August 7, 2020
Happy August!
Now that this unusual summer has passed its halfway point, we wanted to communicate our thoughts regarding the Department of Public Health (DPH) guidelines and our office practices, specifically with regard to COVID testing and quarantine requirements.
DPH Recommendations for COVID Testing:
The Massachusetts approach to the management and containment of COVID-19 is one of widespread testing and with isolation (quarantine) and contact tracing of infected persons. In order for this to be successful, it depends upon the screening of ALL SYMPTOMATIC INDIVIDUALS. As such, DPH guidelines continue to recommend testing for any individual experiencing any of the following symptoms (even if mild):
- Fever or chills
- Respiratory illness (e.g., cough, shortness of breath, runny nose or congestion)
- Fatigue, sore throat, headache, body aches
- Loss of sense of taste or smell
- Other less common symptoms can include gastrointestinal symptoms (e.g. nausea, vomiting, diarrhea), unknown rash
Guidelines for Isolation and Quarantine of Symptomatic Individuals:
So long as infection rates in the community remain low, the likelihood of any one individual with the symptoms listed above being infected with COVID is low. Even so, in order to minimize the spread of COVID-19, it is crucial that any ill individual be civically responsible and stay home and follow quarantine guidelines. Symptomatic individuals may leave house and return to activity (including school/camp/daycare) once the following criteria are met:
- Negative COVID-19 Test – once without symptoms for 24 hours
- Positive COVID-19 Test – once at least 10 days have passed from symptom-onset, with at least 3 days without fever (without taking acetaminophen or ibuprofen) and with improvement in other symptoms
- No COVID-19 Test completed – once at least 14 days from symptom onset
To give an example of this, a 16 year old with a sore throat and nasal congestion who tests negative for COVID may leave the house and return to activity once they have had no symptoms for 24 hours. That same teenager, should they choose not to get tested, must stay home and quarantine for 14 days from the onset of symptoms.
What Do We Think the Fall is Going to Look Like?
Should schools and daycare open for in-person learning, we anticipate that sick children (including minimally ill children) will need to leave school until meeting the above clearance criteria. We anticipate this to lead to a need for lots of COVID testing and office visits in order to decrease the amount of in-person school missed.
What is the Process For Getting COVID-19 Testing?
Right now, testing is completed at most hospitals and many Urgent Care centers. While some of these require an order from our office, many of the are available on request (and do not require an order). To determine the best place for you or your family to get tested, please check the Massachusetts Emergency Management Agency (MEMA) COVID-19 Test Site Locator. This is the website that we refer to – we do not have any inside information.
The turn around time for test results varies according to the site that completes the testing and the week it is being done. Back in May and June when the national case load was lower, we were regularly seeing turnaround times of 2-3 days. Now that the country is in a full surge, any testing site that sends its samples out (and does not have rapid, in-house, testing) is looking at 7-8 days. This continues to change and we recommend you contact the testing site directly to learn what their turnaround times are.
What About Testing at WMPEDS?
It’s complicated! Our office COVID Task Force is aggressively pursuing in-office testing and hope to be able to perform testing this fall. Whether or not we have this capacity depends upon our ability to obtain appropriate protective equipment (PPE) for our staff as well as the availability of in-office testing materials.
Right now, there is a shortage of in-office testing machines so that the earliest we would have that capacity is around Thanksgiving. Assuming we can get PPE and enough swabs, we hope to be able to perform send-out testing (to QUEST) in the next month or so. Unfortunately, this would still leave us dependent on the QUEST turnaround times.
Stay tuned. We hope to have more information on this soon.
Closing Thoughts:
This past spring the entire world was caught off guard and was unprepared for this pandemic. At WMPEDS (as was true elsewhere), we had to completely revamp and reinvent our entire office structure and model. It felt very strange and scary being out of our houses and in the office.
We have now had almost 5 months in this new world with our newly invented practice and things feel much better. Our systems are in place such that virtual visits are largely successful (and preferred by some people) and are in-office environment is running smoothly and safely. Our waiting rooms remain empty and people are getting in and out of the office quickly. We continue to evaluate and update our protocols to ensure the safety of our staff and patients.
COVID cases are again rising in Massachusetts and will likely spike again with the return of college students and school.
Please be responsible and do your part to ensure the health and safety of our community! Wear a mask and make sure your kids wear masks also. Make sure your older children are “following the rules.” Do not go out into the world unless you are completely healthy and, if you have any symptoms of illness, follow the quarantine protocols listed above.
Enjoy the last weeks of summer, take advantage of the warm weather to be outside, and stay kind to others!
-All of us at Westwood-Mansfield Pediatric Associates