As you are doubtlessly aware, there has been a dramatic increase in COVID19 cases across the country. Governor Wolf has issued an executive order requiring all citizens to wear nose and mouth coverings when outside your home. In addition, people entering Pennsylvania from the following states, including popular tourist destinations, must quarantine for 14 days:
Alabama Arizona Arkansas California Florida Georgia
Idaho Louisiana Mississippi Nevada North Carolina
South Carolina Texas Tennessee Utah
Quarantine requires the individual to have *no* direct contact with others outside of the household, regardless of whether symptomatic or not. Those who have symptoms must quarantine for 10 days after the onset of symptoms *and* be fever free for 10 days, *and* have improving symptoms over three days. Please note the onset of symptoms resets the clock for quarantine.
Symptoms recognized by the CDC as associated with COVID19 include but are not limited to:
headache dizziness confusion loss of taste loss of smell
congestion sore throat cough shortness of breath diarrhea
fatigue skin changes blood clots
If you develop any of these or other symptoms please DO NOT present to the Emergency Department or Urgent Care, but notify us immediately. We will provide direction for testing and treatment.
Please be advised that the rapid increase in cases has not been matched by a rapid increase in available tests, supplies, and protective equipment. We are therefore forced to continue vigorous rationing of tests and supplies. This may result in an inability to be tested for exposure, even if this is required for return to work. In this event we will provide documentation to support protection of your employment.
We note that rapid and antibody tests are continually being released to the public and continue to have significant issues with accuracy. We urge you to follow our clinical recommendations and avoid reliance on dubious testing for personal decision making. While many vaccines are in development and “A” vaccine will likely be available within the year, it is doubtful that “The” vaccine — one that will provide universal, effective, and long lasting immunity to COVID 19 — will be forthcoming for many months if not years.
We continue to closely follow emerging science and recommendations that they may inform our policies and procedures. These particulars are designed to provide maximum access to medical care while minimizing safety risks for all concerned. As such we are so very grateful for your continued patience and understanding in this unprecedented and dynamic situation.
Stay well, Stay Masked, Stay Home.
What are you doing to keep yourselves healthy?
In the office, all staff are checking their oral temperatures twice a day. Anyone with a temperature greater than 99.4 without symptoms or with symptoms of any type will be sent for testing and quarantine. We work in small teams which do not overlap in the office to limit physical exposure.
Since March 14 we have adjusted our office practices. Virtual technology is being used when appropriate. If you are seen in the office, you will note that you will be required to mask and the staff will maintain a masked distance of 6 feet from each other and from you. If you need to be touched, staff members will don gloves, a surgical mask, eye protection, and other personal protective equipment. If you need to disrobe, you will be seen in the office. Otherwise you may be seen in our "Doctor Drive-Thru" tents. These actions are intended to reduce the risk of transmission of the virus between individuals. Wearing a mask does not indicate that an individual is sick. Importantly, nor does having no symptoms indicate that a person is not infected or infectious.
Reopening Strategy: Physical/wellness exams and procedures continue to be scheduled in a strategic and staged fashion. If you are due for or have had to reschedule a wellness or procedure appointment, please call the office to make an appointment. Please note that appointment dates, times, and modes are subject to change, particularly as COVID19 cases surge. We appreciate your ongoing flexibility and patience as staff levels, regulations, and equipment availability are in constant flux.
Routine follow up appointments will be conducted at scheduled times by virtual or in-person means (please note these times are very likely to change). You will receive a call from the office with instructions at your scheduled date and time. All sick visits and calls will be triaged by our staff and instructions given at that time. Please note that all visitors to the property are required to wear nose and mouth coverings.
In person visits will be conducted in the office and by "Doctor Drive-Thru" (tents constructed in the parking lot). This procedure is designed to ration supplies, limit sterilization needs, and allow for patient privacy, all while maintaining the physical distance required to limit the spread of COVID19.
The doors to the office will remain locked. When coming to the office for any reason, please remain in your car and call the office to notify us of your arrival. You will be greeted outside by one of our staff.
You are asked to address all medical concerns by telephone or portal to our office. We encourage you to utilize your portal for communication, which can be accessed through this website on the HOME button. Please do not use an outside Online Urgent Care, present to an Urgent Care, or go to the Emergency Room without being directed to do so by one of our staff. Please be advised that we check both telephone and portal messages throughout the day and response time will vary based on urgency.
Healthcare providers are being asked to make some very difficult and, let's face it, unpopular decisions and recommendations at this time. The thrust is to conserve equipment, conserve medications, conserve emergency resources, and conserve personnel. While we in the US fervently hope that our efforts at social distancing will result in our not realizing the effects that COVID-19 is having on our worldwide neighbors, the painful lesson they offer is "be prepared". Let us stick together by staying apart!
