How can we safely open up our lives in Southwest Oklahoma?

How can we safely open up our lives in Southwest Oklahoma?

The most important lessons about reopening the community are learned from places that never locked down in the first place: hospitals.

As the author of this linked article describes it, in the face of enormous risks, American hospitals have learned how to avoid becoming sites of coronavirus spread.

This approach to reopening the community that is documented to make the difference can be thought of like a “combination therapy” or a “drug cocktail.” These ingredients (below) are all familiar to you. Each has flaws. But skip one, and the treatment doesn’t work. Taken together – and taken seriously – the virus is shut down.

1. Hygiene measurescleaning your hands frequently. In the previous 2002 SARS epidemic, hand washing 10 times a day cut down transmission by over 50%. Disinfecting surfaces is likely very important, also, though less research exists.

2. Screeningtaking temperatures prior to entry to a building; and also self-reporting of a new fever, cough, sore throat, shortness of breath, loss of taste or smell, and even just persistent nasal congestion/runny nose.

Ideally, we will test people with new symptoms to allow people to quickly get back to work or to life, without quarantine. Without testing, people with symptoms should self-quarantine for at least seven days from the start of their symptoms and until they’ve been fever-free and with improving symptoms for 72 hours.

3. Distancing – SARS-CoV-2, the coronavirus that causes COVID-19, spreads primarily through respiratory droplets emitted by infected people when they cough, sneeze, talk, or simply exhale, and the droplets are then breathed in by others. This is why social distancing is so important.

4. Masks – three major points here. First, it turns out that infected people just on the verge of having early symptoms or just beginning to have mild symptoms, are important sources of coronavirus spread.

Second, the effectiveness of masks has recently been extensively reviewed and suggests that if at least 60% of the population wore masks that were just 60% effective in blocking viral particles – which a well-fitting, two-layer cotton mask is – the epidemic could be stopped.

Third, since cloth and surgical masks do not fit tightly, you can breathe air coming in around the sides. They are designed to safeguard others, not the wearer, although laboratory research finds that surgical masks reduce inhalation of respiratory-droplet-size particles by about three-quarters. The basic logic is: I protect you; you protect me.

The linked article is a quick and entertaining read, and answers a number of obvious questions about coronavirus and COVID-19. I urge you to read it, and then: embrace the desire to keep others safe, not just ourselves.

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Flattening the Curve


Understanding the Importance of Social Distancing and Isolation to Slow the Spread of the Coronavirus

Much has been said on the news and in social media about “social distancing” and “flattening the curve.” But what do those mean? And why do they matter?


In the Common Sense Family Doctor Blog, Kenny Lin, MD offers a concise description of what it is and why it matters.

Read Dr. Kenny Lin’s entire post here

“If the peak of the epidemic curve exceeds the surplus capacity of our health care system (and as others have pointed out, it’s not like hospitals maintain thousands of empty intensive care unit beds just waiting for an epidemic to strike), then more people will die, as health care professionals fall ill or succumb to exhaustion and there aren’t enough resources for the critically ill to go around.

That’s why it’s so important to start social distancing now, and to cancel or postpone mass gatherings such as conferences, concerts, political rallies, and athletic events.”

Here in SW Oklahoma, we anticipate adequate testing soon. Meanwhile, please take every precaution to keep your distance (for now) and avoid attracting or spreading this and all viruses.

Read Common Sense Practical Advice from a Medical Expert

Read The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

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Preventing COVID-19, Practical Advice

Preventing COVID-19, Practical Advice

Common Sense Practical Advice from a Medical Expert

Dr. James Robb is a consulting pathologist at the National Cancer Institute. Among the first molecular virologists in the world to work on the coronavirus category of viruses back in the 1970s, he knows what he’s talking about more than many of those who have spoken publicly on the coronavirus. And he also knows how to translate his expertise into practical advice.

Minor edits were made to these recommendations due to new information.

Here’s Dr. Robb’s advice to his colleagues:

Dear Colleagues: These are the precautions that I take and will take:

  1. NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
  2. Use ONLY your knuckle to touch light switches, elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
  3. Open doors with your closed fist or hip. Do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
  4. Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
  5. Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
  6. Keep a bottle of sanitizer available at each of your home’s entrances. AND in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands.
  7. If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
  8. Hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
  9. Zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

Note: This virus only has cell receptors for lung cells (it only infects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average – everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this virus before and have no internal defense against it.

Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share.

Good luck to all of us!
James Robb, MD FCAP

James Robb, MD was professor of pathology at the University of California San Diego and one of the first molecular virologists in the world to work on coronaviruses (the first strains that were identified in the 1970s). He was first to demonstrate the number of genes the virus contained. Since then, he has kept up with the coronavirus field and its multiple transfers into the human population (e.g., SARS, MERS), from different animal sources.

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The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

The first step is to be educated about the disease and how it spreads

It is time – now – to prepare for the coronavirus (COVID-19). Day by day, community spread is documented around the country, and although the first case in Oklahoma was travel-related, NOT attributed to “community spread,” it is more and more likely to happen. This is particularly true because of Ft. Sill and the many comings and goings from around the country and around the world.

The first confirmed Oklahoma case of COVID-19 was reported March 6 in Tulsa County.

There are steps we can take to prepare. The first step is to be educated about the disease and how it spreads.


Please read this page. Coronavirus is very flu-like in that it spreads from person-to-person,

  • between people who are in close contact (within about 6 feet)
  • via respiratory droplets produced when an infected person coughs or sneezes, or
  • by touching a surface and then touching your own mouth, nose or eyes (less likely).

Coronavirus can spread even before symptoms appear, although the data on this is still being confirmed.

Symptoms can take between 2 and 14 days to appear after being infected.


Main symptoms appear to be Fever, Cough and Shortness of breath. Although some have presented with abdominal pain or other unexpected symptoms.

These facts make coronavirus hard to stop once community spread has started. Read this page for more information.


There is NO vaccine to prevent infection. Best estimates for availability of a vaccine: 2021. There is no treatment for this infection, either.

Testing: The Oklahoma State Department of Health said in a news release March 6 that the state’s lab began testing Friday and will continue to test as specimens are received from health care providers. Hopefully Comanche County will be able to test for coronavirus soon.

Please follow everyday preventive actions recommended by the CDC to prevent spread of respiratory diseases:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

As always contact your primary care provider ASAP if you feel symptoms or are concerned that you may be infected.

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Announcement of Katherine Moore, APRN, CNP at MainSt. Clinic

Announcement of Katherine Moore, APRN, CNP at MainSt. Clinic

Dr. Brian Birdwell and the MainStreet Clinic are excited to welcome Katherine Moore, Certified Nurse Practitioner. Katherine is joining the clinic with 10+ years of experience as a Registered Nurse and is offering services for all ages.

Katherine is now accepting memberships for personalized health care in the direct primary care model at MainSt. Clinic. Her goal is to make a difference in the lives of her patients, through a personal relationship built on trust, transparency and availability. Katherine seeks to make every client feel like family, where personal values and beliefs are respected.

Clinic membership includes unlimited office visits, home visits when needed, timely access to your provider via text, cell phone calls, emails, video chat or even through the Spruce online medical support app.

In 2007, Katherine graduated from the University of Oklahoma Health and Science Center with a Bachelor’s in Science and Nursing and has been a practicing Registered Nurse ever since. In 2018, she graduated with a Master of Science in Nursing and achieved her certifications as an Advanced Practice Registered Nurse and Family Nurse Practitioner.

Her reputation as an avid community volunteer and leader is well known, as a past board member for the United Way of Southwest Oklahoma, heading the Community Investment Committee for several years; a current Cameron University Alumni Association Board member; and nationally, on the Community Education Committee for the American Association of Neuroscience Nurses.

For more information or to schedule your appointment, contact Katherine Moore via her website or call MainSt. Clinic at 580-248-9966.

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How To #FightFlu This Season

How To #FightFlu This Season

Getting a flu shot is the best way to protect yourself, your family and vulnerable people in our community

Flu shots can reduce flu illnesses, doctor visits, and missed work or school due to the flu, as well as prevent flu-related hospitalizations.

A 2017 study in Pediatrics was the first to show that flu vaccination also significantly reduced a child’s risk of dying from influenza.

The more people who get vaccinated, the more people will be protected from the fluincluding older people, very young children, pregnant women, and people with certain long-term health conditions who are more vulnerable to serious flu complications.

What’s new this flu season?

Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].

