That turned dark quickly. Instead of getting better we were getting worse every day. We started doing more tests on her and they turned up negative. We did another test that was more of a screening and that was positive. Then all this was picked up, so I’ve got a patient. My physician and I were very involved in her treatment, but I thought we were doing something that was very low risk and the outcome—by definition—is not guaranteed. I had an 80-year-old woman in my office whose family history was all positive. I said, this is something that is very low risk for her. It turned out—I’ll never forget it. There was a knock on my door and I said, excuse me, whoever’s there, and the person said, it’s the police. They gave me that kind of reception I didn’t expect. I got my license—I got into trouble at work because I was a nurse and everybody was asking me questions. I thought, this is bad. Now I have two patients with a potentially bad outcome. How can I do this as a healthcare provider and have a plan that’s going to be safe and acceptable to the patient and make sure this doesn’t happen again? So that’s what we’re going to talk about today. We’re going to cover all the aspects of this. We’ll start out with a little bit of a medical history. You’ll see a lot of similarities as to how I developed my plan and how we developed our plan. We’ll talk about how we came up with our plan to make sure that everything was understood. I’m going to describe my specific plan that we developed. Then we’re going to talk about the differences between the FDA guidelines and how that’s going to affect how people are going to see things. I’m going to talk a little bit about what we see in the guidelines. Finally I’m going to tell you about the three things that you need to think about when you’re making sure you do things safely for patients. And I’m going to leave you with a very real example of how we’re going to work through the things that you need to think about to make sure you get this right. I’m going to start by talking about the medical history of the patient that you’re going to want to use for your plan. In the next two slides, I will talk about the three things that we have to deal with when we are dealing with patients with the Covid-19 infection. The first thing is we need to understand that many people who are infected will experience a mild illness, a mild illness. Some of them may experience more severe illnesses. And some of them may experience a death. The second thing is that we should be understanding that there are factors that may make this a worse outcome for a patient and make it more severe. And we have some treatment guidelines that are going to be a little bit useful when it comes to some of these things. We’re going to talk about how some of these risk factors will make things different. And then the third thing is that we also need to talk about things we can do to prevent this, prevent this from becoming much worse. And the most common of these are things that you can do in your home. I’m going to come back with a little bit of an example of a patient that we treated who had a lot of these risk factors. If you go to this website you can see a few things of what we need to think about when we are working with our patients. I’m going to read to you from what the FDA says about how to treat these patients. These are some of the things that we’re going to talk about. I will make sure that I’ll come back here in the middle of this presentation. These are some of the things that you can use to help when you’re talking to your patients about any of these Covid-19 outbreaks, because this is really all that we have. These guidelines are not that great at all. These guidelines are being updated on a regular basis. There’s nothing here that says you’ve got to change anything. The point of these is that the guidelines are for healthcare providers. These guidelines are in many different languages and they’re not quite clear, but this is the information that we have. Okay. I’m going to read to you what the FDA is saying about things that may make things a little bit worse and make it harder for patients to recover and get better. Okay, so the first one is that patients who are elderly. The second one is that patients who have underlying health problems such as diabetes, obesity, cardiovascular disease, or lung disease. These are things that are associated with a more serious outcome. The third one is if the patient has a chronic condition like asthma or diabetes that’s complicated. The fourth one is having certain kinds of conditions that make it harder for the patients to breathe. That’s things like heart or lung failure. The fifth one is if the patient has received hospitalization or had to be treated in the ICU for any reason. The sixth one is if the patient is on immunosuppressive therapy. Immunosuppression is drugs that prevent the body from regulating its own immune system, and that includes drugs like chemotherapy and other treatments that have an impact on the immune system. It can be things like steroids. Any of these things will make patients feel worse when they are infected with this virus, and they will make it more difficult for the patients to get better. And the last thing is that the patients who are infected with a certain kind of flu that causes a lot of pneumonia. These are the common flu. They are very closely related to what this virus is. Okay, so I’m going to talk about the patient that we had that presented with these risk factors. And that’s just going to help us understand what we need to do as healthcare providers. We can’t think that they’re the only patient we’re going to see. I think we need to be able to understand the population that we’re dealing with. We’re going to be talking about the Covid-19 infection. And what is our patient? I’m going to show you a very real situation and the patient we talked about. This is a picture of a 68-year-old white male. He weighs about 160 pounds. He is about six feet tall. He is very cooperative, and I anticipate that you’re going to feel very comfortable talking about him because you can see some of the things that are associated with what we talked about earlier. He has a heart attack at age 50. He was treated for that, and he never really had any trouble with that. He never had any problems with that for more than twenty years. He never has been hospitalized, and he never has had any medical treatment outside of cardiology. This was more than twenty years ago, when I graduated medical school and had my first medical rotation. He’s never had a serious medical condition since he was 50 years old. The reason that’s important is that we’re dealing with a lot of the factors that can be associated with a serious outcome to the infection. He has hypertension that we treat with medicine, blood pressure medication. We have him on