Information Regarding Coronavirus COVID-19Updated on Feburuary 17th, 2021

YES! We will continue to keep all the offices open at all costs during this difficult time. Please be aware of the changes to the office and its flow:

1. Masks are required for all patients and parents at all times in the office whether there for a sick or a well visit to maintain the safest environment for our patients

2. Our staff will continue to sit behind plexiglass windows at the front desk to protect both our employees and our patients from close interactions

3. We will continue to schedule well visits and sick visits on opposite sides of the office and never intermingle the rooms. If you have any symptoms of fever, cough, or congestion, you will not be scheduled for a well visit.

4. Please only bring children who have an appointment. If you are bringing your child for a well visit, please do not bring siblings, especially if any of them have cold symptoms. If you have a child who is sick, please only bring that child to again minimize the risk of exposure and spread of diseases.

5. When you check in, if your patient room is not immediately available, we will ask you to wait in your car with your child until the room is ready. We will call your cell phone when the room opens up and is clean in order to minimize sick children from congregating in the waiting room. We sincerely apologize for any delay in care this practice may cause, but it is in order to maintain the safety of our staff and patients.

6. We will continue to sterilize rooms between all well and sick visits with medical grade cleaning supplies including Caviwipes, sterilizing solutions, and sterile exam paper. We will also continue to shut down and place high efficiency air filters to sterilize the air of the entire exam room over 12 times after any patient leaves a room after exhibiting COVID-like symptoms or concerns for infection or exposure. This practice, in line with the CDC clinic standards and regulations of mitigating infections, will continue to maintain sterile visit rooms between patients.

7. We will offer and encourage non-urgent visits to be scheduled as televisits. These include ADHD rechecks, non-urgent behavioral visits, and routine asthma rechecks.

Please note we highly recommend continuing to keep routine well visits as vaccinations are of paramount importance during this time to protect secondary outbreaks of vaccine preventable diseases.

COVID 19 stands for “coronavirus disease 2019.” The virus is a strain from the family of coronaviruses, which have been present around the globe for centuries and most often are one of the viruses that cause the common cold. Certain strains of this family of viruses, like the severe acute respiratory syndrome coronavirus (SARS) in 2002, mutate and cause severe lung disease in certain individuals. COVID 19 is the most recent of these more dangerous strains of coronaviruses.

The good news is studies suggest that over 80% of the individuals infected will experience nothing more than a mild flu-like illness needing minimal medical care. However, in about 10-15% of infected individuals, the COVID 19 virus can cause more than just flu-like symptoms of fever and cough. These patients may require hospitalization and anything from oxygen to an ICU stay to help them through the disease.

Unlike influenza (the flu) or other coronaviruses like SARS and MERS, all the current evidence shows COVID 19 is not a life-threatening illness in children and younger, healthy individuals. Less than 1% of patients with severe disease in the 70,000 patients in China were aged less than 19 years of age and none of those patients died. The most at risk population is proving to be older individuals, specifically above the age of 65, individuals with chronic medical conditions, especially of the metabolic nature (diabetes, heart disease, obesity, COPD, etc.), and individuals with compromised immune systems (patients on chemotherapy, HIV infected individuals, individuals with autoimmune disease, etc). While highly unlikely, it is possible that healthy individuals and children can contract severe disease, but this is much more rare given the current studies of global data.

What statistics have shown is that well over 80% of infected individuals will experience nothing more than a very mild cold. However, the over 50 million people in the USA aged 65 and older are at serious risk for severe respiratory disease and being hospitalized, which would put a significant burden on the hospital system and inevitably lead to a number of deaths. While treatment modalities have improved, death rates continue to be at about 1.7% in the USA, and we are trying to keep it as low as possible. For this reason, trying to minimize the spread before these at risk individuals are infected is extremely important.

Infected individuals spread the disease in 1 of three ways:

• Respiratory droplets: This is when someone releases microscopic drops of water in the air by sneezing, coughing, or even breathing without a mask. Estimates say this cloud of infected droplets can be as wide as 6 feet.
• Direct Inoculation: This is when someone transfers virus directly onto another individual by touching or hugging them.
• Indirect Inoculation: This is when someone touches an infected surface and then touches their eyes, mouth, or nose before washing their hands and infects themselves. It is important to note that the disease does not spread immediately through the skin after touching an infected surface but only after touching the eyes, nose, and mouth.

