Doctor's Orders

Lung Force Podcast with Dr. Chow

January 2021


WNY Immediate Care’s Medical Director, Dr. Chow is interviewed by Alexis Gigliello on the Independent Health Lung Force Podcast. The LUNG FORCE Podcast Series focused on lung diseases and local lung health trends, risk factors and commonalities!


Listen as Dr. Chow addresses the ongoing trends, projected upcoming challenges and hopeful successive, concerns, miss, and advice for moving forward in our current state of the COVID-19 pandemic.




Alexis 0:09

Hello, and welcome to the lung force podcast series. My name is Alexis and I’m your lung force host from the American Lung Association in Buffalo, New York. Lung cancer is the leading cause of cancer deaths in America for both men and women. People that you know are struggling with lung cancer, COPD, asthma and more every single day, we hope to change the stigma that lung cancer only affects smokers that asthma is only a mild issue that polluted air doesn’t impact our lung health and much more. Our lung force initiative is designed to do just that. Lung force was founded in 2014 in response to the rising rate of women being diagnosed with lung cancer. Each year, we host our lung force walk to raise funds and awareness for research, education and advocacy around lung cancer and lung disease. Each month, we’ll bring you a few episodes covering different lung health topics that are local and relevant to our community by interviewing experts around the area and digging deeper into the lives of those affected by lung disease. Thank you for tuning in and joining our lung force. Hello to all of our followers today, we are excited to get started on our second season of the lung force podcast series. Season Two will be focused on lung disease and lung health trends, commonalities and factors in the western New York area. We are also really excited to kick the season off with the biggest current health topic around the world. You guessed it COVID-19 the lung force Podcast Series is sponsored by our lung force presenting sponsor independent health. Independent health is extremely active in the western New York Community promoting healthy lifestyles by giving people the opportunity to engage in physical activity throughout our cities. They also assist with healthy meal options and plans and personal health care programs. visit their website at independent To learn more about what they do and how to get involved with them. I am pleased to introduce you all to Dr. Joseph Chow, medical director of Western New York immediate care along force partner. During this episode, Dr. Chow will address some of the ongoing trends projected upcoming challenges and hopeful successes, concerns, myths and advice for moving forward and our current state of the covid 19 pandemic. All right. Hi, Dr. Chow. Welcome. And thank you so much for joining us on this podcast episode. We’re really excited to have you here today.


Dr. Chow 2:26

Of course, pleasure pleasure being here.


Alexis 2:29

So first, could we just start off a little bit about just tell us a little bit about who you are? Your title what you do with Western New York immediate care?


Dr. Chow 2:38

Yeah, no happy to. I’m the I’m the president and medical director of Western New York Immediate Care. At Western New York Immediate Care, we have five sites throughout Western New York to in the north towns in the south towns and one, one in downtown buffalo.


Alexis 2:53

That’s awesome. And I know, Western New York Immediate Care is a new partner with American Lung Association over 2020, kind of how we got involved with you guys. So it’s been amazing, being able to learn more about your sites and work with you this past year. And so I’d love to kind of direct this episode a little bit about COVID-19 testing and work that you guys have been doing in the community, because I know that you have been doing a lot. And if I’m remembering correctly, I know when COVID was first being introduced in the US, and testing was kind of first becoming a new service that we had here. It seems that Western New York immediate care was kind of at the forefront of testing you were doing a lot of testing during the early stages. Would you be able to touch on what just kind of the introduction to all of that was like for you and your team?


Dr. Chow 3:42

Yeah, absolutely. I think COVID was something that really hits everybody, rather quickly, swiftly and really entered into everyone’s lives from a work standpoint, personal life, everything. So there was a lot to learn about COVID just what it is who had affected what kind of symptoms do you get from it? So there’s a lot of learning of COVID that really started back in the early part of the year, you know, back in March. And I think from the standpoint of people were thinking they had symptoms for COVID, or even the flu. And one of the most common questions we got was, Hey, I had some of these symptoms that are very similar for COVID. I just thought it was a cold. I thought it might have been the flu and just really didn’t think anything about it. And so they were people were wondering, did I actually have COVID or not? So when we start talking about testing, I would say there’s it’s almost a tale of two tests. And I’ll get into that in a moment. But some of the large amounts of testing that we did originally a lot of other facilities, and I would say back in the you know, in the April/May standpoint, was to really answer that question that people were wondering, did I actually have COVID or not? And so that testing is what we call antibody testing. And this test essentially, lets us know, did you In fact, were you infected with COVID and presumably people got over for it. And so that was a very popular test, I would say a lot of people wanted to know. And so that was the test that we first introduced in our centers back in May, and certainly did a lot of those tests. And again, a lot of other facilities did that test too, because they were really trying to answer that question that people had was, again, did I did I actually have COVID or not? And so I hope this helped answer that question.


