We are continuing to learn about the new coronavirus and the disease it causes, referred to as COVID-19 or the coronavirus disease. 

At this time, there is no vaccine available for COVID-19. On May 1, 2020 the [FDA](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment) issued an emergency use authorization for the investigational antiviral drug remdesivir for the treatment of suspected or confirmed COVID-19 in adult and children hospitalized with severe illness. 

However, the best course of action remains to practice individual and community-based strategies to help slow the transmission of the coronavirus and to reduce overall illness and death. Slowing down the spread of the disease also helps to protect individuals who are at increased risk for severe illness, such as older adults and those with underlying health conditions. 

__Even if you aren’t worried about your own health, efforts taken by all of us can help reduce the transmission of the coronavirus to the most vulnerable people among us.__
 
We talked about some of the ways you can keep yourself healthy in [this article](https://www.heydoctor.com/learn/covid-19-how-can-i-stay-healthy) and how you can use social distancing (staying away from crowds, avoiding close contact with others) to help reduce transmission of the coronavirus in your community [here](https://www.heydoctor.com/learn/coronavirus-what-is-social-distancing).


Now let’s discuss when it is appropriate to increase precautions to home isolation.




## Who qualifies for home isolation?

According to the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-
spread.html), people who qualify for home isolation include:

- People with confirmed or suspected COVID-19 (including persons who are being tested for COVID-19) who do not need to be hospitalized. 
- People with confirmed COVID-19 who were hospitalized and determined to be medically stable to go home.


## If home isolation is recommended, what do I need to do?

- Restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. 
- Avoid using public transportation, ride-sharing, or taxis.
- Stay in a specific room and away from other people at home. Also, use a separate bathroom, if available.
- Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, wash them thoroughly with soap and water.
- Wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before entering a healthcare provider’s office. If you are unable to wear a facemask (e.g., because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.
- If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.
- Continue to follow the same precautions prior to isolation. Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can. Immediately wash your hands with soap and water for at least 20 seconds, or, if soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.



## Why is home isolation important?

People who are mildly ill with COVID-19 are able to isolate themselves at home during their illness. According to the CDC, this strategy may help prevent COVID-19 from spreading to other people in their homes and in their community. Please take advantage of [HeyDoctor’s free screening](https://www.heydoctor.com/services/coronavirus/) to evaluate your level of risk.

## What if I feel worse and I am isolated at home?

Seek prompt medical attention if your illness is worsening (e.g., difficulty
breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. Ask your healthcare provider to call the local or state health department.


If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for, COVID-19. If possible, put on a facemask before emergency medical services arrive.

## When is it OK to stop home isolation?

Patients with confirmed COVID-19 should remain under home isolation precautions until the risk to others is thought to be low. The decision to stop home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

## The bottom line

It is easy to feel overwhelmed and powerless in a period of uncertainty like this one, but small steps taken by individuals and communities have a large impact to slow the spread of the coronavirus. Continue to check in with the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/index.html) or your state’s health department website (listed below) for the most up-to-date information on how to stay safe.


 
**State resources**

Find your state department of health website below.

Alabama:
- [Alabama State Department of Health: Coronavirus](http://www.alabamapublicHealth.gov/infectiousdiseases/2019-Coronavirus.html)
- [Local Health Departments in Alabama](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AL#card-filter)

Alaska:
- [Alaska State Department of Health: Coronavirus](http://dhss.alaska.gov/dph/Epi/id/Pages/Human-Coronavirus.aspx)
- [Local Health Departments in Alaska](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AK#card-filter)

Arizona:
- [Arizona State Department of Health: Coronavirus](https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/index.php)
- [Local Health Departments in Arizona](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AK#card-filter)

Arkansas:
- [Arkansas State Department of Health: Coronavirus](https://www.Healthy.arkansas.gov/programs-services/topics/novel-Coronavirus)
- [Local Health Departments in Arkansas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-State=AR)

California:
- [California State Department of Health: Coronavirus](https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/nCOV2019.aspx)
- [Local Health Departments in California](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CA#card-filter)

Colorado:
- [Colorado State Department of Health: Coronavirus](https://www.colorado.gov/pacific/cdphe/2019-novel-Coronavirus)
- [Local Health Departments in Colorado](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CO#card-filter)

Connecticut:
- [Connecticut State Department of Health: Coronavirus](https://portal.ct.gov/DPH/Public-Health-Preparedness/Main-Page/2019-Novel-Coronavirus)
- [Local Health Departments in Connecticut](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CT#card-filter)

Delaware:
- [Delaware State Department of Health: Coronavirus](https://dhss.delaware.gov/dhss/dph/epi/2019novelCoronavirus.html)
- [Local Health Departments in Delaware](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=DE#card-filter)

Florida:
- [Florida State Department of Health: Coronavirus](http://www.floridahealth.gov/diseases-and-conditions/COVID-19/)
- [Local Health Departments in Florida](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=FL#card-filter)

Georgia:
- [Georgia State Department of Health: Coronavirus](https://dph.georgia.gov/Coronavirus-disease-2019-covid-19-outbreak)
- [Local Health Departments in Georgia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=GA#card-filter)

Hawaii:
- [Hawaii State Department of Health: Coronavirus](https://Health.hawaii.gov/docd/advisories/novel-Coronavirus-2019/)
- [Local Health Departments in Hawaii](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=HI#card-filter)

Idaho:
- [Idaho State Department of Health](https://Healthandwelfare.idaho.gov/Health/tabid/60/Default.aspx)
- [Local Health Departments in Idaho](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ID#card-filter)

Illinois:
- [Illinois State Department of Health: Coronavirus](http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/Coronavirus)
- [Local Health Departments in Illinois](http://www.idph.State.il.us/local/alpha.htm)

Indiana:
- [Indiana State Department of Health: Coronavirus](https://www.in.gov/isdh/28470.htm)
- [Local Health Departments in Indiana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=IN#card-filter)

Iowa:
- [Iowa State Department of Health: Coronavirus](https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus)
- [Local Health Departments in Iowa](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=IA#card-filter)

Kansas:
- [Kansas State Department of Health: Coronavirus](http://www.kdheks.gov/coronavirus/index.htm)
- [Local Health Departments in Kansas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=KS#card-filter)

Kentucky:
- [Kentucky State Department of Health: Coronavirus](https://chfs.ky.gov/agencies/dph/Pages/covid19.aspx)
- [Local Health Departments in Kentucky](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=KY#card-filter)

Louisiana:
- [Louisiana State Department of Health: Coronavirus (site hasn’t been updated since Feb. 14, 2020)](https://ladepthealth.blogspot.com/2020/02/coronavirus-2019-ncov-covid-19.html)
- [Local Health Departments in Louisiana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=LA#card-filter)

Maine:
- [Maine State Department of Health: Coronavirus](https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus.shtml)
- [Local Health Departments in Maine](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ME#card-filter)

Maryland:
- [Maryland State Department of Health: Coronavirus](https://phpa.Health.maryland.gov/Pages/Novel-Coronavirus.aspx)
- [Local Health Departments in Maryland](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MD#card-filter)

Massachusetts:
- [Massachusetts Department of Health](https://www.mass.gov/guides/information-on-the-outbreak-of-2019-novel-Coronavirus-covid-19)
- [Local Health Departments in Massachusetts](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MA#card-filter)

