ND Physicians Offer Pandemic Health Advice

Doctor and Patient

We, as North Dakota Physicians, remain committed to partnering with you, our patients, to work toward us all becoming the best version of ourselves.  As physicians, we recognize the importance of caring for the whole self to optimize health.  In times of crisis, like this pandemic, this is more important now than ever.

We would like to provide the following health recommendations for our fellow citizens during this time of pandemic:

  1. Adequate sleep is essential– Most adults require at least 7-8 hours of sleep/night. The amount of required nightly sleep increases as age decreases.  It is very difficult to keep your mind and body healthy without adequate sleep.
  2. Proper nutrition is essential– Eating a well-balanced diet that includes plenty of servings of fruits and vegetables with caloric intake and portion sizes that reflect calories burned will help you maintain (gain if you are a child) appropriate weight. Supplementation with a daily multivitamin and up to 1000 IU vitamin D, if not instructed otherwise, may help to safely boost those co-factor levels that are not readily available through your diet, sunlight exposure etc.
  3. Daily exercise is essential– Movement is medicine. It is important to move your body throughout the day, every day. The American Academy of Pediatrics recommends a minimum of 1 hour of active play each day.  The American Heart Association recommends at least 150 minutes of moderate physical activity weekly.  Emotional stress resulting from this pandemic can in part be dissipated by releasing some of that negative energy via physical activity.
  4. Managing our “interior” life is essential. Depending upon your beliefs, this may be achieved in prayer/worship, yoga, meditation, and/or mindfulness techniques.
  5. Avoidance of excessive substance use or return to unhealthy/addictive behaviors is essential during this time of stress.  While this may serve as a temporary way to deal with negative stress, this pandemic has been and will be around for a while.  Hence, this band aid approach will not work for management of long-term stress, thus increasing risk for substance abuse/dependence.  In addition to drugs and alcohol, remember that excessive food intake can also provide immediate comfort/stress relief, but is not a useful chronic stress management tool.

These basic health recommendations, as stated above, are always essential for optimal physical and emotional health.  We have additional recommendations specific to optimize health during the Covid-19 pandemic.

We believe that reducing your risk of becoming infected with Sars-CoV-2, the virus that causes Covid-19, is important for the following reasons:

  1. If you are a person with underlying conditions, you have an increased risk for severe illness that may lead to death.
  2. No one knows what the long-term health effects of this virus are. We continue to learn about this 10-month-old virus every day.  Choosing to intentionally become infected with this virus is similar to choosing to ingest an unknown mushroom- many types of mushrooms are great for eating, but ingestion of a few species of mushroom may result in liver toxicity that is fatal.
  3. This virus can result in no symptoms for a person during a time that they may be extremely contagious. This results in the potential spread to vulnerable people who will require hospitalization due to severe illness that may result in death.  Ultimately, this drives up death rates and healthcare costs, as well as limits access to healthcare. We all carry the burden of these consequences.
  4. Infection from Sars-CoV-2 hurts the economy by compromising businesses due to employee infection and quarantine. The potential for increase in insurance costs resulting from cost of care associated with Covid-19 will also significantly impact businesses.

We would like to illustrate the risk for becoming infected with SARS-CoV-2 with this simple equation:

Infection = Exposure to Virus x Time

Based on this equation, the following strategies are effective in limiting the spread of Sars-CoV- 2:

  1. Minimize virus in the air we all breathe by:
    1. Limit crowd density- fewer people per square foot = fewer breaths/sq. foot and less likelihood of infected person in that space
    2. Limit time in public places- less time in one spot=less breaths of recirculated air that may contain Sars-CoV-2 virus.
    3. Mask use- this reduces (not eliminates) the amount of droplets (which carry the virus) released when you breathe, speak, sing etc. The fewer droplets in the air, the less virus in the air.  The greater percentage of people wearing masks in a given setting, the less virus in the air.
    4. Increase air exchange/filtration of air- This air movement helps to disperse/dilute the amount of virus in a given air space.
    5. Stay home and isolate when infected with Sars-CoV-2- This confines your viral air to your small space that is inhabited by only you.
    6. Quarantining of those with exposure to an infected person that is significant enough to merit risk of infection has the potential to limit this person’s spread of virus through the air to others at a time when this person may be infected and contagious, but not feel symptoms.
  1. Minimize virus on surfaces– Note that this is NOT the primary route of transmission, but does contribute to transmission
    1. Wash your hands frequently
    2. Do not touch your face- If you have to touch your face, please wash your hands before and after.
    3. Frequently disinfect surfaces.
    4. Stay home and isolate when infected with Sars-CoV-2- This confines your virally contaminated surfaces to your small space that is inhabited by only you.
    5. Quarantining of those with exposure to an infected person that is significant enough to merit risk of infection has the potential to limit this person’s spread of virus via contaminated surfaces to others at a time when this person may be infected and contagious, but not feel symptoms.

