Dr. Brendan J. Mulholland
MONMOUTH COUNTY, NJ – Locally, nationally and around the world, we are in a war against the COVID-19 Pandemic. Anxiety is through the roof for many, as folks are becoming sick, most getting better, yet every day others are tragically dying. There is also a flood of data to wade through and concerned readers may not know where to turn.
TAPinto had the opportunity to interview local doctor, Dr. Brendan Mulholland, a family practice professional with office locations in Red Bank, Hazlet, Fair Haven and Shrewsbury. TAPinto met him at his Red Bank Family Medicine practice, 231 Maple Avenue, Red Bank, NJ, where Dr. Mulholland has transformed the parking lot into a tented Drive-in COVID-19 Clinic for screening patients who have called in asking to be evaluated and possibly tested. The COVID 19 testing is available, but is in limited supply so it is reserved for the most ill, and for essential personnel (police, first responders and healthcare workers).
Mulholland has a treasure of timely information and his words bring you into his practice, share with you calming guidance to make sound decisions and empower you to protect yourself and your family - starting now.
We caught him coming off a tough day earlier this week. The rain was pouring, and he was working outside with patients, his personal protective equipment on - his caring demeanor always present. His bedside manner replaced with his 'carside' manner during the most significant health emergency in modern times.
Mulholland is navigating the new waters in a very strategic manner. He is one of the frontline healthcare providers, carefully navigating the COVID-19 environment with his patients, staff, and the public. He dispenses advice with calm certainty:
TAPinto: Dr. Mulholland, what succinct messages do you have for those readers concerned about COVID-19?
- Be calm and be smart
- Call your doctor
- Don’t try to tough it out
Dr. Mulholland continues: If you remember those three points when you are analyzing the day to day news on COVID-19, that will help navigate your thinking to a healthier place. Let me expand on that further;
Stay Calm and Be Smart: The science tells us that 98% of the people or more are going to be absolutely fine. The actual number is probably higher than that because there are probably a lot of people walking around with no symptoms that don't even know that they have it. So people have to stay calm. At the same time, we need to be smart and understand and appreciate the fact that even though someone may feel okay or are feeling better, COVID-19 is extremely contagious and you can still pass it on to others.
For example, you may pass it on to your friend, and he may be fine, but then he’ll pass it on to his mother, and she can potentially get very sick because she is elderly and has medical problems. You might think there is no harm with going to the park and playing basketball with your friends but not practicing social distancing is one of the absolute worst things that people can do right now.
Call Your Doctor: There are going to be some people who legitimately don’t feel well, and they're nervous. Those people simply need to call their doctor and have a ‘telemedicine’ visit or if their fevers are high, and they are in the high risk group – elderly or those with medical problems, or they are young with really high fevers, those people will most likely have their doctor advising that they need to be seen.
Don't Tough it Out: The Coronavirus is a highly contagious respiratory illness. If you are having shortness of breath, you do not ignore that symptom. If you have a fever of 100.4 or higher, you do not tough it out. The first thing we will do is put a pulse oxygenation meter on the patient's finger, just to see how well they are getting oxygen into their bloodstream. That is a telltale sign of real problems if that number starts to drop. That oxygenation number plus temperature are guides. If you have a real high fever and low oxygen levels, you are now categorized as a higher risk person for COVID-19. However, if you are a young person and your oxygenation is 99% and your pulse is 60 and your temperature is 99.1 you’ll be fine – you’ll go home.
So, you gotta be smart – you gotta call your doctor when you are not feeling well – don’t try to just completely tough it out without the advice of a medical professional.
TAPinto: You were one of the first practices locally who stopped seeing sick patients in your office when the news of the pandemic broke. You ramped up telemedicine and put drive up evaluations and testing into place very quickly. What are the current day-to-day patient procedures in place?
