MARCH 23, 2020
The COVID-19 pandemic is teaching us many lessons. Our priority remains the wellness and safety of our patents and staff. Social distancing will help “flatten the curve” of this pandemic and we salute your dedication to this mission. The AAP is recommending that children social distance and avoid playgrounds and playdates. We also want you to know we are still here for you and we are following these guidelines in the office:
- We are staying in communication with health leaders in our state by attending teleconferences. We are following current recommendations to limit exposure to illness while in our offices using distancing, exam room sanitization, hand-washing, and personal protective equipment.
- For in-person visits we require that ALL families call when they arrive in the parking lot to see if they can come into the building. Please let us know before coming in if you have known exposure to the COVID-19 virus or if you or anyone with you is not feeling well, or has a cough or fever.
- We are limiting the number of families in each office at one time. Families are not allowed to wait in the waiting room. We will arrive your child and perform registration via the phone from the parking lot. Please do not bring guests or siblings with any symptoms of illness with you when you come for a Well Child appointment.
- We are seeing patients in both offices for Well Child Checkup and vaccine appointments during morning office hours. We are wearing appropriate masks and gloves at all times. We are not seeing any children in the office with illnesses until the Well visits are completed.
- We are offering car-side in-person Sick Child appointments with the doctors (weather allowing) by appointment. We are also seeing patients inside for low risk Sick Child appointments but you will be ushered directly back into an examination room.
- We are now offering remote Telemedicine appointments for Sick Child care only - not Well Child care at this time. Please see our new link on the webpage. Telemedicine appointments can be scheduled by calling the office. Several insurances including Highmark of Delaware, Aetna and Cigna are waiving co-pays and out-of-pocket deductible payments (“member cost sharing”) for Telemedicine visits due to the pandemic.
- The nurses and doctors will be wearing gloves, masks, and eye protection. We are not working if we have any symptoms of illness or unprotected exposure to COVID-19. We are also social distancing when not in the office.
We are very grateful for your understanding and cooperation. Please contact us for any concerns about your children. Thank you.
MARCH 14, 2020
A MEMO REGARDING COVID-19 FROM YOUR DOCTORS AT FIRST STATE PEDIATRICS
The novel coronavirus (COVID-19) was declared a pandemic by the WHO on Wednesday March 11, 2020. The United States and the state of Delaware declared State of Emergency statuses due to this pandemic on March 13. Governor Carney decided to close all Delaware public elementary and high schools from March 16 to March 27.
We at First State Pediatrics are guided by our training and core values to continue to care for and assist our patient population during this pandemic. Our offices are still open to see your children and we will do so in the safest ways possible in accordance with current recommendations. For example, you will see us in gloves and facial masks in our offices and we will be implementing changes as outlined below.
The information we are receiving about the pandemic is evolving day by day and we will do our best to share information as we have it. We encourage you to talk to your children about safety measures such as effective hand washing and avoidance of face-touching during this pandemic. For the time being, please review the following information and resources. Please check back here regularly for updates.
1. What are the symptoms of COVID-19?
Symptoms of COVID-19 include cough, runny nose, fever, chills, and shortness of breath – similar to the flu. In children the illness generally presents as a much milder illness but in more vulnerable populations the illness is more likely to be much more serious or deadly. A more vulnerable individual would be anyone who has underlying medical problems (eg: heart, lung, kidney, immune, including diabetes and asthma) or is an older person / senior citizen. In contrast, seasonal allergy symptoms can include sneezing, itchy watery eyes, an itchy congested or runny nose, post nasal drip, and cough without a fever.
2. If my child has cold symptoms consistent with COVID-19 should I take them to the hospital?
We want everyone to know that we do NOT recommend taking otherwise healthy children with cold symptoms (including fever) to any hospitals or emergency rooms unless the child is in distress (such as difficulty breathing or change in mental status) or is rapidly worsening. Please call us for advice about your child’s symptoms before seeking emergency medical attention if they are stable. As of this week the illnesses we are seeing in the offices are typical seasonal illnesses (such as Strep throat and ear infections) and these can be handled as usual by our offices. The flu is still circulating and if your child is not feeling well we may want to see them to evaluate if they have a flu-like illness and to check their breathing. Otherwise, if your child is only having mild cold symptoms we are going to recommend that you stay home and socially isolate until the symptoms have cleared (up to 2 weeks).
