CORONAVIRUS (COVID-19) PATIENT INSTRUCTIONS

SARS-CoV-2 ANTIGEN TEST PATIENT INSTRUCTIONS2020-07-29T09:34:49-05:00
HOW DOES COVID-19 AFFECT THE CLINIC?2020-07-29T09:27:15-05:00

As you are likely aware, cases of the coronavirus disease 2019 (COVID-19) are being reported worldwide, including in the United States. While much information about the disease is unknown, we want to share with your family what we do know.

Our top priority is keeping our patients, families, visitors and team members safe. We are closely monitoring updates and alerts from the local health departments and the Centers for Disease Control and Prevention (CDC). In addition, we are working with local county and state health departments. Our protocols and processes are updated to add new information as it is available.

We may ask you to wait in your car.
We only have so many exam rooms, especially when we are reserving rooms for children with special care needs. You may be asked to return to your car to wait until an exam room is available. Don’t worry, we will call or text when we are ready to bring you in the office. We apologize for the extra walk back to the parking lot, but a few extra steps are good for everyone.

Our cleaning procedures are heightened.
We have stocked up on EPA-approved cleaning agents and increasing the cleaning protocols. Both sick and well areas will be cleaned multiple times per day, in addition to the routine cleaning we have always provided.

No one will come to work sick.
We are preparing for a larger number of staff being gone at once. This may result in appointment cancellations with painfully short-notice. We ask you that you listen to messages carefully and be prepared for last-minute changes. We promise that as this situation settles, everyone will get the visit times they need to stay on track should cancellations occur.

Our phone lines are busy.
Be patient. Be kind. Our nurses are working as fast as they are able, and under the stress of knowing that things may rapidly change. We are communicating to our staff regularly and their primary job is to deliver pro-active and helpful messages directly from us to you. In turn, we ask that you respect their advice. Those who are verbally abusive, belligerent, or offer false information will be subject to dismissal from our practice. But, we know none of you would ever be like that.

Well care will continue in exclusively well spaces.
We are creating distinct well care areas with separate entrance/exit paths. To the best of our ability, we want every family to know that coming to see us for routine care and needed vaccinations is still part of the plan. Now, more than ever, we want to address any questions and make sure you are comfortable with the health and wellness of your child.

Care of sick children will continue in dedicated areas.
We are available to care for the common childhood issues that will continue to exist over the next few weeks. The entrance/exit paths may be not what you are used to, but this will allow our clinicians to limit the risk of exposure. After completing the screening process, our staff will move you to a dedicated exam room.

HOW DOES COVID-19 SPREAD?2020-07-29T09:22:03-05:00

COVID-19 is spread from person to person in these ways:

Through the Air
The virus spreads from respiratory droplets produced when a person coughs or sneezes. The infected droplets can then be inhaled by a nearby person or land on the surface of their eyes.

Physical Contact
Most infected people also have respiratory secretions on their hands. These secretions get transferred to healthy people on doorknobs, faucet handles etc. The virus then gets transferred to healthy people when they touch their face or rub their eyes.

GENERAL COVID-19 INFORMATION2020-07-29T09:28:10-05:00

COVID-19 Symptoms
The most common symptoms are fever, cough and shortness of breath. Less common symptoms are muscle aches, chills, headache, sore throat, runny nose, rash on toes, loss of taste/smell and even diarrhea.

Incubation Period for Symptoms
Average 5 days (range 2 to 14 days) after coming in contact with a person who has COVID-19.

Mild Infections
80% have a mild illness, much like normal flu or a bad cold. The symptoms usually last 2 weeks.

No Symptoms but Infected
About 20% of infected patients have no symptoms.

Severe Infections
20% of those with symptoms develop trouble breathing from viral pneumonia. Many of these patients need to be admitted to the hospital. People with complications generally recover in 3 to 6 weeks.

Infections Resulting In Death
Children generally have a mild illness and recover quickly. Pediatric deaths are very rare. Older adults, especially those with chronic lung disease or weak immune systems, have the highest death rates.

Anti-viral Medication and Vaccines
There is currently no vaccine to prevent COVID-19. Many labs are working on developing a vaccine, but that will take at least a year. Currently, there are no effective anti-viral medicines.

Treatment
Treatment is supportive with fever reducing medications and encouraging fluids. Treatment with oxygen and IV fluids are used for hospitalized patients. Some patients need to be placed on a ventilator machine to help their breathing.

