Coronavirus (COVID-19) Alert

Summit Recommendations

Summit Medicine and Pediatrics COVID-19 Recommendations

Summit Medicine and Pediatrics is informed and prepared for the COVID-19 pandemic. We are in contact with the Center for Disease Control (CDC) and the Arizona Department of Health (AZDH) and have developed an action plan to manage the unique requirements of this disease. From time to time, based upon the developing course of this pandemic and the evolving opportunities and tools for medical management of patients infected with COVID-19, we will update our Coronavirus (COVID-19) Management Policies and Recommendations. Herein we provide:

·       Coronavirus (COVID-19) Exposure Risk Reduction Strategy

  • State and Federal Agency Recommendations
  • Summit Medicine and Pediatrics Recommendations

·       Coronavirus (COVID-19) Risk Cohorts

  • Risk Cohort 1: Standard Risk
  • Risk Cohort 2: Moderate Risk
  • Risk Cohort 3: High Risk

·      Coronavirus (COVID-19) Monitoring and Testing Recommendations

  • Exposure to Person with Possible COVID-19 Infection
  • Exposure to Person with Confirmed COVID-19 Infection
  • Suspected COVID-19 Infection
  • Confirmed COVID-19 Infection

Coronavirus (COVID-19) Exposure Risk Reduction Strategy

Risk Reduction Strategy

It is important to remember that there is no risk reduction strategy or set of recommendations for containment of disease that is currently, or ever has been, 100% effective.  Furthermore, there is no one risk reduction strategy or set of recommendations that can or should be applicable to every community in the United States.  The healthcare needs of each community in our nation are based upon the needs of the individuals within that community, and therefore a generalized, nationwide strategy for containment and treatment of disease is not always optimal.  Nevertheless, the implementation of basic principles, based upon the fact and observation, is an essential starting point for containment of the spread of infectious disease.

Based upon a rapidly changing healthcare environment, these recommendations for risk reduction are likely to change frequently.

For the current COVID-19 pandemic, the following risk reduction strategies and recommendations have been advanced:

  1. Maricopa County Department of Health (MCDH) Recommendations to Reduce Risk of Exposure to COVID-19.

The MCHD has advanced specific recommendations and guidelines for prevention of COVID-19 illness and spread: Maricopa County Health Department

  1. Center for Disease Control and Prevention (CDC) Recommendations to Reduce Risk of Exposure to COVID-19.

The CDC has advanced specific recommendations and guidelines for prevention of COVID-19 illness and spread: Center for Disease Control and Prevention

  1. World Health Organization (WHO) Recommendations to Reduce Risk of Exposure to COVID-19.

The WHO has advanced specific recommendations and guidelines for prevention of COVID-19 illness and spread: World Health Organization

  1. White House COVID-19 Task Force (WHCTF) Recommendations to Reduce Risk of Exposure to COVID-19.

The WHCTF has advanced specific recommendations and guidelines for prevention of COVID-19 illness and spread:

  • Avoid Gatherings of More than 10 People
  • Engage in a Home Schooling when Possible
  • Avoid Discretionary Travel
  • Avoid Eating and Drinking at Bars, Restaurants, and Food Courts
  • Quarantine Entire Household If One Member is Diagnosed
  • Focus on Protecting Elderly and People with Pre-existing Conditions
  1. Summit Medicine and Pediatrics (SMP) Recommendations to Reduce Risk of Exposure to COVID-19.

Summit Medicine and Pediatrics agrees with and supports the current MCDH, CDC, WHO and WHCTF recommendations. In addition, there are some basic principles of infection control that everyone should apply to their day-to-day activities, whether or not we are in the midst of fighting a pandemic, that merit emphasis. All of us should apply the following basic principles of infection control at all times:

