COVID-19 Update

Many of our patients have asked about the novel coronavirus and we felt it necessary to address this directly.

SARS-CoV-2 is the causative agent for the disease we now call COVID-19. In the past few months we have seen global spread of this virus and as of today there have been 423 total cases and 19 deaths in the United States. Currently, 35 states are reporting cases, including Kansas and Missouri. The closest case to our clinic has been a person in Johnson County who has recently been admitted to KU for observation and is doing well. This person was likely infected during a trip to the Northeast U.S.

This being said, it is no longer a matter of WHETHER we will see this virus, but WHEN. We are committed to taking the best care of our patients possible during this time. For this reason, we are implementing guidelines to help keep ourselves and our patients as safe as possible as the situation develops. Here are some important highlights of our guidelines. You can find the complete algorithm below.

Mild respiratory symptoms
If you have a mild upper respiratory illness (cough, nasal congestion, and/or sore throat) we will ask you to stay at home and implement supportive measures (fluids, cough medicines, and rest). You should avoid public places (such as grocery stores or church functions) until you are feeling better and should wash your hands frequently. Consider staying in one room and bathroom in your house and disinfect these areas frequently, including doorknobs and light switches.

Mild respiratory symptoms WITH fever >100.4ºF
If you have respiratory symptoms such as cough, congestion, and/or sore throat and your temperature is OVER 100.4ºF, please call, text, or email our office so that we can set up a phone visit and determine if you need further care. If we determine that you need testing or need to be seen in the office.  If an office visit is necessary, we may ask that you take extra precautions such as putting on a mask upon arrival or even having you call us on arrival if we feel it is safer to come evaluate you in the parking lot. Yes, in the parking lot.  This is the safest way to prevent spread in our office and similar procedures are being implemented all over the country. The same guidelines apply regarding avoiding public places, washing your hands, and confining yourself to one area of your home to avoid infecting others.

Severe respiratory symptoms WITH fever >100.4ºF AND significant shortness of breath
If you are having respiratory symptoms, fever, and are feeling significantly short of breath or having trouble breathing, we will likely refer to the Emergency Room (ER) for further care. The most susceptible to this category of severe infection with COVID-19 are those over the age of 60 and those with underlying health conditions such as lung disease, heart failure, diabetes, or immunocompromised (patients taking steroids, biologic medications, or other immune suppressants, etc). Onset of severe symptoms tends to be around day 8-9 of infection.

IF YOU HAVE TRAVELED TO HIGH RISK AREAS, INCLUDING DOMESTIC TRAVEL, IN THE LAST 2-3 WEEKS AND DEVELOP SYMPTOMS, YOU MAY NEED TO BE TESTED. PLEASE ALERT US BY PHONE OF ANY TRAVEL HISTORY OR POTENTIAL CONTACT WITH PATIENTS UNDER INVESTIGATION FOR COVID-19. FOR NOW, ALL TESTING WILL BE ARRANGED THROUGH THE JOHNSON COUNTY HEALTH DEPARTMENT AND NOT AT OUR OFFICE.


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 isn’t good enough.
• There is no such thing as a lower “fever” cutoff based on your baseline temperature.

We cannot be more explicit than this: if we come into contact with someone who is positive for COVID-19, all Health Suite 110 staff who made contact with that individual will have to quarantine for 14 days.  As we are a small practice, this may lead to a situation where we will have to close for all in-person interactions for up to (and potentially longer than) a 14-day period.  If this were to occur, we would attempt to still offer telephone triage and telemedicine visits. We would like to prevent this if at all possible, so please help us do so by staying home if you are sick. We would be happy to write you a work note if needed.

Again, we are putting these guidelines in place to prevent the spread of this illness to the most vulnerable around us.  We appreciate your understanding, patience, and effort to keep everyone in our Health Suite 110 family healthy as we all see our routines altered by this virus.

Please do not hesitate to ask questions or reach out.

Sincerely,
Your Health Suite 110 team

Find out how you can protect yourself and your family HERE.

