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COVID-Related Volume Challenges and FAQ

Dear Patient,

We know many of you have more questions about COVID-19, as there are many people who are testing positive – often with home tests– recently. We hope the information below will help.

Please note that our practices are receiving an incredibly high volume of messages and calls. We are also experiencing staffing shortages. Response times may be delayed. We apologize for the delays and appreciate your understanding. Practices are working hard to reply to messages and calls as fast as they can.

I have symptoms that I think might be COVID. Do I need a test?

If you have symptoms, you should get tested. Massachusetts has many testing options. If you live somewhere else, check your state website for resources. You can also use a home testing kit (often called antigen tests). The Centers for Disease Control and Prevention (CDC) has more information about home testing here. Please do not go to the emergency room or urgent care only to get a COVID-19 test.

 

Please note that Mass General Brigham has limited capacity for testing at this time. We are no longer able to offer elective testing (for example, testing for travel). We are adding testing capacity. We hope to be able to offer elective testing again soon.

 

What is the difference between isolation and quarantine?

Isolation is for people who have tested positive for COVID-19. Quarantine is for people who have been exposed to someone with COVID-19. The CDC has more information here.

 

I have been in close contact with someone who has COVID. What does this mean?

“Close contact” refers to time you spent directly with an infected person. This means you were within 6 feet of an infected person for a total of 15 minutes or more within a 24-hour period. The 15 minutes do not need to be at the same time. For example, three separate 5-minute exposures over the course of a day would total a 15-minute exposure. If you were in close contact with an infected person, you should be notified either by the person, by the school, or by the health department, though community contract tracing efforts have recently been reduced.

 

Guidance around the need for quarantine and testing after an exposure is changing. See the CDC, Massachusetts Department of Public Health or your state website for the most up to date guidance.

 

Note that most Massachusetts public schools are following the Massachusetts Department of Public Health guidance. However, some schools may have different guidelines. Please call your child’s school to find out what their specific policy is on quarantining if your child has been exposed.

 

I tested negative after an exposure. What should I do?

If you tested negative with a home test, follow the current guidelines related to quarantine and other testing. If you develop symptoms, you should test again. If a home antigen test is negative and you have symptoms, public health experts recommend getting a PCR test or testing yourself again with a home test after a few days.

 

In Massachusetts, unless local health departments have chosen otherwise, schools may allow a child to test and stay in school if they are exposed in school. Please call your child’s school to understand the school’s policy.

I tested positive at home. Do I need to get a PCR test?

If you use a home testing kit and test positive, you have COVID-19. You do not need a PCR test for confirmation. Please start home isolation immediately and notify your close contacts of your positive test. This guidance may change over time depending on how much COVID is in our community. We will let you know if this changes.

 

Am I at high risk for severe COVID-19?

High-risk conditions for severe COVID-19 include undergoing treatment for cancer, currently taking medications for transplant, or immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may pre-dispose you to worse symptoms from COVID-19 or influenza. The CDC has more information here.

 

I tested positive. I’m not at high risk for severe disease. I’m worried about my symptoms. What should I do?

Mild Symptoms – Stay Home and isolate

Mild symptoms are a temperature below 100.4 degrees (below 102.4 degrees for children older than 3 months), aches and pains, or a mild cough. If you have these symptoms, stay at home and isolate. Rest, drink plenty of fluids, and monitor your symptoms. Hopefully you will start feeling better within a few days. You do not need to contact your doctor to let them know you have COVID.

 

Moderate Symptoms – Call Your Care Provider

If you have moderate symptoms like a fever higher than 100.4 degrees, significant coughing, or shortness of breath, contact your primary care provider’s office. If you are receiving cancer treatment, please call your oncologist’s office.

 

For children ages 3 months and older who are not immunocompromised, a high fever is greater than 102.4 degrees. If your child has a fever, significant coughing or shortness of breath. you also should call their primary care provider’s office. You should also call if they are sleepier, if they have not gone to the bathroom in more than 10 hours (if 3 years or older) or more than 8 hours (if younger than 3 years old). Your child’s doctor can recommend next steps.

