Current Status of Testing
There is no perfect test for detecting the SARS-CoV-2 virus (that causes COVID-19). Typically testing is compared with a live culture of the virus to determine absolute accuracy. To avoid exposure to those who work in a lab, labs around the country have used PCR and Molecular testing, as these have been the most accurate type of testing for other infections including the Flu and Strep Throat. With all this in mind, Four Seasons Pediatrics has made the decision to only use PCR/Molecular testing for COVID-19, rather than antigen testing. No test is 100%, but antigen testing is more likely to have a false result when it is negative. Therefore, we have been sending PCR/Molecular for all testing in the office.
Most other offices are sending patients to testing sites and then seeing patients after the negative test. This offers the highest protection to the office. Our office has taken an outside exam room approach. This approach allows our patients to be seen and tested in one place and at an earlier time. It allows us to make an earlier diagnosis of infections such as Strep throat, ear infections, coxsackie virus etc. This is the upside of our approach. Our novel approach will be featured on Channel 13 on Monday.
The downside of our approach, is the special precautions we need to take. These precautions protect you and protect us. An outside visit reduces exposure to staff and families. No patient with a COVID-19 symptom enters the building. This reduces your risk when you come for a well visit. When patients are seen for a COVID-19 symptom outside, they are only seen by the provider (Physician or our Physician Assistant Joyce), which reduces risk to reception staff and nurses. The nurse and provider calls our families before seeing them. This reduces face to face time, to reduce risk to the provider. The provider puts on Personal Protective Equipment (PPE) including a gown, N-95 mask, face shield and gloves. This has to be removed carefully to prevent exposure to the provider.
Challenges
Due to the extra precautions taken, we are finding that visits are pushing and extending the time to complete a sick evaluation. We are also finding that a significant number of visits are accompanied by extra anxiety for the patients and the parents. It is taking much longer to relax children who are already anxious. With the pandemic looming, some parents are requiring more time and a need to address more concerns and worries.
Since forming Four Seasons Pediatrics in 2001, we have been able to predict the need for sick visits and have provided same day appointments for those who called for an ill child. The pandemic has created unpredictable needs and we have seen that we have been running significantly behind on appointments and running out of appointments to meet all the needs. In the interim, we ask for your patience as we adapt to these special different times. Our staff will do their best to update you, if we are running behind. We are considering the possibility of rescheduling some well visits, if we continue to have a greater need for sick visit evaluations. We will give you advance notice if we need to take such an option.
Point of Care Testing
We have been working on getting a rapid test since the first Emergency Use Authorization of a Molecular Test. Please note that other offices have been unable to get test kits as well. We continue to work extremely hard to get these kits and are optimistic that we will get them. We remain committed to getting molecular/PCR tests to have the most accurate results for in office point of care tests.
Thank you for the privilege of caring for your family
The Providers, Nurses and Staff of Four Seasons Pediatrics.
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