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Corona Virus Update 2020

Like many in our community, we know there is a lot of growing concern around the Coronavirus.  We continue to check in with the Partners Healthcare Pediatric Infectious Disease team and the Pediatric Emergency Room at Newton Wellesley along with the management teams at the Affiliated Pediatric Practices to monitor the ever present changing recommendations and we are taking all necessary precautions.

Prior to arriving for either a well or sick appointment, please contact our office if you meet two or more of the following three points: 

  1. You have traveled- there is a 14 day quarantine period for travelers- 
  2. You currently show signs of acute respiratory illness: fever, cough, shortness of breath.
  3. Have had DIRECT contact with a known positive case of Coronavirus

Otherwise, we are happy to continue to see sick patients as we normally do.

To best prevent the spread of respiratory and other illness we are asking doctors and staff to refrain from handshaking.

We thank you for your cooperation in helping to ensure the health and safety of all our patients and staff, as this is our top priority.


Please find more information below:

Coronavirus Hotline
Supporting Clinicians, Patients and the Public
Phone Number: 617-724-7000
The call line will be open from 8 a.m. to 8 p.m., seven days a week.

Partners patients and the public:

Any patient or member of the public is encouraged to contact the call line with questions and concerns and for reliable, expert information about the developing outbreak.

If you have traveled to, from, or through China, South Korea, Japan, Italy, or Iran within the last 30 days, please call the Coronavirus Hotline.

Important Information about the Novel Coronavirus Outbreak

The PCPO and other Partners entities are closely monitoring the 2019 Novel Coronavirus (2019-nCoV) outbreak in Wuhan, the capital city of Hubei Province in central China. Cases in China continue to increase and multiple other countries have reported cases as well. Scattered cases have been documented in the U.S. including one case in Massachusetts. The Centers for Disease Control and Prevention (CDC) is advising continued vigilance. Below, please find details about the virus as well as updated screening information for clinicians and their offices and initial infection control measures.

About 2019 Novel Coronavirus (2019-nCoV):

  • There are many strains of coronaviruses. They can cause a range of different illnesses including SARS, MERS and the common cold.
  • Symptoms of 2019-nCoV can include fever, myalgias, cough and shortness of breath.
  • Human-to-human transmission is well established. China is reporting that some health care workers have become infected after caring for patients.
  • Incubation time after exposure can be up to 14 days.
  • Most patients recover but a small percentage of deaths have been reported (~2%). This is in contrast to a mortality of ~0.1% for the 2019-2020 seasonal flu to date.

Planning for the Fall and Winter Holidays in the context of COVID-19.  

Many families are used to gathering with larger groups indoors during the holidays which can facilitate spread of the virus.  It is well established that private gatherings in homes is a major source of spread of COVID-19.  Here is some practical guidance to consider when planning for the holidays and ways to reduce risk if it does not seem feasible to avoid gathering with others.  We hope that everyone enjoys the season and stays safe and healthy!

THE MOST EFFECTIVE MEASURES CURRENTLY TO PREVENT SPREAD OF COVID-19 ARE:

  • Maintaining social distancing (staying greater than 6 feet from others).
  • Avoiding people who are sick with symptoms of COVID-19 or who were recently exposed to or tested positive for COVID-19 within the prior 2 weeks.   Those individuals should remain in quarantine per DPH and medical guidelines and should not be socializing with others during that time.
  • Wearing a face mask that covers both nose and mouth during social interactions.
  • Regular washing of hands; avoiding touching face or eyes.

 

FACTORS THAT INCREASE RISK OF SPREAD OF COVID-19:

  • Smaller indoor spaces without good ventilation.
  • Activities that prevent mask wearing around others (e.g. eating).
  • Singing/projecting one’s voice loudly.
  • Greater number of people and amount of contact with others in 2 weeks prior to the event.
  • Individual risks of exposures due to employment setting.
  • Less effective “masks” (e.g. gaiters/bandannas) or improper use of face/nose coverings.

