Day 9 of SIP [shelter in place] is coming to a close, and there is much to share with all of you:

• Los Angeles Public Health Department has retracted yesterday’s report of a pediatric fatality from COVID-19, and we are not aware of any local pediatric fatalities from COVID-19
• There is evidence that California is seeing a much slower rate of rise of COVID-19 infections which is very good news! Local experts are still expecting numbers to rise, local hospitals are still planning for a surge in patients, and following CDC and local county guidelines about social distancing/shelter-in-place is even more important now.
• We are getting lots of questions about whether it is safe to use ibuprofen right now, and there are a lot of internet warnings based on the 3/14/20 statement from the French Minister of Health. As of 3/18/20 the World Health Organization stated “based on currently available information, WHO does not recommend against the use of ibuprofen.” Experts in the USA continue to review the research but have NOT issued warnings about using ibuprofen as of today. If you have further concerns or questions we encourage you to reach out to your doctor at PWG.
• Testing remains very limited in our area, we do not have access to unlimited tests for COVID-19 and are referring to local test centers. They are telling us they also have very limited access to testing and are following CDC guidelines to decide who gets tested. These include: if you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 than testing may be indicated.
• keeping our staff safe while staying open to serve our patients and families is our priority; we have made changes to PWG protocols so please see our 3/23/20 update for details
• we encourage you to use the patient portal which allows you to communicate with us via email. We are actively working on a way to have families sign up for the portal without having to come into the office and will announce those details on our website, Facebook and Instagram pages
• We want to thank all of our families for doing their part in keeping our kids and our community healthy by following health department directives and NOT walking in to our office without calling us first.

We wanted to take a moment to acknowledge the hard work and dedication of our staff.  Mary Kate, our intrepid medical assistant, sewed masks for all of us this week! Team PWG is here for our families and our community, we are strong and we will get through this!

 As day 8 of SIP [shelter in place] comes to a close we are hearing more news of rising COVID-19 cases both nationally and locally.  As of today there were 1023 confirmed cases in the Bay Area while Los Angeles reported the first possible pediatric death from COVID-19. Many of our area hospitals are ramping up planning for surge patient volumes, but we still have very limited testing capacity. Items we want to share:

• keeping our staff safe while staying open to serve our patients and families is our priority; we have made changes to PWG protocols so please see our 3/23/20 update for details.
• we encourage you to use the portal which allows you to communicate with us via email. We are working on a way to have families sign up for the portal without having to come into the office and will announce those details on our website, Facebook and Instagram pages.
• we do not have access to unlimited tests for COVID-19 and are referring to local test centers. They are telling us they also have very limited access to testing and are following CDC guidelines to decide who gets tested. These include: if you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 than testing may be indicated.
• We want to thank all of our families for doing their part in keeping our kids and our community healthy by following health department directives and NOT walking in to our office without calling us first.
• here are 2 online tools to help you determine if you need to be seen and/or tested for COVID-19:
  • the CDC and Microsoft have collaborated to create a coronoavirus self-checker
  • Vital, a digital platform for emergency care, launched a Coronavirus checker on 3/20/20

We wanted to share this picture of Krystal, one of our fantastic MAs, who has been doing a very deep clean of our entire office.  Team PWG is committed to the health and well being of our staff, patients, families and community. We are strong and we will get through this!

Week 2 of SIP begins…and we are making some changes to our office protocols to keep our staff and our patients as safe as we can during this outbreak. We are monitoring both the national and local situation closely and will continue to adjust our workflows as needed.

Effective immediately:

• • we will be limiting the number of people present at an appointment to the child being seen and 1 parent/guardian.
  • we will be taking everyone’s temperature as they enter our office.
  • we will be making telemedicine appointments for all sick visits, based on that visit you and your doctor may decide to treat at home, bring your child to the office, or be referred to the right place for the right care.
  • we will continue to see well visits for infants and toddlers 18 months and younger to keep them on track with their vaccines as per the AAP guidelines.
  • we are not making any well visit appointments for kids 2 years and up right now.

Like everyone in health care we face shortages of PPE [personal protective equipment], Team PWG is being creative at making what we have work for us right now. We are grateful to all of you for your patience and understanding, we are a strong community and we will get through this!

COVID19_flowchart_03.18.20

Day 4 of SIP [shelter-in-place], TGIF!

Today the Governor announced the legal order requiring all Californians to stay at home in order to try and slow down the spread of COVID-19. We want to thank all of our families for doing their part in keeping our kids and our community healthy by following those directives and NOT walking in to our office without calling us first. News we wanted to share:

• As of 3/19/20 there were 18 cases of COVID-19 in pediatric patients 0-17 years in the entire state of California
• We are not aware of any local pediatric fatalities, all of our local experts are telling us that COVID-19 is less severe in kids than adults.
• There is still very limited pediatric testing in our area, we do not have access to unlimited tests. We have included an infographic published by the California Health Department which follows current CDC guidelines. We are seeing patients via video visits and if someone meets the criteria for testing we are working to arrange testing, we want you to get the right care at the right place.
• Current CDC criteria for testing are: if you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 than testing may be indicated. Local hospitals have limited COVID-19 testing capacity and are following CDC criteria to make final decisions about who gets COVID-19 testing.
• There are several fantastic resources to help families find healthy ways to stay connected with “the outside world”, we are sharing some of our favorites:

• • Audible has free stories available for all kids to enjoy
  • The AAP’s Healthy Children website has some great tips on working and learning from home
  • you can tour some of the best museums in the world without leaving your living room
  • you can take free art classes at home
  • public television has great At-Home learning resources

We are working hard to make sure we can keep our staff safe while continuing to serve our patients, and will post updates regularly, we appreciate your patience and understanding! We are a strong community, we will get through this, and Team PWG is here for you!