 

If you don’t have a primary care provider or you have symptoms that need immediate attention, try our Urgent Care options:

  1. Schedule an appointment with Mass General Brigham Virtual Urgent Care (for ages 3 and older)
  2. Visit one of our in-person Urgent Care centers (ages seen vary by site, check website for details)

 

Severe Symptoms – Emergency

Go to the Emergency Department if you have severe symptoms such as:

 

  • Severe trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or dizziness
  • Inability to wake or stay awake
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

 

If you cannot get to the emergency department, call 9-1-1.

 

I tested positive and I’m at high risk for severe disease. I am worried about my symptoms. What should I do?

Call your primary care provider’s office

You may be eligible for outpatient COVID treatment. Please note, we have limited supplies of these therapies.

 

For example, monoclonal antibody therapy (mAB), can help fight the infection. Call your primary care provider’s office to be referred. You are eligible if you are at high risk for severe COVID-19 and have either a positive antigen test or PCR test and are within 10 days of starting symptoms.

 

High-risk conditions include undergoing treatment for cancer, currently taking medications for transplant, or taking immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may pre-dispose you to worse symptoms from COVID-19 or influenza. The CDC has more information here.

 

Note that mAB is not available at Urgent Care or the Emergency Department. If you are eligible, your primary care provider will refer you to a designated infusion clinic.

 

Also, the U.S. Food and Drug Administration has issued an emergency use authorizations (EUAs) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets) and Merck’s molnupiravir. These are pills that can be used to treat mild-to-moderate COVID-19. Paxlovid is available for adults and children 12 years of age and older weighing at least 40 kilograms. Molnupiravir is for adults only. Both are available by prescription only for patients who are at high risk for severe COVID-19. Both should be started as soon as possible after the diagnosis of COVID-19 and within five days of the start of symptoms. We do not yet have this treatment available but anticipate limited quantities soon. We will provide updates when it is available. Please do not call or message your primary care provider’s office to request these drugs as they are not available right now.

Please note that the flu is now spreading in our community too. If you have a negative COVID test but have moderate symptoms, including fever and body aches, contact your primary care provider’s office. They may test you for the flu or give you a medication for the flu, especially if you are in one of the high-risk groups listed above.

 

We will provide more information as it becomes available. Please continue to take precautions to keep yourself and others safe.

 

Sincerely,

 

Thomas Sequist, MD

Chief Medical Officer

Mass General Brigham

Separating Fact from Fiction: Kids and COVID Vaccines

Separating Fact from Fiction: Kids and COVID Vaccines

It is exciting news that children ages 5-11 are now eligible to receive the COVID vaccine!

At every phase of the vaccine rollout so far, careful research with volunteers has checked to make sure that the vaccine is effective and safe before giving it to millions. And every time, the vaccine has held true. We expect the same now.

A young child’s vaccine dose is 1/3 of the adult dose, just like there is a children’s version of Tylenol. The vaccine works very well to prevent severe illness and death, reduce the risk of “long COVID” complications, lower COVID spread to family members and others in the community, and help stop other COVID variants from emerging.

Side effect rates have been similar to what we have seen in other age groups—including fatigue or headache for 1-2 days. One area of concern is heart inflammation, called myocarditis. Developing myocarditis was a very rare problem for some who received the higher dose; thankfully, they all recovered. Remember that COVID itself is much more likely to cause myocarditis than the vaccine. In the end, the pediatricians who analyzed all the safety data unanimously recommended getting your 5-11 year old vaccinated as the safest decision.

I watched a jumbo airplane lift off the ground recently and marveled at accomplishment of flight: human scientific genius! Vaccination is no less amazing. It has been our proven path out of many previous epidemics—from smallpox to polio to measles. Like vaccines, there are many safety checks on air travel, but who would argue that airplanes are a bad thing? Doctors are standing behind these vaccines because we know what vaccines can do.

Two things are happening right now as vaccines roll out. #1 is undermined confidence in experts. COVID is still very new, and experts are learning as we go. Sometimes new information forces changes in recommendations, but it’s our job to be honest and humble. #2 is the spread of information that is not accurate. Sharing information is valuable and sometimes helpful, but it’s important to filter out what is false or exaggerated. Your child’s doctor can help.

