News

CV🦠News, Week of July 6, 2020

Healthy greetings, TVD friends,

Yes, let us continue our journey into black history and awareness. Please spend a few minutes reading below.

And yes, it is getting more (COVID) complicated out there. We are seeing more cases (fortunately no one is particularly ill), and testing is under strain. So let me please remind you:

  • Wear a mask when out in public

  • Use “physical distancing” when going out

  • Shelter in Place as much as possible

And please enjoy and learn from (and share!) our newsletter!

Remember the Dixie Chicks? 
Well, THEY have opened their eyes… Renamed “The Chicks” (see image of the three of them above), last month the country-pop group shared “March March” and removed the “Dixie” from their name amid ongoing protests for racial justice. Read more in Rolling Stone magazine here.

“If your voice held no power, they wouldn’t try to silence you.” – unknown

(Use your VOICE. Use your VOTE.)

Use your eyes to watch “March” here, and use your mind to browse the links they suggest below:

Headcount / www.headcount.org
Black Lives Matter / www.blacklivesmatter.com
Human Rights Campaign / www.hrc.org
American Civil Liberties Union / www.aclu.org
Supermajority Education Fund / www.supermajority.com
March For Our Lives / www.marchforourlives.com
Mi Familia Vota / www.mifamiliavota.org
Native American Rights Fund / www.narf.org
Planned Parenthood / www.plannedparenthood.org
White People For Black Lives / www.awarela.org
Innocence Project / www.innocenceproject.org
Proclaim Justice / www.proclaimjustice.org

NOTE: CV🦠News is a labor of love. If you enjoy reading this, please share widely! Was this forwarded to you by a friend? Please subscribe here.

UPDATE: WHERE CAN I GET TESTED LOCALLY FOR COVID-19?
As of July 8, 2020 testing for active COVID-19 (by nasopharyngeal swab) for symptomatic patients continues to be available at Stanford through their Express Care program by appointment. Drive-through testing at the Emergency Department is no longer available. Appointments for Express Care can be made online through MyHealth or the MyHealth app, or by calling 650-736-5211. Note there has been a significant increase in demand for testing since July and there are longer wait times to get an appointment and receive results. We’re seeing this nationally, not just in our county.

With Express Care, our experience is that you will first get a call back from a nurse to screen you clinically, who will then schedule you for your drive-by test, which takes only a few minutes. The testing sites are at the Hoover Pavilion and at the Galvez Street location in Palo Alto from 9 a.m. to 6 p.m., seven days a week. Patients with positive results will be called back and care plans established. Negative results can be found online on MyHealth after 24 – 36 hours.

There is also testing at GOHEALTH, which is part of the Dignity Health system. They have an urgent care site in Redwood City that tests adults and children and also require a video visit with their MD prior to scheduling your nasal swab for viral testing. Again, there is high demand and limited availability. It is IMPORTANT to note that Dignity Health uses the COVID PCR test developed by Abbot. This test has less sensitivity than the Stanford and Labcorp tests. A lower sensitivity test means there is a higher percentage of false negative results. Bottom line, while this test is faster (typically same day results) it is less accurate.

Testing is also available through PAMF (Palo Alto Medical Foundation) Urgent Care “drive through”, but only in selected locations (Palo Alto and San Carlos), and only to PAMF patients with an order from their PAMF primary care doctor. Kaiser has a similar program for their patients.

If you live in San Francisco, you can learn here about the test sites available throughout the city.

And lastly, and a newly discovered option which includes availability for children (see more below), Santa Clara County Testing — no video visit or doctor’s order required, multiple sites located in Santa Clara, San Jose, and Morgan Hill. Testing is for ASYMPTOMATIC patients only. Residency in Santa Clara County is not required. Again, for children and adults who DO NOT have symptoms of COVID-19. Testing appointments are made through their website, or download Santa Clara County’s MyHealth App for iOS or Android.

**If you get tested through any of the above pathways, please be sure to keep your phone handy and answer unknown numbers to avoid delays in processing and getting your results**

Asymptomatic patients (people with no symptoms) who would like to be screened for active disease (“asymptomatic shedding”) with a nasal or nasopharyngeal swab test now have many options of varying quality. We recommend the following two for their combination of convenience and reliability. NOTE these options do NOT test children under the age of 18 (See the next FAQ below!) We are actively monitoring testing options for more availability and will be adding to this area as soon as we have reliable information:

  1. LabCorp Pixel: A home test, this is most convenient and has a fairly quick turn-around. Ordered online, it is shipped via FedEx for next-day delivery, picked up from your home by FedEx to be shipped back with next-day delivery upon notification by you that it’s ready for pick-up, and results take 24 hours after arrival back at their lab. If you swab the same day you receive the kit, it’s a total turn-around time of 72 hours (labs are processed over the weekend as well), and we found the whole process to take only about 15 minutes of total coordination time (ordering, collecting specimen, calling for pick-up by FedEx).
  2. Project Baseline / Verily (working with the county public health system): With drive-through testing options in Redwood City and San Mateo, appointments can be scheduled online 48-72 hours in advance, and results take 3-4 days.