Alexis 5:26

Yeah I do remember hearing a lot about the antibody testing. And I actually remember hearing people were wondering if their antibody tests have shown that they maybe had been exposed to COVID? Or did have COVID in their system that they were maybe immune to it in the future?


Dr. Chow 5:44

Yeah. So in a short timeframe, relatively speaking with COVID. Keep in mind, it’s only been less than a year now. Really, we have learned more about it, I would say there’s still some questions that are outstanding, with this specific antibody test did tell us was, were you infected with COVID? In the past. And so that’s kind of where we left it, we really couldn’t make any assumptions about, hey, if my test was positive, and I had antibodies, does that mean I’m, quote unquote, safe? We really didn’t have these answers, because this is the first time through with a virus. And to be honest with you right now, even if you do have antibodies, we still can’t say with 100% certainty that you’re completely safe. We have learned more. And certainly we kind of tap into history to say if you do have antibodies to infection, it should, it does suggest that you do have some immunity to that. And right now, if you have had COVID, you test positive for antibodies, generally speaking, you have what’s called natural immunity. And that typically, we haven’t seen many people getting reinfected within 90 days. Again, so that’s very, that’s kind of a high level thinking. If you have antibodies, if you have had the infection that we can presume you have natural immunity for about two to three months, this doesn’t mean I’ll make an Asterix on this, this doesn’t mean that you should stop practice social distancing, you should stop wearing masks, it doesn’t mean that at all, because we still, they’re still outstanding questions that just because if you just because if you don’t get it again, doesn’t theoretically mean that you couldn’t transmit it, if you get exposed again. So again, that’s my long way of saying we still need to learn a lot about this. But that testing in particular, just lets us know if you have had the infection before. But again, it does not remove your, really your duty to continue to social distance and wear your mask.


Alexis 7:49

Yeah, thank you so much for sharing that I know, our organization, as well as any healthcare system out here. We are all definitely, you know, hearing and promoting all the time that no matter kind of what’s happening to you, if you if you did get the antibody testing, and it has shown up or if you have already had COVID, that it doesn’t mean that we can stop caring for the public health and, you know, practicing our social distancing, and everything. So thank you very much for touching on that. And so I know that you actually hold a very unique position with the understanding of COVID-19. Because at one point you were actually diagnosed and experienced this disease. So would you mind discussing some about your personal experience?


Dr. Chow 8:32

Yeah, of course, this is something that I think a lot a lot of people wonder, especially people who don’t have it, what was the like, and I would say, you know very much that it really can affect different people differently. I think we’ve all heard it, people who have had it and may not even know they had. And so they these are the asymptomatic, we have a lot of people, I would say especially the younger age group, where they seem like they get over it fairly quickly, may present like a light flu or even a cold. Some people just lose their taste and smell. We can go straight to the other end of the spectrum, obviously, this is the things that we hate to see, we hear on the news that people are dying from this respiratory issues, you know, being admitted to the hospital. So when you take a look at the span, it is a very incredibly wide span of what kind of symptoms people get. Myself. Yes, I did get it. A few months back. My symptoms were more along the lines of a flu, were just a fevers, a lot of chills, and quite a bit of fatigue. I did not have a lot of the respiratory symptoms such as coughing, you know, coughing, vomiting, or no rash or anything like that, but I did lose my taste and smell. And interestingly that’s become one of these almost key findings that people present and they’ll say, Hey, I lost my taste and smell in the context of, you know, cold symptoms and that really has helped us to tipped us off to say, Hey, I strongly consider COVID in this case, you know, my symptoms, the others were the duration, whereas you know, I’ve had the flu before in the past. And normally after a few days, you have bad symptoms, and then you, then you, you know, you get over it, this one lasted a little bit longer, I would say mine was a good week to a week and a half to two weeks. So for me, my experience was flu like just longer. And so I’ll knock on wood, I’m grateful and thankful that I did recover, because, again, just the span of it can be pretty severe symptoms that people are getting. So again, I’m very grateful that you know that mine was only a week and a half to two weeks.