Michigan:
- [Michigan: Coronavirus)](https://www.michigan.gov/coronavirus)
- [Local Health Departments in Michigan](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MI#card-filter)

Minnesota:
- [Minnesota State Department of Health: Coronavirus](https://www.Health.State.mn.us/diseases/Coronavirus/index.html)
- [Local Health Departments in Minnesota](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MN#card-filter)

Mississippi:
- [Mississippi State Department of Health: Coronavirus](https://msdh.ms.gov/msdhsite/_static/14,0,420.html)
- [Local Health Departments in Mississippi](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MS#card-filter)

Missouri:
- [Missouri State Department of Health: (No coronavirus page yet)](https://www.mo.gov/Health/public-Health/)
- [Local Health Departments in Missouri](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MO#card-filter)

Montana:
- [Montana State Department of Health: Coronavirus](https://dphhs.mt.gov/publicHealth/cdepi/diseases/Coronavirusmt)
- [Local Health Departments in Montana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MT#card-filter)

Nebraska:
- [Nebraska State Department of Health: Coronavirus](http://dhhs.ne.gov/Pages/Coronavirus.aspx)
- [Local Health Departments in Nebraska](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NE#card-filter)

New Hampshire:
- [New Hampshire State Department of Health: Coronavirus](https://www.dhhs.nh.gov/dphs/cdcs/2019-ncov.htm)
- [Local Health Departments in New Hampshire](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NH#card-filter)

New Jersey:
- [New Jersey State Department of Health: Coronavirus](https://www.nj.gov/health/cd/topics/ncov.shtml)
- [Local Health Departments in New Jersey](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NJ#card-filter)

New Mexico:
- [New Mexico State Department of Health: Coronavirus](https://nmHealth.org/about/erd/ideb/ncov/)
- [Local Health Departments in New Mexico](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NM#card-filter)

New York:
- [New York State Department of Health: Coronavirus](https://www.health.ny.gov/diseases/communicable/coronavirus/)
- [Local Health Departments in New York](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NY#card-filter)

North Carolina:
- [North Carolina State Department of Health: Coronavirus](https://epi.dph.ncdhhs.gov/cd/diseases/COVID19.html)
- [Local Health Departments in North Carolina](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NC#card-filter)

North Dakota:
- [North Dakota State Department of Health: Coronavirus](https://www.Health.nd.gov/Coronavirus)
- [Local Health Departments in North Dakota](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ND#card-filter)

Ohio:
- [Ohio State Department of Health: Coronavirus](https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Novel-Coronavirus/2019-nCoV)
- [Local Health Departments in Ohio](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OH#card-filter)

Oklahoma:
- [Oklahoma State Department of Health: Coronavirus](https://www.ok.gov/health/Prevention_and_Preparedness/Acute_Disease_Service/Disease_Information/Coronavirus_Disease_2019/index.html)
- [Local Health Departments in Oklahoma](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OK#card-filter)

Oregon:
- [Oregon State Department of Health: Coronavirus](https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx)
- [Local Health Departments in Oregon](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OR#card-filter)

Pennsylvania:
- [Pennsylvania State Department of Health: Coronavirus](https://www.Health.pa.gov/topics/disease/Pages/Coronavirus.aspx)
- [Local Health Departments in Pennsylvania](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=PA#card-filter)

Rhode Island:
- [Rhode Island State Department of Health: Coronavirus](https://Health.ri.gov/diseases/respiratory/?parm=163)
- [Local Health Departments in Rhode Island](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-State=RI)

South Carolina:
- [South Carolina State Department of Health: Coronavirus](https://scdhec.gov/Health/infectious-diseases/viruses/Coronavirus-disease-2019-covid-19)
- [Local Health Departments in South Carolina](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=SC#card-filter)

Tennessee:
- [Tennessee State Department of Health: Coronavirus](https://www.tn.gov/Health/cedep/ncov.html)
- [Local Health Departments in Tennessee](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=TN#card-filter)

Texas:
- [Texas State Department of Health: Coronavirus](https://dshs.texas.gov/Coronavirus/)
- [Local Health Departments in Texas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=TX#card-filter)

Utah:
- [Utah State Department of Health: Coronavirus](https://coronavirus.utah.gov/)
- [Local Health Departments in Utah](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=UT#card-filter)

Vermont:
- [Vermont State Department of Health: Coronavirus](https://www.Healthvermont.gov/response/infectious-disease/2019-novel-Coronavirus)
- [Local Health Departments in Vermont](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=VT#card-filter)

Virginia:
- [Virginia State Department of Health: Coronavirus](http://www.vdh.virginia.gov/surveillance-and-investigation/novel-Coronavirus/)
- [Local Health Departments in Virginia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=VA#card-filter)
- [Virginia public school districts (contacts available)](http://www.doe.virginia.gov/directories/schools/school_info_by_regions.shtml)

Washington:
- [Washington State Department of Health: Coronavirus](https://www.doh.wa.gov/emergencies/Coronavirus)
- [Local Health Departments in Washington](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WA#card-filter)
- [Seattle Department of Health: Coronavirus](https://www.kingcounty.gov/depts/Health/communicable-diseases/disease-control/novel-Coronavirus.aspx)

West Virginia:
- [West Virginia State Department of Health: Coronavirus](https://dhhr.wv.gov/COVID-19/Pages/default.aspx)
- [Local Health Departments in West Virginia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WV#card-filter)

Wisconsin:
- [Wisconsin State Department of Health: Coronavirus](https://www.dhs.wisconsin.gov/disease/Coronavirus.htm)
- [Local Health Departments in Wisconsin](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WI#card-filter)

Wyoming:
- [Wyoming State Department of Health: Coronavirus](https://Health.wyo.gov/publicHealth/infectious-disease-epidemiology-unit/disease/novel-Coronavirus/)
- [Local Health Departments in Wyoming](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WY#card-filter)







Coronavirus: Information on Home Isolation

We are continuing to learn about the new coronavirus and the disease it causes, referred to as COVID-19 or the coronavirus disease. At this time, there is no vaccine available for COVID-19. On May 1, 2020 the [FDA](https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment) issued an emergency use authorization for the investigational antiviral drug remdesivir for the treatment of suspected or confirmed COVID-19 in adult and children hospitalized with severe illness. The best course of action remains to practice individual and community-based strategies to help slow the transmission of the coronavirus and to reduce overall illness and death. Slowing down the spread of the disease also helps to protect individuals who are at increased risk for severe illness, such as older adults and those with underlying health conditions. 
 
__Even if you aren’t worried about your own health, efforts taken by all of us can help reduce the transmission of the coronavirus to the most vulnerable people among us.__
 
We talked about some of the ways you can keep yourself healthy in [this article](https://www.heydoctor.com/learn/covid-19-how-can-i-stay-healthy). This includes washing your hands with soap and water for 20 seconds; avoiding touching your eyes, nose, and mouth; and cleaning and disinfecting frequently touched objects. Now let’s discuss a community-based strategy called “social distancing”. 
 
## What is social distancing?
 
[Social distancing](https://www.cdc.gov/coronavirus/2019-ncov/community/index.html) refers to measures taken to avoid crowds and minimize close contact with others in order to avoid spreading illness. The overall goal is to keep individuals approximately 6 feet away from others when possible.  
 
