5/27/2020

The providers at Papago Buttes Pediatrics first want to thank you all for being so patient and cooperative during these unprecedented times. We wanted to provide you with a quick update as we continue to monitor the spread of COVID-19 in our community. Our office flow for well visits will remain the same as you enter in the front “well door” and exit out the back door to allow for one-way traffic in the office. Starting Monday June 1st, we plan to open same-day appointments in the morning and afternoon for all “non-well” visits in order for children with ear aches, rashes, injuries, and acute conditions to be seen in a timely manner and not have to wait until the end of the day for an appointment. If you still prefer a telemedicine appointment, please contact our office and our staff will route you to our triage team to determine if you qualify. We want our patients to feel safe in our office as we continue to follow CDC guidelines and take appropriate precautions to prevent spread of infection. We still have designated “sick” and “well” entrances and exits, are appropriately disinfecting all surfaces, and all staff are continuing to wear masks, eye protection, and gloves when appropriate. We encourage you to continue wearing face masks and practice social distancing in the office as well. We also recommend bringing toys or books from home for your children to play with as we have decided to permanently remove community toys, books, and magazines from our office as we feel they cannot be properly disinfected and we want to continue to do our best on preventing the spread of infection. Thank you for all that you do and we look forward to continuing to care for your children at our office!

5/21/2020

Arizona lifted its stay-at-home order on May 11th, but COVID-19 remains a serious threat to the
community. The decision to return to “normal life” needs to be based on necessity and individual risk
factors. Home isolation and social distancing are still the best options for continued safety, but we
understand that parents need to return to work and daycare/camp might be the only option available to
you.

For those individuals at high risk, or those with family members at high risk, it is recommended to
continue the shelter-in-place guidelines and NOT attend daycare/camps, if possible.

Some conditions that are considered high risk for severe illness with COVID 19:

• 65 years or older
• Individuals in nursing home or long-term care facilities
• Individuals with chronic lung disease or moderate to severe asthma
• Individuals with serious heart conditions
• Individuals who are immunocompromised (Smokers, cancer treatment, immunodeficiencies)
• Individuals with obesity (BMI 40 or greater)
• Individuals with diabetes
• Individuals with chronic kidney disease undergoing dialysis
• Individuals with liver disease

We still recommend:

• Wearing face masks in public- this is important to decrease spread, even if you are
asymptomatic—we know that some people are contagious without symptoms
• Avoid touching your hands to face and eyes
• Wash hands with soap and water for 20 seconds frequently, use hand sanitizer when soap and
water not available
• Keep surfaces clean with sanitizing solutions
• Keep at least 6 feet apart
• Avoid large crowds and unnecessary travel

For those children returning to daycare or attending summer camps, the CDC has guidelines for social
distancing while at daycare, camps, and other community settings, which can be found here:

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-forchildcare.html#SocialDistancing

For those individuals who do not have a facemask or face covering, the CDC has instructions on how to
make your one face covering:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

The following is a link that shows physical distancing with acceptable activities outside of the house.

https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/infectious-diseaseepidemiology/novel-coronavirus/public-resources/social-distancing.pdf

5/7/2020

Dear Papago Buttes Family

We wanted to update you on the current state of things at Papago Buttes as we move through the Covid-19 pandemic. As always, we are taking the health and safety of our patients extremely seriously and our response has changed over time as the realities of the pandemic have shifted. It appears currently that the social distancing that Arizonan’s have participated in has had a significant impact on the spread of the virus through our metropolitan areas and state in general and so the worst case scenarios of rapid spread have not materialized. Over the next few days, weeks and months our state is likely to begin re-opening and finding some sense of normalcy, altered as that will be.

With this in mind, two large priorities are going to be front and center in the ongoing care of your children’s health. First, the American Academy of Pediatrics is warning that with delays in childhood vaccination due to offices being slowed and limited there is a significant concern for outbreaks of vaccine preventable childhood illness to re-emerge on the heels of the Covid-19 illness. We are carefully considering the best ways to ramp up access to well child checkups and vaccine catch-up without increasing the risk to our population of contracting the Covid-19 virus. One plan that will be changing soon is increasing our availability of well child checkup appointments as the need for sick visit appointments fade with the end of the normal respiratory virus season. This will likely take the form of making all morning appointments dedicated to well child visits and vaccine catchup. Our goal will still be to minimize any time spent in waiting rooms and we plan to continue to take patients to rooms as quickly and directly as possible. Unfortunately, we in Arizona do not have the luxury of having people sit in their cars until their exam room is available in the summertime so we will be watching our flow closely to schedule a patient flow that meets existing room availability. The afternoon schedule for now will still utilize the back entrance for well checks with a limited number of sick visits available in rooms dedicated for the afternoon to those types of visits. The rooms that may be utilized in the afternoons for sick visits will be thoroughly deep cleaned at the end of the day so that they are safe and available for use the next morning for well visits. Throughout these transition times we will adapt as needs dictate and will be using our telephone triage staff to make sure that we continue to be able to provide safe and professional care for sick visits as well. Stay tuned as it is possible that changing events may force us to adapt and change our office flow several times over the next few weeks.

