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Important COVID-19 Updates for North Texas Physicians

The North Texas Medical Society Coalition is sharing two important and timely COVID-19 updates as you help navigate care for your patients. 

First, the Texas Department of Emergency Management (TDEM) has opened a second COVID-19 antibody infusion center in North Texas. The new facility, located at Collin College in McKinney, will be in addition to the existing center in Ft. Worth. Click here to access the referral form and here for location details for the McKinney location. Click here for the referral form and here for location details for the Ft. Worth location.

Second, regional hospital emergency departments are requesting that well and mildly ill patients requiring a COVID-19 test (e.g. students, teachers and others who are seeking to return to school/work, or, individuals with mild symptoms), be directed to offsite COVID testing facilities. Emergency departments are being inundated with both sick patients and COVID-19 testing requests and have asked for the assistance of referring physicians to direct test-only patients to offsite locations. To access an offsite testing location, please click here. Please advise patients to contact the testing center prior to arriving to inquire about any limitations (e.g. no pediatrics, hours, appointments needed, etc.), and other important details. Hospitals have advised that patients who present at the emergency department for testing only may be charged an emergency department visit fee. While the COVID test itself is free, a facility visit fee may apply.

Thank you for all you are doing to serve your patients and our community. You are appreciated!

The NTMSC represents more than 11,500 physicians in the communities of Collin-Fannin, Dallas, Denton, Grayson, and Tarrant County. Founded in 2020, the NTMSC works with community healthcare partners, including public health departments, hospitals, and business leaders, to advise on medical recommendations to serve the health care needs of the residents of North Texas.

Lights in the Dark

by Angela Self, TCMS President

This article was originally published in the May/June issue of the Tarrant County Physician. You can read find the full magazine here.

I once wrote about my hopes for life after medical school. I would imagine my office decor, my conversations with patients, the time I would spend coordinating their care. The thoughts were all happy and gave me hope when the dark days of medical school cast a shadow over my upbeat mood, when classes took me down the road of insomnia and gave me a near flat affect from studying more than 12 hours a day during exam time. I guess we all looked like zombies immediately before and after our exams, and some even had the fragrance. 

Once a girlfriend came to visit me and she stayed at a hotel on the beach. I discovered the pleasure of sitting and enjoying a piña colada and having zero thoughts of gluconeogenesis or small, slow-conducting fibers (protopathic). Denise, the Coyaba hotel, and a piña colada were all little lights for a med student who was over 2,000 miles from home.

There are times during my professional life that I once again feel like I’m over 2,000 miles from home. Denise is now married and living in Ohio. Piña coladas have way too many calories. The Coyaba hotel would require more PTO than I’m able to take. I’m sitting at my dining room table as I write this because stepping back into the office would make me feel like I’m still at work. I started to take an evening walk but turned around when a close friend told me how much my article sucked (the one you’re not going to read). He didn’t actually say that it sucked; he just pointed out how opposite of uplifting or encouraging it was and said, “It’s not your best work.” Thank you, “D,” for your honesty.

Why would I not be the happiest person you could meet? I have a great job. I am happily single and able to go out and meet a girlfriend for coffee any time I want. I see my beautiful daughter on a regular basis (who is working, doing well in school, and enjoying her youth by spending time with her close friends). My mom survived a hospitalization that nearly took her life in 2013 and has never smoked again (I had taken her home on hospice ten days after she was admitted). Heck, I barely have enough bills to qualify as debt. I should be dancing around the whole Grapevine/Colleyville area. But I’m not.

The strange thing about being there for everyone else is that you sometimes forget to keep a little piece of yourself to enjoy—you just give it all away. Yes, this is a “me” problem. I am the one who picks up the phone when I know the person calling is going to vent for the next 30 minutes, but after 20 years of friendship, you make an effort to still “be there” because that’s what friends do. When your very best friend calls and frantically asks for prayer because the vet is coming to put their horse down (which happened two days ago), how do you not take that call? When your mom wants to tell you about a grandkid she’s concerned about and says the stress is overwhelming, are you going to hang up on her? Another friend tells you they are really concerned because they are still having fatigue and shortness of breath since their heart procedure—and this is one of your health-conscious friends. How can you not feel that? Then there is the job that you love doing, but sadly you do it for 12 hours many days. I find myself on long walks, asking, “Am I missing something?” I wonder if there are elderly patients that I could be helping, or if I’m not fulfilling my calling by now being on the “administrative” side of Medicine.

Long walks, good coffee, and two cats have replaced Denise, the Coyaba, and even the piña colada. As I walk along, I play music from the 80s and 90s and look at all of the different trees—I love the long needle pines the best, they look and smell good. I see the cardinals and the other birds flying around and admire how they know the meaning of commitment. On the weekends I spend hours at the coffee shop with the same few people I’ve been meeting there for years (none of us got COVID-19, and almost everyone is getting vaccinated). They give me a special discount at Buon Giorno, just don’t tell anyone. What? They give everyone that same discount for bringing their thermal mug? I look up at the stars and try to find the big dipper, but I live in Grapevine and, you know, light pollution. I run a hot bath and sit there until it’s barely warm. Netflix holds many fond memories from my COVID-19 nights: Shtisel, Sex and the City, The Crown, Girlfriends . . . I really do make the most of each day and try to laugh as much as I can. It’s just been hard to laugh lately, and I wanted to share in case someone else is also having a hard time laughing, or sleeping, or even folding the laundry.