## Why is social distancing important?
 
When a person coughs or sneezes, they spray small liquid droplets from their nose or mouth. If the person coughing has the coronavirus disease COVID-19, the droplets from their coughs or sneezes may spread the virus to others. If you are too close, you can breathe in these droplets and become ill. Preventing this exposure through social distancing can significantly slow and reduce the spread of COVID-19.
 
## Examples of social distancing
 
Social distancing can be accomplished through both individual actions and by local and state officials. Social distancing could include things like postponing or canceling mass gatherings such as sporting events, concerts, or religious gatherings. 
 
More recent examples of social distancing have been the near-total closures of schools, universities and colleges, closures of restaurants and bars and mandatory work from home orders for all non essential workers.  . 
 
 
 
## Should I practice social distancing?
The [World Health Organization (WHO)](https://www.who.int/emergencies/diseases/novel-coronavirus-2019) has officially declared the coronavirus outbreak a pandemic. 
 
Again, even if you aren’t worried about your own health, efforts taken by all of us can help reduce the transmission of the coronavirus to the most vulnerable people among us, including those who are pregnant, over the age of 65, and have pre-existing medical conditions (like respiratory or heart problems, a weaker immune system, or poor overall health). 
 
Let’s all practice social distancing by avoiding large crowds, working from home unless an essential worker, staying the recommended 6 feet away from others when in public, and wearing a mask.
 
Please take advantage of [HeyDoctor’s free screening](https://www.heydoctor.com/services/coronavirus/) to evaluate your symptoms and overall risk level.
 
 
 
 
## The bottom line
 
It is easy to feel overwhelmed and powerless in a period of uncertainty like this one, but small steps taken by individuals and communities have a large impact to slow the spread of the coronavirus. Continue to check in with the  [CDC](https://www.cdc.gov/coronavirus/2019-ncov/index.html) or your state’s health department website (listed below) for the most up-to-date information on how to stay safe.
 
**State resources**

Find your state department of health website below.

Alabama:
- [Alabama State Department of Health: Coronavirus](http://www.alabamapublicHealth.gov/infectiousdiseases/2019-Coronavirus.html)
- [Local Health Departments in Alabama](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AL#card-filter)

Alaska:
- [Alaska State Department of Health: Coronavirus](http://dhss.alaska.gov/dph/Epi/id/Pages/Human-Coronavirus.aspx)
- [Local Health Departments in Alaska](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AK#card-filter)

Arizona:
- [Arizona State Department of Health: Coronavirus](https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/index.php)
- [Local Health Departments in Arizona](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=AK#card-filter)

Arkansas:
- [Arkansas State Department of Health: Coronavirus](https://www.Healthy.arkansas.gov/programs-services/topics/novel-Coronavirus)
- [Local Health Departments in Arkansas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-State=AR)

California:
- [California State Department of Health: Coronavirus](https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/nCOV2019.aspx)
- [Local Health Departments in California](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CA#card-filter)

Colorado:
- [Colorado State Department of Health: Coronavirus](https://www.colorado.gov/pacific/cdphe/2019-novel-Coronavirus)
- [Local Health Departments in Colorado](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CO#card-filter)

Connecticut:
- [Connecticut State Department of Health: Coronavirus](https://portal.ct.gov/DPH/Public-Health-Preparedness/Main-Page/2019-Novel-Coronavirus)
- [Local Health Departments in Connecticut](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=CT#card-filter)

Delaware:
- [Delaware State Department of Health: Coronavirus](https://dhss.delaware.gov/dhss/dph/epi/2019novelCoronavirus.html)
- [Local Health Departments in Delaware](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=DE#card-filter)

Florida:
- [Florida State Department of Health: Coronavirus](http://www.floridahealth.gov/diseases-and-conditions/COVID-19/)
- [Local Health Departments in Florida](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=FL#card-filter)

Georgia:
- [Georgia State Department of Health: Coronavirus](https://dph.georgia.gov/Coronavirus-disease-2019-covid-19-outbreak)
- [Local Health Departments in Georgia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=GA#card-filter)

Hawaii:
- [Hawaii State Department of Health: Coronavirus](https://Health.hawaii.gov/docd/advisories/novel-Coronavirus-2019/)
- [Local Health Departments in Hawaii](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=HI#card-filter)

Idaho:
- [Idaho State Department of Health](https://Healthandwelfare.idaho.gov/Health/tabid/60/Default.aspx)
- [Local Health Departments in Idaho](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ID#card-filter)

Illinois:
- [Illinois State Department of Health: Coronavirus](http://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/Coronavirus)
- [Local Health Departments in Illinois](http://www.idph.State.il.us/local/alpha.htm)

Indiana:
- [Indiana State Department of Health: Coronavirus](https://www.in.gov/isdh/28470.htm)
- [Local Health Departments in Indiana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=IN#card-filter)

Iowa:
- [Iowa State Department of Health: Coronavirus](https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus)
- [Local Health Departments in Iowa](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=IA#card-filter)

Kansas:
- [Kansas State Department of Health: Coronavirus](http://www.kdheks.gov/coronavirus/index.htm)
- [Local Health Departments in Kansas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=KS#card-filter)

Kentucky:
- [Kentucky State Department of Health: Coronavirus](https://chfs.ky.gov/agencies/dph/Pages/covid19.aspx)
- [Local Health Departments in Kentucky](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=KY#card-filter)

Louisiana:
- [Louisiana State Department of Health: Coronavirus (site hasn’t been updated since Feb. 14, 2020)](https://ladepthealth.blogspot.com/2020/02/coronavirus-2019-ncov-covid-19.html)
- [Local Health Departments in Louisiana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=LA#card-filter)

Maine:
- [Maine State Department of Health: Coronavirus](https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus.shtml)
- [Local Health Departments in Maine](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ME#card-filter)

Maryland:
- [Maryland State Department of Health: Coronavirus](https://phpa.Health.maryland.gov/Pages/Novel-Coronavirus.aspx)
- [Local Health Departments in Maryland](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MD#card-filter)

Massachusetts:
- [Massachusetts Department of Health](https://www.mass.gov/guides/information-on-the-outbreak-of-2019-novel-Coronavirus-covid-19)
- [Local Health Departments in Massachusetts](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MA#card-filter)

Michigan:
- [Michigan: Coronavirus)](https://www.michigan.gov/coronavirus)
- [Local Health Departments in Michigan](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MI#card-filter)

Minnesota:
- [Minnesota State Department of Health: Coronavirus](https://www.Health.State.mn.us/diseases/Coronavirus/index.html)
- [Local Health Departments in Minnesota](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MN#card-filter)

Mississippi:
- [Mississippi State Department of Health: Coronavirus](https://msdh.ms.gov/msdhsite/_static/14,0,420.html)
- [Local Health Departments in Mississippi](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MS#card-filter)

Missouri:
- [Missouri State Department of Health: (No coronavirus page yet)](https://www.mo.gov/Health/public-Health/)
- [Local Health Departments in Missouri](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MO#card-filter)

Montana:
- [Montana State Department of Health: Coronavirus](https://dphhs.mt.gov/publicHealth/cdepi/diseases/Coronavirusmt)
- [Local Health Departments in Montana](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=MT#card-filter)