Trusted Sources for Accurate COVID-19 Information

WHEN SHOULD YOU CALL YOUR DOCTOR?2020-07-29T09:20:42-05:00

Call your doctor if:

  • You have trouble breathing.
  • There are signs of dehydration.
  • You think you or your child needs to be seen.
RETURNING TO WORK, SCHOOL OR DAYCARE AFTER RECOVERING FROM COVID-19.2020-07-29T09:28:52-05:00

You can return to work, school, preschool or daycare, when ALL of the requirements below are met:

  • at least 72 hours have passed since resolution of fever (defined as greater than 100.4) without fever-reducing medications,
  • improvement in respiratory symptoms (such as nasal congestion, cough and shortness of breath) AND
  • at least 10 days have passed since symptoms first appeared.

Note: Some facilities may require two documented negative COVID tests 24 hours a part. Please check for additional details from your institution.

TREATMENT OF COVID-19 SYMPTOMS2020-07-29T09:19:19-05:00

The treatment is the same whether you have COVID-19, influenza or some other respiratory virus.  The only difference for COVID-19 is you need to stay at home in isolation until you recover. You want to protect other people from getting COVID. Treat the symptoms that are bothering you the most. There is no anti-viral medication for treating COVID-19 and antibiotics are not helpful for viral infections. You don’t need to call or see your doctor unless you develop trouble breathing or have signs of dehydration.

Fever Treatment
If an individual is less than 8 weeks of age, please call your doctor. If an individual is 8 weeks to 6 months of age, and fever is above 102 F (39 C), you may provide acetaminophen. If an individual is greater than 6 months of age, and fever is above 102 F (39 C), you may provide acetaminophen or ibuprofen. For fevers 100.4-102 F (37.8 to 39 C), fever medicines are not needed. This is because fever turns on your body’s immune system. Fever helps fight the infection. However, if the patient also has pain, please treat fever for comfort. Click here for acetaminophen or ibuprofen dosing.

Fluids
Offer cool fluids in unlimited amounts. Children often respond well to taking cold ice-pops or electrolyte ice-pops (such as Pedialyte Ice Pops) to prevent dehydration. Staying well hydrated helps the body sweat and give off heat. Staying well hydrated also helps loosens up any phlegm making it easier to cough up. If an individual is breast fed, please continue to offer breast milk often if tolerated. This is superior to providing electrolyte fluids or electrolyte ice pops. Please contact your physician if your child has not urinated at least 3 times in a 24 hour period.

Cough Medicine
Under 1 year: No homemade or over the counter cough medications. These are not safe in this age range.

Caution: Avoid honey until 1 year old due to risk of botulism.

1 to 3 years: May give warm clear fluids (e.g., apple juice or lemonade) to thin the mucus and relax the airway. Dosage: 1-3 teaspoons (5-15 ml) six times per day. Age 1 year and older: Use Honey 1/2 to 1 tsp (2 to 5 ml) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. OTC cough syrups such as Zarbees containing honey are also available. They are not more effective than plain honey and cost much more per dose.

6 years and older: Use Cough Drops (throat lozenges) to decrease the tickle in the throat. If not available, hard candy is acceptable. Avoid cough drops before 6 years of age due to risk of choking.

6 years and older: OTC cough medicines are not recommended as there is no proven benefit for children under 18 years of age. OTC cough medicines are not used because cough is a protective reflex and decreases risk of pneumonia. Honey has been shown to work better.

Home Isolation
Isolation means separating sick people with a contagious disease from people who are not sick. They are contagious and can spread their infection to others. (CDC) That means staying at home. Other family members should also stay at home on quarantine. Living with a suspected COVID-19 patient implies close contact has occurred. Do not allow any visitors such as friends or family that do not already live with you. Do not go to camp, daycare, school or work. Do not go to stores, restaurants, places of worship or other public places. Avoid public transportation or ride sharing. The patient needs to stay at home but does not need to be confined to a single room. Preventing spread of respiratory infections within a home is nearly impossible. The sick person should try to avoid very close contact with other family members. That includes hugging, kissing, sitting next to or sleeping in the same bed.

Protecting Others When You or Your Child are Sick
To protect others when you or your child are sick:

  • Stay home from school or work if you are sick.
  • Cough and sneeze into your shirt sleeve or inner elbow. Don’t cough into your hand or the air. If available, sneeze into a tissue and throw it directly into the trash can.
  • Wash hands often with soap and water for 20 seconds or use hand sanitizer, especially after coughing or sneezing, after touching your face or adjusting a mask.
  • Don’t share glasses, plates or eating utensils.
  • Wear a face mask when around others. Be a good example for your child while wearing a mask. Practice wearing a mask at home; it is a new “accessory” to wear when outside the home! Find a comfortable mask that fits your face well (covering your nose and mouth) and avoid touching your face and face mask after it is put on. Wash your hands or hand sanitize before and after putting on or taking off your mask, or adjusting your mask.  Throw away your disposable mask directly in the trash can after it is used and launder cloth face masks after every use.  Always wear a face mask if you have to leave your home (such as going to a medical facility) and always call first to get approval and careful directions.