Continued myths include whether the vaccine causes death, infertility, or alters your DNA. None of these are true, but it is hard to dispel a rumor. It can be scary and confusing as a parent or guardian. Your child’s doctor here at Pentucket Medical wants to answer your questions. Please reach out to us via our Gateway portal or call us on the phone—we are here for you

Pentucket Medical Pediatrics at Lawrence/Riverwalk is Moving!

 

Pentucket Medical is excited to announce that our Lawrence/Riverwalk pediatric providers are moving a short 9 miles or 12 minutes away to our Andover office, located at the Andover Medical Center, 323 Lowell Street on August 1, 2021. The Andover location is easily accessible from route 93 on route 133.

Baby and toddler laying on bed

The Riverwalk team including Dr. Suzanne Damiani, Dr. Kenneth Fowler, Diane Hazel, CPNP-PC, and Laura Kelliher, CPNP-PC, is looking forward to joining their Andover colleagues to create a hub of care supporting children of all ages in the Merrimack Valley. Dr. Henry recently joined our Andover team with additional training in adolescent medicine bringing skilled advanced care to patients as they transition to adulthood.

This short move will provide our team with more robust support and our patients better accessibility to the care that they have come to expect. The Andover Medical Center site also offers an ExpressCare, lab, radiology and other specialty services.

What is not changing? Our phone number, your medical record and the same excellent care.

Thank you for choosing Pentucket Medical for your pediatric care. We look forward to seeing you in our new home!

Announcement- HIV & Viral Hepatitis Clinic in Lawrence, MA Now Open

 

HIV, High-Risk HIV & Viral Hepatitis Clinic

 

We are pleased to announce the opening of our specialized clinic focused on treating patients with HIV, high-risk HIV exposure and viral Hepatitis. Located at our Riverwalk/ Lawrence site, the clinic is managed by the highly experienced and welcoming care team of Jessica L. Wisocky, APRN-CNP and Katie Cailleach, RN-BC, CCCTM.

 

Click here to learn more.

Scoliosis Screening in Adolescents

Dr. John Maddox, Pentucket pediatrician and Haverhill School Physician reminds us that June is Scoliosis Awareness month. Scoliosis is an exaggerated curve to the spine, which can lead to deformity, pain and compression of the heart and lungs. Scoliosis can progress quickly during a growth spurt, so screening is another reason to have an annual well visit for adolescents. The provider will examine the patient carefully and sometimes order a painless x-ray. Scoliosis is more common in girls and when there is a positive family history. Generally, the key ages for early detection are 10-12 years for girls and 13-14 years for boys. (School nurses screen all students in grades 5-9.)

Most scoliosis cases do not progress rapidly and can be monitored every 6 months. Those that do exhibit rapid progression benefit from bracing and scoliosis-specific exercises. Braces today are much better than the full-body casts of old; they often fit inconspicuously under a teenager’s clothing. In fact the most popular brace used today is called the Boston brace! The ultimate goal is to avoid the need for surgery.

Here at Pentucket, we are fortunate to have a close relationship with scoliosis experts at Mass General Brigham’s orthopedic department to help with managing our cases.

Keeping the spine and the rest of the body healthy has been highlighted recently with all the remote learning and screen time imposed upon us during COVID. Now that the vaccines are so successful, we can all enjoy becoming more active again. So celebrate Scoliosis Awareness Month with some swimming and simple stretching exercises, which are particularly helpful for good posture!

Vaccines Now Available for Children Over 12

Submitted by Dr. John Maddox, Pediatrician, Pentucket Medical/Haverhill

It is exciting news that children ages 12 and older are now eligible to receive the Pfizer COVID vaccine!

We know that the Pfizer vaccine is effective and safe for ages 16 and older. The vaccine generates even more antibodies for the younger patients, which translates to stronger immune protection. The vaccine was given to over 1000 patients, ages 12-15, and they were compared to 1000 patients who were not vaccinated. In the weeks following full vaccination, 18 of those not vaccinated came down with COVID. Zero of the vaccinated individuals developed COVID. So the early results show 100% effectiveness in protection.