Find out what to do if you are in a high risk category HERE.

Find out how to mitigate spread in our community HERE.

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3/14/20 UPDATE & ADDITIONAL COVID-19 RESOURCES
As of 3/13/20, Johnson County has declared a state of emergency and the latest advisory from Kansas Department of Health and Environment reads:
People should exercise vigilance when attending large public gatherings, particularly those people over age 60 and those with weakened immune systems or chronic medical conditions.
 
If you have symptoms such as fever, cough or shortness of breath and believe you may have had contact with someone with a laboratory-confirmed case of COVID-19, stay home and call your health care provider. You may also call the KDHE phone bank at 1-866-534-3463 Monday through Friday, 8 a.m. to 5 p.m. 
 
Here are some websites we trust and would recommend looking into if you want more information:
World Health Organization
Center for Disease Control
Kansas Department of Health and Environment
For parents of young children

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3/19/20 UPDATE
First, we would like to thank everyone for their support and encouragement as we work to navigate this evolving situation with you all. There are advances and updates coming in from around the world daily, sometimes hourly, and we are doing our best to stay up to date on the latest guidelines.

With that in mind, we have a few updates.
- In an effort to keep our clinic open and protect our staff and patients, we have reduced our in-clinic staff to 1 nurse and 1 physician while the rest of us work remotely.  
- ALL our physicians continue to be available by email and can arrange phone or in-person visits as necessary.  
- We will continue to reschedule all non-essential clinic visits during this time and appreciate everyone’s flexibility and patience.

Medication refills: please continue to use our online refill request form or contact clinic directly at [email protected] or 913-948-7652. We do request at least a 48 hours notice for refill requests – thanks!
a) Curbside pick-up - just call once you are parked at clinic and we’ll bring it out to your car (standard until further notice).
b) Lockbox - located just outside clinic doors – you will be sent a code and can pick-up anytime during or after clinic hours.
c) Mail delivery - about $12, may take up to 1 week after request.
d) NEW Courier service (if unable to utilize above) - delivery to your doorstep in 1-2 days by kind volunteers. Tips appreciated! Call clinic for more details.

General COVID-19 updates/reminders:
- Mild upper respiratory infections can look like the common cold (cough, sore throat, fever) and should be treated at home.
- Lower respiratory infections can result in pneumonia and cause cough, fever and shortness of breath. Severe symptoms may require hospitalization.
- Seniors and those with chronic medical conditions are at the highest risk for developing severe symptoms. 
- Treatment is supportive as there are no currently approved treatments specifically for COVID-19. Some evidence that Zinc and certain antimalarial drugs (chloroquine, hydroxychloroquine) may be helpful. We are keeping a close eye on these developments.
- Testing is not widely available at this time due to limited supplies of testing materials and personal protective equipment for clinicians outside of the hospital.

Bottom line: everyone should be practicing social distancing during this time. Social distancing is putting space (at least 6 feet) between individuals to prevent the spread of illness. We encourage people to put this measure into practice for the health and safety of all.


Community updates:
- Jackson County has had their first cases and has prohibited groups of more than 10 through May 15, 2020. Jackson County updates.
- Johnson County has now reached community transmission levels. Johnson County residents with mild symptoms should isolate at home and away from others for at least seven days after symptoms started or for 72 hours after fever is gone without the use of fever reducing medications and symptoms have significantly improved, whichever is longer. Anyone with more severe symptoms should call their healthcare provider. Individuals who have mild symptoms should not expect to be tested at this time. Kansas Health Department quarantine updates (including recent travel to Florida).

Dr. Dana Hawkinson, infectious disease specialist at KU has good advice of what to do if you are feeling sick. 

In summary:
1. Don’t panic.
2. Stay at home and treat like any other virus with rest, fluids, pain/fever medications as needed.
3. If you have severe or worsening symptoms, contact your physician who can advise you on home treatment and if evaluation in the ER is necessary.

We will continue to keep you posted with updates thank you for trusting us with your care.

Health Suite 110