Again, as your North Dakota Physicians, we care deeply about you becoming the best version of yourself.  We understand that this pandemic has and continues to present unprecedented stress during an unprecedented time.  However, we also understand, appreciate, and never underestimate the resilience of our North Dakota citizens.  We are here, with you, as North Dakotans who hope to use this resilience to turn this stressful time into a time of unprecedented healthy growth and development for all North Dakotans.  We look forward to our continued partnership with you.

Dr. Mohammad Adie

Dr. Hawaa Alao

Dr. Marisa Albertson

Dr. Kathy Anderson

Dr. Misty Anderson

Dr. Barry Amos

Dr. Travis Anderson

Dr. Laura Archuleta

Dr. Lacey Armstrong

Dr. Kenneth Asogwa

Dr. Biron Baker

Dr. Shawna Baker

Dr. Gabriela Balf Soran

Dr. Gaurav Bansode

Dr. Kaylan Belville

Dr. Barbara Bentz

Dr. Timothy Bischof

Dr. Heidi Bittner

Dr. Rose Brandt

Dr. Ronald Brockman

Dr. James Buhr

Dr. Ann Cadwalader

Dr. Nicole Careen

Dr. Paul Carson

Dr. Thomas Carver

Dr. Benjamin Chaska

Dr. Ling Chow

Dr. Christian Colon Ripoll

Dr. Joan Connell

Dr. Ranon Cook

Dr. Lindsey Dahl

Dr. Stephanie Dahl

Dr. Kevin Dahmen

Dr. Joshua Deere

Dr. Tanya Diegel

Dr. Faith Dieleman

Dr. Angie Dornacker

Dr. Shelby Dvorak

Dr. Terry Dwelle

Dr. Dale Ernster

Dr. Lori Esprit

Dr. Ashley Evanoff

Dr. J Patrick Fahn

Dr. Elizabeth Faust

Dr. Ellen Feldman

Dr. Emmanuel Fermil

Dr. Stephanie Foughty

Dr. Rene Fredstrom

Dr. Joy Froelich

Dr. Vijay Gaba

Dr. Mridu Gandhi

Dr. Aaron Garman

Dr. Hafiz Ghaffar

Dr. Jason Go

Dr. Yvonne Gomez

Dr. Bethany Gourneau

Dr. Greg Greek

Dr. Michael Greenwood

Dr. Dubert Guerrero

Dr. Robert Guttormson

Dr. Jean Gustafson

Dr. Katherine Hall

Dr. James Halvorson

Dr. Matt Hamar

Dr. Johathan Haug

Dr. Chris Henderson

Dr. Marshall Henderson

Dr. Allison Hetland

Dr Ann Hoff

Dr. Tonia Hoggarth

Dr. Michael Holland

Dr. Shannon Holsen

Dr. Jeffrey Hostetter

Dr. John Hoyt

Dr. Sohaib Hussaini

Dr. Cheryl Huber

Dr. Sabine Hyder

Dr. Eric Jacobson

Dr. Stephanie Jallen

Dr. Michael Jankoviak

Dr. Sadaf Javaid-Kayani

Dr. Marisa Jennings

Dr. Eric Johnson

Dr. Jennifer Jones-Dees

Dr. Kirsten Juhl

Dr. Derek Kane

Dr. Emmet Kenney Jr

Dr. Fahad Khemani

Dr. Lee Kiedrowski

Dr. Alexandre Kindy

Dr. Ermelinda Kerpi

Dr. Amin Kichloo

Dr. Scott Klein

Dr. Jacinta Klindworth

Dr. Scott Knutson

Dr. Renee Koltes-Edwards

Dr. Lisa Kozel

Dr. Parag Kumar

Dr. Darin Lang

Dr. Daniel Lee

Dr. Gordon Leingang

Dr. Collette Lessard

Dr. Laura Lizakowski

Dr. Oscar Llanos

Dr. Samuel Lohstreter

Dr. Madeline Luke

Dr. Carlo Mandujano

Dr. Ahmed Maraey

Dr. Paul Mariani

Dr. Jared Marquardt

Dr. Alex Marsh

Dr. Erling Martinson

Dr. Candelaria Martin

Dr. Tracy Martin

Dr. Dawn Mattern

Dr. Maryse Mathieu

Dr. Steven Mattson

Dr. Justin Mauch

Dr. Sarah McCullough

Dr. Jean McGowan

Dr. William McKinnon

Dr. Andrew McLean

Dr. Michael McMahon

Dr. Jaron McMullin

Dr. Tara Mertz-Hack

Dr. Keith Millette

Dr. Vanessa Miller

Dr. Jagila Minso

Dr. Kevin Moore

Dr. Laura Morgan

Dr. Kevin Mork

Dr. Rup Nagala

Dr. Avish Nagpal

Dr. Fadel Nammour

Dr. Kristen Nardozzi

Dr. Sara Nausheen

Dr. Tracie Newman

Dr. Bahram Nico

Dr. Marc Nielsen

Dr Margaret Nordell

Dr. Casmiar Nwaigwe

Dr. Paul Olson

Dr. Shari Orser

Dr. Daniel Padgett

Dr. Diana Peterson

Dr. Jennifer Peterson

Dr. Heidi Philpot

Dr. Michelle Placke

