Thomas S. Bottiglieri, D.O.

Good morning everyone,

  Newly identified cases of COVID in New Jersey & New York State continue to decrease. Here at Columbia Orthopedics, we have some exciting news! As of Monday, 5/18 we will be re-opening our office for in-person visits according to Phase-1 guidance on a limited basis.

  As of Monday, May 18^th,  steps toward reopening will happen across New York and New Jersey. The restart of non-essential construction; along with that of non-essential business for curbside pickup will be permitted. Drive-in and drive-thru events are now allowed in NJ, while abiding by the social distancing rules. In both NJ and NY, face coverings continue to be required to protect one another when in public spaces, especially indoors. 

  There are two types of diagnostic tests designed to determine COVID infection status. The nasal swab and the saliva test developed from scientists at Rutgers University. The nasal swab involves a 6-inch-long swab (Q-tip like) inserted through the nose, into the nasopharyngeal cavity (between the nose and mouth). This takes approximately 15 seconds of rotating the swab several times, before repeating on the opposite side. The swab is then placed into a sterile container and sent to the lab. Results can take up to a week.

  Scientists at Rutgers recently developed an FDA approved saliva test, which can be performed more easily, decreasing exposure and risk for healthcare professionals and improving testing availability. This saliva test involves spitting into a vial with a funnel attached. After filling the tube it is sent to a lab via an overnight courier or US Postal Service. Results are provided in 24-48 hours. With this new testing method, we are hopeful the number of tests performed daily will increase, which will more quickly identify infected persons and will slow the rate of spread.

  Antibody testing has also ramped up – however understanding the validity of test results remains imperfect. The FDA relaxed rules for offering Antibody testing to the public, but is now contracting due to the realization of some faulty tests in the community. This testing is done via serology (blood work), requiring a needle stick with a trained clinical person, and subsequent laboratory analysis. Results of SARS-CoV-2 antibody presence does not perfectly align with expected results in confirmed cases of COVID, and positive results do not necessarily mean long-term immunity to COVID-19. As testing improves, epidemiological data gets analyzed, and testing becomes more universally available, we will be more well-equipped to provide meaningful information regarding infection rates, risk of severe illness, and death rates.  This will certainly help to guide policy.

  The process for testing staff and students will become more clear as we understand cost, availability, and implement tactics for administration. At this time it seems clear that some reassurance with negative testing will be necessary for larger groups of people to come together such as in a school setting.

  Contact tracing is also a vital component of reopening strategies.  Johns Hopkins has released a training course (FOR FREE) to train people in this vital skill.  We will need thousands more contact tracers in order to effectively and safely return to activities.  As pockets of injection decrease, we will be able to identify person of interest and their contacts to test, isolate, and prevent further spread.  I encourage anyone in an administrative role to take this course or delegate to personnel at their organization.

  There are numerous free apps to help guide exercise; and as a reminder, many children are able to continue their sport specific skills (i.e. ball drills for soccer player and stick handling for hockey players) even when they are not able to participate with team practices!  We have posted some videos for this purpose as well.  Continue to be mindful, take breaks, limit social media, connect with friends & family, exercise daily, and find meaning & purpose during this crisis.

I look forward to seeing you all soon.

Be well & be safe.