Alexis 10:41

Yes, I know, I’m very glad that you know, you were able to recover and in a timely fashion, but also just in general, we are, like you’re saying hearing, you know, of course, terrible stories. And I actually know, some of my family members or friends have contracted the disease. And it has been completely different. Some of them I know, have felt sick for up to four weeks or something like that. So almost speaking along those lines of like the symptoms, the side effects, the time length, as COVID continues to grow. I know. Like you’ve said, most of us kind of understand the symptoms that were occurring. When COVID was first introduced, such as the coughing or respiratory issues, or even flu like symptoms, and then we started to kind of notice these newer symptoms that seemed unique at first, like losing your sense of taste and smell. I know, the common public, when I first heard of that we were all like, that’s a little bit crazy. We hadn’t thought of that before. And I do remember, starting to, you know, the internet can tell you almost anything at this point, starting to read a lot of different, unique or interesting symptoms that some I think were scientifically proven, some were not. So would you possibly be able to elaborate on maybe some more of those unique symptoms that people have experienced that you’ve heard of that? Not just coughing or your fever, but like different aches in the body or just other symptoms people have described?


Dr. Chow 12:12

Yeah, it’s really pretty vast. And you’re right as, as we’ve learned more about this virus and more people getting it a lot of a lot of additional symptoms potentially could be attributed to COVID. Aside from the ones that you talked about, certainly lost a taste and smell, I’ve really rises to the top, people can get rashes. And again, a lot of viruses can cause rashes, also, so very non, you know, nondescript, but rashes. I know, at one point, some people mentioned COVID toes where you can get discoloration of the toes, which can be part of COVID. To then all sudden, COVID seems like it’s actually span different really systems. So in other words, respiratory symptoms, like your coughing, cold type symptoms, but also GI so some vomiting, some diarrhea, we spend into the skin with the developing rashes, some of the more some of the other symptoms that we’ve now heard are some of the longer term effects. You know, the fog had that people have had, where it’s almost like a concussion type symptoms where you just can’t concentrate very well, we certainly know now that some people actually get pretty serious long term effects, from lung issues from almost scarring of the lungs. We know there’s a lot of people who’ve actually had some heart issues, where you can get a temporary or even permanent damage to the heart itself, where it doesn’t function quite as well. So when you talk about what started off as more of a respiratory, like cold illness, boy, we’re starting to learn a lot more that this can really span into the GI the skin, cardiac, you know, pulmonary, even neurologic boy, when you start talking that and this is really presents itself in many different ways. And sometimes it can be hard to really nail down exactly if that’s what it is. Because now, anybody who has any symptom, obviously would be concerned, Hey, is this COVID or not?


Alexis 14:10

Yeah, definitely. Thank you so much for sharing your expertise in that area. I know. Every time I just kind of hear about the severity of this disease, and like you’re saying how vast the symptoms can be. It just reminds me how important it is that we keep educating ourselves, funding research, supporting our health care workers and everything along those lines. So thank you so much. I’m kind of integrated with that. I have also heard news that there might be multiple strains of COVID-19, that kind of assist in that range of severity. So I’m not sure if that is again, something that we are, you know, just hearing in the news hearing on the internet, or if there’s actual scientific proven kind of facts behind different strains of COVID.


