Dear Patients and Friends:

We are excited to announce the re-opening of Unger Primary Care beginning June 1. I feel that we can safely manage our patients using both in-person and virtual appointments. Although the look of the practice has changed somewhat due to COVID-19 concerns, we will continue to provide outstanding and comprehensive medical care to all members of our practice.

As a physician, I am very concerned about the welfare of all people whether or not they are afflicted with COVID-19. I understand that this virus can kill, but in reality most people who acquire COVID-19 are either asymptomatic or likely to recover completely from their infection. We know that those who are most at risk of dying from COVID-19 are those people older than age 80, in nursing homes with co-existing diseases such as COPD, heart disease, poorly controlled diabetes and hypertension.

Over the past 2 weeks the San Bernardino statistics demonstrated a 3.5% decrease in COVID-19 hospitalized patients as well as a 9.4% decline in patients testing positive for COVID-19 within the ICU. The death rate is 2.5/100,000 people and just 55 deaths have been reported in the past 14 days attributable to COVID-19. By comparison, over the past 3 years, the death rate due to cancer in the US is 158/100,000 while 442/100,000 people were newly diagnosed with cancer. Other disease rate comparators are noted in Table 1. Note that more people are injured in elevators than become infected with COVID-19.

Table 1
Incidence of Disease Per 100,000 People In the US

CDC: National Health Statistics.

In reality, no one knows what will be the ultimate outcome of this pandemic. Be cautious about the promise of vaccines. Interestingly, England has tested over 10,000 people with their COVID-19 vaccine. However, researchers are concerned that they are actually running out of volunteers to test. In order to determine efficacy of a vaccine, people who receive placebo vaccine would have to eventually test positive for the virus. However, fewer people than anticipated are actually testing positive for COVID-19 in England at this time. A vaccine trial should access efficacy and safety over a 3-month period. Let’s say that 1000 people receive the vaccine and 1000 receive placebo. If just 5 people in both groups acquire the virus in 12 weeks, researchers will be unable to address efficacy of the vaccine for disease prevention.

A better means of preventing the disease is through the development of “monoclonal antibodies.” These designer antibodies can protect our cells from becoming infected with the virus. If the virus is the “key” and the cell is a “lock” monoclonal antibodies effectively place “gum” on the lock preventing entry of the key and preventing disease. We are currently using MCAs to treat diseases such as eczema, migraine, and colitis. MCAs appear to have minimal side effects and work quickly to improve the lives of patients. Scientists are also looking into effective acute and preventive therapies for COVID-19 afflicted patients.

Overall, the number of new cases of patients presenting to the ER with COVID-19 is on the decline as can be seen in Figure 1. In addition, the CDC reports large decreases in mortality rates — and hospitalizations — during April and May throughout most of the United States. Only 10% of people living in “hot spots” such as NYC are testing positive for COVID-19 vs over 40% 1 month ago. The virus is FADING!

Figure 1

Over the past 2 weeks, the number of cases presenting to the ICU or Emergency Department has declined by 50%. Across the country, the US is below the baseline for normal influenza-like symptoms normally reported in emergency rooms nationwide.

More good news… that the number of people in the US who have reported a “flu-like illness” has decreased from over 20% to just 2% in all age groups.

Unger Primary Care Concierge Medical Group Is Prepared To Open!

After looking at our state and local statistics, Lisa and I have decided to move forward and re-open the office two days per week with certain restrictions as noted below. We will continue to see our patients through our telemedicine portal (Doxy.me) on Mondays and Wednesdays. Fridays will be reserved for “teaching” and evaluating our hospice patients. If all goes well, the office will open additional days in July. Here are the changes you will experience when scheduling appointments:

  • When scheduling an appointment, Sarah or Amanda will screen each patient and his/her caregiver to make certain that they have not had a cough, shortness of breath or a fever within 14 days of their visit. Please note, that only a single caregiver may be present for appointments.
  • Patients will be screened once again 24 hours in advance of their appointment via a phone call.
  • Upon arrival to our building, patients will be reminded to call us and wait in their car before coming into the office. Our staff will call you when the exam room is ready. We will be using just a single exam room for now.
  • Patients and caregivers will undergo temperature screening upon arrival in the exam room.
  • Every patient and caregiver MUST wear a mask. Please note, that we do not have spare masks. No mask, no entry. (Note, the CDC has determined that the likelihood of virus transmission between an infected and uninfected person is minimal if both people are using masks).
  • Amanda or Sarah will collect all copays 24 hours prior to a scheduled appointment. We will NOT accept cash or credit cards on the day of the visit. If we are unable to collect payment in advance, the appointment will be canceled.
  • Each appointment will last 30 minutes after which the exam room will be deep cleaned and prepared for the next patient. Late appointments will need to be rescheduled. Therefore, we encourage all patients to arrive on time to the parking lot!
  • Dr. Unger and staff members will be wearing gloves and masks during the visit.
  • Labs will NOT be drawn on site. Patients will be directed to Lab Corp or Quest. Random urine drug screens will be performed when appropriate.
  • Patient visits will be restricted to 5 per day.
  • Dr. Unger will continue to see emergent and routine follow-up appointments through our telemedicine platform (phone, Doxy.me, and Facetime).
  • We look forward to giving you all a virtual high five and not seeing your smiling faces as you come in to the office.

I would like to thank you all for your patience and please rest assured, that we will do everything in our power to keep you safe, happy, and informed.

Sincerely,
Jeff Unger, MD, FAAFP, FACE
Director, Unger Primary Care Concierge Medical Group
Associate Professor of Family Medicine, UC Riverside School of Medicine

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