We’ve been getting quite a few questions about the “coronavirus” (COVID-19) in the past weeks. Nobody is certain how quickly this virus will spread through the community but it is surrounding us and I am sure that there will be more spread in the coming weeks.
Inevitably, many of you will get sick with some type of respiratory infection now or soon; 99% of those will be common viral illness or influenza. But, given the potential of COVID-19, we all need to approach things at our clinic and in public a little bit differently. These recommendations and measures are meant to help you and us.
Please read ALL of the following as it will answer most questions you have or that may come up. We are happy to answer questions individually where needed, but reading this first will help our staff out tremendously.
IF YOU ARE SICK
We are fully committed to caring for our patients in the most science-based, safest way possible. To this aim, we’ve instituted a few policies to protect ourselves and our staff, which — in turn — keeps all our patients, families, and communities as healthy as possible.
Our triage protocol for upper respiratory infections (URI), is outlined in detail below.
The most important parts are:
- URI symptoms WITHOUT FEVER.
If you have symptoms of an upper respiratory infection (cough, runny nose, congestion, etc.) and no fever (less than 100.4 F) that is less than 3 weeks in duration, we will recommend home care and that you not come in for an in-person visit to our clinic. This is the same as we currently do for most common colds and suspected influenza, but now it is even more important to avoid clinic visits.
- URI symptoms WITH FEVER.
If you have upper respiratory symptoms and/or a fever WITHOUT signs of severe illness (namely, shortness of breath), a nurse or your provider will recommend a telephone visit to ascertain if testing* treatment, or an in-person visit is warranted. If we determine that you need an in-person visit, the visit will occur in your vehicle in the parking lot of our clinic so as to prevent potential spread and exposure to others. SERIOUSLY, WE WILL SEE YOU IN THE PARKING LOT!
With or without testing, it is advisable you isolate yourself as much as possible for 7–10 days from onset of symptoms. This is especially important with larger crowds (stores, events, etc) and with vulnerable populations. (elderly and/or ill)
- URI with FEVER and/or SEVERE symptoms.
Based on what we know thus far, in healthy people under 60, the odds of severe illness (10%) or death (1%) are very low with COVID-19 infections. But, if you have URI symptoms with severe concerns such as shortness of breath, we will likely refer you directly to an emergency room (hospital).This is the best course of action with or without COVID-19. Cases of COVID-19 have shown most people who get really sick (require hospitalization) occur approximately 9-12 days after onset of symptoms first appear; much more common in higher-risk people (age 60+ and/or chronic diseases).
REMINDERS ON FEVER
- Fever is 100.4 F or higher measured by a thermometer. (If you don’t have one, get one!)
- “Feeling” a fever (subjective) isn’t good enough.
- There is no such thing as a lower “fever” cutoff based on your baseline temperature.
TESTING WHEN SICK
Influenza or other things. There are many things that are much more likely to cause URI symptoms than COVID-19, namely influenza. If there are enough concerns and a fever, we may recommend a nasal swab for influenza or throat swab for strep.
Coronavirus testing will be limited for the foreseeable future. We do NOT currently have access to COVID-19 testing but we are working with our lab vendor to confirm the exact specifics (like pricing and where the testing will be available). Hopefully, that will be soon but even when so, we will not be recommending testing for everyone with URI symptoms. We will be making this decision on a case-by-case basis, but the near-term reality is there will not be enough testing nationwide to test every person with a cough.
AVOIDING THE ER
Emergency rooms are not going to perform on-demand COVID-19. So, unless you are having a real emergency, please avoid them at all costs. Overburdening our hospitals and exposing yourself to lots of sick people due to anxiety of COVID-19 is not wise; trust me!
IF COVID-19 IS FOUND IN OUR PATIENTS OR CLINIC
Why are we taking extreme caution to avoid clinic visits?
If an individual enters our clinic carrying COVID-19 (later found by testing), we would likely have to close our clinic for 14 days or longer! Like, completely close….no in-person interactions and exams, prescription pickups, etc. This would obviously be very bad for us and you! (If this were to occur, we would attempt to still offer telephone triage and telemedicine visits but we want to avoid closing our doors, of course!)
Even if we individually get exposed to a COVID-19 case, we will likely need to isolate ourselves (no patient interactions) for 14 days or longer. This would be needed to avoid exposing others, especially our sicker patients.
We have put together these guidelines to prevent the spread of this illness to the most vulnerable around us. We so appreciate your understanding, patience, and effort to keep everyone in the Harmony family healthy as we all see our routines upended a bit by this virus.