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Covid 19 Update

December 30, 2021



Dear JCP Families:

We would like to provide you with an update on the current COVID situation.

The GOOD NEWS:

Quarantine guidelines have been updated and shorter durations of quarantine are now recommended.  See below.

The BAD NEWS:

We are experiencing another surge of cases.  The Omicron variant and the Delta variant are both circulating in our community.  At this time, the majority of illness we are seeing is from COVID.  Influenza A and other respiratory viruses are increasing as expected for this time of year.  The big concern is overwhelming our medical facilities and exhausting medical supplies (and staff).

Early information suggests that the Omicron variant is less severe but more contagious.  Vaccinated individuals are at risk for mild to moderate infection, but still relatively protected from severe disease.

Children's Healthcare of Atlanta is overwhelmed with patients in both the Urgent Care and Emergency Rooms.  Check this webpage https://www.choa.org/medical-s...or the CHILDRENS HEALTHCARE OF ATLANTA app for current wait times and call ahead appointments.   Many patients are requesting testing and are not in need of urgent or emergency care.  CHOA is not testing in these situations; go to a testing site.   Please avoid going to CHOA ED or UC unless you have an emergent or urgent condition.  You can ALWAYS call us to help you decide if you need an urgent or emergency visit.  

Testing supplies are becoming difficult to obtain.  Our office has a limited supply of antigen tests.  We will be judicious in deciding who needs a test, focusing on high risk patients and patients with at risk household contacts.  If your child is exposed or only mildly ill and you want a test, please go to a testing center. We want to reserve our appointments for patients with medical needs.  We will let you know when we are able to get more supplies.

COVID Vaccines:

We continue to recommend vaccination for all eligible individuals to safely reduce the spread of COVID and limit the opportunity for COVID to mutate and evade vaccine induced or natural immunity.  

BOOSTER DOSES are now recommended for all individuals age 16 and up.  At this time we have a limited supply of COVID vaccine in our office to vaccinate initial series for 5-12 year olds and adequate supply for 12 and above and booster doses for age 16 and above.  We are giving these vaccines by appointment only.  The vaccine is widely available locally and we encourage you to get it anywhere that is convenient for you.  In addition to local pharmacies, you can also go to

https://viralsolutionsga.com/

https://www.covidcarega.com/

Many of you have already decided that you want to have your children vaccinated and some of you are still not sure.  Our practice has listened to trusted experts at Children’s Healthcare of Atlanta, CDC, and the American Academy of Pediatrics.  We are confident that the vaccine is safe and effective.  Please see an information sheet with FAQs here:

COVID VACCINE INFORMATION:

covid-pediatric-vaccine-faqs.pdf

pfizer-covid-19-vaccine-fact-sheet-10202021.pdf

  https://www.cdc.gov/vaccines/c...

A few reminders:

EXPOSURE   If you are notified of an exposure and your child is well, we recommend continuing to wear a mask in public and protecting any high risk people in your home.   


WHO NEEDS AN APPOINTMENT OR TEST?  NOT EVERYONE WITH A COLD OR VIRAL SYMPTOMS NEEDS A COVID TEST!  Testing too early may increase the chance of a false negative test, give a false sense of security and put others at more risk.  DO NOT GET MULTIPLE TESTS DURING ONE ILLNESS.  If you have a positive result, believe it.  False positives are rare; false negatives are common.  Please follow these guidelines:

Your child had an unknown or poorly defined exposure to COVID at school but is well. .   You do not need a test or quarantine.  Wear a mask at school and protect any vulnerable individuals that you are around.  These recommendations are for everyone anyway so really no need to do anything different.  You want a test anyway.  Do not get tested until at least 5 days after the exposure to minimize false negatives.  The best test in this situation is a PCR test, which we do not have in our office.   See the testing center link below.

The school, camp, sport, travel or other activity is requiring COVID testing.  Get a PCR test at a testing center.

Your child has mild symptoms of viral illness and no clear exposure.  Mild symptoms would include low grade fever, runny nose, slightly decreased appetite, intermittent cough, a few episodes of vomiting or diarrhea.  A low grade fever is defined as a rectal or oral temperature between 100.5 and 102 degrees (exception is if your child is 3 months old or less, please call for any fever greater than or equal to 100.4)  See symptom checker here.  You do not necessarily need an appointment or testing.  Stay home until you are fever free and improving.  Wear a mask (if over age 2) as the cough and congestion resolve over the following week or two to prevent spreading whatever other viral infection you have.  Please do not come in during the first 2-3 days of a mild viral illness for a test.  A test in this setting may yield false negative results.

Your child is mildly ill and has an exposure.  We recommend testing at day 3-5 after onset of symptoms.  We can test your child in the office at the time of a sick visit.  If your child has mild symptoms and you do not think he or she needs an appointment, you can go to a testing center for a test.  Of course, quarantine at home and isolate from other household members to the best of your ability until you get test results.  Treat symptoms as below and monitor for signs of worsening illness that would require a visit to our office.

