April 2nd, 2020
SPA Covid Plans
Salisbury Pediatric Associates is working very hard to mitigate the risks of Coronavirus illness for patients that need care. We will remain open as long as the NC State government allows us to care for children.
According to the NC DHHS, we are still encouraging young children to come in and get their physicals and vaccines. From a public health perspective, the medical community is weighing and measuring the vaccine interruption risk with the exposure to other illnesses in the clinic setting. To that end, we have split the clinic into two separate buildings where all well care is segregated from sick children. This is likely to be very effective based on the Diamond Princess cruise ship experience.
Thankfully, the insurance companies and federal/state governments have loosened the rules on telemedicine to accommodate the stay at home mentality. We are ramping up telemedicine care for the visit types that are amenable to such medical delivery. Telemedicine is not amenable to infectious diseases that require a physical exam. It is frankly poor quality medicine to prescribe antibiotics over the phone for perceived infections as this process has a serious long term negative effect on the gut microbiome and long term health risk with chronic diseases. It is a short term perceived gain over a serious long term known risk. Telemedicine is excellent for behavioral health, integrative/functional medicine, asthma/allergy, basic gastroenterology and many follow up types. We definitely recommend all young children and kindergarteners keep their well child checks in place to maintain immunization adequacy so as to prevent further infectious outbreaks that occur when known herd immunity wanes.
We do not recommend coming in if your child has any mild upper respiratory illness symptoms without significant fever or respiratory distress including increase speed and work of breathing. Whatever the mild virus is, COVID or other, it is best treated at home in quarantine. If the child is experiencing significant respiratory symptoms, then a visit to the local emergency room can hasten admission to a tertiary care center accepting COVID patients. This direct to hospital care protects the outpatient settings that do not have the PPE supplies and the means to test and admit COVID patients.
The good news is that children are not experiencing significant disease in the overwhelming majority of cases from COVID. As always, if your child is experiencing symptoms that are consistent with worsening disease like difficulty breathing, high fever, lethargy or other concern, please alert us by phone of your symptoms so that we can triage you appropriately for the correct care type. This is a critical decision and we are trying very hard to perform it correctly in every case.
Appreciate everyone's patience and understanding as well all tackle the daunting task of navigating a world with SARS2/COVID.
Praying for all to be safe and healthy,
P.S. If anyone missed last weeks prevention email, see this link.