Unfortunately, there is growing evidence that patients can transmit the disease a few days before they have symptoms. This is the minority of cases where the disease is spread but is likely the reason why it has been so hard to contain the spread. However, infected individuals are most contagious after they start showing symptoms, which can be anywhere from 2-14 days after being exposed to the virus

1. WASH YOUR HANDS!! It is the simplest and most important way to prevent the spread. Nothing fancy, just plain old soap and water and washing thoroughly for at least 20 seconds. Touching anything from an infected iphone to an infected door knob and then touching your eye, nose, or mouth is a risk so do not touch your face at all until you have just washed your hands.
2. Clean surfaces often. The Center for Disease Control (CDC) has some great tips for cleaning here. Briefly, use soap and water at a minimum to wipe down surfaces that are concerning for infection and do not share iphones, ipads, or other objects with individuals whose risk is high for infection or whose risk you do not know.
3. Avoid large gatherings as much as possible. Because even asymptomatic people may be spreading the disease within a 6 foot radius of their bodies, it is worth avoiding large crowds or going out as much as possible in the next few weeks until we have a better idea of who is infected and how severe the spread is.
4. Stay home as much as you are able. If you avoid interacting with people you will greatly reduce the risk of exposure from infected individuals.
5. If you have been exposed to COVID 19 (as defined below), self-quarantine. Explained more below, self-quarantining means to remain in a separate room for 14 days with a closed door to see if you are developing symptoms.

The Illinois Department of Public Health has released information about who should go for testing which we have summarized below or you can check out the following link:

Step 1: Were you exposed?

Concerning methods of exposure:

• I have had close contact (been within 6 feet for more than 20 minutes) with a patient with laboratory confirmed or laboratory pending COVID 19.
• I have traveled to at risk countries of China, South Korea, Iran, Japan, and Europe (Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, San Marino, Vatican City)
• I was in a congregate living facility (a dorm, nursing home, etc.) where multiple patients have been diagnosed or suspected to have COVID 19.

Step 2: Do you have symptoms?

Concerning symptoms are fever and/or lower respiratory symptoms (cough, difficulty breathing, blue skin around the mouth or fingers). It is important to note that sore throat and/or runny nose alone without a fever, deep cough, or difficulty breathing make COVID 19 infection very unlikely.

If you are not having active symptoms as defined above by fever and/or lower respiratory symptoms (cough, difficulty breathing, or blue skin around the mouth or fingers), testing is unlikely to return positive. However, if you get these symptoms and have at least one of the following, you should consider getting tested:

• Exposure as explained above within 14 days of having symptoms
• High risk individual with no other source of your symptoms (you did not interact with someone who had the flu, a cold, or pneumonia). High risk means: you are above the age of 65, have chronic medical conditions (patients with diabetes, heart disease, COPD, etc.), or have a compromised immune system (patients on chemotherapy, HIV infected individuals, or immunosuppressive medications, etc).

We currently have COVID 19 testing for our patients only! Our practice is unable to offer COVID 19 testing to family members or non-practice patients at this time. However, we now offer 2 types of testing:

1. Rapid PCR/molecular testing by Abbott Pharmaceuticals:

   This testing modality has been shown to be very accurate for symptomatic patients. A thin swab is gently placed midway up a patient’s nose for 5 seconds on each side. The test then rapidly multiplies viral RNA and has very accurate results in 15 minutes. According to the most recent Cochrane review article of this type of testing, the average sensitivity was estimated between 90-95% and specificity of 98.9%. This means, if you have COVID, this has a 90-95% chance of diagnosing you. It has a false positive rate of 1.1% and a false negative rate of 5-10%.

2. Send out RT-PCR by Southern Lab Partners:

   The RT-PCR testing is the gold standard of diagnosing COVID 19. A thin swab is placed through the nose quickly to the back of the throat in each nostril where the virus multiplies the most. While slightly uncomfortably, quick movement and the thinness of the swab make it very well tolerated. These samples are then sent to the Southern Lab Partners laboratories, which run RT-PCR to multiply any RNA and determine if there is a positive or negative sample. We can also send for a number of other viruses with the same sample if desired. As this is a third party subscriber, we do not bill you for this procedure. Rather Southern Lab Partners will bill you if necessary but usually this is covered by all insurances. Please be aware it takes 48-72 hours to get results. The results are much more sensitive meaning they have >96% chance of catching COVID in a symptomatic or asymptomatic patient with the disease. There is a slightly higher false positive rate of 3%, but your doctor will discuss this with you as needed. This is the only testing method if you are not having symptoms but were exposed to COVID 19 >5 days ago.

If you are concerned you or your child may have COVID 19, please call our office to schedule an appointment for school clearance.

The Center for Disease control has very good guidelines on self-quarantining and how to know if this is the right course of action for you or your child which you can read here. To briefly summarize, self-quarantining is the act of staying home away from any person for at least 14 days after being exposed to this virus. This means staying in a separate room with a door, having a separate bathroom, and having all household members interacting with you only when necessary to give you food or change of clothes. It is not the right move for everyone but maybe a good choice for well appearing children since this disease does not seem to affect them severely. If you are unsure if self-quarantining is right for you or your child, please call the office.

If you believe your child has one of the above exposures to COVID 19, please call the office to schedule an appointment. All COVID 19-related cases will be handled on a case by case basis after they are discussed with one of our physicians to ensure the safety of our staff and our other patients. Keep anyone with COVID 19 exposure away from high risk individuals described above and if they are having difficulty breathing or are ill-appearing, take them to the ER immediately.