Dr. Chow14:59

I think Where that probably came from, is now that we’re really in our third surge compared to the first surge. We know that the elderly were certainly affected more and had worse outcomes with the second and third surges. Now that we actually have had a little bit more track record with it, we actually saw with these most recent searches, it seems to be more with the young people. And about a month ago, we really didn’t see as much bump in the hospitalizations or the death rate or the ICU utilization. So but we did seem to see a lot more spread among the young people. And so there were questions that were popping up that said, or that were asking, Hey, is this a different strain that maybe is not quite as strong and maybe affecting young people more, as we know now, more than likely that the virus did not mutate or change this virus, the Coronavirus is actually not a new virus there. There have been Corona viruses and many examples in the past. And it’s not, it’s not uncommon for them to change somewhat. We don’t believe though, that this has changed completely. In other words, it’s a completely different strain from what it was six months ago, what more than likely happened was there, there might have been small changes, but it’s still by and large, the same virus, but just really the way that affected the community and the way the community reacted, has changed. So for example, we were seeing less hospitalizations than we did earlier. Again, not by not by numbers, we’re seeing more, but that’s because we have more people infected, but as a percentage, more young people, and a lot of that is because of really behaviors, you know, people around each other more, the percentage of, you know, the deaths, as well as ICU, compared to the population and positivity are better now than it was before. And that’s because we’ve gotten better at treating it. There are certain medications now that if you’re in the hospital, we can use that we didn’t know before, you know, the utilizations of ventilators. We know now not to do that as early as we did before. So really in a short time period, we’ve learned a lot more. So that’s really changed the way that we’ve approached COVID. And so from the standpoint of the virus itself changed completely, I would say no, I think it’s unlikely, I think just the parameters about which people are, you know, essentially reacting to the virus, meaning how people are gathering outside and even how better we are to treat it, that’s probably had more impact on the way it looks a little bit different now.


Alexis 17:42

All right, I see. Thank you for clarifying that I know, especially all the time, but especially with this pandemic, just the different news that circulates through social networks, and what we think that we understand, but in reality, we don’t understand because it’s ever changing. And it’s, it is a lot of information. And so thank you for sharing all that. And in clarifying what we’re really kind of looking at. So kind of in a little bit of a different direction, I wanted to mention, and ask about the misconceptions of the rules and regulations surrounding the pandemic, of how people are viewing their, quote, unquote, bubble or their group of in person connections, as maybe this one or two small groups of people that they’re interacting with? And how in reality, that bubble actually consists of many, many more people than we think that it does. Do you have any guidance that could help people understand, you know, their personal groups and versus what their actual reach is, when it comes to social distancing?


Dr. Chow 18:46

Yeah, sure. So unless you’re literally in a bubble, you really don’t know, you know, how far your bubble extends. And so one person, let’s say, in your bubble, is interacting, no doubt with other bubbles, you know, within their family or within their within their group. And so essentially, if you bring that person who has multiple bubbles into your bubble, you’re being potentially exposed to everyone they have been exposed to. And so unless again, unless you are truly in a bubble, that you’re not going anywhere, that people in your bubble are not going anywhere, that’s really not reality. Because people are still working, going to school, you know, trying to lead their lives, you will be exposed to everybody who they were exposed to also. So I think, you know, bubble is a tough concept just because it’s really a tough concept to, to sell because you are exposed to everybody else. And that’s why it’s so important to have everyone mass. And so if you we know that people are going to interact, and so if they’re going to interact, there’s a high likelihood because there’s COVID is really pretty high prevalence out here in the community. It’s very likely you’re going to encounter someone who has COVID. So the rules That really got us improved from back when this first started, are really the same rules are going to get us through this. And so it’s making sure you have your mask on at all time, making sure you you’ve tried to social distance best that you can really these concrete things that improve their numbers before is what’s gonna get us through this again. So I totally get everyone’s tired, everyone’s fatigued, it’s a holiday. But as much as we can adhere to those, really some of those standards, the better off we’re going to be that certainly in the near future and the distant future.


Alexis 20:35

Yes, I agree, thank you for kind of explaining that out a little bit more. And I know we have heard a lot about just the fatigue that everybody is kind of going through. And I know from an organization standpoint, we also continue to stress the, you know, staying home wearing your masks just kind of pushing through it. And we’ve Luckily, especially over the past, like month and few weeks, been able to see some advancements, and some, you know, excitement and glimpses for hope. So I, I hope that we can continue to kind of go down this precautionary road until that, you know, we have something that we can really rely on. So thank you for sharing that. So, now to get into a little bit more about kind of immediate care services and what you offer, if somebody wants to get tested for COVID. And I know, many people have already been doing this throughout the past few months. But how would they go about doing so with Western New York Immediate Care?


