Dear Patients,

Take a deep breath, let it flow (click here for music). You are listening to Yiruma, River Flows in You. The confluence of the pandemic, economic uncertainty and social unrest has resulted in daily distressing news. What is happening to our world? What is real? What is hype? What can you believe? Breathe, be present, let the river flow in you. Let your thoughts be clouds and do not get attached to them. Breathe.

The tragic death of George Floyd has triggered chaos. I am deeply saddened and disturbed by it all, including rioting, anarchy and looting. If you are feeling sad, anxious, dark, less hopeful, you are not alone; I understand. These times are exactly when we need to go deep into our core and find the big message that helps us swim to the surface and get our breath. There has got to be something we can take from this and move forward. And the daily news: is it making it better or worse for you? For me, worse. My go-to author, Rolf Dobelli, has a TED talk about the news that I think is worth listening to. See if it changes your mind about the 24-hour news cycle.

So, my message is to be kind, be grateful, respect the law, and vote. And when I vote, I will be mindful to select a candidate who has the courage to stand up for the rule of law so my family, community, state and our country are safe.

The numbers:

• Nationally, yes, case numbers are up. Why? We are testing more. Unfortunately, the increased test numbers are being reported in a fashion that may cause you to panic. Do not! The meaningful information is in the hospitalization numbers, ICU admissions and mortality numbers.

• Maryland reports the fewest new coronavirus cases since March 31; hospitalizations continue to decline.

• The Rt in Maryland as of today is 0.79. You may recall the the Rt is a measure of how fast the virus is growing; when it is below 1.0, the virus will stop spreading.

Diagnostics and Therapeutics:

• Every day we understand more about the biology of this virus; 94% of the time, it will be acquired by exposure to respiratory droplets. The CDC says 6% or less of infections are due to contact inoculation.

• Dexamethasone, an inexpensive steroid drug, seems to moderate the viral respiratory failure. Published peer-reviewed information is pending. Early reporting sounds like a game-changer.

• Remdesivir is an expensive drug that was touted by NIH to be helpful but not a "knockout punch", yet no better than placebo in a Lancet article, and is in short supply.

• There are nearly 160 COVID-19 vaccines in development. Accordingly, there is optimism that we may have something soon and perhaps will be used first for our most vulnerable.

What to do now:

• Always wear your face mask when you are out.

• Wash your hands or sanitize frequently.

• Avoid large social gatherings (>10 people).

• Maintain at least 6' of social distancing.

• No hugging, kissing or shaking hands

• Most importantly, accept that it's time to learn how to safely live with COVID-19; breathe and re-enter life smartly.

On a Musical Note:

I think we need to relax and get a hold of ourselves; Come Sail Away by Styx fits the bill.

On a lighter note:

Reach out. Stay connected. Stay home. Save lives. The power of one. Be well.

Feel free to forward this on: spread the word, not the virus.

Harry A. Oken, M.D.