Dr. Mulholland: With the pandemic, we are now open seven days a week. Our Red Bank practice has now become the main hub during the pandemic. We welcome any phone call, and we are happy to help folks to the best of our ability. The regular practice for patients who are not presenting with sick symptoms, is managed earlier in the day. Patients who express COVID-19 symptoms are seen starting at our pop-up COVID-19 Clinic, at 1:30 p.m. every afternoon when the office is closed. The clinic is set up under easy drive-in tenting in our parking lot area.
So, every morning we have office time set aside for patients who need an in-person visit for a healthcare matter that does not fall under the category of being sick. If you are sick, we are keeping you out of the office, even with a minor case of the sniffles. Every patient that calls in is set up with a strategic plan to best protect and serve that patient and everyone else as well. Many patients can fall under the telemedicine category, which means they can have a thorough telemedicine appointment with one of our medical professionals, from the comfort of their home, where the patient has zero chance of being exposed to germs.
Here is a quick sample of a telemedicine appointment with Red Bank Family Medicine. This is a clip of an actual patient's appointment. The patient has been experiencing symptoms of a sinus infection and prefers not to have an in-person visit at a doctor's office and possibly be exposed to new germs, or expose others to her germs. You can listen to a small clip of her appointment:
The telemed patient commented, "It was my first telemedicine appointment and it was so easy. They use an app called Doxy.me. I needed an early morning appointment to work around my virtual college classes, and they accommodated a 7:45 a.m. appointment. I don't think it could have been made any easier or more convenient. They called in a prescription that I needed and other recommended over the counter items, to my pharmacy, Hazlet Pharmacy, which also offered convenient drive through pick up service of everything. I'm feeling much better one day later and did not have to worry about sharing germs in the doctor's office or the pharmacy." TAPinto spoke with the medical practitioner Dana Essner, DNP, APN. Essner commented, "When I'm conducting a telemedicine appointment there is a lot going on. I have two computer screens in front of me as I'm asking all the exam questions. I'm listening very carefully. With this particular patient, I could hear the congestion she has over the phone. We are very fortunate to be able to offer this to our patients. Dr. Mulholland thinks of everything with the patient's health first. What he is doing now with the COVID Clinic at our Red Bank location is amazing, but not surprising to me. I was here when Hurricane Sandy hit and our offices had no electricity. Sick patients were calling in. Dr. Mulholland set up a clinic in the parking lot where he was seeing patients out of his parked truck. He is an excellent doctor and wonderful person."
TAPInto: Dr. Mulholland, how does the transition from the morning office visits to the afternoon COVID-19 testing unfold daily?
Dr. Mulholland: Every afternoon at 1:00 pm, we close the office to any patient traffic, we completely suit up in sanitized protective gear, and we transition to the outside pop-up center, to see sick patients who have had a phone conversation with us that has led to a scheduled visit for possible COVID-19 symptoms. The patient drives up when it is their appointment time, and they are then evaluated carefully and safely. The reality is, I'm doing the Coronavirus test on just a select few people. Meaning, the test isn't for everyone. We have very strict procedures in place for sterilizing and protecting everything that comes in contact with the patients and all of us healthcare workers. Every piece of medical equipment receives operating room procedure sterilization. All of us healthcare workers are continuously gloved, masked and cleaning. Everyone is a janitor, myself included. Everything is being wiped down all day long - every time we touch a patient we have rubber gloves on, and we take the gloves off right away. When I go out to a car to see a person I am bringing my stethoscope, I'm bringing a pulse oximeter, I'm bringing a thermometer. Before and after use every bit of every piece is completely sterilized before seeing the next patient.
The means and methods of care described at Dr. Mulholland's office is like an operating room. Clean and sterile with every precaution, to ensure that patient care and the protection of medical staff remains paramount.
While visiting Red Bank Family Medicine, TAPinto met up with Family Practitioner, Dr. Denise Hayward, who gave us this important message:
If you would like to make a telemedicine appointment or feel you need to be tested for COVID-19, call the Red Bank location at 732-842-3050.
TAPinto: Dr. Mulholland, can you explain how important the test is and what criteria someone needs to qualify for the test?