Dr. Chow 21:31

Yeah. So when we’re talking about testing, this is kind of the second half of the tale of two cities about testing. Whereas earlier to answer the question, if you’ve had it or not the antibodies, a good test for that. Most of the questions we’re seeing right now is do I actually have it. And so that’s testing for the actual virus itself, to see if you’re infected right now, there’s a lot of a lot of different use cases that are coming in. So again, hey, I have symptoms, I’m wondering if it’s COVID, there’s other people come comes in to say, Hey, I was exposed or I traveled. So a lot of different use cases for that. With regards to the testing, this is a different type of test where it again, it does test for the actual virus or test for the particles proteins on the virus itself. And so these are the tests that again, will let you know, if you have COVID are not from the standpoint of how do you get that test, you know, the immediate care where we’re a walk in facility, so people can walk in and get it. However, we also do recommend because there may be weights for that, we also have a system where you can go online, and check in and actually make an appointment or make a time slot for which you can come in to get tested, evaluated and tested. We always say it’s something that we would want you to discuss with one of our health care providers, which test is best for you. Because there are different tests out there. We did talk a little bit about antibody testing, the testing that we’re talking about right now, there are some variations to them. There’s one called the molecular test, which detects really low levels of viruses. And that can answer a lot of questions. That is typically a test that we have to send out to a lab. And it takes a few days to get back. There’s another test called an antigen test, which we are rolling out this week. And this test is quicker, it’s about 15 minutes. But this test is best used if you have symptoms within five days. So it’s not, it’s a good test for that. But if you don’t have symptoms, and if your question is, Hey, I was exposed to somebody, but I feel totally fine. This test. This test isn’t the right one for you. And so we always recommend talk to one of our doctors, one of our pa nurse practitioners about what’s your specific scenario, and we’ll discuss it with you in order the most appropriate test for you. Because we want to make sure it’s the right test to answer your question and the needs that you have.


Alexis 24:03

That’s very exciting that immediate care is getting the antigen testing, I think that will help things run smoothly and like you said, just kind of help give certain people what they need in the moment. So that’s amazing. And for either of those tasks, what can somebody expect to pay or can they expect a cost or for it to be covered by the other


Dr. Chow 24:27

but the best thing to do is they actually talk to your insurance about specifically about these tests and what’s covered and what’s not. For example, many of the many of the tests if you use for reasons such as Hey, I just need a test to go back to work I feel totally fine. Or I need a test to go back to school and I feel totally fine. Many insurances actually will not cover that. But they will cover it you know if you have certainly the if you have symptoms and you’re concerned about COVID. Most of them do, most of them do cover that. So I think the best thing to do would be to contact your insurance and say, Hey, this is my scenario, are these are these tests that are covered or not? And I say that also because, you know, in time, a lot of that has changed. There’s many insurances out there. And although most tried, I think, be reasonably same, there may be some nuance that we certainly don’t want to blanket say, yes, this is covered and find out that the insurance does not cover it.


Alexis 25:29

I know, there’s been a lot of changes as well throughout the past several months just on, you know, what is covered and what isn’t. So thank you for just clarifying and making sure that everybody just does talk to their insurance company, I think is the best bet. And I know that testing has been just a little bit different at some different health centers. What does the COVID testing entail at immediate care? For example, can one expect to self administer their test in the car or come in and actually speak with somebody?


Dr. Chow 26:03

Yeah, so that’s one thing that exactly, we do try to keep people. The last thing we want is a crowded waiting room where you have a lot of people bunch of sick people bunched in together. And so we typically, if we, if there’s accommodations in rooms in the back, we’ll triage people up in the front to see what kind of symptoms they have. If we have the rooms to accommodate, we’ll bring them right back into the room, if there’s going to be a little bit of a wave, we would prefer that they stay in their car, you know, again, away from everybody, and then we will call them back. And when they do come back, they’ll come back into a room. So we’re really trying to limit the amount of exposure that other patients and our staff have. So we do try to keep everybody safe. After you speak with one of our clinicians and decide again, which of these tests are going to would be the most appropriate for you for what you’re, you know, the answer that you’re looking for, then our staff will, our staff will do it. These tests are nasal, nasal pharyngeal, so the swab does have to go into your nose and, and frequently it does have to go and just beyond a little twist on the outside of the nose. Most of these tests, you want to get a good sample. And so I think most people will understand we need to get a good sample for it. It can be uncomfortable for a short amount of time, but it certainly shouldn’t be something that is intolerable. So that’s something that our staff that our staff would do, just because we do want to get a good sample. One other point to add on that keep in mind, there’s flu out there now too. So it may be more than just one swab, if we think you have flu, or the symptoms coincide with a flu, and honestly, for many of these symptoms, they can present fairly similar. So I would say the expectation is you may not only get one, you may in fact get two swabs, just because it is difficult to tell between the two COVID as well as flu. Again, there may be some nuance to it, between flu and COVID. But I think this this winter season, this flu season, I think there’s going to be likely, for many people, you know, at least two swabs,