  • Take your own temperature every week, at a minimum, and at any time you feel ill:
    • If your temperature is above 102.0 degrees Fahrenheit once, place yourself in isolation, check your temperature daily, and seek medical evaluation promptly
    • If your temperature is above 100.4 degrees Fahrenheit consecutively for 3 days, place yourself in isolation, check your temperature daily, and seek medical evaluation promptly
    • NOTE: It is currently safe to take either acetaminophen or ibuprofen to manage the symptoms of fever, headache and pain associated with COVID-19 infection
  • Wash your hands for a minimum of 20 seconds with soap and warm water:
  • Every 2 hours at a maximum interval while awake (15-20 times per day)
  • Prior to handling or eating food, and taking medications or supplements
  • After shaking hands, exchanging ‘high-fives’ or hugging others (not recommended)
  • After touching or handling dirty, common or non-sanitized objects or surfaces:
    • Cash, credit cards, shopping carts, gas pumps nozzles, etc.
    • ATM screens, payment keypads, door handles, exercise equipment, etc.
  • If washing hands with soap and warm water is impossible, use plenty of sanitizer
  • Use emollients every day to keep your skin healthy and supple after washing frequently
  • Sanitize daily frequently-touched or -handled surfaces and objects:
    • Glasses, sunglasses, hearing aids, helmets, etc.
    • Phones, keyboards, keys, FOBs, jewelry, wallets, purses, etc.
    • Car steering wheel, gear shift, dashboard buttons, seatbelts, etc.
    • Doorknobs, light switches, chair arms, appliances, pens, etc.
    • Salt and pepper shakers, mailed envelopes and boxes, etc.
  • Avoid self-inoculation of others’ pathogens:
    • Avoid completely touching your face, eyes, nose and mouth
    • Put on clean clothes upon arriving home at the end of each day
    • Avoid using footwear worn outdoors inside your home
    • Avoid sharing use of eating utensils and cups with others
  • Avoid aerosolization of your own pathogens:
    • Cough always into your elbow
    • Sneeze always into a disposable tissue, and throw the tissue into the trash
  • Apply the principle of ‘Social Distancing’:
    • Avoid sustained presence of others within 6 feet of your person
    • Avoid hugs and kisses in casual interpersonal interactions
    • Avoid shaking hands or exchanging ‘high-fives’
  • Avoid all international travel and all travel to ‘hot spot’ areas within our nation (currently Washington, New York, Washington DC and Massachusetts)

Summit Medicine and Pediatrics also recommends that the following action be taken and important information be obtained from EVERY person with whom you anticipate passing time in close proximity (within 6 feet) for more than a few minutes. For example, these recommendations apply to every person whom you meet in passing, who arrives at your workspace or at the front door of your home, or who approaches you in a common or public area.

When approached by any other person, or when approaching others, in passing, take the following action:

  • When approaching others, maintain a minimum distance of 6 feet from others at all times
  • When approached by others, say ‘STOP’; instruct others to remain outside of a 6 foot radius from you
  • Explain that you are maintaining a safe ‘Social Distance’ to prevent the spread of COVID-19
  • Always avoid congregating and lingering within groups of 10 or more

When inviting visitors into your home or workspace:

  • Take the Temperature of Your Visitor. Carry with you a thermometer at all times. The temperature of your visitor should be taken by temporal or ear thermometer, and if your visitor has a temperature >100.4 degrees Fahrenheit, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space. This is particularly important when you are within enclosed or confined spaces. Always remember to sanitize your thermometer after each use!
  • Ask Your Visitor the following 5 questions:
    • Have You Had a Fever in the Last 14 Days? If your visitor states that s/he has had a fever, for ANY reason at all, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space. A report of fever can be either objective (measured) or subjective (felt). If your visitor states s/he doesn’t think so, and hasn’t checked, it is reasonable to accept the proximity to your visitor, and to remind your visitor that s/he should measure core temperatures periodically.
    • Have You Had a Dry Cough in the Last 14 Days? If your visitor states that s/he has had a dry cough, for ANY reason at all, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space.
    • Have You Had Shortness of Breath in the Last 14 Days? If your visitor states that s/he has had shortness of breath with routine, low impact activity, for ANY reason at all, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space.
    • Have You Been within Groups of 10 of More in the Last 14 Days? If your visitor states that s/he has been engaged in the activities of groups of 10 or more, for ANY reason at all, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space. For example, those who have been at church gatherings, movie theaters, most waiting rooms, clubs and pubs, etc. would qualify as having been within groups of 10 or more.
    • Have You Been in Direct Contact with Anyone Confirmed to Have Had COVID-19 Infection? If your visitor states that s/he has been in DIRECT contact with someone who has tested positive for COVID-19, DO NOT permit your visitor to remain within your company at any distance or within any enclosed space.