Nebraska:
- [Nebraska State Department of Health: Coronavirus](http://dhhs.ne.gov/Pages/Coronavirus.aspx)
- [Local Health Departments in Nebraska](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NE#card-filter)

New Hampshire:
- [New Hampshire State Department of Health: Coronavirus](https://www.dhhs.nh.gov/dphs/cdcs/2019-ncov.htm)
- [Local Health Departments in New Hampshire](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NH#card-filter)

New Jersey:
- [New Jersey State Department of Health: Coronavirus](https://www.nj.gov/health/cd/topics/ncov.shtml)
- [Local Health Departments in New Jersey](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NJ#card-filter)

New Mexico:
- [New Mexico State Department of Health: Coronavirus](https://nmHealth.org/about/erd/ideb/ncov/)
- [Local Health Departments in New Mexico](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NM#card-filter)

New York:
- [New York State Department of Health: Coronavirus](https://www.health.ny.gov/diseases/communicable/coronavirus/)
- [Local Health Departments in New York](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NY#card-filter)

North Carolina:
- [North Carolina State Department of Health: Coronavirus](https://epi.dph.ncdhhs.gov/cd/diseases/COVID19.html)
- [Local Health Departments in North Carolina](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=NC#card-filter)

North Dakota:
- [North Dakota State Department of Health: Coronavirus](https://www.Health.nd.gov/Coronavirus)
- [Local Health Departments in North Dakota](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=ND#card-filter)

Ohio:
- [Ohio State Department of Health: Coronavirus](https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Novel-Coronavirus/2019-nCoV)
- [Local Health Departments in Ohio](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OH#card-filter)

Oklahoma:
- [Oklahoma State Department of Health: Coronavirus](https://www.ok.gov/health/Prevention_and_Preparedness/Acute_Disease_Service/Disease_Information/Coronavirus_Disease_2019/index.html)
- [Local Health Departments in Oklahoma](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OK#card-filter)

Oregon:
- [Oregon State Department of Health: Coronavirus](https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx)
- [Local Health Departments in Oregon](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=OR#card-filter)

Pennsylvania:
- [Pennsylvania State Department of Health: Coronavirus](https://www.Health.pa.gov/topics/disease/Pages/Coronavirus.aspx)
- [Local Health Departments in Pennsylvania](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=PA#card-filter)

Rhode Island:
- [Rhode Island State Department of Health: Coronavirus](https://Health.ri.gov/diseases/respiratory/?parm=163)
- [Local Health Departments in Rhode Island](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-State=RI)

South Carolina:
- [South Carolina State Department of Health: Coronavirus](https://scdhec.gov/Health/infectious-diseases/viruses/Coronavirus-disease-2019-covid-19)
- [Local Health Departments in South Carolina](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=SC#card-filter)

Tennessee:
- [Tennessee State Department of Health: Coronavirus](https://www.tn.gov/Health/cedep/ncov.html)
- [Local Health Departments in Tennessee](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=TN#card-filter)

Texas:
- [Texas State Department of Health: Coronavirus](https://dshs.texas.gov/Coronavirus/)
- [Local Health Departments in Texas](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=TX#card-filter)

Utah:
- [Utah State Department of Health: Coronavirus](https://coronavirus.utah.gov/)
- [Local Health Departments in Utah](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=UT#card-filter)

Vermont:
- [Vermont State Department of Health: Coronavirus](https://www.Healthvermont.gov/response/infectious-disease/2019-novel-Coronavirus)
- [Local Health Departments in Vermont](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=VT#card-filter)

Virginia:
- [Virginia State Department of Health: Coronavirus](http://www.vdh.virginia.gov/surveillance-and-investigation/novel-Coronavirus/)
- [Local Health Departments in Virginia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=VA#card-filter)
- [Virginia public school districts (contacts available)](http://www.doe.virginia.gov/directories/schools/school_info_by_regions.shtml)

Washington:
- [Washington State Department of Health: Coronavirus](https://www.doh.wa.gov/emergencies/Coronavirus)
- [Local Health Departments in Washington](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WA#card-filter)
- [Seattle Department of Health: Coronavirus](https://www.kingcounty.gov/depts/Health/communicable-diseases/disease-control/novel-Coronavirus.aspx)

West Virginia:
- [West Virginia State Department of Health: Coronavirus](https://dhhr.wv.gov/COVID-19/Pages/default.aspx)
- [Local Health Departments in West Virginia](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WV#card-filter)

Wisconsin:
- [Wisconsin State Department of Health: Coronavirus](https://www.dhs.wisconsin.gov/disease/Coronavirus.htm)
- [Local Health Departments in Wisconsin](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WI#card-filter)

Wyoming:
- [Wyoming State Department of Health: Coronavirus](https://Health.wyo.gov/publicHealth/infectious-disease-epidemiology-unit/disease/novel-Coronavirus/)
- [Local Health Departments in Wyoming](https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=WY#card-filter)





How to help your community slow the spread of COVID-19.

Coronavirus: What Is Social Distancing?

Coronavirus and COVID-19: How Can I Stay Healthy?


 
Knowledge about the COVD-19 pandemic continues to evolve almost daily. According to the [CDC](https://www.cdc.gov/flu/pandemic-resources/national-strategy/intervals-framework.html), the United States has been currently in the acceleration of the pandemic wave, or the upward curve as the new virus infects susceptible people. 

Since there is no vaccine or drug to prevent the virus, the focus has been on community actions including [social distancing](https://www.heydoctor.com/learn/coronavirus-what-is-social-distancing) and [home isolation](https://www.heydoctor.com/learn/coronavirus-information-on-home-isolation) to mitigate the spread of coronavirus and the subsequent disease COVID-19. 

Across the country, schools, movie theaters, restaurants, and sporting arenas have been closed to discourage social gatherings and non-essential work staff have been encouraged to work from home.
 
 
 
 
 
 
 
## What is the next step?
 
These community actions, while designed to save lives and flatten the curve, have caused social and economic hardships experienced on a global level. Therefore, there has been a great focus and debate on the next steps in  response to this pandemic. 

According to the Centers for Disease Control and Prevention (CDC), these next steps can only happen when a deceleration of the pandemic wave has been determined. Because COVID-19 has impacted regions of the US with different levels of intensity, states have the responsibility to determine and implement recovery plans. The [United States Federal Government](https://www.whitehouse.gov/openingamerica/) has proposed the following state and/or regional criteria that must be satisfied before a phased reopening can begin. 
 
## What is a phased reopening?
 
Once certain criteria has been met, the state or region could advance to:
 
- Phase 1: Vulnerable individuals would continue to shelter in place and schools would stay closed. Workers would be urged to telework and non-essential travel would be discouraged. Businesses, such as restaurants, could reopen with strict social distancing protocols. 
- Phase 2: Schools and daycares could reopen and some people could return to their workplaces. Non-essential travel could resume. Gatherings of more than 50 people would be avoided. Vulnerable individuals would continue to shelter in place. Nursing home visits would still be prohibited.
- Phase 3: There would be no workplace restrictions. Businesses like restaurants would operate under very few restrictions. Vulnerable individuals could go out in public but would be encouraged to practice social distancing.