Dr. Mulholland: The test does not make you better one day sooner. It identifies the illness, but I will tell you that right now if someone is walking around, a middle age person, and they've got a fever, and they are coughing, most likely it's the corona virus, and 98% of people with the virus in their system are going to be absolutely fine.
So, what I’m doing is this - I’m evaluating to save lives. I'm trying to identify those 2 % that can potentially develop a life threatening problem. The people with really mild symptoms - we want them to do telemedicine with us - they don't need to come in person. If you are a young person and you have a low grade fever, a little bit of a cough, and no underlying medical condition that you are aware of, you can just call in, and we'll do a telemedicine visit with a doctor.
On the other hand, if you’ve got a high fever and your cough is severe or you are short of breath then absolutely - that’s the person we want to see because we want to make sure as those are the ones that could potentially fall into that small 2% category.
I am most concerned about 65 and above if they have 100.4 fever, or older or younger, and they have medical conditions, they have respiratory conditions, they have heart conditions or auto-immune conditions. Those people are very susceptible to getting sick, very fast, so I may want to do a COVID test on them.
TAPinto: How many patients are you seeing daily at the drive-up pop-up for COVID evaluation?
Dr. Mulholland: Last Friday, it was beautiful weather, and we saw 64 drive-up patients 1:30 p.m. to 4:00 p.m. Of those 64 we tested 35 patients during that time. We do have a limited amount of tests and the most at risk patients are the most likely to receive a test. Also, law enforcement, fire EMS and healthcare providers would also typically be tested if they present with symptoms, as they need to remain on the frontline and not infect people. If they work in a nursing care facility, as an example, they will get their work environment sick and those folks may be the ones who may end up on ventilators.
TAPinto: How are the patients that have been testing positive?
Dr. Mulholland: The vast majority of people who have tested positive have relatively minor non life threatening symptoms (fever and cough) and recover quite nicely. Yes there are a few very sick individuals but this is actually the rare case. Our true goal with our COVID clinic is to identify the sickest individuals and help them through their illness thereby reducing the burden on our over taxed hospitals.
TAPinto: What differentiates COVID-19 from the flu or other contagious viruses?
Dr. Mulholland: COVID-19 is not like the flu as it is much more contagious and much more deadly. The danger combo. is that this virus is highly contagious, but it is not highly symptomatic. Many people are walking around with the virus and have very little symptoms. So they are spreading it to other people, that is the problem. Just because you feel well it should not give you solace that you're okay and you're not infecting other people. That is why right now social distancing is so important. That is the reason for the 6 feet of personal space.
TAPinto: What is the biggest challenge you see in the COVID-19 fight?
Dr. Mulholland: The country in general is not prepared for this. Community spread is by far the greatest challenge in New Jersey. Community spread can't happen if everyone just shelters in place and if they have the virus, their body will beat the virus, and they'll be fine and in two weeks, and they will not be spreading it to other people. For the future we need to look to South Korea and China to see trends on how long this will last. Many feel it will minimally be several more weeks.
TAPinto: Thank you so much for taking time out of your very busy day. Any last words of advice to our readers?
Dr. Mulholland: ￼The actual numbers of people with the virus is widespread and significantly under-reported in the media, so please STAY HOME. Also, equally important, people are letting their anxiety get the best of them and are only making matters worse for themselves. Please STAY CALM. As healthcare workers we are trying our best, it's all we can do. We are so thankful for all the community support we have received. We've had folks sending us over food and much-needed safety gear, masks, protective suits, and kind words from so many. The outpouring of community support is what keeps us going seven days a week. We are 'community strong', that's for sure. Remember: stay safe, stay calm, and STAY HOME.
Note: To best manage the high volume of patients during the pandemic, the Hazlet office has temporarily closed until the crisis abates, to consolidate manpower to the Red Bank location. This enables the practice to serve more individuals 7 days a week. The phone # from Hazlet has been rerouted to Red Bank. You can call the Red Bank location at 732-842-3050 and speak to a friendly team member who will decide with you what is best; an in person office visit, a telemedicine appointment or a drive-in COVID Clinic reservation. Click HERE for Red Bank Family Medicine.