Author: All Pediatrics

We have once again enabled the ability for you to schedule your well visit appointments through the patient portal.

We have also just opened up our August schedule.

Please log into the portal today to book your child’s summer checkup.  

Part 7 (4/26/2020)

Once again, my weekly thoughts on coronavirus.  As always, these are my personal opinions, and I reserve the right to revise them as new information arises.

Probably the major question facing this country is when to re-open it.  Fortunately, polls indicate that most American understand the issue and accept the need for social distancing, masks, and closures, even at personal cost to themselves.  The current recommendation is to wait for two weeks’ worth of steadily dropping new cases in a region.  We don’t have good previous experience with the virus to draw on, but this seems like a very reasonable approach to me. The numbers in Virginia continue to accelerate, so we will be in stay-at-home mode for many more weeks still. 

One of the major items you will be hearing about is the development of antibody testing, so I will devote the rest of the blog to this issue.  For example, ALLCARE walk-in clinics, a multi-state chain, will begin offering the test this week.

Antibodies are part of the body’s immune system.  They help fight off infection, and also provide immunity against being reinfected.   It can take a couple of weeks before they can be detected in the blood or saliva, so a positive test indicates that you have been infected (even if you were asymptomatic), but do not indicate whether you are actively infected, and contagious, now. For that, the current COVID-19 testing (such as we do in the office) looks for actual viral particles.

It is very important that the test not have many false negatives (saying you have antibodies, and are immune, when you are not).  If you are immune, you should be able to go about freely in the community, without worrying that you might catch the disease and/or spread it to others.  You can imagine the possible catastrophe if the test is wrong.  At this time, I have not seen data on the accuracy of the test, so I would not rely on it.

If you are immune, how long does that last?  For most viruses, assuming you are not immunosuppressed (e.g. by chemotherapy), this is life-long.  I had measles as a child, and 50 years later, blood tests showed I was still immune.  Looking at a different virus, rabies, vaccination leads the body to create antibodies which last at least two years (the immunity may be lifelong, but since rabies is almost uniformly fatal, nobody is going to do a study to see just how long it actually does last).  You may think that flu immunity only lasts one year, but it almost certainly lasts well beyond that; the problem is there is a new flu strain each year, which as far as your body is concerned is a new infection, so you need the vaccine yearly.

Having antibodies to coronavirus should be highly protective.  There could be people who get the virus twice, but I expect them to be quite rare.  There have been reports of this happening in some cases, but I feel it is more likely that the diagnosis was incorrect (our current COVID-19 test is not fully accurate) to account for this.  Ongoing studies will answer this question.

How long will natural immunity last?  We do not know that yet. However, I am confident it should last long enough to provide protection until we have a vaccine ready.  Thus, once we have an accurate enough test, it will enable people to know whether they are at risk, and how much precaution they should be taking, until the vaccine is available.

Should you get the test now, before we know how accurate it is?  I will give my answer by quoting from the ALL CLEAR walk-in clinic website itself:  Is it (the test) FDA approved?  Does positive test mean immunity?  NO!

Bottom line, this will be an incredibly valuable test, especially if it can be done in the office or perhaps even at home, but we are not there yet.

As always, good handwashing, wear your masks, and practice social distancing.  And if you are on furlough, take what advantage you can by spending more quality time (nature walks, board games, reading together, etc.) with your children.

AN IMPORTANT REMINDER: We have block scheduling to separate well children and sick children. We are calling families about 4-5 days before the appointment to reschedule the well visit to the appropriate block of time.  Our goal is to minimize any exposure to illness when your family is in our office. Our staff is cleaning exam rooms thoroughly between patients and you may wait in your car if the provider is delayed.

·        Sick visits can be done by telehealth during all office hours. If a child needs to be examined, we will see them in the afternoon schedule ONLY.

·        Since many children (and parents) are at home and due for well visits, we encourage you to schedule an appointment now to avoid the inevitable summer rush. We have appointments open now with your favorite providers 🙂

·        To minimize the number of people entering our offices and waiting areas; it is extremely important that you bring only the child with an appointment and one parent. All other family members should remain at home.

·        We ask that families wear masks to our office (for children over 2 years of age). We have a limited number of masks due to the nationwide PPE shortage. If you are unable to make or find a mask, please be assured that all of our staff will be wearing masks.

·        As your family’s medical home, we want to partner with you to provide the best care for your child. Please call us before taking your children to an urgent care clinic.

·         If you believe your child has been exposed to COVID 19 or has symptoms consistent with COVID 19, please call us to schedule a video visit. We will make every effort to coordinate testing for your child.

·        We continue to provide exceptional care in your child’s medical home.

Effective immediately, due to the COVID 19 pandemic, our Lakeridge and Alexandria offices will be closed from 12:30pm to 1:30pm and our Lorton office will be closed from 12:00pm to 1:00pm.

We will not have evening hours until further notice.

We are excited to announce that you can now schedule your telehealth video visit right from our website.

Book a video visit!

When searching for an appointment please be aware that you may select any of our three offices. Please search all three to find the time that works best for you.

Please see our other news articles for assistance with setting up the Healow app and starting a televisit.