 
 

## What criteria must be met before phase 1 can begin?
 
The following criteria in symptoms, cases and hospitalizations must be met:
 
- SYMPTOMS: Downward trajectory of both influenza-like illnesses AND COVID-19 type cases reported within a 14-day period.
- CASES: Downward trajectory of documented COVID-19 cases within a 14-day period or a downward trajectory of positive tests as a percent of total tests within a 14-day period.                    
- HOSPITALS: Ability to treat all patients without COVID-19 crisis care AND robust testing program in place for at-risk healthcare workers, including emerging antibody testing.


 
 
##  What is robust testing?
 
According to these guidelines, these criteria can only be met when there are systems in place to accurately identify and isolate new exposures to coronavirus. This includes the ability to:
 
1. Quickly set up safe and efficient screening and testing sites for symptomatic individuals and trace contacts of those with positive COVID-19 test results.
2. Test indicated persons with influenza-like illnesses for COVID-19 and trace the contacts of those with COVID-19 positive test results.
3. Ensure surveillance sites are screening for asymptomatic cases and individuals withCOVID-19 results are traced; as well as identifying all persons who may have come into contact with an infected person.  
 
 
 ![national-cancer-institute-Cx0LsYrM Ns-unsplash](//images.ctfassets.net/tpmoqmonp0iq/4CNiNRzrUALnafESWag5Lr/eb5d5dc974827a786f0a9d25b1b6f0eb/national-cancer-institute-Cx0LsYrM_Ns-unsplash.jpg)
 
 
## What testing is now available?
 
In order to successfully screen as the above criteria demands, there will need to be a fast and reliable way to screen large numbers of people. Currently, there are several different ways to test for coronavirus. Two main types of tests for coronavirus are available: molecular and serological. Molecular tests use swabs to detect the presence of viral genetic material in the nose and/or throat. This is the way that COVID-19 is diagnosed. Serological tests are blood tests that can identify those that have recovered from the COVID-19 infection. 
 
The U.S. Food and Drug Administration (FDA) recently approved the first at-home collection molecular test. The test kits contain supplies to collect samples, including a nasal swab which you send back to the lab for testing. There is also a new [point-of-care test](https://abcnews.go.com/Health/rapid-coronavirus-diagnostic-test-provide-results-minutes/story?id=69875037), that just received emergency-use authorization by the FDA, that may deliver results in as little as five minutes. For more information about available testing for coronavirus please read this [article](https://www.goodrx.com/blog/coronavirus-covid-19-testing-updates-methods-cost-availability/)
 
 
## When will Phase 3 occur?
 
Even when wide-spread point of care testing is available and accessible to all, life may not return to pre-coronavirus standards anytime soon. There are still no FDA-approved medications to treat COVID-19.  An available [vaccine](https://hub.jhu.edu/2020/04/16/coronavirus-vaccine-timeline/) may not be available for several years. It is easy to feel overwhelmed and powerless in a period of uncertainty like this one. The important thing to know is that small steps taken by individuals and communities have a large impact to slow the spread of COVID-19. Continue to check in with the CDC for the most up to date information on how to stay safe.



Coronavirus and COVID-19 - The Next Step

We are continuing to learn about the new coronavirus and the disease it causes, referred to as COVID-19. Right now, people around the world are being asked to practice strategies like [social distancing](https://www.heydoctor.com/learn/coronavirus-what-is-social-distancing) and [home isolation](https://www.heydoctor.com/learn/coronavirus-information-on-home-isolation) to help slow the transmission of COVID-19 in their communities. Slowing the transmission of COVID-19 helps to reduce overall illness and death and protects the most vulnerable individuals, such as older adults or those with underlying health conditions. 


While it is crucial to ensure the physical well-being of yourself and others, it’s also important to take care of your mental and emotional health in this stressful time.




## Why do I feel so anxious?

You are not alone. According to the [CDC](https://emergency.cdc.gov/coping/selfcare.asp), stress during an infectious disease outbreak such as the COVID-19 outbreak is common and can include things like:


- Fear and worry about your own health and the health of your loved ones
- Changes in sleep or eating patterns
- Difficulty sleeping or concentrating
- Worsening of chronic health problems
- Increased use of alcohol, tobacco, or other drugs

To add insult to injury, the strategies that we need to use to help slow the spread of coronavirus (social distancing and quarantine) can lead to increased feelings of isolation, as well as the inability to use some of the coping mechanisms we might normally use to feel better.


## What can I do to feel more like myself?

Taking care of yourself, your friends, and your family can help you cope with stress. Helping others also strengthens community bonds. The [CDC](https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html) offers the following tips for managing your anxiety and stress:


- Take care of your body by eating healthy, well-balanced meals, exercising regularly and getting plenty of sleep. 
- Avoid alcohol, tobacco, and other drugs.
- Connect with others. Share your concerns and how you are feeling with a friend or family member. Although we can no longer gather in groups, we can connect by phone and video calls and social media.
- Take breaks. Make time to unwind and remind yourself that strong feelings will fade.
- Take deep breaths. Try to do activities you usually enjoy.
- Stay informed. When you feel that you are missing information, you may become more stressed or nervous. Watch, listen to, or read the news for updates from officials. Be aware that there may be rumors during a crisis, especially on social media. Always check your sources and turn to reliable sources of information like your local government authorities.
- Avoid too much exposure to news. Take breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see difficult images repeatedly. Try to do enjoyable activities and return to normal life as much as possible and check for updates between breaks.


## How do I exercise?

Even though many gyms are closed and group sporting events are canceled, it is still possible to exercise. If you want to exercise outdoors, you can.  Make sure to stay a minimum of 6 feet away from others during your run or bike ride. 

Another option is exercising at home. There are many apps to help you with this goal. Some are designed to work with a treadmill or exercise bike, which requires you to have home equipment. But there are also lots of workouts that can be completed with weights, resistance bands, a yoga mat, or [no equipment](https://darebee.com/) at all. Another option is home yoga and pilates. There is a growing number of studios and gyms like the [YMCA](https://ymca360.org/) and [CorePower Yoga](https://www.corepoweryogaondemand.com/keep-up-your-practice) that are offering free online workout videos. Use exercise as an opportunity to be social: try jogging in place while chatting with friends on speaker phone.

 
## How do I relax my mind?
	
Anxiety can cause repetitive or racing negative thoughts that can feel hard to control. One way to minimize these thoughts is to practice mindfulness meditation. Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us. Here are some sample steps for a mindfulness meditation:

1. Sit comfortably. Find a spot that gives you a stable, solid, comfortable seat.
2. Notice what your arms and legs are doing. 
3. Straighten your upper body.
4. Soften your gaze.
5. Feel your breath. Bring your attention to the physical sensation of breathing: the air moving through your nose or mouth, the rising and falling of your belly or your chest.
6. Notice when your mind wanders from your breath. There’s no need to block or eliminate thinking. When you notice your mind wandering, gently return your attention to your breath. 
7. When you’re ready, gently lift your gaze (if your eyes are closed, open them).

Take a moment and notice any sounds in the environment. Notice how your body feels right now. Notice your thoughts and emotions.


## The benefits of teletherapy

People with preexisting mental health conditions should continue with their existing treatment plans during an emergency while monitoring for any new symptoms. In this time of social distancing, how can this be achieved? Teletherapy and telepsychiatry refer to the delivery of traditional behavioral health and psychiatric care using a phone or the internet. 