WHERE CAN KIDS BE TESTED FOR COVID-19?
Santa Clara County Testing — No video visit or doctor’s order required; multiple sites located in Santa Clara, San Jose, and Morgan Hill. Testing is for ASYMPTOMATIC patients only. Residency in Santa Clara County is not required.
Who: Children and adults who DO NOT have symptoms of COVID-19.
How: Make a testing appointment through their website, or download their MyHealth App for iOS or Android

Stanford Express Care — Requires registration on MyHealth if not done previously, and a video visit prior to scheduling a drive-through testing appointment. Having a primary care physician at Stanford is not required.
Testing sites located in Palo Alto and Emeryville
Who: Children and adults.
Note: Priority is given to those who are symptomatic or were exposed to confirmed or suspected COVID contacts.
How: Visit the website to schedule a video visit, call (650) 736-5211, or download their App for iOS or Android
For “Specialty” select “COVID-19 Testing” and complete the checklist.

Sutter Health — Requires registration if not already a patient, and a video visit prior to scheduling a testing appointment.
Note: priority given to those who are symptomatic or were exposed to confirmed or suspected COVID contacts.
WHO: Children and adults who are, or can be registered as, Sutter Health patients.
How: To register and/ or schedule a video visit, visit their website.

Dignity | GoHealth Urgent Care — Requires a video visit prior to scheduling a testing appointment.
Testing sites in Redwood City, San Bruno, the Castro, Mill Valley, Piedmont (Oakland).
Who: Children and adults
Note: GoHealth uses the Abbot point-of-care test which has significantly less sensitivity than the tests listed above. However, results are available within an hour. Priority is given to those who are symptomatic or were exposed to confirmed or suspected COVID contacts.
How: Visit their website to schedule a video visit.

San Mateo County Testing — operated by Verily’s Project Baseline and is NOT available to children under the age of 18. This is problematic and unfortunate.

Pixel by LabCorp — in-home testing NOT available to children under the age of 18.

Bottom Line
For children cared for by The Village Doctor pediatricians, contact us if you have a unique situation or are having trouble getting testing using the methods above. We are always here to help and we closely follow the ever-changing and bewildering testing options available locally.

UPDATED: IF YOU HAVE TESTED POSITIVE FOR COVID, WHEN CAN YOU STOP HOME ISOLATION?
Per the CDC guidelines, people with COVID-19 (either having tested positive or by a presumed diagnosis by your doctor) who have had symptoms and have been on “self quarantine” at home can stop home isolation after these three things have happened:

  • You have had no fever for at least 72 hours (that is three full days of no fever without the use of medicine that reduces fevers)
    AND

  • other symptoms have improved (for example, when your cough or shortness of breath have improved)
    AND

  • at least 10 days have passed since your symptoms first appeared

If you tested positive for COVID-19 but did NOT have symptoms, you can stop self-isolation when:

  • At least 10 days have passed since your test (as long as you have not developed symptoms since then, in which case you should follow the guidelines above for people WITH symptoms)

For a few days following discontinuation of isolation, these persons should continue to limit contact (stay 6 feet away from others) and limit potential of dispersal of respiratory secretions by wearing a covering for their nose and mouth whenever they are in settings where other people are present. After that, they can follow regular facial covering and social distancing protocols.

Source: CDC “When You Can be Around Others After You Had or Likely Had COVID-19”

UPDATED: WHAT ISOLATION IS NEEDED FOR PEOPLE WHO HAVE BEEN IN CLOSE CONTACT WITH SOMEONE WHO HAS COVID-19?
The CDC defines “close contacts” as people who have been within approximately 6 feet of a COVID-19 case for a “prolonged period of time” (greater than 10 or 15 minutes) while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case or people who have had direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on). Importantly, this is IRRESPECTIVE of whether either person was wearing a face covering.

If you have been consistently using recommended precautions for home care and home isolation and do not have symptoms, you should stay at home for 14 days and closely monitor yourself for any symptoms (check temperature twice a day, watch for cough, shortness of breath and other symptoms).

If you were exposed, testing may or may not be helpful depending on the timing of the exposure. If you opt to get tested after exposure, you should quarantine until the test results are returned. Most importantly, remember that a negative test only means you were probably not infected at the time of the actual swab. A negative test does NOT guarantee you will not become ill or that you will not spread the virus. In other words, a negative test cannot tell you you are “safe”- safety is based on your choices and behaviors, not testing. Please read  more on this topic in our FAQ- “Am I safe to visit high-risk relatives if I just had a negative COVID-19 nasal swab?”

Source: CDC “Public Health Guidance for Community Related Exposure”

HOPE AND GRACE
If you have made it this far, time for a reward, something to lighten your day, and acknowledge the human spirit. Find some escape, or perhaps even inspiration, in this collection of works and perspectives gathered from around the world. Please contact me directly if you have come across something that has lifted your heart today.  Dr. Eric Weiss

The bond between father and son (which resonates particularly with me these days). With flights banned, Juan Manuel Ballestero began his journey home the only way possible: he stepped aboard his small sailboat for what turned out to be an 85-day odyssey across the Atlantic. Read more here about his solo sailing trip across the Atlantic to see his father, aged 90.

Again, CV🦠News is a labor of love. If you enjoy reading this, please share widely! Was this forwarded to you by a friend? Please subscribe here.

*****

Yours, in health and resilience,

Eric and the TVD MD team…