Fluzone High-Dose is licensed specifically for people 65 years and older. Fluzone High-Dose helps build up protection against flu viruses. The higher dose of antigen in the vaccine is intended to give older people a better immune response, and therefore, better protection against flu.

This high-dose vaccine is not available at MainSt Clinic, however it can be gotten at most major pharmacies, and is covered if you have Medicare A and B.

Fact Check: Can the flu vaccine give me the flu?

No. The flu vaccine is made with killed virus or a recombinant method using non-living ingredients.
So the flu shot can’t give you the flu. But a few people may develop flu-like symptoms after getting a flu shot for a variety of reasons, including:

  • Reaction to the vaccine. Some people experience muscle aches and a slight fever for a day or two after receiving a flu shot. This may be a side effect of your body’s production of protective antibodies.
  • The two-week window. It takes about two weeks for the flu shot to take full effect. If you’re exposed to the influenza virus shortly before or during that time period, you might catch the flu.
  • Mismatched flu viruses. In some years, the influenza viruses used for the vaccine don’t match the viruses circulating during the flu season. If this occurs, your flu shot will be less effective, but may still offer some protection.
  • Other illnesses. Many other diseases, such as the common cold, also produce flu-like symptoms. So you may think you have the flu when you actually don’t.

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MainSt. Clinic Third Anniversary Celebration Goes On The Road

MainSt. Clinic Third Anniversary Celebration Goes On The Road

Open House Wednesday, November 7 at the Lawton Food Bank 3:00 to 4:30 pm

Dr. Brian Birdwell announced that MainStreet Clinic will celebrate its third anniversary on Wednesday, November 7 with the theme “MainSt. Clinic Gives” by hosting an Open House at the Lawton Food Bank, 1819 SW Sheridan Road in Lawton, from 3:00 to 4:30 pm.

Members of the Clinic and the entire Lawton area community are invited to attend and bring at least one item of non-perishable food or a financial contribution to help the Lawton Food Bank meet the food and nutritional needs of our community this holiday season.

“We want to promote healthy lives throughout our community, wherever and whenever people need care. This holiday season, we will take our anniversary celebration “on the road” to the Lawton Food Bank,” Dr. Birdwell said.

Please join us November 7 to meet Jeri Mosiman, executive director, and tour the Lawton Food Bank facility. Viridian Coffee and refreshments will be served.

About Brian Birdwell, MD and MainSt. Clinic

MainStreet Clinic is a direct primary care membership clinic offering innovative medical services in the old fashioned style of a personal physician caring for each patient individually. MainStreet Clinic provides comprehensive primary care services for individuals and families, regardless of insurance coverage, and occupational health and wellness services for employers.

Established in 2003, our clinic has grown steadily along with business and the community in Southwest Oklahoma. We are a team of medical professionals dedicated to health care that is accessible to all, affordable, and a quality experience for our patients.

Board Certified in Internal Medicine, Brian Birdwell, MD has worked in private practice in Lawton since 2001. He has more than 25 years of experience in occupational medicine. He served as medical director for McBride Occupational Medicine in Oklahoma City and served 11 years as medical director and plant physician for Goodyear Tire and Rubber Co. in Lawton, Oklahoma.

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Featured Recipe: Salmon Patties with Yogurt Sauce

Featured Recipe: Salmon Patties with Yogurt Sauce

According to Good Housekeeping Magazine, salmon is a super food that is a great source of lean protein containing omega3s, selenium and vitamins A and D that are key to building up your immune system. Salmon may also help you fight inflammation, especially when paired with a leafy green salad. This featured recipe for salmon patties with yogurt sauce is quick and delicious.

Remembering Mother’s recipe, the yogurt sauce has been added.


1 (14.75 oz.) can salmon
1 egg
1/4 cup chopped onion
1/4 cup chopped yellow or red pepper
1/4 cup finely chopped parsley
1/2 cup seasoned dry bread crumbs
1 tsp Worchestershire sauce
2 tsp lemon juice
1/2 tsp salt
1/4 tsp pepper
1 cup corn meal in a bowl
1 Tbsp olive oil


Sauté onion and pepper in small amount of oil. Set aside. Drain and save liquid from salmon. Mix first 10 ingredients together. Make into salmon patties. If mixture is too dry, add liquid from salmon. If too moist, add more bread crumbs. Coat patties with corn meal. In a frying pan, heat olive oil.