Your child has moderate or severe illness symptoms or symptoms that are not improving after 2-3 days.  Signs of more concerning illness include respiratory distress, dehydration, inconsolable crying, symptoms that are worsening after 2-3 days of illness.  Respiratory distress includes frequent cough, labored breathing (rapid breathing, skin pulling between ribs with breathing), low energy or interest in playing.  Signs of dehydration include poor fluid intake, decreased urine output, no tears when crying, listlessness.  Dehydration typically occurs in the setting of vomiting and diarrhea or prolonged poor fluid intake due to respiratory symptoms.  If your child seems to get better and then worsens, fever returns, this may signal a bacterial infection such as pneumonia or ear infection and we want to see him or her.   If a fever persists more than 2-3 days and is not improving, we want to evaluate your child.  If you are unsure, please ask to speak with our phone nurse and she will guide you.  If you think your child has severe symptoms (listlessness or lethargy, blue lips, worsening respiratory distress or dehydration) call 911.  

HOME CARE:  

Viral illnesses do not require antibiotics or other prescription medications.  We treat symptoms to make the child more comfortable and monitor for signs of worsening.  Control fever with acetaminophen ( Tylenol) or ibuprofen (Motrin or Advil).  Click here for dosing guidelines.  For infants, use saline and suction to keep the nose clear.  Obstructed nasal passages make little ones very uncomfortable.  Use a humidifier or vaporizer in the child's room (cool mist please).  You can try baby Vick's rub on the chest.  Your baby will need extra tender loving care while ill.  Make sure you have help because you need to get rest too.  For children over a year, you can try giving a teaspoon of honey by mouth to soothe the throat irritation.  For older children, try Zicam zinc nasal spray.  Cough is a protective reflex that clears mucous and is important to prevent pneumonia.  Cough can also signal a lower respiratory tract infection that requires medical attention (see signs of moderate to severe illness above).  Vomiting and diarrhea are frequent symptoms of viral illness.  Encourage fluids and a mild diet.  If children have frequent vomiting or diarrhea, we recommend Pedialyte to replace losses.  If you are concerned about dehydration from frequent vomiting and diarrhea with signs as above, please call us.  Your child may need to be seen.  

HOW TO PREVENT THE SPREAD OF COVID:

Wear your mask

Wash your hands

Watch your distance

Stay home when ill.

Get your  COVID vaccine if you are age 5 and above.

Following these guidelines is more important now than ever.  

Flu Vaccination is crucial.  An epidemic of flu during a COVID surge severely compromises our medical systems.

Please do not spread false information.  There are many touted treatments and fads on the internet.  Please always consult trusted medical sources.  You can always call us!

LINKS

Testing Resources

for COVID-19 PCR testing, drive-up sites, and quick turn around for results visit: 

https://viralsolutionsga.com/

or

www.covidcarega.com 

For other possible testing options visit:

https://dph.georgia.gov/castli...


Symptom checker

For young children

https://covid-choa.mybluemix.n...

For older children

https://www.cdc.gov/coronaviru...


QUARANTINE AND ISOLATION:
Definitions
Quarantine:  You have been exposed but are not ill.  Stay home during this period of time to avoid spreading COVID to others outside your home.
Isolation:  You have a COVID 19  positive test (with or without symptoms) and need to avoid spreading COVID to  household contacts and those outside your home.
New guidelines

 Please click on the links for the exact guidance from Department of Public Health.  A short reference summary follows:
Exposure requiring quarantine  https://files.ctctusercontent....
If you are vaccinated and have a close contact exposure, you do not need to quarantine.  Wear a tight fitting mask when around others for 10 days (we should all be doing this right now anyway).  If available get a test at day 5.  If you develop symptoms at any point, get a test.  If you are positive, follow guidelines for positive tests below.
If you are not vaccinated or incompletely vaccinated (fewer than 2 doses or 2 doses but less than 2 weeks from the 2nd dose for 5-16 year olds, or lacking a booster dose or booster given less than 2 weeks ago for 16 and up):  quarantine for 5 days.  If you remain asymptomatic you may leave quarantine.  Consider testing if available, continue to wear a mask for 5 additional days.

COVID 19 Diagnosed Illness requiring isolation  https://files.ctctusercontent....

If you become ill and test positive for COVID 19

Isolate in your home, avoiding household contacts as much as possible for 5 days from onset of symptoms.   You may leave isolation on or after day 5 if you are fever free without fever reducing medication and feeling better for 24 hours.  You may still have some symptoms.  Continue to wear a mask for 5 additional days.

If you test positive but do not have symptoms

Isolate in your home for 5 days from the positive test.  If you are symptom free at 5 days, you may discontinue isolation but continue to wear a mask for 5 days.  If you develop symptoms, your isolation restarts with the first day of symptoms and follow guidelines above.

COVID VACCINE INFORMATION:
covid-pediatric-vaccine-faqs.pdf

pfizer-covid-19-vaccine-fact-sheet-10202021.pdf


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