Coronavirus Disease 2019 (COVID-19) Information
Dear Blue Fish patients and families,
We are sorry that the threat of COVID-19 to you, our children, our families, and our loved ones is adding more of a burden to our already busy and sometimes stressful lives. None of us really have much extra bandwidth to spend on such an ominous threat to the whole world especially when it affects our children. We would like to give you an update on how we are addressing the threat.
First, we have some encouragement. Given the limited and evolving data set we have, so far it seems that most healthy children infected with COVID-19 have a mild, self-limited illness similar to other viruses you are all used to navigating.
Currently, we have decided to interact with all people as if they might have COVID-19. After much study and deliberation, we have come to the realization that the epidemiological criteria that have been used early on in the pandemic are not sensitive enough to determine accurately who is most likely to have the illness. Geographic and symptomatic criteria have become an ineffective means of risk stratification.
What was once a short list of “at risk” travel destinations now includes our entire community. What was once a short list of symptoms such as fever and cough does not address the data showing that asymptomatic or nearly asymptomatic people are spreading the virus perhaps as much as those with obvious symptoms. In addition, we now know that a few pediatric patients present with predominantly vomiting and diarrhea.
Therefore, we are currently focusing our efforts on three main concepts:
- Decreasing the number of people who come to the office as much as is logistically possible and sustainable
- Reducing the risk of COVID-19 transmission in the office
- Screening by questioning all people coming to the office for those who have had contact with a person who has tested positive for COVID-19
Please click the toggles below to examine more closely how these and other concepts are being brought into action.
Here is how we are currently decreasing the number of people who come to the office as much as is logistically possible and sustainable:
- Website and internet resources to inform parents when to be concerned
- Triage and education to help patients avoid medically unnecessary visits
- Triage to phone and telemedicine visits
- Efforts to limit visits to one adult accompanying a patient into the office (we realize this is not always possible)
- Education and encouragement on how to manage mild illnesses at home
- When necessary and clinically indicated, testing outside of the office
- Removal of non-urgent office visits (e.g. behavioral, ADD, ear piercings, etc.)
- Allowing only critical staff and patients in the office
Here is how we are reducing the risk of COVID-19 transmission in the office:
- Well child checks and sick visits will be done during separate segments of the day. We will call you to reschedule if needed.
- Newborns visits will be seen first thing in the morning
- Well visits will be at designated times with no sick visits scheduled during this period
- Sick visits will be at designated times. The waiting room will be separated into those with respiratory issues and those without
- Patients will be moved quickly into exam rooms, bypassing the waiting room, when space allows.
- Patients will be required to stay in their exam rooms
- Patients will go directly to the exit, bypassing checkout. We will be doing as much as logistically possible at check in. We will also be contacting parents after the visit to schedule any recommended follow-up visits.
- Patients with cough will be required to wear a covering of their nose and mouth. Due to a shortage of masks, please bring a bandana or piece of cloth from home. We realize that most of our little patients will not cooperate with this part of the plan.
As families are heeding the city’s stay-at-home order and as we see an increase in telemedicine visits, our in-office visits have significantly decreased, resulting in less patients than usual in the waiting room. There are also far fewer patients of other practices in the buildings where our suites are located.
Here is how we are screening every patient before they come to our office. Our receptionists will be asking each family the following question:
- Have you or a family member been in direct contact with a positive confirmed case of COVID-19?
If they answer yes, we will direct them to the appropriate facility for testing or if they are acutely ill, we will send them to the appropriate emergency room.
Dear Blue Fish patients and families:
After much study and deliberation, at this time, Blue Fish Pediatrics has decided not to offer testing for COVID-19 in our offices for the following reasons:
- Testing is not likely to alter patient treatment. Fortunately, children with COVID-19 usually exhibit mild symptoms or none at all. Like other viruses our families have experienced, there is currently no established treatment available other than supportive care. Our patients know that we usually do not order tests without knowing how the test results will change our treatment plan.
- Testing is not likely to change how our patients are triaged in an outpatient pediatric setting. Because most of our patients will experience mild illness, a positive test for COVID-19 would not change our recommendation for you to monitor your child’s condition at home. While a positive test might inform you how diligent to be with isolation efforts, the CDC currently recommends aggressive social distancing for everyone. This is especially true if your child is ill. In other words, if you are concerned that your child has COVID-19, you should consider at isolating them even without a positive test result. On the other hand, a negative result, while reassuring, does not eliminate the ongoing risk of your child contracting or spreading the illness.
- Testing is likely to bring more people into the office, which will facilitate the spread of the disease.
- Testing will strain the already limited testing capabilities that are needed by hospitals and healthcare providers on the very front lines.
- Testing in our office will not substantially contribute to the epidemiological understanding of the COVID-19 pandemic at this time (large scale efforts are currently being implemented). Here is a link to the Harris County/Houston Coronavirus Disease (COVID-19) self-assessment tool which can determine who is at risk for COVID-19 and then refer you to a testing site if appropriate: www.checkforcorona.com/harris-county#/welcome
For all of these reasons, we expect that the majority of our patients, even those who have been exposed to or are experiencing symptoms consistent with COVID-19, will not require testing in our office at this time. As always, if your child is ill and you are concerned about their condition, please call our office for guidance. If your child’s doctor determines that your child meets the criteria for testing established by our local public health authorities or you desire to have them tested, please visit www.checkforcorona.com/harris-county#/welcome
Thank you for understanding and please let us know if you have any questions or concerns.
