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August 23rd, 2020

Dear Clinic Members,


In the past few weeks there have been a number of developments with respect to the coronavirus pandemic. This edition of our newsletter will address this fall’s flu vaccine, updates from the CDC, the recent Covid19 outbreak at St. Michael’s (formerly Harrison) Hospital in Bremerton, the upcoming school year, and the importance of routines for physical and mental health.


We have received our first shipment of influenza vaccine for this coming winter, and we are creating a systematic plan that will allow for our patients to get their dose early on in the season. For the sake of efficiency, in years past we have designated one or two days per week where our staff would immunize as many patients as possible. Due to the pandemic situation, we will be taking a different tack this year — we would like to space out the appointments over a longer period of time, in order to minimize the number of patients in the clinic at any given moment. We will also offer the option of doing the immunizations in an outdoor setting. Plan to hear back more about flu shots over the coming two weeks.


We want to make you aware of a change in the CDC guidelines for quarantine/isolation periods related to Covid19. The new guidelines shorten the recommended time period from 14 days to 10 days in many cases. As always, you should contact us for further guidance if you or a family member has had a potential or a confirmed exposure to Covid19.


Patients who are at high risk of death or severe complications from Covid19 should continue to stay home as much as possible. Most grocery stores now offer home delivery or drive-through pickups for food, etc., and we encourage everyone to take advantage of these services as much as possible. 


We are continuing to see cases of Covid19 increase in Kitsap County at an alarming rate, and the recent outbreak among staff and patients at St. Michael Medical Center (previously Harrison Medical Center) is a case in point as to how easily the virus can spread. If you have a scheduled elective procedure in Kitsap County, we are now recommending that you consider postponing it. The Washington State Department of Health news release about this outbreak says: “To prevent the spread of COVID-19, it’s critical that everyone continues to stay home when possible and have fewer, shorter and safer interactions with others.”


It is important to bear in mind that we are still in phase 2 of the reopening process (and hopefully won’t need to move back to phase 1). As a reminder, phase 2 includes these rules:

  • Outdoor recreation involving 5 or fewer people outside your household is permitted 
  • Gather with no more than 5 people outside your household per week
  • Essential travel and limited non-essential travel for permissible activities


You can download the full Safe Start Washington plan here:



This month, the Washington Department of Health released a decision tree to help school districts walk through the decision-making process of when to open schools for in-person learning. We fully support Superintendent Peter Bang-Knudsen’s decision to start the coming school year in a remote-learning format. We also recognize that remote learning places a significant burden on many families, in addition to the negative consequences that it may cause for our children. 


One thing that we believe can be particularly valuable for the mental and emotional health of our children is to create and adhere to new routines as a way to replace the many disrupted ones; it’s important to identify and create anchor points around which we weave the substance of our lives. The beginning of the school year is a great time to reflect on how well our current routines are serving us. Everyone, no matter their age or family circumstance, benefits from consistent routines that revolve around anchor points such as meals, exercise, safely socializing with others, hobbies, work or school routine, gratitude reflection, religious practice, and meditation. 


Because so many of our previous anchor points have been removed or have significantly altered, it is not surprising that there is growing concern regarding mental health, particularly amongst teens and young adults. We appreciate the many resources for teen mental health linked to on this webpage:



We acknowledge the toll that the circumstances of the pandemic are taking on everyone’s mental health and we encourage families to keep tabs on one another in this regard. For those of you living alone or who are not in a position to find emotional or mental help at home, please reach out to us at the office if you are experiencing distress. 


We expect that the office will continue to operate at reduced hours and reduced staffing for at least the next several weeks. We believe that it remains safer for appointments to take place using telemedicine (phone calls or video chats) whenever possible. 


The office transitioned to a new telephone system during this last week, and the process was not without a couple of hitches. We apologize to any patients who might have been trying to reach us on Thursday afternoon and evening. Things were cleared up by Friday, and patients should be able to contact us again in the usual ways.


Lastly, we want to say that we are thinking about our patients every day. We know that many of you are lonely or are feeling cooped-up after these many weeks of social distancing. We know that many of you are deeply missing the physical contact with friends and family members. It is a little disheartening to realize that we are in the sixth month of the pandemic in America, and there is not yet a clear end in sight. We recognize that there have been tremendous consequences — economic and otherwise — for many of our patients. 


With all of that, we still hold hope and gratitude in our hearts. We believe that our doctors and other scientists will find solutions and bring this pandemic to an end. We are grateful for the numerous sacrifices that you and many people around the world are making. We are grateful for the support and understanding of our patients. 


We remain committed to your health and well-being.


Warm regards,

Dr. Crandell and Staff