I’ve been exposed. Now what?


June 21, 2020

You CAN’T stay in your house forever.
We never planned on maintaining a quarantine until the virus “went away.”
Our city continues to open up and ease restrictions. COVID-19 cases continue to rise. Your children may be venturing off to daycare or summer camps. You may be returning to your workplace.

HOW ARE YOU SUPPOSED TO ACCEPT AND BALANCE THIS NEW NORMAL?

As a reminder, let’s review what “SOCIAL DISTANCING” includes:

Enjoy time with the family members in your household, whether inside or out.
When you get together with family outside of your household, try to keep a 6-ft distance.
Avoid groups of more than 10 people*.
When 6-ft distancing is not possible with a certain activity, wear a mask.
When venturing out to stores, restaurants, meetings, and other indoor/ enclosed/ crowded spaces, wear a mask (including all those over 2 years of age)
Ideally “eating out” (especially with kids) would mean eating outside (if they are honoring the 6-ft rule), or choosing take-out.
*(10 people is not a lot. BUT, imagine if you hung out with 10 people this weekend, and each of those 10 people hung out with a different 10 people last weekend, and all those people hung out with a different 10 people the weekend before… That means that if just ONE person turns out positive for COVID-19, there are ONE THOUSAND people that would need to be contact-traced.)

NOTHING CAN REPLACE GOOD HAND-WASHING!

Social distancing is NOT :

Staying home isolated indefinitely
Watching the TV ticker of COVID cases all day
Fearing that your mail or deliveries will infect you
Worrying about a case of COVID-19 that has 6-degrees of separation from you.
Skipping visits for routine childhood vaccines (LOL, had to get that one in there)

So, HERE we are…. NOT in a situation that any of us enjoy. But we CAN go over some recommendations and FAQ’s that will give you some knowledge about how to handle some scenarios that are bound to come up.

I have been around someone that is sick or has a fever!

Don’t panic.
If you were practicing social distancing, your risk of infection is LOW.
There are lots of other germs out there other than SARS-CoV-2.
We would not recommend rushing out to get COVID-19 testing.

I have been around someone with CONFIRMED COVID-19!

Don’t panic!
If you were practicing social distancing, your risk of infection is LOW.
If you would like to be tested (despite having no symptoms), the optimal time to get testing would be 5-7 days AFTER the exposure.
If you develop symptoms of illness BEFORE this 5-7 day period, we would recommend that you GET TESTED.
If you TEST NEGATIVE, this is not a guarantee that you are truly negative, nor that you won’t test positive within the next 2 weeks.
If you TEST POSITIVE (and DO NOT develop symptoms of illness), you should QUARANTINE from friends and high-risk family members for 14 days.
If you choose NOT to get tested, and your exposure to a confirmed case was while you were NOT social distancing, it will be prudent for you to:
Start practicing social distancing
QUARANTINE from friends and high-risk family members for 14 days.
GET TESTED if you develop symptoms of illness within 21 days of exposure

MY CHILD HAS A FEVER…. Or any other symptom that makes me worry that he/she has COVID-19!

Don’t panic!
There are lots of other germs out there other than SARS-CoV-2.
Our treatment of FEVER remains the same. (for all children over 3 months of age)
We do not worry about the number.
We focus on other symptoms of illness.
We encourage you NOT to withhold a fever reducer just to prove to us your child is hot.
CALL THE OFFICE: If symptoms other than the fever are worrisome. For example:
Dehydration
Labored breathing
Change in mental status even WITH a normal temperature
Skin rash as a part of the illness, especially with red lips and red eyes
Symptoms that keep getting worse over time.
FEVER lasting 3-5 days WITHOUT the numbers slowly trending down**
Depending on your child’s exam, history, and potential for exposure, we may order testing for COVID-19
Because children can be co-infected with COVID-19 AND other germs at the same time (much more often than in adults), if your child tests positive for something like FLU or STREP or clinically has been diagnosed with something like Hand-Foot-Mouth, we may still suggest appropriate precautions AS IF your child is also sick with COVID-19.
**And YES, we will ALWAYS have MIS-C in the back of our minds as we assess your child EVEN if we do not mention it.

MY CHILD HAS COVID-19. When can they get back to daycare or school???
Current recommendations for a person who is ill, and subsequently tests positive for COVID-19:

Quarantine may end AT MINIMUM 10 days after the ONSET of symptoms.
ONLY IF that patient has NOT had a fever for at least the last 3 days.
AND ONLY IF that patient no longer has any respiratory symptoms.
(OR 2 negative tests at least 24 hours apart which is NOT feasible right now)
NOTE: Return to daycare/ school is actually different than how long a person should “quarantine.”

The SCHOOL OR DAYCARE may let your child back if fever-free for 24-hrs like it has been for years. I keep reading and there is no consensus on any new rules yet. If schools require “proof” that your child does not have COVID-19, at this point in time that is an unfair request. There is no 100%. We will not provide a letter stating that your child does not have COVID-19. We will be happy to describe your child’s current illness, our estimate of risk to other children, or call and discuss with your child’s teacher.

Your child’s QUARANTINE as described above is a different story. It would include:

staying away from crowded public places
cancelling play-dates with friends
avoiding contact with high-risk family members.
REMEMBER: kids under 15 yrs of age do NOT get as sick with SARS-CoV-2 as adults. AND, young children HAVE not been found to be the SUPER-SPREADERS of this virus. So this all makes sense. We will not be able to avoid the virus completely, but we can make smart decisions about how to protect those in everyone’s lives that are high-risk.

How do I get my child tested for COVID-19???
These may change on a weekly basis, but these have been our consistent options for now:

In our office:

We can do a NP*** swab and send out to a local lab. Turn-around time is 2-10 days.
We are hoping to have one we can run IN our office by August…. maybe.
Arnold Palmer Hospital Emergency Department:

This is an NP swab, in the ER. Note that you will be checked in and seen by a provider. ER Copays will apply. 2-3 day turn-around.

Centracare on Lee Rd:

This is a saliva**** test. 5-14 day turn-around.
It is “drive-in,” no appointment needed IF YOU HAVE ASKED OUR OFFICE TO FAX OVER AN ORDER FOR IT.
If you show up and there is no order on file, they will direct you to check-in to the Urgent Care Center to be evaluated and that doctor will decide if you need testing.
*** NP means “nasopharyngeal.” Yes that is the one adults say feel like the swab goes “up into your brain.” It is not pleasant, but often the only option we have for younger patients.

**** Saliva Test: you get to sit in your car with a tube and keep spitting into it until it is full. I am not sure the minimum age. I will say, make sure the top is screwed on tight so all your spit does not get spilled and ruin the test results.

HOW ACCURATE ARE THESE TESTS?
Statistics are ALL OVER THE PLACE. Maybe somewhere between 40% and 90%???
Is there a test right now that is 100%? NO

NOW…. TAKE A BIG BREATH!
That is A LOT of information.
Let it simmer, and then go back and read again.
SAVE THIS EMAIL for reference when questions come up, OR print out and use for TP 🙂
BUCKLE-UP. We still have 1/2 of 2020 to go.

KNOW THAT WE ARE HERE TO HELP.