We are the ones who are there for everyone else. Who is there for us? Though my friends and family can drain the very life force from my body, I want you to know that I am here for you. You have sacrificed so much for others, and your colleagues see you. They care even though you thought they didn’t like you. I am struggling a bit these days, as I suspect many of us are after the year we’ve been through. 

Perhaps this is just my COVID-19 carb crash, but I am ready for this season to end. I am praying; I like to pray. I am even going to church on occasion . . . not that I care for going to church. But my faith has always seen me through the most difficult of times, and I once again find myself reading Joshua 1:9, knowing that He will be with me wherever I go. I am going to put that and a few other verses on the wall behind my laptop as a reminder that He is always with me. I have friends who do not share my faith, my politics, or my taste in music, but we do share the need to connect, to laugh, and to be heard. Thank you for reading my article and for being one of the lights in a sometimes dark place. Call me any time at 817-798-8087 (text first if you actually want me to pick up). We’re all walking through this—let’s do it together. 

Tarrant County COVID-19 Activity – 02/25/21

COVID-19 Positive cases: 240,416

COVID-19 related deaths: 2818

Recovered COVID-19 cases: 219,208*

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Thursday, February 25, 2021. Find more COVID-19 information from TCPH here.

*These data are provisional and are subject to change at any time.

Deaths and recovered cases are included in total COVID-19 positive cases.

Tarrant County COVID-19 Activity – 01/28/21

COVID-19 Positive cases: 213,611

COVID-19 related deaths: 2123

Recovered COVID-19 cases: 161,348

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Thursday, January 28, 2021. Find more COVID-19 information from TCPH here.

*These data are provisional and are subject to change at any time.

Deaths and recovered cases are included in total COVID-19 positive cases.

The Dead Horse of 2020 (No, not the Election)

By Angela Self, MD – TCMS President

This piece was originally published in the January/February issue of the Tarrant County Physician. You can read find the full magazine here.

Though I vowed not to touch the pandemic as a topic, it seems to be the one thing that’s on my mind. Still crazy after all these months.

I was in Florida when I saw President Trump come on television and announce that we were facing some big changes due to the coronavirus. What I remember most was that his face was white as a sheet and his voice, uncharacteristically, had no dramatic intonation. The serious look on his face and the coming lockdowns scared me much more than the thought of running out of toilet paper. I knew we were headed for a major disaster in this country and it hit me in the gut, hard. I cried easily and often for the next two weeks. I mourned the loss of my country. I knew that many would die, that we would be divided over the handling of the pandemic, and that the pandemic would be highly politicized. I kept changing the channel that March day in 2020. Forgetting Sarah Marshall was needed, and fast. It was an election year and we were already dealing with the polarity of being either a Democrat or a Republican, and now we would be divided over COVID-19 controversy. Let me just say that I have never, ever wanted to get sick from anyone in any public place who was coughing and spewing infectious particles. Masking is about the best idea I’ve ever heard of; I think it’s a great way to decrease disease spread during every cold and flu season, as well as in a pandemic. I once missed Thanksgiving with my family after my sister called and said, “We’re going, but John is sick and he’s running a fever.” I took the next exit off of I-35, turned around, and spent Thanksgiving home alone. It was worth it. 

This past January I was speaking with a girlfriend who was getting over a pretty bad upper respiratory infection. She wasn’t sneezing or coughing, but as we talked a little spit droplet flew out of her mouth and into my eye. When that happens, and it does, I just say, “Whatever they’ve got, you’ve got it now.” I do not get that close, or face to face, to this friend anymore. Some people have to spray it when they say it, and COVID-19 is the last thing you want to have sprayed in your face. Looking back over this year I remember a few of my friends had severe upper respiratory infections. Was it COVID-19? Maybe. It seems like years ago that it was okay to cough or sneeze in public, but not now, and it’s just been a little over nine months. Now when a dust particle brings on an unexpected sneeze, the next thing you hear is, “It’s just allergies, I’m not sick!” I agree with stringent infection control measures in public places. I am saddened, however, by businesses closing, millions losing their jobs, nursing homes not allowing any visitors in a safe, distanced way (meaning little accountability and possibly increased neglect), and healthcare professionals using their credentials to further polarize an already confused society.

“Masking is about the best idea I’ve ever heard of; I think it’s a great way to decrease disease spread during every cold and flu season, as well as in a pandemic.”