The side effects are no more frequent and no more severe for this age group. The list is now familiar: sore arm, tiredness, headache, chills, muscle pain, fever and joint pain; lasting 1-3 days and more common after the 2nd dose. The Pfizer vaccine is one of the vaccines that must be kept extra cold to maintain full strength. So, a person experiencing those mild side effects can rest assured that the vaccine was kept cold and that the immune system is working properly!

While there have been some concerns about certain vaccines, the Pfizer vaccine has not demonstrated a serious health risk in the many millions of doses given, dating back to research trials last summer.

There is a lot of false information swirling around the internet and social media. Rumors that the COVID vaccine can affect infertility, that the vaccine contains some tracking device, that the vaccine can change your DNA. The Pfizer vaccine does not linger in your body’s cells long enough to do any of this. Within 48 hours of the vaccine, you can’t find any trace of it. The vaccine lasts long enough to prompt your immune system to do what it does every day — protect you. The vaccine simply gives your body a photocopy of the COVID virus — like a wanted criminal — so your immune system can jump into action, if you are exposed to COVID at a future date.

Children generally have milder COVID symptoms than adults, but this important step of vaccinating more humans reduces new people that COVID can infect. This stops the development of new mutations and gets us closer to those happier days of less masks and closer distance.

COVID-19 Vaccination and Younger Children

Submitted by Dr. John Maddox, Pediatrician, Pentucket Medical/Haverhill

Now that those age 16 years and older are able to receive the COVID vaccine, pediatricians are fielding questions about when younger children will be next.

Vaccines typically spend years being studied for effectiveness and safety. That process was understandably expedited due to the lives being lost due to COVID illness. COVID’s is the first vaccine to ever be approved under the Emergency Use Authorization (EUA) process. As with any medical treatment, there is always a balance between benefit and risk. Every treatment carries some risk that must be considered in comparison to its benefit.

The risks of the vaccine for an individual age 65 and older are much, much lower than the risks of COVID. That math is very different for children under age 16, where the risk of death from COVID is one tenth of one percent. Even the risk of the treatable multi-inflammatory syndrome (MIS-C) is 2 per 100,000 — which means that most pediatricians will never see a case. For children, we will have the luxury of time when evaluating the effectiveness and safety of the COVID vaccine.

Until most adults have been vaccinated, we need to continue general mask-wearing and social distancing. But children can safely return to their childhood, including in-person school, without delay. Immunizing children has always been an important piece of preventing infectious diseases and building herd immunity, but we can focus our attention now on vaccinating as many adults as soon as possible.

Walk-in Urgent Care Available at ExpressCare Riverwalk

Walk-in urgent care services are once again available at ExpressCare located at 370 Merrimack Street in Lawrence.

To support all our patients’ healthcare needs, we will continue to provide respiratory care and treatment safely in a dedicated, isolated space at our Respiratory Illness Clinic at the same location. Walk-in respiratory care is also available.

COVID-19 Vaccine Distribution

 

  • Given the large demand and limited supply of vaccines, Mass General Brigham is following Massachusetts’ phased plan and therefore in this phase is only offering vaccines to patients ages 75 years and older.
  • Please sign up for a Patient Gateway account if you not already done so. This will be Mass General Brigham’s primary means for managing the vaccination process.
    • Mass General Brigham will begin reaching out to eligible patients soon via Patient Gateway, email, phone calls, and text messages. We are in an ‘outreach only’ phase so patients will be notified when they have been selected. Please do not call Pentucket Medical with questions about your status.
    • Selection for “invitation” is random, but special consideration is being given to more heavily impacted communities such as Lawrence and Haverhill.
  • Pentucket Medical will begin vaccinating patients at Haverhill-Primrose beginning Wednesday, February 3.
  • Eligible patients can also find other locations and schedule a vaccine appointment through the Massachusetts web site. This resource should be considered in addition to ongoing Mass General Brigham efforts.
  • For additional information please click here.