Video teleconferencing allows patients to continue therapy even if they can’t physically travel to an appointment. [Research has shown](https://iocdf.org/covid19/teletherapy-in-the-time-of-covid-19/) that exposure and response prevention delivered remotely via video teleconferencing was as effective as in-person treatment. 

Some apps you may want to consider for teletherapy are [Better Help](https://www.betterhelp.com/) and [Doctor On Demand](https://www.doctorondemand.com/what-we-treat/behavioral-health). 



## How can I help my child through this difficult time?

[According to the CDC](https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html), it is important to take time to talk with your child or teen about the COVID-19 outbreak. Many strategies are similar to how we recommend that you deal with your own stress and anxiety.

- Reassure your child or teen that they are safe. Let them know it is OK if they feel upset.
- Share with them how you deal with your own stress so that they can learn how to cope from you.
- Limit your family’s exposure to news coverage of the event, including social media.
- Children may misinterpret what they hear and can be frightened about something they do not understand.
- Try to keep up with regular routines. While schools are closed, create a schedule for learning activities and relaxing or fun activities.
- Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

## Additional resources

If you or someone you know is struggling with suicidal thoughts, call the [National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/) at 1-800-273-TALK (8255) any time day or night, or [chat online](https://suicidepreventionlifeline.org/chat/).

You can also call the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) [Disaster Helpline](https://www.samhsa.gov/find-help/disaster-distress-helpline) at 1-800-985-6990, or text TalkWithUS to 66746 for support 24/7. This is a toll-free, multilingual, and confidential crisis support service that is available to all residents in the United States and its territories.

The [National Coalition Against Domestic Violence (NCADV)](https://ncadv.org/), encourages those with a dangerous or abusive home situation to seek out shelters (where available), hotlines, therapists, and counselors. Victims are also encouraged to turn to a trusted friend or family member, if available, who can make a call to a hotline on their behalf, should they not be able to do so themselves. Resources include the [National Domestic Violence Hotline](https://www.thehotline.org/help/) (1-800-799-7233), [National Resource Center on Domestic Violence](https://www.nrcdv.org/) (1-800-537-2238), and [National Sexual Assault Hotline](https://rainn.org/) (1-800-656-4673).

## The bottom line

We are all in this together. Find creative ways to be social while social distancing. Take care of yourself and check in with your friends and family regularly. Use the resources listed above if you feel you need to so. It is easy to feel overwhelmed and powerless in a period of uncertainty like this one. 

The important thing to remember is that small steps taken by individuals and communities have a large impact to slow the spread of COVID-19. Continue to check in with the [CDC](https://www.cdc.gov/coronavirus/2019-ncov/index.html) for the most up to date information on how to stay safe.



Caring for your mental and emotional health in an uncertain time.

Mental Health During the COVID-19 Outbreak


## Why do we need sleep?

In honor of World Sleep Day on March 13, 2020, we're taking a look at why sleep is so important to overall health. While we all feel better after a good night’s sleep, many of us do not achieve this goal every night. According to the [CDC](https://www.cdc.gov/sleep/index.html), a third of US adults report that they usually get less than the recommended amount of sleep. 

Across age groups, sleep deficiency is a common public health problem in the United States. The amount of sleep required per night changes according to your age. Here are the recommended sleep amounts by age group, according to the [National Sleep Foundation](https://www.sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times): 


- School age children (6-13): 9-11 hours a night
- Teenagers (14-17): 8-10 hours a night
- Younger adults (18-25): 7-9 hours a night
- Adults (26-64): 7-9 hours a night
- Older adults (65+): 7-8 hours a night

## Do you get enough sleep?
 
In this busy day and age, obtaining an adequate amount of sleep per night often does not take priority. Why is sleep so important to health?
 
According to the [National Sleep foundation](https://www.sleepfoundation.org/articles/why-do-we-need-sleep), sleep is not merely a time of rest after a busy stressful day. Sleep is an active period in which important processing, restoration, and strengthening occurs. Sleeping helps us solidify and consolidate our memories.  

Researchers have also shown that after people sleep, they tend to retain information and perform better on memory tasks. Our bodies all require long periods of sleep in order to restore and rejuvenate, to grow muscle, repair tissue, and synthesize hormones and have a health immune system
 
Sleep deprivation not only results in a cranky, foul mood but is also linked with many chronic diseases and conditions such as type 2 diabetes, heart disease, obesity, and depression. Sleep deprivation also can lead to motor vehicle crashes and mistakes at work. Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don't get enough sleep you feel hungrier than when you're well-rested. 

## Burning the midnight oil

I want to focus on what we can do to improve sleep hygiene, a series of healthy sleep habits that can improve your ability to fall asleep and stay asleep 
 
### Limit Technology
Using electronic devices before bedtime can be physiologically and psychologically stimulating in ways that can adversely affect your sleep. According to the [National Sleep Foundation](https://www.sleepfoundation.org/articles/why-electronics-may-stimulate-you-bed), using TVs, tablets, smartphones, laptops, or other electronic devices before bed delays your body’s internal clock, suppresses the release of the sleep-inducing hormone melatonin, and makes it more difficult to fall asleep. 

The more electronic devices that a person uses in the evening, the harder it is to fall asleep or stay asleep. Over time, these effects can add up to a significant, chronic deficiency in sleep.
 
### Avoid Excessive Caffeine
Caffeine is a drug that acts as a stimulant, both mentally and physically. It is found in common foods and drinks such as tea, coffee, soda and chocolate. 

Caffeine can affect sleep in three ways. This stimulant can make it harder to go to sleep, it can make you sleep more lightly and wake up more often during the night, and it may make you have to get up to go to the bathroom throughout the night. 
 
### Limit Alcohol
Drinking alcohol can make you feel sleepy therefore helping you fall asleep at night. However alcohol can disrupt your sleep later. According to [Sleep Health Foundation](https://www.sleephealthfoundation.org.au/pdfs/CaffeineAlcohol-0713.pdf), in the second half of the night, sleep after consuming alcohol is associated with more frequent awakenings, night sweats, nightmares, headaches and is much less restful.

### Stop smoking!

Nicotine is a stimulant and makes it harder to fall asleep.
 
## The bottom line:

The good news is that most sleep complaints can improve by being attentive to behaviors that are referred to as “sleep hygiene.” 

- __Be consistent.__ Go to bed at the same time each night and get up at the same time each morning, including on the weekends. Set a bedtime where you can get at least 7 hours of sleep.
- __Use your bed only for sleep or sex.__ Don’t watch TV, read your iPad, or study in bed.
- __Ensure a comfortable sleep environment.__ Make sure your bedroom is quiet, dark, relaxing, and at a pleasant temperature.
- __Read a book before bed.__ Avoid the electronic blackhole. Remove electronic devices, such as TVs, computers, and smartphones from the bedroom. 
- __Avoid caffeine__ at least 4 hours before bedtime.
- __Adjust your eating habits.__ You should allow 2-3 hours between the last main meal of the day and going to bed
- __Avoid alcohol__ for at least 4 hours before going to bed. It will disrupt your sleep during the night.
- __Get some exercise!__ Being physically active during the day can help you fall asleep more easily at night.




If you do not notice an improvement in quality and length of sleep, please visit your primary care provider to rule out other causes of sleep deprivation.



