The Physicians, APRN providers and staff at High Ridge Family Practice (HRFP) realize this remains a difficult and confusing time for everyone. High Ridge Family Practice has remained open throughout the Pandemic and seeks to continue to do so by continuing our safety protocols.
As we head into the Flu Season while we are still dealing with SARs-CoV2 or Covid-19 as it is more commonly known, adhering to these policies and protocols will provide us the best chance to manage everyone’s medical care safely.
Many of our patients have questions and we frequently get requests regarding appointments and testing. I will attempt to answer some of these questions and address the requests, in general.
First, all appointments will be made to minimize exposures and contact times in office while still providing complete and comprehensive medical care. Our staff will ask you multiple questions, many of them are repetitive, so please be patient with them on the phone and in person and provide fully honest answers so we can help you best, as well as keep you, your family, our community and our staff safe.
When you arrive at the office building, please park your car and call up to the office. Please do not come into the office without speaking to one of our office staff and being advised we are ready to receive you and come up to the office. You will have your temperature taken upon arrival and a series of questions will then again be asked or clarified.
If you have had Contact with someone who has been ill within the prior 14 days, we need to know that information so that we can process you and assess your level of exposure. If you have any symptoms of illness - there are many varied symptoms though fever, cough, shortness of breath are the primary ones, there are many others and many symptoms overlap with the flu (influenza) as well as other common acute illnesses - you should be seen and appropriately assessed medically.
When you arrive at the office building, please park your care and call up to the office. Please do not come into the office without speaking to one of our office staff and being advised we are ready to receive you and come up to the office. You will have your temperature taken upon arrival and a series of questions will then again be asked or clarified.
If you have just been told of an exposure to a known individual with Covid-19, when you call our office, please tell us when you were exposed. As soon as you have been advised of an exposure, you and any close contacts should be isolated and quarantined until you can be tested and receive the test results as clearing you. Testing should occur in anyone who is asymptomatic (without symptoms) no earlier than 3-5 days following exposure. Being tested earlier is likely to yield a false negative test result (which means you do have the Coronavirus, but the test is not yet positive).
Everyone who has had an exposure should be tested. Again, while waiting to be tested and getting a negative test result, please isolate and quarantine.
If you have symptoms of illness, early on your Covid-19 testing could still be negative, but during the Flu season that extends from September to May in most years, being seen earlier than the 3-5 day period is important as Influenza can have severe consequences as well. Influenza needs to be addressed and treated within the first 24-72 hours. In the first 24-48 hours Xofluza is an option for treatment. Within 24-72 hours Tamiflu is an option for treatment. You will be tested from November through then end of the Flu season which is somewhere between March and May (the case numbers we see and get reported will signal the end of the Flu season - though the Flu can be year round - so PLEASE GET YOUR ANNUAL FLU VACCINE)
If you test negative for the Flu and/or your medical history, symptoms and medical condition indicate you will be tested for Covid-19 as well, and if negative you may be asked to come back for reevaluation and testing (while remaining isolated and quarantined). Testing can be done through a variety of tests can be coordinate through HRFP. All acute testing is done through a nasopharyngeal swab (a culture swab placed deep into both nostrils to the back of the throat, uncomfortable but not terrible). The labs can then be sent out for BioFire testing (which will test for the Flu and other viruses and some bacteria as well as Covid-19) and we will have a result back within 2-4 hours.
Additionally, labs can optionally be sent to Quest Diagnostic Labs, Boston Heart in MA both of which we should have results within 3-5 days or less. Other options you have for testing is to go to The Stamford Hospital (you would call to book an appointment for testing and may or may not require a physician or provider prescription - in which case you would need to speak to one of the providers at HRFP), Greenwich Hospital, Norwalk Hospital, an Urgent Care Facility - AFC / DOCS / MinuteClinic or go to Coronatestct.com to locate a screening site near you through Murphy Medical Associates.
We are preferentially (we are not charging or responsible for the billing for the actual testing) using BioFire, Boston Heart and Quest as they have been the most accurate, reliable and timely for our patients. Once tested, you are to leave the office (we will escort you out) and go directly home, please do not be in contact with others until your test results are returned, are noted as negative and a follow-up plan is in place.
Testing should occur in anyone who is asymptomatic (without symptoms) no earlier than 3-5 days following exposure. Being tested earlier is likely to yield a false negative test result (which means you do have the Coronavirus, but the test is not yet positive. If you are asymptomatic, as noted above, testing should occur within 3-7 days post exposure date and once you are advised of exposure please remain isolated until you have the results of your tests back.
Testing can be done through a variety of tests we can coordinate through HRFP. All acute testing is done through a nasopharyngeal swab (a culture swab placed deep into both nostrils to the back of the throat, uncomfortable but not terrible). The labs can then be sent out for BioFire testing (which will test for the Flu and other viruses and some bacteria as well as Covid-19) and we will have a result back within 2-4 hours.
Additionally, labs can optionally be sent to Quest Diagnostic Labs, Boston Heart in MA both of which we should have results within 3-5 days or less. Other options you have for testing is to go to The Stamford Hospital (you would call to book an appointment for testing and may or may not require a physician or provider prescription - in which case you would need to speak to one of the providers at HRFP), Greenwich Hospital, Norwalk Hospital, an Urgent Care Facility - AFC / DOCS / MinuteClinic or go to Coronatestct.com to locate a screening site near you through Murphy Medical Associates.
We are preferentially (we are not charging or responsible for the billing for the actual testing) using BioFire, Boston Heart and Quest as they have been the most accurate, reliable and timely for our patients.
