inflammatory reaction that happens in many of the critically ill patients that makes the risk of death higher.
  • It is essential that we all work together to slow the spread of this virus so that our hospitals are not overwhelmed with more sick people than they can take care. This is happening in Italy now and could happen here.
  • The best way we can slow the spread is to stay at home, away from gatherings large and small.
  • Handwashing frequently, avoiding touching your face, and disinfecting surfaces with cleansers containing alcohol, bleach or peroxide helps prevent transmission.

Focusing on these important strategies in your home and workplace is essential. Letting go of plans, keeping our children separated from vulnerable elders, and checking in on neighbors to make sure they have what they need is very important. Doing everything we can to support our immune system and decrease inflammation is important both for our individual health and the health of our community. Now is the time to be making wise choices. Here are my recommendations:

  • Good sleep is central to immune function. Here is a link to a very comprehensive handout on things you can do to support your sleep. Contact us if you’d like a phone appointment to discuss this important issue.
  • Strictly avoid immune suppressing and inflammatory foods like sweets, sugar, and processed foods with lots of chemicals in them
  • Choose brightly colored fruits and vegetables
  • If you smoke, please stop. Contact us if you’d like a phone appointment to get support on this.
  • Getting exercise boosts the immune system and is anti-inflammatory.
  • Being in nature boosts the immune system and decreases inflammation. Walks in nature are very good for you.
  • Many herbs that are easily grown here are anti-viral and immune supporting. Rosemary, oregano and thyme are great to include in a big pot of vegetable broth, as is garlic.
  • Stress and anger inflame and suppress the immune system. Let go of what you can, and let us know if you need help with stress or anger management.
  • A strong “vagal tone”, meaning, a strong “rest and digest” (as opposed to fight or flight) nervous system supports the immune system and decreases inflammation. A meditation or prayer practice supports this, as does giving and receiving love, singing, dancing, swimming in cold water, laughing, petting a pet, appreciating beauty, listening to music.
  • Immune supporting and anti-inflammatory herbs and supplements may be helpful. However, they will be so much more effective if you partner with them by doing the above things. My favorites:
    • Vitamin D-high dose (10,000 IU) for the first four days after any sign of illness.
    • Elderberry and astragalus are two immune supporting herbs with anti-viral effects.
    • Omega three fatty acids (both DHA and EPA) are anti-inflammatory
    • There are others, and I’m currently researching those with the strongest evidence in this type of virus. I’ll continue to send these out along with other updates.

This is a challenging time we are facing together. It is a good time to bring our focus on what is most important, and to reach out to and support vulnerable friends and neighbors.

We will continue to be in contact here each week, and will reach out to let you know other measures Coastal Health Alliance will be taking as the situation unfolds. Please share these recommendations widely.

With love and care,

Anna O’Malley, MD

Mask Communication April 4 2020

Dear community,

I am so delighted by the way in which our community is taking up the call to make mask-wearing in public the social norm, in such a crafty and fun way. All around West Marin, people are sewing masks, supporting friends and neighbors to wear them every time we go out in public. Yay! So important. Just in case there is confusion about what these home-made, cotton masks (tightly woven cotton material, like quilting fabric or batik, in two layers, performs best in studies) can and cannot do, I’d like offer important clarification:

  • Homemade cotton masks protect others from the droplets that come out of your mouth and nose.
  • They help decrease spread, especially due to asymptomatic or presymptomatic carriers of the virus.
  • They do help remind us to not touch our face, especially our nose and mouth.
  • The do not make it safe to relax on social distancing and staying home
  • Wearing a mask does not make it safe for an elder or those at high risk to go out.
  • They do not offer enough protection to care for an ill family member.
  • They do send a signal that we are caring for and protecting one another from our own possible contagion, and that we are protecting health care workers by reserving surgical masks and N95 masks for them.

Please remember to wash them after you have worn them, take them on and off by the ties or elastic, and do not touch the front of the mask as you might be getting virus on your hands.

Do develop the skill of smiling with your eyes, and expressing gratitude to the sewing members of our community. Now is a great time to dust off your machine, if you have one, and pick a pattern and support your community.

With care,

Anna O’Malley, MD