March is All About Sleep Awareness

Telemedicine is a rapidly evolving field, so we thought it would be helpful to provide a few facts and figures around the adoption, regulation, and use cases for telemedicine. At HeyDoctor our goal has always been to improve access to high quality and affordable healthcare for all Americans, and the thoughtful use of telemedicine can help many more Americans get treated for  common medical needs using the devices we all carry.

## 10 Stats about Telemedicine

1. 49 States and the District of Columbia (D.C.) have a definition for either telehealth, telemedicine or both in state regulations. [Center for Connected Health Policy](https://www.cchpca.org/sites/default/files/2019-05/50-State%20Infograph%20Spring%202019%20FINAL.pdf) 
2. 11 states provide Medicaid reimbursement for telemedicine or telehealth visits using [store & forward telemedicine](https://mhealthintelligence.com/features/store-and-forward-telemedicine-services-expand-connected-health "telemedicine definitions"). [Center for Connected Health Policy](https://www.cchpca.org/sites/default/files/2019-05/50-State%20Infograph%20Spring%202019%20FINAL.pdf) 
3. All 50 states and D.C. provide Medicaid reimbursement for live video telemedicine. [Center for Connected Health Policy](https://www.cchpca.org/sites/default/files/2019-05/50-State%20Infograph%20Spring%202019%20FINAL.pdf)
4. Telehealth is growing fast - a study of insurance claims filed for alternative settings of care found claims for telehealth rocketed up 53% from 2016 to 2017. That growth greatly outpaced other places studied—14% at urgent care centers, 7% at retail clinics, and 6% at ambulatory surgical centers (ASCs). [American Medical Association](https://www.ama-assn.org/practice-management/digital/telehealth-53-growing-faster-any-other-place-care)
5. As of 2017, 76% of U.S. hospitals connected patients and consulting practitioners at a distance through the use of video or other technology. [American Hospital Association](https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf)
6. According to a survey of employers in 2017 - 78% of employers offered a telemedicine option for office visits and another 16% were planning or considering to by 2019. [22nd annual Best Practices in Health Care Employer Survey by Willis Towers Watson](https://www.willistowerswatson.com/en-US/News/2017/08/us-employers-expect-health-care-costs-to-rise-in-2018)
7. The American Medical Association conducted a physician survey in 2016 and found that 15.4% of physicians worked in practices that used telemedicine. [Health Affairs December 2018](https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05077)
8. Consumers are interested in using telemedicine - in a 2017 survey of over 5,000 patients across the country, 77% of respondents would consider seeing a provider virtually. [Virtual Visits Consumer Choice Survey by the Advisory Board](https://www.prnewswire.com/news-releases/virtual-visits-with-medical-specialists-draw-strong-consumer-demand-survey-shows-300475757.html)
9. However more work needs to be done to provide patients with access to high quality telemedicine options - only 9.6% of consumers have used telehealth in lieu of a doctor's office, urgent care, or emergency room visit in the last 12 months. [2019 J.D. Power Telehealth Satisfaction Study](https://www.americantelemed.org/wp-content/themes/ata-custom/download.php?id=3546)
10. Bonus fact: On HeyDoctor the cost for most services is only $20. Why is that important? The cost for most of our services is 25% *less* than the average out-of-pocket copay in 2017 ($27). [“Tracking the rise in premium contributions and cost-sharing for families with large employer coverage.” By Matthew Rae, Rebecca Copeland and Cynthia Cox (August 14, 2019)](https://www.healthsystemtracker.org/brief/tracking-the-rise-in-premium-contributions-and-cost-sharing-for-families-with-large-employer-coverage/)

Do you have a fact or figure that you think we should include here? Send us a message at feedback@heydoctor.com

Telemedicine - Facts and Figures

# Information About HeyDoctor for Policy Makers and Regulators

Hello and thanks for stopping by!

HeyDoctor was established in 2017 by Brendan Levy, a California-based primary care physician, to provide patients an affordable, safe, and convenient way to get primary care online. Dr. Brendan believes that augmenting the skill and knowledge of medical professionals with safe, secure and intelligent technology can enable all Americans to receive high-quality, evidence-based preventative medical care.

Visits with a medical professional through HeyDoctor work much like a typical in-person primary care visit, with the added benefit of ensuring that all relevant information is collected from the patient and a clear treatment plan is provided when necessary. Best of all, the results of these visits are used to continually improve these interactions for maximum patient benefit.

The typical visit conducted by a medical professional on HeyDoctor begins with the creation of a comprehensive picture of the patient, their medical history and their current ailment.  

-	First, the patient is asked about their chief complaint and symptoms. 
-	Then, the patient is asked to provide past relevant medical history, allergies, other medications and other questions relevant to that complaint. 
-	When appropriate, the patient may be asked to provide specific data or test results, to the best of their knowledge. 
-	Lastly, the patient is required to provide photo identification.

Once the patient’s information has been collected, a board-certified primary care medical physician, nurse practitioner, or physician’s assistant (depending on the state of the patient) will talk with the patient over secure messaging and/or telephone to help the patient understand the risks and benefits of different testing, treatment, and referral options. Lastly and only if necessary, an easy-to-understand treatment plan is provided to the patient. 

Post visit, the patient has the ability to remain in contact with their medical professional or his/her peers for follow up questions or issues. 

We know that telemedicine is an evolving area, and we’re also aware that not all telemedicine providers always adhere to best medical practices. We believe that our medical professionals provide quality medical care using technology available to virtually all Americans in a way that enhances both the patient and physician experience. We welcome the opportunity to share our mission with policy makers, regulators and the medical boards charged with ensuring access to safe and high quality health care. 

Below are answers to some common questions we’ve received from regulators and policy makers. If we haven’t answered your question, please contact me with any inquiries.

## HeyDoctor Medical Professionals 

At HeyDoctor, all medical care is provided by independent physician-led medical groups that use our secure technology platform to connect with and treat patients. Patients are charged a visit fee per medical consultation and match each patient to a board certified clinician licensed in the patient’s state of residence.

All clinical decisions are made by a licensed medical professional exercising their independent medical judgment after reviewing a patient’s health needs and medical background.
 
HeyDoctor Medical Group was founded by Dr. Brendan Levy, a board certified family medicine doctor who trained at the University of Washington, the Saint Louis University School of Medicine, and completed residency at Georgetown University and Providence Hospital.  

## Evidence Based Medical Care 

All the services we provide are designed to adhere to the highest quality evidence based medical evidence and national guidelines (e.g. CDC MEC, JNC 8). We continually update our guidelines and information to incorporate advances in primary care. 

Telemedicine offers a great opportunity to increase access to quality healthcare for all Americans. However, it is isn’t appropriate for every medical issue and in certain instances, an in person evaluation may be required. The services offered on HeyDoctor were selected by our medical teams, working with an advisory board of medical experts, to meet or exceed the standard of care for each type of service. As with any medical visit we only treat patients we can fully diagnose and treat. If appropriate, we order testing where it aids our diagnosis, and refer patients to seek in person care if they require further diagnosis, more urgent treatment, or a service that our physicians don’t provide. 

All clinical decisions are documented in medical records for each visit and we encourage patients to update their in person primary care doctor and help them setup in-person primary care if they don’t have it.  