Coronavirus (COVID-19) Risk Cohorts

During the COVID-19 pandemic, it is imperative to the well-being of our patients and our communities that each of us evaluate the risk of both contraction and transmission of the disease. In doing so, each of us may then apply more stringent infection control strategies to mitigate higher morbidity and mortality of disease due to the COVID-19 pandemic. SMP recommends that each person review and assign for themselves one of the following three Risk Cohorts, and consider augmenting the strategy to reduce risk for exposure and illness due to COVID-19 based upon assignment to the particular Risk Cohort. It is important to note that one’s Risk Cohort may change in the course of life, and therefore one should reevaluate and, if necessary, reassign one’s Risk Cohort periodically.

  • Risk Cohort 1: Standard Risk
  • Under the age of 65 years; and
  • Healthy; no major chronic or acute medical conditions; and
  • Low exposure; no routine exposure to large groups of people or those with illness

EXAMPLES: Most of the population

  • Risk Cohort 2: Moderate Risk
  • Over the age of 65 years; and/or
  • Healthy; with 1 major chronic or acute medical condition; and/or
  • High exposure; with routine exposure to large groups of people or those with illness

EXAMPLES: Younger retirees; retiree caregivers; medical professionals and first-responders

  • Risk Cohort 3: High Risk
  • Over the age of 65 years; and/or
  • Unhealthy; with >1 major chronic or acute medical conditions; and/or
  • High exposure; with routine exposure to large groups of people or those with illness

EXAMPLES: Older retirees; nursing home and group home residents; hospitalized patients; medical professionals and first-responders; retiree caregivers; individuals with uncontrolled diabetes, respiratory illness or cardiac disease; individuals with compromised immune systems; pregnancy

In addition to recommendations for all individuals to apply basic principles of infection control, individuals in Risk Cohorts 2 and 3 should apply (if at all possible) the following basic principles of infection control at all times:

  • Take your temperature every day, at a minimum, and at any time you feel ill; if your temperature is above 100.4 degrees Fahrenheit once, place yourself in isolation and seek medical evaluation promptly
  • Utilize isolation equipment (N-95 mask, protective eyewear, isolation gown and surgical gloves) to mitigate the risk for exposure to COVID-19 if unable to remain in isolation or if required to interact with moderate or high risk individuals
  • Clean and sanitize professional and personal equipment, furniture and supplies daily
  • Avoid all non-essential travel within the community

Coronavirus (COVID-19) Monitoring and Testing Recommendations

Principles for Monitoring and Testing

COVID-19 is a virus that is highly communicable, highly deadly, and it is spreading broadly throughout the world.  There is no question that most Americans, if given the choice to do so, would prefer to be tested upon demand for infection with this pathogen. They would do so both to ensure that they are safe from illness due to COVID-19, and to reassure friends and family that they pose no risk to spread the virus to others.  Such testing, if made available to be administered in a broad manner throughout the nation, would certainly be a vital component in a comprehensive plan to reduce the spread of disease and death due to the virus.

Unfortunately, our ability to test for COVID-19 infection is currently limited. First, at the outset of the pandemic, the test method for the novel Coronavirus required CDC oversight, and it wasn’t until February 2020 that the CDC authorized private laboratories across the nation to run the test. Second, the materials required to run the test are supplied, in part, through China and other countries whose factories and economies are already devastated by the COVID-19 pandemic. Now that the availability of the COVID-19 test is gradually improving, it is likely, in the coming months, that recommendations for testing expand to include many who are asymptomatic.

For questions about whether or not you qualify for a test for COVID-19 infection, contact Dr. Mike at 480-981-9000.

Maricopa County Department of Health (MCDH) Recommendations to Reduce Risk of Exposure to COVID-19.

The MCHD has advanced specific recommendations and guidelines for prevention of COVID-19 illness and spread: Maricopa County Health Department

If you HAVE, THINK YOU HAVE, or HAVE BEEN TESTED FOR COVID-19 infection, you should immediately:

  • Stay at home except to get medical care. Do not go to work, to school, or to public areas, and do not use public transportation. Do not make social visits to the homes of others, and in particular, do not visit with anyone in Risk Cohorts 2 or 3.
  • Call ahead before visiting your doctor or any medical facility. It is vital that doctor’s offices and medical facilities are given prior notice of your arrival so as to facilitate isolation upon your arrival. Wear an N-95 face mask when arriving at a medical facility.
  • Separate yourself from all other persons in your home. Establish your own room of isolation with access to your own bathroom, if possible.  Minimize personal, proximal interaction at all times.
  • Wear an N- 95 face mask whenever it is unavoidable to be in the same room with others and whenever visiting a healthcare provider or a healthcare facility.
  • Avoid sharing household items with others, dishes, cups, eating utensils, mobile telephones, keys, bedding, etc.
  • Cover coughs and sneezes into elbows or into disposable facial tissues.
  • Wash hands with soap and warm water 15-20 times per day.
  • Avoid touching eyes, nose and mouth in casual, non-sanitized fashion.
  • Sanitize daily flat and frequently-touched surfaces, doorknobs, drawer handles, etc.

Once you’ve applied the recommendations for isolation above, take the following action:

  • If not tested for COVID-19 and you have non-compatible symptoms (no fever, no dry cough, and no shortness of breath with routine activity) and you:
    • Have NOT traveled to COVID-19 ‘hot spots’ in the previous 14 days, and have NOT been exposed directly to an individual who is confirmed to have COVID-19:
      • Remain at home in isolation precautions for 24 hours AFTER fever and all remaining symptoms of acute illness are completely resolved; contact Dr. Mike directly for additional medical advice if symptoms worsen
    • Have traveled to COVID-19 ‘hot spots’ in the previous 14 days, or have been exposed directly to an individual who is confirmed to have COVID-19:
      • Remain at home in isolation precautions for 7 days from specimen collection OR until 72 hours after fever and symptoms of acute infection resolved completely, whichever is longer; at present, repeat testing is not advised; contact Dr. Mike directly for additional medical advice if symptoms worsen
    • If not tested for COVID-19 and you have compatible symptoms (fever, dry cough, and shortness of breath with routine activity) and you:
      • Have NOT traveled to COVID-19 ‘hot spots’ in the previous 14 days, and have NOT been exposed directly to an individual who is confirmed to have COVID-19:
        • Remain at home in isolation precautions for 72 hours AFTER fever and all remaining symptoms of acute illness are completely resolved; contact Dr. Mike directly for additional medical advice if symptoms worsen
      • Have traveled to COVID-19 ‘hot spots’ in the previous 14 days, or have been exposed directly to an individual who is confirmed to have COVID-19:
        • Remain at home in isolation precautions for 7 days from specimen collection OR until 72 hours after fever and symptoms of acute infection resolved completely, whichever is longer; at present, repeat testing is not advised; contact Dr. Mike directly for additional medical advice if symptoms worsen
      • If tested for COVID-19 and awaiting results:
        • Remain under home isolation precautions until results are reported (3-5 days with further delay depending upon the volume of testing processed in the laboratory); contact Dr. Mike directly for additional medical advice if symptoms worsen
      • If tested for COVID-19 and POSITIVE:
        • Remain at home in isolation precautions for 7 days from specimen collection OR until 72 hours after fever and symptoms of acute infection resolved completely, whichever is longer; at present, repeat testing is not advised; contact Dr. Mike directly for additional medical advice if symptoms worsen
      • If tested for COVID-19 and NEGATIVE and you have compatible symptoms (fever, dry cough, and shortness of breath with routine activity):
        • Remain at home in isolation precautions for 72 hours AFTER fever and all remaining symptoms of acute illness are completely resolved; at present, repeat testing is not advised; contact Dr. Mike directly for additional medical advice if symptoms worsen
      • If tested for COVID-19 and POSITIVE:
        • Remain at home in isolation precautions for 7 days from specimen collection OR until 72 hours after fever and symptoms of acute infection resolved completely, whichever is longer; at present, repeat testing is not advised; contact Dr. Mike directly for additional medical advice if symptoms worsen

Summit Medicine and Pediatrics recognizes that the COVID-19 pandemic is changing rapidly, and that recommendations for reducing risk of transmission and illness, and for testing of this disease, must be reviewed and revised constantly. We are committed to providing our patients and our community with the most accurate and up-to-date information regarding the COVID-19 pandemic.

Dr. Mike and The Summit Team

© 2020 Summit Medicine and Pediatrics | All Rights Reserved

Call to schedule your no-cost, no-obligation meeting with Dr. Mike to see if Direct Access Medicine© care is right for you and your family!

480.981.9000 | 6828 E Brown Rd. #102 | Mesa, AZ 85207

CONTACT