It has been reported that there are triple the number of OPIOID related deaths in March 2020 compared to January 2020, and triple the number of OPIOID related deaths in March of 2020 compared to March of 2019. If you or someone you love has an OPIOID problem, please seek medical help immediately.
Asking for Help:
We recognize that some in our community are without local family or resources. If you need, or someone you know who is a patient of our practice needs, help with getting food, medications, or other life sustaining assistance during quarantine or "shelter in place" orders, please call our office. We are coordinating assistance delivered by our staff to patients in need. In addition, if you are having difficulty paying for your medications, please notify us.
COVID-19 Facts updated 7/3/2020
What happens if I get sick?
The recommendation is to call us. If we feel you are at risk for COVID 19 we will refer you for testing. If you have mild disease that can be managed at home, this is what will occur. If you are seriously ill you will be referred for hospitalization.
We do well to remember that other medical conditions continue to occur. Interestingly we have in recent weeks seen a number of unusual cases and unusually severe complications. Whether this is related to COVID is unknown.
Both York Hospital and UPMC Memorial Hospital are observing strict precautions to sequester non-COVID patients from potential COVID exposure.
As always, if you develop any symptoms of concern please notify us immediately. We are available 24/7/365.
The above is the best information we have available as of 12.00 pm 7/3/2020. Please check back frequently for updates. For additional information, a series of (home produced) short informational videos featuring Dr. Johnson has been posted on our Facebook page.
For more information, please visit the following websites:
CDC Coronvirus FAQs:
Avoiding Coronavirus spread in homes: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%Fcoronavirus%2F2019-nov%2Fguidance-prevent-spread.html
Where Coronavirus came from:
Hospitals and surgical centers are beginning to schedule non-urgent procedures.
In the setting of the global COVID19 pandemic it is our recommendation for you to consider postponing any elective surgery or procedure.
Please read below our recommendations for activity prior to your surgery. Our intent is to minimize the risk for any COVID related complications of your procedure and recovery.
If you have had direct contact with any person confirmed COVID positive in the 30 days prior to your procedure, please postpone.
If you have any new symptoms that develop within 14 days of your planned procedure, please postpone. New symptoms can include but are not limited to: fever, chills, headache, confusion, excessive sleepiness, loss of smell or taste, cough, sore throat, activity intolerance, shortness of breath, irregular/fast/slow heartbeat, persistent nausea, diarrhea, weakness, body aches, numbness, or tingling.
You should be tested for COVID19 between 1 and 5 days prior to surgery. Directly after you
receive your test, you should observe a full quarantine until your procedure. This means
do not leave your home,
do not come into contact with anyone outside of your household,
take contactless delivery of any food, mail, and shopping items.
Do not allow visitors during your hospitalization. If you will be going to a rehab facility after
your procedure, do not allow visitors.
These recommendations apply specifically to procedures planned for the duration of the COVID19 pandemic. Adherence to these recommendations does not in any way guarantee that you will not be affected by COVID 19 at any time. COVID19 is in the community and its behavior is still not well understood, particularly in people undergoing non-life sustaining procedures.
Your best chance of avoiding illness Is to wear nose and mouth covering in public, maintain physical distance from others, defer any group gatherings, and limit your activities away from home.
As always, we are here to support and assist you.
What about the News?
There are several items in the news that can be confusing, and there is a great deal of misinformation circulating. We will address here items of scientific interest.
Medications: It appears as though taking some medications may increase the risk of serious COVID-19 disease. These include Inhaled Corticosteroids (such as FLOVENT, SYMBICORT, ADVAIR) and immune suppressing agents such as biologics and chemotherapeutics. NSAIDs (such as IBUPROFEN, NAPROXONE, and ASPIRIN) lower the body temperature and may mask a fever, which can indicate CORONAVIRUS infection. Please do not discontinue any mediations if you are currently taking them. Please call the office for instructions.
There is some research suggesting that the virus gets into our cells through something called an Angiotensin Converting Enzyme receptor. You might recognize this enzyme as ACE, as in “ACE-inhibitors”, a type of Blood Pressure Medicine. At this time there is no evidence that taking ACE inhibitors or their molecular cousins ACE Receptor Blockers (“ARBs”) has a direct effect on COVID-19. Please do not discontinue these medications if you are currently taking them.