## HeyDoctor Does Not Own or Operate a Pharmacy

HeyDoctor does not own a pharmacy. We do not dispense medication, and our doctors are provided no incentive to do so.  We operate like a traditional medical practice and charge patients for visits. 
 
## Direct Pay Only 

We bill patients directly for professional services rendered. Today, we don’t currently accept or bill insurance, but we are evaluating the option to accept insurance in the future. 

## State Regulatory Guidance around Telemedicine

As state regulators and medical boards learn more about telemedicine and how it is being utilized, we expect that they may be understandably cautious. Although HeyDoctor is currently available for a limited set of primary care conditions in only 20 states, we’d like to bring our vision for an online doctor’s office to more Americans. We know the best way to achieve that vision is to enter into proactive conversations with regulators. 

A core regulatory challenge for any medical organization looking to provide high quality healthcare via telemedicine is the ambiguity in some state regulations around telemedicine. Depending on the state, the laws may be subject to interpretation, may not address key issues around telemedicine, or lack clear guidance from the state medical board or regulators. It is in these circumstances where a thoughtful dialogue between regulators and medical boards on the one hand and telemedicine organizations on the other, would be most beneficial.

We’ve designed our technology platform to be adaptable to the requirements of any state, regardless of modality, so once clear expectations and requirements are set, the implementation to meet those guidelines can be done quickly. 

That said, if you are a state medical board or regulator reading this, we encourage you to contact us at the email or phone number below to start the discussion. We want to learn more about the specific laws and guidelines in your state so that we can determine how we can provide your state’s residents with affordable, safe and convenient healthcare access.

Dr. Brendan Levy


Information About HeyDoctor for Policy Makers and Regulators

Anaphylaxis Prevention (Auto-injector Refill)

We can help you get refills for epinephrine auto-injectors including Adrenaclick, Auvi-Q, EpiPen, and Symjepi. To learn more about these medicines read the Important Safety Information - including how to use, contraindications, common side effects, and other information. 

High Cholesterol (Hyperlipidemia) Medicine Refill

We can help you get refills of cholesterol lowering statin medicines including Lipitor (atorvastatin), Pravachol (pravastatin), Crestor (rosuvastatin), and Zocor (simvastatin). To learn more about this medical condition and the medicines we commonly use to treat it read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Coronavirus (COVID-19) Screening and Triage

Coronavirus (COVID-19) continues to spread. We’ve created an assessment based on CDC guidance to help you protect yourself and loved ones, and to know when to stay home and when to seek testing or medical attention. Currently available in AK, CA, FL, GA, IL, KY, MI, MN, MO, MT, NE, NY, NC, OH, PA, SC, TN, TX, WA, and WY. 

Short Term Medicine Refill

We can help provide short term medicine refills for your regular medicines. You can use this service when you aren't able to get into your primary care provider and need a short term (30 or 90 day supply depending on the medicine) of the medicines you take regularly. We do not refill controlled substances (Adderall, Vicodin, Xanax, etc) and only refill medicines your provider determines are appropriate to refill on HeyDoctor. We can only provide this service once in 12 months so make sure to follow up with your in-person provider.

Asthma Short Term Refill

We can help you obtain a short term refill of asthma until you can get back to your primary care doctor. We can help you start or refill most asthma medicines - no insurance needed.

General Visit

We can help treat simple medical conditions like skin conditions, women's health, allergies, 
reflux, and more. You can use this service when you aren't able to get into your primary care provider quickly or just want to get help from home. 

We use evidence based guidelines to decide if based on your symptoms it is appropriate to prescribe antibiotics for UTI, whether we should order further lab testing, or whether something is probable and we should refer you elsewhere.

Urinary Tract Infection (UTI) Antibiotics and Treatment

Get a same day prescription for an effective UTI antibiotic. We'll send the prescription to your local pharmacy. We'll give you a full refund if we can't help. To learn more about this medical condition and the medicines we commonly use to treat it read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Birth Control Prescriptions and Refills

Get a prescription for birth control after a quick online visit. We can help you start or refill any birth control pill, ring, or patch - no insurance needed. To learn more about the medicines we commonly use read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Acne Treatment and Prevention

Acne is a common skin condition that causes blemishes. We provide prescription strength creams and medicines to cure and prevent it. To learn more about this medical condition and the medicines we commonly use to treat it read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Cold Sore Prescription Treatment and Refills

Get prescription-strength cold sore treatment for cold sore outbreaks from your phone or computer - no insurance needed. It takes just 5 minutes and we can send the prescription to your local pharmacy.

Hair Loss Prevention and Regrowth

Male pattern hair loss or balding is very common. We can prescribe medicines like finasteride that prevent further hair loss and in some cause hair regrowth. To learn more about this medical condition and the medicines we commonly use to treat it read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Naloxone for Opiate Overdose

Naloxone, including Narcan and Evzio, is a medicine that can stop an overdose or bad reaction to opiate medicines or heroin and save a life.

Eyelash Growth

We can prescribe or refill topical medicine to help you grow longer, thicker, and fuller eyelashes to treat eyelash hypotrichosis. To learn more about this medical condition and the medicines we commonly use to treat it read the Important Safety Information. It includes information on how to use the medicines we prescribe, contraindications, common side effects, and other information.

Erectile Dysfunction (ED) Diagnosis and Treatment

ED is a common problem affecting men. We can provide treatments that help you solve it. Most men with ED can be treated.

Quit Smoking

Quitting smoking is one of the hardest things you can do. We can recommend medicines and strategies that will help you quit for good. To learn more about these medicines read the Important Safety Information - including how to use, contraindications, common side effects, and other information.

Internal Condom Prescription

Internal (female) condoms are a contraceptive device to protect against pregnancy and sexually transmitted diseases. They can be used with other forms of birth control.

Vitamin D Screening and Treatment

Vitamin D is essential for healthy bones, digestion, and overall health. We can check your levels and improve them if they are low.

Hepatitis C Screening and Referral

Hepatitis C is a silent viral illness that can lead to cancer, fortunately now there is an effective cure. Find out if testing is right for you.	

Hypothyroidism Medicine Refill

We can help refill your thyroid replacement medicines for those with uncomplicated hypothyroidism.

Pregnancy Testing

We can order pregnancy testing at a local lab to help you find out if you are pregnant.

Pre-Diabetes Testing and Referral

We will order a Hgb A1c test to analyze your recent blood sugar levels. Depending on your levels we can help you stay in optimum health or find treatment.

Wrinkle Reduction and Photo-Aging Treatment

We can prescribe medicines to help treat wrinkles and photo-aging and improve skin health and appearance. Topical retinoids can increase skin collagen, firmness, and reduce the appearance of fine lines and wrinkles.

Tuberculosis (TB) Testing and Referral

Tuberculosis (TB) is a bacteria that can cause a dangerous chronic lung infection. Get high quality QuantiFERON testing to determine if you need treatment.

Metabolic Performance Analysis

We can order, and help you understand, laboratory testing of your vascular system, blood sugar, electrolytes, and other key body performance metrics.

Find Out Your Blood Type

Find out your blood type and group. We will order a blood typing and help you understand your results.

HIV Testing

HIV is a virus that can be sexually transmitted. Get high quality testing to ensure you and your partner stay safe.

General