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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.

How can I prevent my child from developing diabetes, which runs in my family?

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

There are two types of diabetes. Type 1 develops in childhood, but it is less likely to run in families. Unfortunately, based on current knowledge, there is not as much a parent can do to prevent type 1. Thankfully, this type is more rare. I’ll add that families that deal with type 1 are some of the most resilient that I have seen as a pediatrician.

Type 2 is more likely to run in families but is also much more preventable. Diabetes, as its core, is about not having enough insulin to help glucose get from the blood stream into the body’s cells to provide energy. The primary key to avoiding type 2 comes from good nutrition. All foods are eventually digested into glucose (also called blood sugar) as our fuel. Foods that are digested slowly allow our body’s pancreas to release insulin slowly, creating a gradual rise and fall of input and output that generates optimal health. Foods that are slowly digested (like an apple) have a low glycemic index; foods that are rapidly turned to sugar (like a potato) have a high glycemic index.

Fascinating new research reveals that a window of taste preference exists for infants ages 6-12 months. A baby might make a face the first few times peas or green beans are offered. However, with 8-10 days of persistence, we can successfully prime their palate for a healthier lifetime ahead.

Should schools be open or closed during COVID?

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

School staff and families are experiencing tremendous fatigue from the heroic work to maintain in-person education during the COVID pandemic. Millions of hours and millions of dollars have gone into mitigation efforts (like masks and distancing and ventilation).

Most schools use a hybrid model, with each student only in the building 2 days per week. Furthermore, close contacts are quarantined. These modifications significantly reduce the likelihood of COVID spread.

Given the benefits of in-person education and the health risks of COVID, decisions about if and when to temporarily shut schools are very complex — requiring wise judgment. It’s important to avoid being reactionary, when fear clouds fact. The fundamental question should be: “is having our school open right now making the pandemic here now worse?”

Massachusetts has its system of red, yellow and green communities, which marks the degree of caution each district should be using in its decisions. This is a particular challenge for urban cities, where both the rates of COVID and the harms of remote education are highest.

To use a baseball analogy, closing a school is like shifting the infield to double play depth when a runner is in scoring position with one out. It’s a tool that gets you out of a pinch. If this school year were a game, we’d be in the top of the 3rd inning. We need to encourage and reward good managers, who keep an eye on the long view and the final outcome.

Teens and Mental Health

By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

Photo by Polina Zimmerman from Pexels

A recent personal experience with the sadness and shock of suicide weighs on my mind these days. Suicide is the 2nd leading cause of death in the US, among ages 15-24. Rates have increased by 41% over the past 17 years. Males have a rate three times higher than females. Dismal statistics like these can sometimes be numbing, which discourages the hopeful proactive energy we need to bring, in order to prevent future tragedy.

When listening carefully to people who have considered suicide, one element that comes up invariably is psychological pain. The pain of loneliness or unworthiness can be as real and unbearable as physical pain. We humans are built for connectedness: an antidote to isolation. The time and energy invested in relationships reinforces that each of our days matter. We are grateful for those who help us, and we take joy in the opportunity to help others.

World Mental Health Day is this Saturday October 10th. Read more about “10 Things Parents Can Do to Prevent Suicide”

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5 Reasons Why Everyone Needs a PCP

A primary care physician (PCP) is always there for you, whether you have a common cold, need help managing a chronic condition, or are due for an annual checkup. These doctors tend to be the entry point for patients first entering the medical system, and developing a good working relationship with one is very beneficial to you and your health. Here are five reasons why you should have a PCP by your side.

1. Your Primary Care Physician Knows You

Having an established relationship with your PCP allows him or her to be familiar with you and your family’s medical history. This makes it easier for them to find patterns in your health and know how your body responds to certain illnesses.

2. A PCP is Your Entry Point to the Continuum of Care

Having a PCP is a great way to learn how to navigate the somewhat complicated medical system. They can refer you to specialists who may be more knowledgeable about a specific health issue. Through Pentucket Medical you have access to a network of primary care, medical specialists and urgent care services throughout the Merrimack Valley.

3. You Have Lower Out-of-Pocket Costs

A primary care physician co-pay is typically much cheaper than a visit to an emergency room. Having a go-to doctor who you can easily set appointments with creates a much lighter burden on your wallet, especially in the long run. Take a look at your insurance card to see the difference in cost between an office and emergency room visit.

4. A PCP Can Help You Reach Your Goals

Have goals like weight loss, eating better or general wellness? Your primary care physician can work with you to plan out how you can achieve your goals. Your doctor can recommend diets, exercise plans, and more to help you on your wellness journey.

5. You Can Receive High-Quality Preventive Care

In addition to providing care for acute illnesses and chronic conditions, your doctor can help you take measures to prevent their onset. Your PCP keeps track of your health over time, performs preventive services and screenings to catch diseases early, and offers advice to help you maintain a healthy and happy life.

Establish a relationship with a Pentucket Medical clinician today and start on the path to a healthier you. Our doctors offer same or next-day appointments, online scheduling through the Patient Gateway and an extensive list of accepted insurance plans.

cite: Baylor Medical Center

Sources:
U.S. News & World Report | How to Find the Best Primary Care Doctor
NCBI, U.S. National Library of Medicine | Contribution of Primary Care to Health Systems and Health

 

 

Reminder: To protect all of our patients, you must wear a mask to enter any of our locations.
Public health guidance for masking related to vaccination status has NOT changed in healthcare settings.

Vaccine Appointment Scheduling

Patients age 12 and older can schedule a vaccine appointment on the State’s website. Please note, any patient under 18 needs a parent or guardian’s consent which can be found here.

COVID-19 Information