 

Here are some ideas to consider with each phase of planning your event: 

TRAVEL

  • Interstate travel:  Many states (including Massachusetts) have regulations regarding visitors or residents arriving from out-of-state.   Go to https://www.mass.gov/info-details/covid-19-travel-order to see the most recent update.  At the time of this writing, there is a significant daily fine for those found not to be in compliance with the law.
  • Mode of travel: Travel by car (rather than by air) makes it easier to avoid contact with others before arriving at your destination.  Stops along the road to should be planned to limit contact with others.  Avoid spending time inside restaurants or other buildings – bring your own food.  Wear a mask when outside of the car.
  • Plan on everyone at your gathering to self-quarantine for 2 weeks prior to the holiday to reduce likelihood of asymptomatic spread of the virus at your event.
  • Anyone with a known close exposure to a COVID-19 case should not travel and should remain in self-quarantine for 14 days, regardless of any test result or presence/absence of symptoms. 

TESTING CONSIDERATIONS

  • A “negative test” DOES NOT rule out the possibility that a person may be carrying and spreading COVID-19.  It may provide some level of reassurance however, if that individual is asymptomatic and has not had any known exposures within 2 weeks of the event.
  • Types of tests:  Different types of tests have different levels of “reliability” so it is important to know the type of test being done and the context in which it is being performed.   
    • “Rapid test” – this term refers to how quickly a result may be available, but does not distinguish which type of test was performed, so it is not a useful term.
    • “Antigen tests” – Usually done by nasal swab.  Typically faster results (usually same day), less expensive to perform, but have a higher risk of missing an infection in a person without symptoms.
    • “PCR/molecular test” – Usually done by nasal swab.  More expensive and “turn around time” for results may vary widely (same day to several days).  Less likely to miss an infection in a patient without symptoms.   A “positive” test may persist however for a significant period of time after an infected patient is no longer a risk of transmitting illness.
    • “Antibody test” – blood test which does not have use in determining whether a person currently has an infection.  A positive test does not necessarily mean that individual has protection from the disease.
    • https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics is a good source of information about types of tests.
  • Cost/insurance coverage:  Many insurers are not covering the cost of a test if there is not a known medical indication (e.g. symptoms of illness, pre-operative planning, known close COVID-19 exposure).   It is important to be aware that places that offer testing may bill you for the service, which can be expensive.
    • As of this writing, Massachusetts DPH is still offering free testing to state residents at several “Stop the Spread” locations in the state.   Locations may have different restrictions (ages tested, appointment times), change locations, and have varying timeframes to get results.  Residents do not require a referral from a physician.  Go to the website:   https://www.mass.gov/info-details/stop-the-spread for more information.

GUESTS

  • Individuals at high risk (advanced age or medical risk factors): it is not medically advised to attend group gatherings in person.  Consider connecting “virtually.”
  • Community considerations: Consider the data about how active the spread of a disease is in the communities people are traveling from/to.   It may not be advisable for people traveling from/to high risk communities to gather.   Massachusetts DPH publishes a community risk map weekly on the web at  https://www.mass.gov/info-details/community-level-covid-19-data-reporting.
  • Limit number of people/households:  Currently, a maximum of 10 persons at a private indoor gathering is allowed in Massachusetts. https://www.mass.gov/doc/covid-19-order-54/download.
  • Limit duration of the gathering: Avoid day-long events and set specific start/finish times.

LODGING

  • Out of town guests:  lodging at a local hotel may reduce contact time and therefore may reduce potential exposure more than staying at relative’s home.

DINING

  • Serving pre-plated food rather than “buffet style” dining is preferred.
  • Space people from different households as far apart as possible (e.g. opposite ends of the table or at multiple tables) to maintain social distancing.
  • Request use of masks when not in the act of eating/drinking.
  • Limit alcohol consumption.

SETTING/LOCATION   

  • Use larger rooms with adequate space (6 feet or more) to maintain social distancing.
  • Ventilation:  outdoors is best if possible; consider opening windows for air exchange.
  • Identify bathrooms for guests to use and provide opportunity for regular use of handwashing and/or hand sanitizer.