COVID

June 22, 2021

Dear CHA parents,

Since the onset of the pandemic, CHA has strived to provide our patients uninterrupted pediatric care while limiting the risk of COVID-19 being spread within our offices.  We have strictly complied with both CDC recommendations and state regulations as conditions have changed.  All CHA medical staff are fully vaccinated. At this time, we feel that additional adjustments can be made to improve your experience within our offices.  Our goal is to have our offices back to pre-pandemic practices as soon as possible.

It is encouraging to see that the statistics have dramatically improved over the last several weeks.  Statewide cases have come down to about 200 per day, and the rate in Oakland county is now about 1.3 per 100,000 residents.  We are heartened that most of our patient’s parents have become vaccinated and that many of our 12 year and older patients have either begun or completed their vaccinations.  Vaccination is the most important measure to protect your health and to help your community gain freedom from this terrible disease.  We encourage all of you to get vaccinated as soon as possible.

CHA will continue to follow CDC and state of Michigan guidance.  Facial masks continue to be required in health care settings regardless of vaccination status.

Due to the significant improvement in the COVID-19 statistics, we are making the following changes:

  1. Effective immediately we will be seeing sick patients in the morning as well as the afternoon.  This will allow us more flexibility in accommodating patients for both sick and well visits.
  2. We will allow the family of healthy children to utilize our waiting rooms.  Sick patients will continue to wait in their vehicles until an exam room is available.
  3. We encourage you to limit the amount of family members in exam rooms, but we will not restrict parents for well visits.  For sick visits we prefer one parent, but we will allow an additional parent or siblings if this is not feasible for your family.
  4. We are planning to resume walk-in hours in SEPTEMBER with a modified format.  We will create VIRTUAL waiting rooms at each office and vehicles will be used as your personal waiting room.  More information will be provided as we get closer to this change.

CHA understands the many hardships that families have faced over this past 15 months.  Many families understandably got behind on recommended checkups or delayed visits for specific problems. We are here to support you and to provide you the professional guidance and treatment that you deserve.  Please contact our offices if your children need check-ups, vaccinations or help with specific problems.

Thank you for your patience and understanding as we continue to navigate this difficult situation.

Sincerely,

Child Health Associates, PC


SARS-CoV-2 (Coronavirus Disease 2019 - COVID 19)

Background

  • Coronaviruses are a common group of viruses, often responsible for the "common cold"
  • SARS-CoV- Severe Acute Respiratory Syndrome (2002)
  • MERS-CoV - Middle East Respiratory Syndrome (2012)
  • SARS-CoV-2 - Coronavirus Disease 2019 (COVID-19)

Social Distancing

  • some studies suggest as few as 1,000 viral particles are required for an infection to take hold
  • minimize opportunities to become infected with COVID-19
  • number of particles x duration of exposure = odds of infection
    • stay 6 ft. away from other people
    • wear a mask
    • limit duration of time around other people

Incubation Period

  • definition - period of time between exposure to COVID-19 and appearance of symptoms
  • between 2-14 days from onset of symptoms (median 4-5 days)

Contagious Period

  • definition - period of time during which a person can infect other people
  • 2 days prior to onset of symptoms
  • 10 days after onset of symptoms

Asymptomatic Carrier

  • someone who has has tested positive for COVID-19 without manifesting symptoms
  • considered contagious 2 days prior to testing positive in the absence of developing symptoms
  • considered contagious until 10 days after testing positive in the absence of developing symptoms

Children

  • typically asymptomatic or present with mild illness

Risk Factors for Severe Illness

  • Age > 65
  • Cardiovascular disease
  • Diabetes
  • Hypertension
  • Chronic lung disease
  • Cancer
  • Chronic kidney disease
  • Obesity
  • Smoking

Symptoms

  • Fever/chills
  • Cough
  • Shortness of breath
  • Fatigue
  • Muscle or body aches
  • Headache
  • Loss of taste or smell
  • Sore throat
  • Congestion
  • Runny nose
  • Nausea
  • Vomiting
  • Diarrhea

Multisystem Inflammatory Syndrome in Children (MIS-C)

  • also known as Pediatric Multisystem Inflammatory Syndrome (PMIS)
  • rare complication of COVID-19
  • our understanding of MIS-C is still evolving

Testing

  • Locate Testing Site (click here)
  • Who should get tested?
    • anyone with symptoms consistent with COVID-19
    • anyone who has been in close contact with someone who has confirmed COVID-19
    • close contact is defined as someone within 6 feet for more than 15 minutes while not wearing a mask
  • Which Test?
    • Antigen testing "Rapid Test"
      • diagnosis of current infection
      • nasal swab, saliva or nasopharyngeal
      • results take minutes to hours
      • less sensitive - unable to identify low traces of COVID-19 earlier in the disease course, but very accurate during the contagious period
      • testing best performed if symptomatic
    • Nucleic acid amplification testing (NAAT) - reverse transcription polymerase chain reaction (RT-PCR)
      • diagnosis of current infection
      • nasopharyngeal swab
      • results take hours to days - testing priority determined by severity of illness
      • more sensitive - able to identify COVID-19 earlier in the disease course, but remains positive weeks after the contagious period
      • testing best performed if symptomatic or 1 week after exposure
    • Antibody testing (Serology)
      • diagnosis of prior infection
      • blood draw
      • results take hours to days - testing priority determined by severity of illness
      • false positives due to cross-reactivity with other coronaviruses
      • unclear whether antibodies indicate immunity against future infections with COVID-19
      • testing best performed 2 weeks or more after illness onset

Nasopharyngeal Swab

Isolation

  • someone who suspects they have COVID-19 should isolate themselves for 10 days, wait until they are clinically improving and fever free x 24 hrs, at which point the contagious period has passed

Quarantine

  • staying away from others for 14 days, at which point the incubation period has passed

Other Resources

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Hours of Operation

Our Regular Schedule

Troy Location

Monday:

8:00 am-4:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-4:00 pm

Saturday:

8:30 AM - by appt only

Sunday:

Closed

Novi Location

Monday:

8:00 am-4:00 pm

Tuesday:

8:00 am-4:00 pm

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-4:00 pm

Saturday:

8:30 AM - by appt only

Sunday:

Closed

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