3. Who is at risk for COVID-19?
Currently we have no evidence that COVID-19 is widespread in our area but it will spread in the coming weeks. Anyone who has been exposed to an individual known to have the virus or who has travelled to an area with more widespread infection (for example international CDC travel advisory areas or domestic areas with more regional infection) is at higher risk. As we currently know little about the way the virus is spreading in communities in the United States, any person could be at risk regardless of known exposures or travel history. As such we are acting fast to implement practice changes in accordance with AAP and CDC recommendations to reduce risk of exposure in our office.
4. How is First State Pediatrics preparing for COVID-19?
At this time we are fluidly changing our practice policies to protect our patients, your families, and our staff from COVID-19. The following are examples of changes we are implementing:
- Continuing a daily deep clean of each office and initiating new protocols to sanitize exam rooms between patients.
- Requesting, when possible, a “one parent, one child” pair to come for appointments instead of bringing other family members in the office (especially grandparents and senior friends).
- All staff will be wearing personal protective equipment (masks and gloves and possibly eye protection or gowns) during face to face encounters; as with many other things masks are in short supply and we can only share with patients when we deem it clinically necessary to reserve supply for our staff.
- We anticipate moving appointments around to have true “well clinic” and “sick clinic” hours, and limiting children with symptoms consistent with COVID-19 to certain parts of the office at certain times.
- We will continue to see all scheduled children for their well child visits and we aim to prevent any well child’s exposure to sick children in the office. PLEASE let us know before coming if your child who has a well child visit - or the parent bringing them - is sick, as we may ask you to move to a different time.
- We anticipate requesting all patients with illness symptoms that can be related to COVID-19 to remain in their cars until ushered/called by staff into the office and directly into an examination room
- We may be doing some car-side check-ins and even visits for higher risk sick patients.
- We are also exploring ways to see select patients remotely (“telehealth”) in the coming weeks - more to come as we learn more about this.
- Please be aware that due to higher phone call volume our return calls may take longer than usual. We will triage calls based on clinical severity. We have been notified that our after-hours nurse triage service may take up to 2 hours to call you back.
- When testing becomes routinely available we will educate families about appropriate times/ways to be tested; for now experts are not recommending testing individuals without symptoms or low risk individuals. Testing should be available soon for patients exhibiting symptoms.
- We are encouraging all children with underlying conditions, such as asthma, to make sure they have their medications refilled in case they become ill
5. Should we practice “Social Isolation/Distancing”?
YES - somewhat - but not indoor quarantine unless you are instructed to by state authorities. Fresh air in wide open spaces is very good for children and they should be allowed to play outside if they are healthy while avoiding larger groups and close social contact. The governor has closed the elementary and high schools and we recommend limiting social gatherings, especially in larger groups, whenever possible. Many organizations are postponing group activities for the next two weeks to start. Senior citizens and immunosuppressed people of any age are at heightened risk of complications from this virus. We strongly urge families to protect their older family members by limiting contact if you have symptoms, feel you could have been exposed, or have any other personal risk factors. Please explore these articles about “Flattening the Curve”, which experts believe will help protect vulnerable groups from this virus.
6. It is Spring Break. Should we travel?
Unfortunately the current recommendations are to limit unnecessary travel especially to high risk areas, to avoid unnecessary flying, to avoid trains and buses unless necessary, and to avoid cruises. This is affecting many of us as well, and we sympathize wholly with the difficulties faced by our families needing to cancel vacations.
7. Our younger children go to daycare. Should I send them?
For the time being the government has not forced the closure of daycare centers but some are closing independently for the next two weeks because they follow the local school district closures. The decision to continue to utilize daycare centers is difficult. We strongly urge any families with children in daycare to keep the children home if they are sick with symptoms that could be COVID-19. You will need to make a personal decision regarding sending your healthy children to daycare. If they continue to go, we would discourage letting the children unnecessarily interact with vulnerable individuals after daycare until we understand more about the pandemic.
8. Where can we learn more about preparing for COVID-19?
Please explore the following websites for more information about the virus:
9. COVID-19 has me feeling worried and anxious. What can I do?
It is natural to have new feelings in the face of a pandemic. Please explore these resources if you are experiencing anxiety. We encourage you to focus on having fun with your children during the next few weeks. Establish a routine so that all know what to expect each day, despite school being closed. Stay safe and talk to your doctor if you need assistance.