Alexis 28:12

I can attest to having gotten actually two different COVID tests myself, I did have one where I did need two swabs, and then I had one where it was just one swab, and it definitely does bring discomfort, but you kind of have that feeling of knowing that it’s worth the pain it like easily goes away very quickly. So I can definitely attest to that for sure. And then lastly, before we close out, I would just like to ask you, I’m sure there’s a ton, but what is your general advice for the public during this time, especially kind of during the winter during the holidays, whether it be about community guidelines, safety or a little bit of what is


Dr. Chow 28:52

The future first, and because I think right now with the vaccines coming out, I think for everybody, this is light at the end of the tunnel. So certainly want to at least give people hope that there is hope out there and the vaccines are being distributed right now. Again, it’s going to go, you know, in a certain order about the high risk first, but we hope that for the general public, we should have a vaccine out for everybody. I would say probably within the next few months. And so one is that yes, there is hope and kind of going backward from there to continue, you know, this hope to get over this pandemic, we really have to continue, you know, washing the hands wearing the mask, as well as social distance. And so these are, you know, some of the really the key foundation to getting over getting through this pandemic. You know, from the standpoint of local recommendations. You know, I think that the communications from our local health officials, keeping everyone up to date has been very good. I think you can always go to websites from the CDC or local health departments. And I think there’s a lot of good information out there. I would say go to trusted sources such as you know, CDC website, your local health department, your own physician, I think these are the sites that that you should go to. I know this is a very fluid scenario with, you know, different zones that we’re in, I think everyone’s done a good job of keeping up with the zones. I would say, when you take a look at what zone you’re in, there’s going to be specific guidelines. If we can all follow those guidelines. And layer on top of that the masking as well, social distancing. Again, I think there’s really good light at the at the end of the tunnel. So for everybody, I totally understand. This is very fatiguing, everyone’s tired with this. But with those things that are coming very soon, boy, let’s hope we get Oh, you know what, we’ll get over this very soon.


Alexis 30:49

yes, I think you worded that perfectly. I think we really are all starting to see the light at the end of the tunnel here. And like, like we mentioned, you know, just have to keep, keep pushing with what we’re doing and kind of ride that through. But thank you so much for all of your insight, it was very beneficial and helpful. And I hope all of our listeners find it just as helpful as I did today. Like I said, thank you so much for all of your insight and for joining us today and hopefully we can talk to you soon.


Alexis 31:20

Thank you so much to Dr. Chow from Western New York immediate care for sharing his expertise, observations and even his own personal experience with COVID-19. If you want to get tested for COVID-19 or would like to visit immediate care for any other medical reason, you can check out their list of services and schedule an appointment by visiting and choosing one of their locations. Just a friendly reminder to stay inside and if you must go out to work the store or any other essential service. Make sure you stay social distance and wear your mask at all times.


And if you do feel sick, please stay home and contact a doctor’s office such as immediate care. As things continue to look brighter in our future. We must remain resilient in our fight against COVID-19 and do all that we can to protect the health of all of our people. for up to date information on COVID-19 or the vaccine you can visit slash COVID-19. As always give us a follow on Facebook at lung force walk Buffalo and reach out to with any questions

About the Lung Force Podcast Series

Welcome to the American Lung Association’s official LUNG FORCE Podcast Series from Buffalo, NY and sponsored by Independent Health! Lung cancer is the leading cause of cancer deaths in America for both men and women. People that you know are struggling with lung cancer, COPD, asthma and more every single day. Each month, we will bring you a few episodes covering different lung health topics that are local and relevant to our community, by interviewing experts around the area and digging deeper into the lives of those affected by lung disease.

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