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Advice and memories of coping with a plague from Millerton doctor

MILLERTON — As COVID-19 rages on, front-line health care workers face an increased risk of exposure to patients who may be carriers of the disease. Small-town physicians — such as Kristie Schmidt, whose internal medicine practice in Millerton has been inundated with patients over the past two weeks suffering from upper respiratory infections, the flu and possibly COVID-19 — are no exception.

Now the doctor is sick. Out of an abundance of caution and sidelined with a fever, Schmidt reported on Sunday, March 22, that she is in self-quarantine until COVID-19 test results allow her to go back to work — and her patients.

Meanwhile, the doctor — who has been practicing medicine for three decades — will continue to see patients via telemedicine from her kitchen.

“Right now in Millerton I am actually quarantined at home with a fever after seeing many patients with URI [upper respiratory infection], cough and fever, some testing positive for influenza A,” said Schmidt by email on Sunday, March 22.

“I am waiting for COVID test results before returning to work.”

To date, said Schmidt, there has been no COVID-19 testing made available in Dutchess County to outpatients. The doctor said she managed to get one from her own physician in Albany, N.Y.

COVID-19 death in Dutchess County

Schmidt said on Sunday that she had heard reports of confirmed COVID-19 cases in Dutchess County, “but I don’t know how they managed to get tested because, as of three days ago, I spoke to the Dutchess County Department of Health, who told me there were no tests available.”

Later on Sunday, the county’s first death relating to COVID-19 was confirmed. In a March 22 news release, the Dutchess County Department of Behavioral & Community Health reported that “while specific information cannot be provided for privacy reasons, it was confirmed the individual was a 69-year old male who developed respiratory distress and was sent directly to Mid-Hudson Regional Hospital where he was treated, but died on Friday, March 20.”

There are currently more than 60 positive cases of COVID-19 and the numbers are expected to increase as more testing becomes available this week, according to the release.

Telemedicine now ‘essential’

As for Schmidt, until her test results are back and despite feeling under the weather, she plans to stay connected to her patients through virtual visits.

Until COVID-19 slows and health care professionals are outfitted with adequate protective gear, Schmidt said virtual doctor visits may become the norm as a way of safely treating patients and steering those most at risk to proper treatment.

“The push toward telemedicine has been abhorrent to me,” said Schmidt, “as I believe seeing a patient physically and emotionally is essential in making a diagnosis. However, this pandemic is going to create a sea change in accelerating our use of remote communication as a society.”

Telemed, said the Millerton internist, “is going to be essential. As a true technophobe I must admit that it has been working and so far all of my patients seem to have been satisfied with the experience and grateful to have access to their doctor while sheltering in place.”

However, Schmidt said, patients who are less tech savvy and those without access to digital devices will need family or community assistance, “and I would welcome ideas on how to get that help into people’s homes.”

No stranger to plagues

Schmidt is no stranger to novel infectious diseases. A New York Medical College med student and resident in the late 1980s and early 1990s during the devastating initial HIV/AIDS epidemic, Schmidt had witnessed first-hand the death and destruction a novel plague can unleash on society.

She recalled her experience at St. Vincent’s Hospital in the West Village, which at the time was at the clinical forefront of the epidemic. It was, she said, “brutal, and in retrospect, bizarre. We treated crazy opportunistic infections and cancers that I’ve never seen since and hope to never see again.”

Even so, she said, work-related risk from COVID-19 is far greater — particularly with the shortage of appropriate personal protective equipment. “However, the consequences of infection are much different, as AIDS was a death sentence in the 1980s and up to the mid 1990s, when protease inhibitors became available.

“As med students and residents, we were all afraid of getting HIV through work-related exposure like needle sticks — of which I had my share. But we were equally afraid of getting it through sex. It was a scary time for all, especially my male friends who were gay.”

Advice to patients

As for advice to her patients, Schmidt had this to offer: “Social distancing, 6 feet apart, is essential. If you must go out to the store or to work, wear gloves if at all possible and avoid touching your face. And if you are sick with a cough or fever, you need to stay home and distance yourself from your friends and family members. This situation is not ending anytime soon.”

Schmidt added that the area offers a wealth of outdoor opportunities that people can enjoy with friends or alone.

“It’s a great time to get to know yourself better, read the books that you’ve wanted to read or play your instrument or make art, or just be in nature and breathe in and out.”

One last word of advice: “Just be sure to do a thorough tick check when you come in.”

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