Place salmon patties in pan, browning on each side about 5 minutes.

Serve with yogurt sauce.

For yogurt sauce combine:

1/2 cup Greek yogurt
1-1/2 Tbsp capers rinsed, drained, chopped
1 Tbsp lemon juice
1 Tbsp lemon zest
Dash of salt and pepper

Serve with salad and a lemon vinaigrette, peas and a glass of white wine. Bon appetit!

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Beat the Summer Heat with Watermelon-Feta Salad

Beat the Summer Heat with Watermelon-Feta Salad

Perfect for backyard cookouts or a weekend brunch

This refreshing Watermelon-Feta Salad is sweet for summer. Ripe, juicy watermelon combined with feta cheese and mint garnish is a sweet-salty blend, perfect for backyard cookouts or a weekend brunch.


12 cups seedless watermelon, chilled and cubed (1-inch cubes)
12 ounces feta cheese (1/2-inch cubes)
6 cups washed baby arugula
1 cup fresh mint leaves, chopped

Vinaigrette Dressing
1/4 cup freshly squeezed orange juice
1/4 cup freshly squeezed lemon juice (2 lemons)
1/4 cup minced shallots (1 large)
1 Tbls honey
1 tsp Kosher salt (adjust to taste)
1/2 tsp freshly ground black pepper
1/2 cup virgin olive oil


Best when made just before serving.

In a small bowl, whisk together lemon juice, orange juice, shallots, honey, salt and pepper. Slowly pour in olive oil, whisking continuously. If not using within an hour, cover and refrigerate the vinaigrette.

In a large salad bowl, layer baby arugula, watermelon and feta. Add mint. Drizzle vinaigrette to coat the greens lightly and then toss. Adjust spices to taste.

Serves 6 to 8

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Direct Primary Care Legislation Passes Congress

Direct Primary Care Legislation Passes Congress

Updated October 31, 2018

Thank you Congressman Tom Cole

The U.S. House of Representatives passed HR 6199 the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 on July 25 by a vote of 277-142. View votes

Our Congressman Tom Cole joined a bipartisan majority to fix an IRS problem that has prevented Oklahomans from using their health savings accounts (HSAs) to pay membership dues at MainSt. Clinic and other direct primary care (DPC) clinics across Oklahoma and the U.S.

The IRS has ruled that direct primary care (DPC) clinic membership is a “separate health plan.” Under this IRS rule, taxpayers are prevented from spending their own HSA money on membership at MainStreet Clinic or any DPC clinic – or even belonging to a DPC clinic if they are currently contributing to an HSA. Congressional action is required to fix this and overrule the IRS.

Thanks also to our Washington lobbyist Jay Keese at Capitol Advocates for his hard work over the past five years to make this happen. But we’re not finished!

Next Step: On To The Senate

What can you do?

1. Call or write Congressman Tom Cole to thank him for his leadership on this matter. Tom Cole just happens to be the Chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. Mr. Cole’s subcommittee has a voice in shaping health care policy and he is an important leader in Congress. Ask Mr. Cole to use his leverage to pass future legislation to permanently fix this problem (see #3 below). 

2. Contact Senators Jim Inhofe and James Lankford to request they do the same: support the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 in the Senate and co-sponsor the Primary Care Enhancement Act, SB 1358, with Sen. Bill Cassidy (R-LA).

3. Ask Rep. Cole and Sens. Inhofe and Lankford to support future legislation to permanently fix this problem by making direct primary care (DPC) clinic membership fees normal, qualified medical expenses under Section 213(d) of the U.S. Tax Code, like other doctor’s fees already are!

Yes, this sounds confusing because it is.

What this means is that when the cost of belonging to MainSt. Clinic is considered a “qualified medical expense” by the IRS, and no longer a “separate health plan,” then your membership fees will be tax-deductible and all the problems of paying for membership with health reimbursement accounts (HRAs) or flex spending accounts (FSAs) will be eliminated!

Contact Congress:

Rep. Tom Cole

2467 Rayburn HOB
Washington, DC 20515
Phone: (202) 225-6165

Sen. Jim Inhofe


205 Russell Senate Office Building
Washington, DC 20510
Phone: (202) 224-4721

Sen. James Lankford


316 Hart Senate Office Building
Washington, D.C. 20510
Phone: (202) 224-5754

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