How about this 2020? Who would have predicted this? Who can stand this? With the debate season starting, the therapist’s couch is a popular hang out!

Well, there’s NO DEBATING beautiful fall colors!

 It’s clear that October is the finest month of the year. In the Berkshires, can there be a doubt? Beautiful colors, wonderful sunny days, and clear cool nights.

And the people who have birthdays in this month are some of the most special people in the entire world. Kudos to us! …er, I mean them.

We know deep down that even though this year is unprecedented, it still must be allowed to be.  I would go so far as to say it belongs and has important lessons for us. What’s the proof? Well, because it’s here… in all its messiness.

Nothing is all one-sided; everything is a mixed bag. These times force us to experience things we would never choose, and we are challenged to find a healthy standpoint. And, it’s our challenges we remember, not our birthday cakes.


And in this mixed bag fashion: Hidden in the crisp beauty of autumn lies the insatiable tick- just as the seed for growth lies in the chaos and uncertainty of 2020.

  • Please be mindful and diligent to tick-check yourself these evenings
  • Tuck your pant legs into your socks when in the grasses or woods
  • Use repellants when hiking or gardening — essential oil repellants are better because none of them work that well anyway and it is best to avoid the harmful chemical ones
  • And for tick phobia, cycling on the road is a great option to enjoy the weather with the lowest tick exposure.

Treating a Bite

Two doses of Doxycycline after a high risk tick bite is an option many Berkshirites choose. The CDC says if the tick is:

  • a deer tick,
  • in an endemic area,
  • engorged,
  • attached for 36 hours it should be considered high risk.

It is time-consuming process for the tick to transfer the bacteria inside of it’s gut that cause the illnesses, like Lyme and Ehrlichiosis and Babesiosis. There are plenty of doctors who study the care of Lyme patients who recommend longer courses of Doxycycline after a bite. And I’ve seen protocols that use prophylaxis against Lyme co-infections like Babesiosis. This is becoming more common, but the approach is individualized.

We are here to discuss your options. If the tick was not on long it’s not unreasonable to do nothing but watch closely for symptoms.

Sending the tick to a lab for analysis can be helpful as well (TickReport.com is who we often use). In any case, in the spring, summer and fall watch for the first signs of feeling poorly (aches, rash and fever WITHOUT head cold symptoms like cough and congestion), and suspect tick illness if you have any outdoor exposure.

COVID review

Global and national numbers

The US is testing nearly 1 million people per day. We have had 7.5 million positive tests (330 million population) over these 7 months with 210,000 deaths. The world population (7.8 billion) has had 34 million cases with over 1 million deaths.


From May to July, COVID-19 incidence increased among all age groups, but the largest increases were observed in individuals under 30 years old, which drove a decrease in the median age of COVID-19 cases — down from 46 years old in May to 38 years old in August.

Gov’t tests

The Feds announced a new program that will distribute 150 million antigen tests nationwide, with the aim of supporting screening efforts at schools and for higher-risk populations (e.g., nursing homes). This is the Abbot Binaxnow. The government program is buying all of the initial supply of these tests. General consumption at the doctor’s office (like a rapid strep test) won’t be available until next year.

Regional news

We remain steady in Massachusetts. We had 11 cases over the last week. That is less than 2 cases per day per 100,000 population. These are reassuring numbers.

It’s notable New York City is experiencing an uptick, which certainly something for us to heed.  We are linked with NYC through the commuters and second home owners. Keep an eye on how that plays out. And, be aware that it might predict our own regional uptick. We still have the travel advisory in effect from August. Guests must test or quarantine when they come here from riskier areas.

Phase change!

Governor Baker announced this week that as of October 5th many parts of the state will move to step 2 of phase three. This is the first update since the beginning of July. Here’s what that means:

  • Indoor performance venues will be permitted to open with 50% capacity with a maximum of 250 people.
  • Outdoor performance venue capacity will increase to 50% with a max of 250 people.
  • For arcades and indoor and outdoor recreation businesses, additional Step II activities like trampolines, obstacle courses, roller rinks and laser tag will also be permitted to open and capacity will increase to 50%.
  • Fitting rooms will be permitted to open in all types of retail stores.
  • Gyms, museums, libraries and driving and flight schools will also be permitted to increase their capacity to 50%.

Revised Gatherings Order:

  • The limit for indoor gatherings remains at a maximum of 25 people for all communities.
  • Outdoor gatherings at private residences and in private backyards will remain at a maximum of 50 people for all communities.
  • Outdoor gatherings at event venues and in public settings will have a limit of 50 people in Step I communities, and a limit of 100 people in lower risk, Step II communities.

Vaccine Updates

  • Moderna says not until spring of 2021
  • Astra Zenica: FDA probe into serious illness expands, causing delays.
  • Pfizer is pushing for an answer of some sort by the end of October 

Hot Pockets

When studying local national and international incidence the word that comes to mind is “hot pockets”. There are 26 states- generally in the West and Midwest- with rising incidence. The West, the Southwest, now the Midwest have taken turns being the hot pocket.

Do you know about Hot Pockets?

They are a microwavable Nestle pizza product, sold frozen. I think they are vital in the efforts to survive this Pandemic. Let me explain.

Comedy Therapy

When you think about Hot Pockets you have to think about one man, comedian Jim Gaffigan (he does a routine on hot pockets). Please watch this YouTube segment of Jim Gaffigan. It’s worth every minute. I’ll be happy to hear your impression. Be certain there are underemphasized ‘medicines’ for COVID, cancer, heart disease, and depression. One of the strongest hidden medicines is laughter.

Our 15 minute molecular analyzer from Abbott looks like it will be available at my office, hopefully by the end of this month! The ID Now has been ordered! I’m excited to have this for us to navigate this year. My secret belief is that we won’t need it… anything is possible and optimism is what is really infectious! In any case, we will be prepared.

Be Well! We are here if you need anything… even comic relief.