Blue Fish Pediatrics
If you are coming in to the office for an asthma related issue, please bring your rescue inhaler (albuterol) and spacer with you.
Updated on March 15, 2020
What is the Coronavirus Disease 2019?
The Coronavirus Disease 2019 (COVID-19) is a new respiratory virus first identified in Wuhan, Hubei Province, China. This virus was not previously known to cause human illness until the recent outbreak. It is believed that the virus was initially transmitted to humans from a wild animal. Human-to-human transmission is now the most common route of transmission.
What are the symptoms of COVID-19?
Similar to many viral respiratory illnesses, the symptoms of the virus mimic the common cold and include mild to severe respiratory illness with fever, cough and difficulty breathing. Symptoms may appear between two to 14 days after exposure to the virus. Also be mindful that we are in flu season and pollen counts are high, so there are many other causes for upper respiratory symptoms that are much more common than COVID-19.
How does COVID-19 spread?
As with any viral respiratory illness, COVID-19 can spread from person to person through small respiratory droplets, which are dispersed when a person with the virus coughs or sneezes and are then inhaled by another person. These droplets can also land on objects and surfaces around the infected person. Other people then catch the virus by touching these objects or surfaces, then touching their eyes, nose or mouth.
How do I protect myself from getting COVID-19?
There is currently no vaccine to prevent COVID-19. The best way to prevent the spread of germs is proper hand hygiene and cough etiquette. Below are some other tips:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash and perform hand hygiene immediately.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
What do I do if I think I have COVID-19?
Based on CDC guidelines, if you think you may have COVID-19 and are experiencing minor symptoms, Blue Fish Pediatrics recommends you self-quarantine at home for at least 14 days and check our website for more information. And please call us if you have additional questions. For severe symptoms, call ahead to your local Emergency Center prior to arriving or dial 911 if you need emergent care.
How can I be tested for COVID-19?
There are a limited number of COVID-19 test kits available nationwide. However, we anticipate in the very near future, that drive-thru testing sites, similar to other major cities, will become available. This will be the safest way to get tested. Harris County and the City of Houston has provided an online self-assessment tool at www.checkforcorona.com that will assist you should you need testing (updated 3/23/2020).
What happens if I test positive for Coronavirus?
If a patient is confirmed with COVID-19, reassuringly the pediatric population has fared very well with the illness. Most will only require a 14-day quarantine at home and will not require hospitalization. However, should they become more acutely symptomatic please contact us ASAP.
Will taking Tamiflu help me protect myself from getting COVID-19?
No, Tamiflu will not protect you from getting the novel coronavirus. Tamiflu is a drug to treat the flu, not a vaccine. The virus is so new and different that it needs its own vaccine. Researchers internationally have been working to develop antivirals, but at the present time, there is no specific treatment or vaccine.
How long does COVID-19 survive on surfaces?
It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses may persist on surfaces for a few hours or up to several days. If you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others.
Should I be concerned about contracting the Coronavirus?
If you are not in an area where the coronavirus is spreading, or if you have not traveled from one of those areas or have not been in close contact with someone who has and is feeling unwell, your chances of getting the novel virus are currently low.
How does COVID-19 compare to other Coronaviruses?
There are several common coronaviruses that typically cause respiratory illness, like the common cold. Symptoms of COVID-19 can range from mild infection to severe respiratory illness.
Is it safe to receive mail from any areas with confirmed cases of the Coronavirus?
Yes. The likelihood of an infected person contaminating commercial goods is extremely low and the risk of catching the virus from a package that has been moved, traveled and exposed to different conditions and temperatures is also extremely low.
How is Blue Fish Pediatrics protecting patients and staff from Coronavirus?
Blue Fish Pediatrics continues to take proactive steps to protect our employees, physicians, patients and community by implementing a workforce protocol based on CDC guidelines. This protocol includes screening members of our workforce who have traveled to affected areas, per the CDC, within the applicable time period, or who have had contact with someone who is under investigation for COVID-19 or has been confirmed with the virus. Based on screening results, we will then provide information on immediate next-level care or mandatory leave for employees for up to 14 days, as necessary.
What is Blue Fish Pediatrics doing to prevent the potential spread of Coronavirus Disease 2019 (COVID-19) to patients and physicians?
To further protect the health of our patients, workforce and the community, and prevent the potential spread of Coronavirus Disease 2019 (COVID-19), Blue Fish Pediatrics is asking that at this time only one caretaker and the patient needing to be seen come to the office when at all possible – we understand this is not always feasible. Additionally, to reduce exposure to healthy children we will be using a modified scheduled for the time being.
Whom may I contact with questions on Coronavirus Disease 2019 (COVID-19) when my physician is not available?
If you have questions regarding Coronavirus Disease 2019 (COVID-19), the Houston Health Department call center is available weekdays from 9 a.m. to 7 p.m. and Saturdays from 9 a.m. to 3 p.m. They will also return voice messages left after hours on the following day.
Houstonians can call the center at 832-393-4220 and talk to department staff to obtain information about Coronavirus Disease 2019 (COVID-19).