The second area of concern that we will be addressing as the summer progresses is the scheduling of our normal fall flu vaccine administrations. Given the likelihood that Covid-19 will re-emerge next fall and winter we consider it especially important this year to get a high percentage of the population covered for flu season. At the very least it will simplify the decision making process for those children who develop high fevers and lower respiratory symptoms as they are bound to do. In addition, the cases of flu followed by covid-19 or vice versa will certainly happen and the risk for pneumonias or other serious complications are much more likely to occur if anybody, including children have to fight first one and then the other illness. Please stay tuned as we will be deciding whether to start our flu vaccination program earlier than usual, or to increase the availability of flu clinics early in our normal vaccination season.

Thank you all for being patient and understanding through this trying time. We are all well aware of the medical and financial stresses this pandemic has placed on our entire way of living and continue to be committed to providing the best care available to your young ones.

3/17/2020

What is Coronavirus?
– COVID-19, is a new strain of Coronavirus. It is in the same family of viruses as SARS and MERS

How is it transmitted?
– Coronavirus is transmitted through droplets spread through cough, sneezing or touch

What are the symptoms and how serious is it?
– Cough, congestion, fever. Symptoms can range from asymptomatic or mild to severe.
– Most people in China had mild disease, including most children. Most of the serious cases were in older patients and/or patients with complex medical conditions

How is it treated?
– Currently there is no specific treatment or vaccine for Coronavirus. Treatment is supportive care to help relieve symptoms. However, some companies are working on vaccines and treatment, so it may be available in the future.

How can it be prevented?
– Best way to prevent is good hand washing with soap and water for at least 20 seconds. If soap/water not available, use hand sanitizer with at least 60% alcohol
– Avoid touching hands to face and eyes.
– If you are sick, stay home. Cough or sneeze into your elbow if you have no mask.
– Avoid crowded events or close contact with people who are sick.
– Clean surfaces regularly with products labeled effective against bacteria and viruses.
– Masks are not recommended for prevention, however, if you are sick and coughing it is recommended to prevent you from spreading it to others
– As masks are in short supply, you can use any thick scarf or bandana to cover nose and mouth to prevent spread of droplets

What to do if you are exposed or you think you may have or at risk for Coronavirus?
– If you have traveled in past 14 days to high-risk areas and are symptomatic call your doctor for medical advice before coming in for appointment.
– If you are having any respiratory distress, go to the ER, let them know you are at risk for Coronavirus

Protecting yourself and the community
– Keep yourself informed and know where to find up to date information (cdc.gov, azdhs.gov, who.int)
– Know the signs and symptoms of COVID-19 and what to do if you are sick
– Wash your hands, clean surfaces regularly, practice good hygiene control measures
– If you are sick, please stay home!!
– Limit community movement to help slow transmission of the virus. This means avoiding public gatherings, staying home unless it is necessary to go out (i.e. work), keeping your distance from others. If people are less mobile and interact with each other less, the virus has fewer opportunities to spread. This will save lives!
– We must all adapt to disruptions in our regular routines (i.e. telecommuting, school closures, event cancellations) and follow advice from our local/state officials.
– Avoid nonessential travel

Testing for Coronavirus
– There is currently still a limited capacity to test patients for Coronavirus even though LabCorp and Sonora Quest are now offering outpatient testing.
– We are currently testing patients based on symptoms and exposure.
* If your child is well with NO symptoms, no testing is currently recommended for Coronavirus. However, if your child has had direct contact with someone who has tested positive for COVID-19, please call our office for further guidance.
* If your child has had fever (100.4 or higher) and/or cold symptoms (including cough, congestion, shortness of breath) AND has been exposed to someone who has tested positive for COVID-19, please notify our office as they may meet criteria for testing. Please DO NOT come to the office before notifying us so we can take the proper precautions to keep our patients and staff safe.
* If you have fever (100.4 or higher) and/or cold symptoms (including cough, congestion, shortness of breath) without a known exposure to COVID-19, testing is not currently recommended. We do recommend supportive care at home. Continue general precautions to prevent spread of illness like good hand washing and cleaning surfaces regularly. If you develop more significant or severe symptoms, please make an appointment.

Important Travel Restrictions
– Delay travel plans if able. Travel by car when circumstances permit.
– Currently the CDC recommends self-quarantine if you have traveled to a Level 3 area, which includes China, Iran, South Korea, Europe (including the UK and Ireland)
– For up to date information on travel recommendations please refer to: www.cdc.gov

What is the risk for Maricopa County and Arizona?
– The current level of community spread is minimal but there are areas of heightened risk.
– For best up to date information on risk in Arizona and Maricopa county: www.maricopa.gov/coronavirus