Once tested, you are to leave the office (we will escort you out) and go directly home, please do not be in contact with others until your test results are returned, are noted as negative and a follow-up plan is in place.
If you are infected:Â You must be without a fever for 3 days, and then additionally without all symptoms for 7-10 days. Therefore, you are looking at 13-14 days, so we are recommending at least a 14-day quarantine for all infected individuals. If your symptoms last longer than 7 days, you should remain in quarantine for the additional 7-10 days.
HRFP is attempting to test and then will be retesting its patient population for active, symptomatic and asymptomatic infections as well as post infection evidence of the infection by assessing antibody titers. This is done through testing all our patients, offering this to all patients since we do now know for sure who has had exposure. We are doing this by sending a full study of labs to Boston Heart Diagnostics for Covid-19 Testing. This will involve a nasopharyngeal swab RT-PCR, as well as a Quantitative serum IgM and serum IgG antibody measurement - an actual measure of the number of antibodies.
If you are Negative for all three tests you will likely be retested in 6 months.
If you are Positive for Serum antibodies you will likely be retested in 3 months.  This is in order to evaluate how long the antibodies remain elevated in the body and identify those who have high enough titers that they might be eligible to donate plasma for antibodies that may then help others.
The best protection and prevention of spread of the Coronavirus infection is in continuing to wear masks in public spaces when in near contact (within 6-10 feet) of others, avoiding large gatherings, frequent handwashing.
Influenza vaccinations is expected to lower the incidence of influenza illness and the possibility of co-infections.
A person who recovers from Covid-19 and has antibodies does not likely leave the patient immune to subsequent infection but may lessen the severity of the illness should they be infected again. Those patients with antibodies could still become reinfected and then again spread the virus to others.
Since we try and triage your symptoms prior to arriving or even making an in-person appointment, some technology at home is helpful.
- Working thermometer, preferably an instant read device.
- Home pulse-oximeter for measuring your blood oxygen saturation % and your pulse.
- An automatic blood pressure cuff for measuring your blood pressure (not surprisingly).
In addition if we are scheduling a telemedicine visit, a home computer with Skype installed and a Skype user logon set up would be needed. We have alternatives, but Skype is preferable. Some providers may ask that you use Doxy.Me and will provide instructions for that.
Yes. You should still self-quarantine for 14 days since your last exposure. It can take up to 14 days after exposure to the virus for person to develop Covid-19 symptoms. A negative result before end of the 14 day quarantine period does not rule out possible infection. By self-quarantining for 14 days, you lower the chance of possibly exposing others to Covid-19.
CDC Nov. 13, 2020
Most people with coronavirus who have symptoms will no longer be contagious by 10 days after symptoms resolve. Â People who test positive for the virus but never develop symptoms over the following 10 days after testing are probably no longer contagious, but again there are documented exceptions.
CDC Nov. 3 , 2020
Things you can do to reduce your risk of contracting Covid-19
- Continue to exercise social distancing recommendations and standards.
- Avoid large groups and gatherings.
- Avoid getting together with people in general you do not know well and cannot verify and be sure they have been adhering to reasonable guidelines regarding Coronavirus / SARs-CoV2 / Covid-19.
- Continue to use masks and face coverings.
- Frequent handwashing.
- Use of gloves when appropriate.
- Seek medical attention early if experiencing any signs or symptoms of illness:
- Fever, cough, deep muscle pains are three most common signs that are the most frequently associated with COVID-19
- There are many other signs and symptoms - Shortness of breath, fatigue, diarrhea, abdominal discomfort, chest pain, sore throat, headaches, loss of taste, loss of sense of smell, rashes, small blue spots on toes or fingers, bluish coloration of toes or fingers.
- If you are going to seek medical attention as outlined above, to immediately go into and adhere to self-quarantine and isolation until the results of testing has returned negative.
- Get vaccinated for Influenza early in the season as soon as vaccines are available.
- Update all appropriate vaccinations as soon as possible.
- Know your personal risk factors.
- Get tested if you suspect exposure to Covid-19.
Additional recommendations to consider:
- Take Vitamin D and get 5-10 minutes of sun exposure 3 X / week if Vitamin D level is less than 30.
- Take Pepcid (famotidine) 20mg-40mg once daily.
- Take Zinc (Zn) 50-60mg once daily.
- Use Mouthwashes:Â Only those that must contain Cetylpyridinium - there are a few options
- Crest Cool Mint, Crest Pro-Health, Colgate Pro-Shield, Sensodyne Pronamel Daily Mouthwash, Colgate Plax Cool Mint.
- Use these as a gargle and mouth / throat rinse daily, especially when you think you may have had some Covid-19 contact,
- If you become infected with Covid-19 and test positive, using these as a gargle and mouth / throat rinse 3x per day may decrease early viral load - leading potentially to  less severe SARs-CoV2 (Covid-19 / Coronavirus) infection.
- Utilizing these vitamins, minerals, OTC medications and Mouthwashes in combination, may show benefit in lessening severity of disease should you contract, get infected with Coronavirus / SARs-CoV2 /Covid-19.
- Additionally, taking a low dose Aspirin daily if there is no indication not to take this may be beneficial and could prevent blood clots, the dose if infected and having symptoms can be increased to 325-650mg per day.
- This information and these recommendations are not meant to be fully inclusive and the recommendations may change over time. They may not be for everyone. The risk of taking these is low.
Consult your medical professional with any questions.
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