Recent studies conducted on using PLAQUENIL (HYDROXYCHLOROQUINE) to reduce the severity of disease after being exposed to COVID-19 have shown that this treatment may, in fact, increase the likelihood of serious disease and death. This medication will not be made available for the purposes of prevention or treatment to patients. Other methods of treatment for critically ill patients are being explored, including donation of plasma from recovered patients and REMDESIVIR, an antiviral medication. These methods are all experimental at this time
Shortages: There has been significant disruption of the supply chain for medications manufactured throughout the world. In anticipation of this, those requesting refills will be limited to a 30 days’ supply at this time. There is also a significant shortage of Personal Protective Equipment (PPE) for health care providers across the country; unavailability of PPE has caused us to delay our reopening process. Like our counterparts elsewhere, we are conserving our supply to maximize the protection of our staff and our patients. We will not be offering general distribution of these materials.
Pets: As the virus seems to have spread from animals to humans, there has been some question as to whether our pets can become sick or make us sick. While there are no confirmed cases of transmission from family pets to their humans, there have now been isolated reports of felines (cats) and canines (dogs) becoming ill from COVID19. As a result the current recommendation is that if you are sick, refrain from interacting with your pets.
Masks: Assertions that wearing face coverings will cause you to become sick by rebreathing your own virus particles or your own carbon dioxide are blatantly false. Masks have been definitively shown to reduce virus transmission between individuals. As estimates of infected persons without symptoms are in the millions, symptomatic patients may shed virus for weeks, and people may become reinfected or reactivated with the virus, we show our respect, compassion, and love for others by wearing a mask ourselves.
Vaccines: Scientists all over the world have been working tirelessly to develop a vaccination for COVID19. The current studies on safety have been conducted on fewer than 10 patients, and their efficacy has not been established. While we are hopeful that a vaccine of some effectiveness will be forthcoming, we anticipate many months will be required for adequate investigation prior to release.
As Pennsylvania and the Nation begin to enact reopening strategies, we remind you that these actions represent a capacity of the health system to manage an increased number of COVID19 cases. On behalf of our staff and all health care providers, first responders, and essential workers, those you know and love and those you don't, Please continue to observe the practices of staying at home when feasible, wearing mouth and nose covering when out for essential activities, and social distancing.
We are all beginning to imagine what the coming weeks and months will bring. It is now understood that, as a result of Executive restrictions around the country, COVID19 will affect our population regionally and in waves. How frequent and how devastating are these waves depends completely on our behavior. State and local officials are cautiously rolling out templates for relaxing restrictions, with fact-driven triggers for resuming restrictive practices when the need arises.
As stated on the home page, Security Family Medicine will continue to operate on a modified team-based schedule. We began performing in-person wellness, procedure, and routine visits on June 8, 2020. As we consider the need to preserve the safety of patients and staff while continuing to provide the best care, our biggest challenges will be how to maintain safe physical distance between individuals and how to maintain our physical spaces. Our policies includes staggered staff working in teams, using our inside and outside spaces, distributing supplies, and creative use of technology. We deeply appreciate your ongoing patience and support.
Medication shortages seem to be resolving as a result of judicious rationing of prescription amounts. We have resumed 90 day refill approvals where appropriate.
We have noted that different health systems in our region are approaching the process of resuming operations in different ways and at different speeds. At Security Family Medicine our approach is safety considerations first. We understand that our approach may result in frustration for some, and as always we value your trust in our process and our intent. As the situation is dynamic, we must remain flexible and ready to adjust our actions quickly. Complaints about local, regional, State, and Federal response to the COVID19 pandemic as well as concerns about insurance and access to care should be addressed to your government representatives.
Another restriction in COVID19 RNA test availability is being realized as case numbers increase rapidly across the country. While we do not have the ability to test everyone for a COVID carrier state, the stringent application of qualifying symptoms for testing has been relaxed. Symptoms of fever, shortness of breath, cough, loss of smell or taste, abdominal pain, diarrhea, chills, unexplained rashes, blood clots, confusion, and excessive sleepiness have all now been linked with various strains of the novel CORONAVIRUS that causes COVID19. If you have any of these symptoms, or develop any other symptoms that are unexplained, please call our office for instructions. A reminder: if you have symptoms concerning for COVID and have been tested but your test is negative, you should still follow instructions for quarantine. It is estimated that 30% of people who actually have COVID19 will test negatively. In addition, the CDC has recently extended the recommended refrain-from-contact duration to be at least 10 days from onset of symptoms, at least 3 days without a fever, AND at least 3 days of improving symptoms.
Antibody tests, some of which are being directly marketed to consumers, had been given emergency FDA approval for release. These tests have not been verified for validity, and results are compromised by the tests' inability to distinguish between the specific CORONAVIRUS that causes COVID19 and all other coronaviruses, of which there are hundreds identified. In addition, it is not known whether the presence of antibodies to the virus that causes COVID19 confers immunity. Therefore these tests are not recommended.
For more information, please visit the following websites: