50 States: COVID-19 Vaccination Information

Last Revised: 01/22/2021

From CNN.com

CNN webpage with links to all 50 states COVID-19 vaccination Info. https://www.cnn.com/2021/01/15/health/us-state-health-covid-vaccination-info-wellness/index.html


Blood Glucose Accurately Predicts COVID-19 Severity

The Nov. 23 issue of Annals of Internal Medicine published an observational study that concluded that hyperglycemia (blood sugar level) independently predicted progression from noncritical to critical condition and death, regardless of prior Diabetes history,  among more than 11,000 patients with confirmed COVID-19, from 109 hospitals in Spain. This study informs how people admitted to a hospital even with mild hyperglycemia should be treated. Since it examines outcome by admission blood sugar level it eliminates the effect of any inpatient treatment.

FDA Approves SalivaDirect via Emergency Use Authorization


Last update: 08/17/2020

The less invasive, lower cost SalivaDirect COVID-19 diagnostic test was issued an emergency use authorization by the FDA on 8/15/2020. This new test collects saliva in any sterile container, and does not require a separate nucleic acid extraction step. This saves time and money, and offers a real hope for expanded testing throughout the country. Here’s the link to the FDA notice;  https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-yale-school-public-health


Overview: Diabetic Self-management and Emergencies During Coronavirus

In most cases people can take steps on their own to correct when blood sugar is too low or high. Those steps are outlined later in this article. Sometimes, people need help. If you are close with someone who has diabetes, consider having a discussion with them about what they want in case of an emergency.

Diabetes and Illness

People with diabetes who get sick with the flu or common cold should stay home and limit contact with others. Other recommendations from the Centers for Disease Control (CDC) include:

  1. Continue taking diabetes medication and insulin.
  2. Test blood glucose every four hours.
  3. Drink extra (calorie-free) liquids.
  4. Eat as normally as possible.
  5. Weigh yourself daily
  6. Check your temperature daily.

The CDC recommends that you contact a health care professional or go to the nearest hospital emergency department if any of the following occur:

  1. Your too sick to eat.
  2. You are not able to keep food down for 6 hours or more.
  3. You are having severe diarrhea.
  4. You have lost 5 pound or more.
  5. You have a fever over 101 degrees F.
  6. Your blood sugar level is < 60 mg/dl or > 300 mg/dl.
  7. You have ketones in your urine.
  8. You have trouble breathing.
  9. You feel sleepy or are not thinking clearly.

Diabetes and Coronavirus

We are learning more about Coronavirus every day. People with Type 2 diabetes are at increased risk of severe illness from COVID-19, and people with Type 1 diabetes may be at greater risk as well.  You can not ensure you have no risk of infection from Coronavirus. When protective measures and strict social distancing can not be maintained, people with diabetes should seriously consider avoiding activities.[i]

High blood sugar (over 250 mg/dl) and low blood sugar (under 70 mg/dl) can be dangerous, and symptoms can turn into an emergency quickly. Knowing the symptoms and what to do when your blood sugars are high or low may save your life.

High Blood Sugar; ( > 250 mg/dl )

The problem with high blood sugar is that your body can start burning fat instead of blood glucose and/or you blood can become acidic in a way that damages vital organs. This can cause medical emergencies that can be fatal.

When your blood sugars regularly exceed 180 mg/dl you should work with your health insurance provider and doctor to find and schedule an appointment with an Endocrinologist.  An Endocrinologist specializes in Diabetes and get help you develop a treatment and management.  You can find one in your area by searching The American Association of Clinical Endocrinologists website.

There is also an uncommon and very serious problem called Hyperosmolar Hyperglycemic Syndrome (HHS) when blood sugar is extremely elevated ; > 600 mg/dl. According to WebMD, HHS happens mostly in older people with uncontrolled diabetes who are sick or have an infection, and often occurs over days or weeks.[ii]


Frequent urination, a fruity smell on your breath, extreme thirst, nausea, vomiting, and stomach pain. Any sudden or unexplained symptom is a signal to contact a doctor. At a minimum you should use a home test or dipstick test to check your urine for ketones. If ketones are present, you should contact your doctor for next steps

Treatments for High Blood Sugar

Drink water – to help your body release urine. You should discuss this method with your health care providers because you can drink too much water; specially if you have heart or kidney issues.

Administer Insulin – discuss with your doctor how much rapid acting insulin to inject when your blood sugar level is too high and check your blood sugar again after 30 minutes to ensure your blood sugar is going down.

Exercise – your body will burn sugar when your heart pumps faster than usual. Any exercise should be discussed before-hand with your health care providers, especially if you are a Type 1 Diabetic.

Low Blood Sugar; ( < 70 mg/dl )

Blood sugar can also be too low. This is called hypoglycemia. Without treatment, low blood sugar can also become life threatening. Blood sugar most often drops too low because a person takes too much insulin, consumes too much alcohol, misses meals, or does too much exercise.

Many times people with diabetes can feel when their blood sugar is too low. However, that’s not always the case. Even for people who have had diabetes for a long time. Symptoms of low blood sugar to be aware of include confusion, dizziness, nausea, hunger, nervousness, sweating, weakness, tiredness, tingling in extremities, and headache. More sever symptoms include seizures and a loss of consciousness.

Treatment for Low Blood Sugar

If at any time a person loses consciousness someone should call 911.

If a person is experiencing mild symptoms or knows that they have low blood sugar they should eat a high carb snack like a glucose tablet, candy, sweet juice, sugar. The American Diabetes Association recommends that you take 15 grams of a carbohydrate and test yourself after 15 minutes. If levels are still below 70 mg/dl take another 15 grams of carbs and test yourself again after 15 minutes.  Once blood sugar levels rise above 70 mg/dl eat a meal. If symptoms continue after eating 30 grams of carbohydrates seek medica help.

In an Emergency

Signs of a possible emergency include the persistence of any of the symptoms outlined above for a prolonged time. Symptoms indicating that the problem is overwhelming the body include chest pain, difficulty breathing, a sudden fever, a severe headache, weakness in a part of the body, seizures, and loss of consciousness.

When any of these symptoms are experienced a call to 911 or trip to the hospital emergency department is needed.  WebMD states that you should give them a glucagon shot to raise their blood levels. aPatientsPlace.com does not support untrained people giving medications to people unless there are no other options.

Diabetes also makes people 2 to 4 times more likely to have a heart attack. Know the common signs of a heart attack and call 911 immediately or go to a hospital emergency department when needed. Stroke risk is also increased with diabetes. Know the symptoms and how to seek emergency care.

In the Emergency Department the primary goals are rapid evaluation and stabilization.[iii] Once the person is stabilized their primary care doctor and Endocrinologist, if they have one, should be contacted for post-discharge follow up and diabetes management care planning.


[i] Centers for Disease Control and Prevention. July 30, 2020. People with Certain Medical Conditions. Accessible at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

[ii] WebMD Medical Reference. Nov. 19, 2018. Diabetes Emergencies: How You Can Help. Accessible at https://www.webmd.com/diabetes/diabetes-emergencies-what-to-do

[iii] Ford W, Self WH, Slovis C, McH=Naughton CD. Diabetes in the Emergency Department and Hospital: Acute Care of Diabetes Patients. Current Emergency and Hospital Medicine reports. 2013; 1(1):1-9. Doi:10.1007/s40138-012-0007-x


Managing Anxiety

Anxiety is a normal emotion. When set against the uncertainty of a pandemic, civil unrest, job loss, financial pressure anxiety can seem over-whelming.

You are not alone. There are many people who feel the same as you. More important, there are resource available to help you.

The Anxiety and Depression Association of America can help you understand the difference between normal anxiety and General Anxiety Disorder. A Patients Place always recommends that a partnership with your primary physician is the best weapon against illness and disease, and the best way to maintain your physical and emotional health. If you are not able to discuss your feelings with your primary care physician, you should find a new one who is more available and you feel more comfortable with. Here’ a link to guidelines to finding a primary care physician.

The Centers for Disease Control (CDC) offers a list of healthy ways to cope with stress and anxiety. You may notice that simply taking an anti-anxiety medication is not on the list.

It’s important to remember that everyone reacts to situations, life in general, stress, and therapy differently. If you need additional support use the free support and guidance service at https://apatientsplace.wordpress.com.

Revised: 07/24/2020

Coronavirus Testing Guidance for all 50 States; with or without a doctor or insurance

Last Update: March 31, 2020

Coronavirus testing

The following steps and state-by-state instructions, links, and phone numbers can help you get a test for Coronavirus Continue reading “Coronavirus Testing Guidance for all 50 States; with or without a doctor or insurance”

We must protect our healthcare workers; now!

We can’t allow our health care and public health workers to remain in short supply of personally protective equipment (PPE). It’s not enough for the administration and state governments to say that “plans to increase global manufacturing are underway,” as the CDC states in its recent guidance on the matter.

If our Emergency Department, hospital, clinic, home care, public health, and other front-line workers are not fully protected, we risk having our hospitals and health providers overwhelmed, our work force becoming patients with some dying, and leaving even fewer qualified professionals to care for our COVID-19 and regular care needs.

This is not only possible, it’s happening today in Balsamo, Italy. In a community where a 1,000-bed hospital has been completely overwhelmed, and where doctors are now treating other doctors and peers for COVID-19 because of the sheer volume of daily cases and the limited supply of personally protective equipment. They are in sheer crisis mode with virtually every citizen caught in the cross-hair of this situation; with no immediate end in sight. The same is happening at a 400-bed in Milan, and in many other places as well.

Finger-pointing and blame for inadequate testing capabilities must give way to action to take care of our healthcare workers. This is an avoidable scenario that need not happen. We’ve seen the outcome of inaction. The administration and state leaders will be to blame and should be voted out of office this fall if we don’t do whatever it takes to increase production and get PPE in the hands of our front-line healthcare workers.


8 Takeaways from Wuhan, China – Coronavirus

Thank you to Bill Frist, MD for sharing highlights of his conversation with three top Chinese physicians leading the Coronavirus response in China.

I’ll summarize here. However, consider watching the video shared by Dr. Frist on LinkedIn.

Lessons learned;

1. Early control of local transmission depends on rapid diagnosis and hospitalization of those with the disease. Failure to do this results in a spike in local cases.

2. Disciplined social distancing allowed for a peaking of cases in Wuhan within 10 days after first being reported. The number of new cases remained elevated for 6 days, followed by a rapid fall in reported new cases.

3. The most common feature of serious infection appeared to be fever, which was present in 98.6% of pneumonia cases reported in Wuhan. Other common symptoms included fatigue, dry cough, and muscle soreness.

4. Viral load, the measure of the virus present in the blood stream, had a direct impact on the severity of the disease.

5. COVID-19 was confirmed with two positive PCR performed one after the other.

6. Chest x-rays and CT scans were not precise in identifying COVID-19.

7. The main incubation periods, the average time from initial infection to onset of infection, in China was about 6 1/2 days.

8. No anti-viral drug has been proven effective against COVID-19. That said, trials are underway on Lopinavir, Retonavir, Remdisivir.

I encourage you to listen to the entire video on LinkedIn.

Trustworthy Sources of Federal/State/Local Information


Caronavirus – COVID-19

Last update: 3/13/2020

It’s natural for everyone to want information about COVID-19 in the U.S.

If you want information, there’s a curated list of trustworthy phone numbers and websites below specifically for COVID-19 (Coronavirus) information and help.

All the phone numbers and website links below are specific to COVID-19 (Cornoavirus). They are from curated and trustworthy federal, state, and local governments and agencies, and educational institutions. The list will be updated regularly as new, credible information becomes available.

Please do not to click on unsolicited emails offering information about COVID-19, treatments, cures, or anything else. No matter how legitimate the email looks.

There is far too much misleading and incorrect information being put out to the public on the Internet and via the media Scammers are already using the CDC and state health department logos to place malicious software on computers as soon as emails are opened.

Every person should take personal responsibility to assess the accuracy of the  information you are consuming.

Phone Numbers


1-888-463-6332: Food & Drug Administration Information Line
1-800-232-4636: Centers for Disease Control and Prevention


617-534-5050: Boston Public Health Commission
760-837-8988: California., Eisenhower Health
866-779-6121: Florida Department of Health
513-529-9000: Miami University, OH
855-600-3452: New Mexico Department of Health
410-455-1000: University of Maryland
304-598-6000: West Virginia University
801-584-2575: Veterans Administration Rocky Mountain Network
877-741-3400: Veterans Administration Tampa, FL




Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
Medicare: https://www.medicare.gov/medicare-coronavirus
EPA’s List of Disinfectants for COVID-19: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2


State Health Department Websites: https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
California, Los Angeles: https://www.lacity.org/highlights/los-angeles-emergency-management-departments-response-covid-19
California, Oakland: https://www.oaklandca.gov/news/2020/new-coronavirus-covid-19-update
California, Santa Clara: https://www.santaclaraca.gov/i-want-to/stay-informed/current-topics/coronavirus-updates
Florida: http://www.floridahealth.gov/diseases-and-conditions/COVID-19/
Florida, Tampa: https://www.tampagov.net/emergency-management/covid-19
Georgia: https://dph.georgia.gov/coronavirus-disease-2019-covid-19-outbreak
Hawaii, Maui County: https://www.mauicounty.gov/2370/COVID-19-Coronavirus-Information
Illinois, Kane County: https://kanecountyconnects.com/2020/03/covid-19-daily-update-president-bans-travel-from-europe-hindale-schools-close-6-new-coronavirus-cases-statewide-who-declares-global-pandemic/
Louisiana: http://ldh.la.gov/Coronavirus/
Maryland: https://phpa.health.maryland.gov/Pages/Novel-coronavirus.aspx
Massachusetts https://www.mass.gov/resource/information-on-the-outbreak-of-coronavirus-disease-2019-covid-19
Montana: https://dphhs.mt.gov/publichealth/cdepi/diseases/coronavirusmt
New Mexico: https://www.governor.state.nm.us/2020/03/11/updated-governor-department-of-health-announce-first-positive-covid-19-cases-in-new-mexico/
New York: https://www.health.ny.gov/diseases/communicable/coronavirus/
New York, Rochester: https://www.rochesterregional.org/coronavirus-covid19
New York, Rockland County: http://rocklandgov.com/departments/health/coronavirus-covid-19/
North Carolina: https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina
Pennsylvania, Alleheny County: https://www.alleghenycounty.us/Health-Department/Resources/COVID-19/COVID-19.aspx
Rhode Island: https://health.ri.gov/diseases/ncov2019/
Texas: https://www.dshs.state.tx.us/coronavirus/
Texas, Dallas: https://dallascityhall.com/Pages/Corona-Virus.aspx
Utah: https://dps.utah.edu/coronavirus/
Washington (state): https://www.doh.wa.gov/emergencies/coronavirus
Washington, Island County: https://www.islandcountywa.gov/Health/Pages/COVID-19.aspx
Washington, Maple Valley: https://www.maplevalleywa.gov/departments-services/covid-19
Washington, Seattle & King Counties: https://www.kingcounty.gov/depts/health/news/2020/March/10-covid-case-updates.aspx

Get Email Updates

CDC: https://www.cdc.gov/Other/emailupdates/
Disclaimer: aPatientsPlace.com is not responsible for any content or advice presented or given on the websites or phone centers included in this article.