As our nation faces this unprecedented event, we at ALL Pediatrics are striving to provide the best care possible for your families.  Although you may have many questions, we have the answers! Video visits are a great way to alleviate your concerns and allow you to have a sick visit with one of our doctor’s right from your home.  

The concerns we can address through telemedicine include:

• Infant concerns such as:
     Teething
     Feeding
     Sleeping
     Cradle Cap
     Thrush
• Constipation
• Cuts or Scrapes
• Diarrhea
• Fever over 1 year of age < 48 hours (alone or with any other symptom on this list)
• Immunization Reaction – redness, swelling, sore at site of injection
• Hand/ Foot Mouth Disease
• Pink Eye/ Eye Discharge
• Pinworms
• Rash:
     Ringworm
     Eczema
     Dry Skin, Acne
     Diaper Rash
• Insect Bite
• Runny nose/Nasal Congestion/Cold symptoms
• Sty
• Vomiting and Diarrhea less than 24 hours (over 1 year of age)
• Behavioral and ADHD consultations

How to correctly associate multiple accounts with your Healow app

By default your app will sign you into the patient account you already have associated with your Healow app.

The common mistake made is that inside of that account, if you click on the patient’s name you will see an option to link another account as seen in the screen shot below.

This is not the route that you want to take in order to add another child to your app. This would be used to add another account for the same child at a different doctor’s office.

To add another child to your app you must click on the settings button in the top right corner and select log out as seen in the screen shot below.

This will bring you to the screen below where you can select begin now to add another child. As you can see this screen will list all accounts you have associated with your app.

Once you have multiple accounts associated, when you return to the app it will default to the account you were last logged into. 

Be sure that you are currently logged into the right account, If not go to settings, and logout to display the list of associated accounts. Your credentials will be stored and you should only have to use the pin that you setup to get into each account.

We ask that all patients use the Healow app for TeleVisits.

We ask that the app be installed on your phone, as we have had less technical difficulties with that vs. on a tablet or logging into the portal on your computer. 

Logging into TeleVisit from Healow app

1.       Download the Healow app from the Android or Apple App Store

2.       Search for our practice by using our practice code AIFFAA

3.       Log into Healow app with your patient portal credentials. (If you do not know your patient portal credentials our patient services staff can provide that for you).

4.       Once logged in click on appointments

5.       In the My Appointments section, click on the TeleVisit icon under the appointment time.

6.       Click on the Start TeleVisit button on the bottom of the screen

7.       You will now see a vitals screen. If you know your child’s height, weight and temperature please enter them. If not you may skip them as well as any other vitals and hit submit vitals.

8.       Once your vitals have been submitted you will see one more screen to where you have to hit start televisit.

Once clicking start televisit please wait for the provider.

 When the provider is ready your visit will begin.

As you are aware, there is a global pandemic disease with early symptoms that are similar to the common cold and flu.  Fortunately, children rarely experience more than mild illness.  The health department and the CDC are encouraging all individuals with cough and fever to stay home.  We all need to follow these guidelines to keep families safe.  If your child has a mild respiratory illness, our nurses can help you provide home care over the phone or we can schedule a telemedicine visit.

ALL Pediatrics is committed to providing a safe environment for our families, our employees and our physicians.  With this in mind, we have made changes to our schedules for the next four weeks.  Please read the information below carefully.

·       All patients will be screened for potential exposure to the coronavirus when scheduling any type of appointment.  We will perform the screening again when you arrive in the office.  If your child has a respiratory illness and is scheduled for a well check; please call our Triage Nurse before coming for well check visit.

·       We are cancelling all WALK-IN visits to allow for better screening and appropriate placement in the schedule.  ALL APPOINTMENTS MUST BE SCHEDULED BY PHONE. If you walk into the office without an appointment, you will be advised to return to your car to call our office.

·       We have disabled the ability for patients to self-schedule for sick visits via the portal or the sick widget in order to screen patients; you may still self-schedule for well visits. 

·       We will have block scheduling to separate well visits and sick visits by two hours.  The Lakeridge and Alexandria offices will see well children ONLY in the morning and sick children ONLY in the afternoon.  The Lorton office will see sick children ONLY in the morning and well children ONLY in the afternoon.

·       We will continue to see children for well visits in a safe environment free of our sick children.

It is very important to maintain regular well check appointments to ensure that all vaccines and screening tests are completed. 

·       We will have evening sick appointments at Alexandria on Tuesday and Thursday nights ONLY.

·       To minimize the number of people entering our offices and waiting areas; it is extremely important that you bring only the child with an appointment and one parent.  All other family members should remain at home.

·       As your family’s medical home, we want to partner with you to provide the best care for your child.  Please call us before taking your children to urgent care clinics.   At ALL Pediatrics, we are working to minimize any exposure to illness when you enter our office.  As coronavirus spreads throughout our community, urgent care clinics will not be able to separate patients. Help us help you.

·       If you feel that your child needs emergency care after our office closes, please call our afterhours line so that we may help you decide if this is necessary. Adult patients are significantly more contagious than children. Additionally, we expect that the hospital systems will be overwhelmed within the next few days and hospitals need to concentrate on caring for the severely ill patients in our community. 

Our May calendar is now available!