Dr. Brandon Price

Dr. Myra Quanrud

Dr. Jacqueline Quisno

Dr. Joshua Ranum

Dr. Michael Rayel

Dr. Roggie Reason

Dr. Deborah Reed-Thurston

Dr. Wanapak Richter

Dr. Sydney Rooney

Dr. Justin Rosenau

Dr. Casey Ryan

Dr. Janelle Sanda

Dr. Peter Sandroni

Dr. Jeffrey Sather

Dr. Shannon Sauter

Dr. Rhonda Schafer-McLean

Dr. Laura Schield

Dr. Lisa Schock

Dr. Julie Schwartz

Dr. Grant Seeger

Dr. Robin Severud

Dr. Brittany Snustad

Dr. Theodros Solomon

Dr. Lori Sondrol

Dr. Gustav Staahl Jr

Dr. Andrew Stahl

Dr. Haley Svedjan

Dr. Grant Syverson

Dr. Randy Szlabick

Dr. Sumaiya Thakor

Dr. Robert Thomas

Dr. Ana Tobiasz

Dr. Jeffrey Verhey

Dr. Harjinder Virdee

Dr. Parveen Wahab

Dr. Joel Walz

Dr. Derek Wayman

Dr. Steven Weiser

Dr. Asher Wolf

Dr. Glen Yoshida

Dr. William Zaks


The Economic Benefits of a Flu Vaccination: Prevention is Wealth

This fall and winter, both COVID-19 and influenza will be circulating at the same time. Both are respiratory illnesses and have similar symptoms. Without testing, it will be difficult to tell the difference between the two. Luckily, we have a way to prevent the burden of having two deadly respiratory diseases circulating at the same time. That prevention is the influenza vaccine.

While the influenza vaccine is not 100% effective, it can substantially decrease influenza illness, hospitalizations, and deaths. During the 2018-2019 influenza season, when the vaccine effectiveness was estimated to be only 29%, the Centers for Disease Control and Prevention estimates that over 50,000 hospitalizations and 3,500 deaths were prevented. This was with approximately 49% of the United States population receiving a flu vaccine. Imagine what could be prevented if everyone received a flu vaccine.

One major component to North Dakota’s COVID-19 response has been to preserve hospital capacity. A severe influenza season while COVID-19 is still circulating in North Dakota has the potential to wreak havoc on our already stressed healthcare system. Health care workers are already stretched thin caring for positive COVID-19 patients. Adding influenza increases the number of beds in use, increases the numbers of patients requiring a ventilator, and increases the need for health care workers. Every hospital bed that is not used for an influenza patient can be saved for a COVID-19 patient.

North Dakota makes it a priority to keep schools and childcare centers open and one sure way to keep these establishments functional is to keep their students and staff healthy. Influenza vaccination of children and staff plays an important role to ensuring that parents can continue working and continue to provide for their family.
North Dakota also strives to keep businesses open and when we have healthy employees and thriving businesses, we can ensure a healthy economy. When employees are vaccinated, employers see a drop in absenteeism and it also reduces the workload burden of healthy employees when sick coworkers are unable to perform their duties.

While it may seem like there is so much out of our control during this pandemic, getting vaccinated against influenza is within our control and will protect not only those who receive flu vaccine but also our friends, families, and neighbors. By everyone doing their part and getting vaccinated the citizens of North Dakota can continue to protect the health of our state.

Misty Anderson, DO
North Dakota Medical Association