So what do we do? How do we move forward? I have a friend who lost his wife to COVID-19 months ago (she was an ER nurse in New Jersey), and I have another good friend who just recovered from COVID-19 pneumonia. This virus is still a public threat. People are still dying. Treatments are helping many, but like the flu and other diseases, there is not a cure. A vaccine will not be 100 percent preventive. It’s the best we’ll be able to do, but it won’t be 100 percent. Do we allow our economy to collapse or do we get back to work in a safe and smart way? It’s easy for those of us who can go to work to say, “Stay home,” as we are able to provide for our families. During this pandemic, I went to a certain coffee shop every day and sat at a table outside with my cousin (it was the only contact that the both of us had with another person during the early days of the pandemic). We would see other coffee friends pull up and have their orders delivered to their car. We watched the mask requirement come in and we complied; we still do. The thing that we mostly did was sit there every morning and act normal while supporting a struggling local business. We were socializing over coffee in a safe manner. If I had to cough (allergies) I would get up and walk around the side of the building. In the spring, if the group ever grew to over the allowed number, someone would leave and let another sit and visit. Our coffee shop owners had to lay off twenty employees and close their shop in Southlake. One of the negative consequences, besides death from illness and job loss, is depression that has been made worse due to social isolation. Though many of us feel we can safely get our groceries, have our coffee, and take care of business, as long as the protective measures are being used, there are still many who are very afraid. That fear has likely served the most vulnerable well, as they’ve had limited exposure to COVID-19, but it has cost others their lives due to depression and suicide. It has cost some child abuse victims their lives, with school being a safe place where they could escape the abuse for at least a few hours. I am grateful that Texas has allowed businesses to reopen and let our citizens get back to work and their kids back to school. This pandemic is not over yet, but hopefully, much of the devastation is behind us as we learn more about this virus and how to best treat it.

 The way I would like to see us move forward is with safety protocols and measures in place, while returning to our livelihoods with moms and dads able to pay the mortgage, keep the lights on, and feed their kids. Talk about “social determinants of health”; can we even measure the food insecurity that’s out there when we’ve taken a meal away from a kid who might not get any meals at home? Let’s move ahead with disease prevention. How many mammograms and colonoscopies were not done this year, leaving cancer undiagnosed and untreated? I’ve seen some “quality” scores and there are many “gaps” that weren’t closed in 2020. The thing about open gaps is that you just don’t know which gap closures would’ve caught a disease process in its early stages.

I wanted to start off the year with an article about avoidable hospitalizations from UTIs gone wild or how medical directors are people too, but instead, I have broken my own rule about avoiding controversy. If you’re a little confused on where I stand on COVID-19, here are my thoughts: 1) respect your fellow man by wearing a mask and keeping a safe distance; 2) consider if you might be putting a high risk person at increased risk (self-quarantine if you’ve been exposed); 3) be kind to each other as many are struggling with the loss of friends, family, personal health, or their job; 4) exercise your rights and freedoms in a safe manner; 5) the virus is very real and very deadly (to some even previously healthy people); and 6) take the vaccine if you get the opportunity—it’s the best we can do to turn the tide on this pandemic. Blessings, and I look forward to an America without COVID-19.

COVID-19 Infusion Centers Info for Tarrant County

Below is the current information about Tarrant County’s COVID-19 Infusion Centers. You can find a more readable version of the information sheet with functioning links here.

You can find the Infusion Centers Referral Form here.

Key points to remember:

  • There are currently two (2) Infusion Center sites in Tarrant County
  • Patients must be referred by a physician, an NP, or a PA
  • Walk-in appointments are not available
  • There is not cost to the patient for treatment

If you have referral questions, call (855) 478-1528.

Tarrant County COVID-19 Activity – 01/19/21

COVID-19 Positive cases: 197,447

COVID-19 related deaths: 1904

Recovered COVID-19 cases: 141,426

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Tuesday, January 19, 2021. Find more COVID-19 information from TCPH here.

*These data are provisional and are subject to change at any time.

Deaths and recovered cases are included in total COVID-19 positive cases.

North Texas Physicians to Host Facebook Live: Understanding the Science Behind COVID-19 Vaccines

Tune in tonight at 7:00pm on the North Texas Medical Society Coalition Facebook Page for another great live discussion with your community physicians. This week, Dr. Mark Casanova (Dallas County Medical Society) and Dr. Bryan Johnson (Collin-Fannin County Medical Society) will host Dr. Gregorio Gomez from the University of Houston College of Medicine for a conversation on the science behind the COVID-19 vaccines.

Tarrant County COVID-19 Activity – 01/13/21

COVID-19 Positive cases: 183,080

COVID-19 related deaths: 1777

Recovered COVID-19 cases: 130,469

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Wednesday, January 13, 2021. Find more COVID-19 information from TCPH here.

*These data are provisional and are subject to change at any time.

Deaths and recovered cases are included in total COVID-19 positive cases.

Tarrant County Opens Vaccine Mega Site, Hopes to Vaccinate Thousands a Day

A new COVID-19 vaccination site was opened in Tarrant County on Tuesday. This new locations, which is hosted at the Hurst Conference Center, has the goal of immunizing 2000 individuals per day. At of yesterday, 23,000 individuals have received their initial COVID-19 vaccination through Tarrant County Public Health.

For more information about the site or to find out if you qualify to register for the vaccine, you can read the Star-Telegram’s article on the topic here.