As Day 2 of SIP [shelter in place] comes to a close we wanted to give you a quick update:

• We are grateful to our patients and families for following current public health guidelines about COVID-19 and NOT walking in to our office without calling us first. Thank you for doing your part in keeping our kids and our community healthy!
• Current CDC guidelines are: if you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 please call our office to set up a video visit. Local hospitals have limited COVID-19 testing capacity and are following CDC criteria to make final decisions about who gets COVID-19 testing. We can help guide you to the right place for the right care.
• We are being asked to refer patients to local testing sites since COVID-19 tests are still in short supply. We will update you if that changes.
• Some of you have asked very good questions on our social media pages, please be aware we cannot respond to anyone directly due to HIPAA constraints.
• We can sign you up for the patient portal which allows you to contact your specific doctor via email, we’ve got information on our blog, or you can call us and we’ll walk you through it.
• Pediatric data about COVID-19 in patients from China was published this week, bottom line: the disease is less severe in kids than adults, and as of today there were NO fatalities in pediatric patients 18 years or younger in the USA. We continue to follow COVID-19 updates closely and will be posting more details in future posts.

And finally we wanted to share a picture of our office St. Patrick’s Day lunch while practicing social distancing…we can stay connected while staying apart 🙂 Team PWG is here for you as we get through this difficult time together.

Stay well, stay home and stay kind!

6 Bay Area counties have enacted a “shelter in place” order from 3/16/20 to 4/7/2020 to try and slow down the spread of COVID-19.  Everyone is asked to stay at home except for essential services, hospitals and medical facilities are currently exempt. This is a critical moment for us in California, together we CAN slow down the progress of COVID-19 and avoid a breakdown in our medical system. PWG is open today and here’s our update:

• If you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 PLEASE DO NOT WALK IN, that is putting everyone at risk. Please call us and we can help triage you to the right place for the right care.
• Our goal is to get you into a room as quickly as possible. If there are no rooms available, we ask you to give us a number to call you and wait in your car. We will call you when it’s time to come in.
• we are cancelling all well visits for children older than 18 months. Infants and toddlers need to stay on track with their vaccination schedule so we are asking you to continue to come in as planned. We will let you know if this changes.
• we have cancelled all “immunization only” appointments except for influenza vaccination. We are still seeing influenza cases, the CDC is still recommending influenza vaccines to help protect people and conserve medical resources by having fewer serious cases. We have a small supply in stock and will continue to make appointments for the flu vaccine until we run out.  If your child has not gotten the flu vaccine yet please consider making an appointment and getting them vaccinated.
• we can make telemedicine visits for families who prefer not to come in. We can map out a plan to make sure your child gets the right treatment at the right time at the right place.
• we are actively reaching out to sign people up on our patient portal. Please contact our office for information, the portal is a way for you to communicate with us via email.
• We will NOT be handing out stickers, suckers, or toys
• We will not have coffee or apples available
• have a Happy St. Patrick’s Day 🙂

Team PWG is here for you and your family as we all navigate these difficult times, we are a strong community and we will get through this. Be kind, and stay well!

San Mateo County has enacted strict limits on gatherings of people. Hospitals and medical offices are exempt; Team PWG wants to be proactive in reducing infections. We will be updating our office policies effective immediately:

• If you or your child have a fever AND a cough AND trouble breathing AND/OR travel to a hotspot AND/OR known exposure to COVID-19 PLEASE DO NOT WALK IN, that is putting everyone at risk. Please call us and we can help triage you to the right place for the right care.
• Our goal is to get you into a room as quickly as possible. If there are no rooms available, we ask you to give us a number to call you and wait in your car. We will call you when it’s time to come in.
• We are setting aside blocks of time for certain sick visits [kids with respiratory infections such as cough, runny nose, fever]:
  • 9 am-10 am Monday to Friday
  • 5:30 pm-7:00 pm Monday to Thursday, 4 pm-5 pm Friday
• If you cannot come during those times, we will make an appointment for a video visit first. We can map out a plan to make sure your child gets the right treatment at the right time at the right place.
• Our front desk can help you sign up for the patient portal, this will allow you to communicate with us via email.
• We will NOT be handing out stickers, suckers, or toys
• We will not have coffee or apples available

The entire PWG team is committed to our community’s health and well being. We will be monitoring the situation closely and will update you regularly.

As many of you know, the WHO has declared COVID-19 to be a pandemic today, we have been getting many phone calls about this and we understand that many of you are feeling anxious and overwhelmed about what is going on.  There has been a flood of news about COVID-19, and the situation is changing rapidly. This what we know today:

• San Mateo County has 15 cases of COVID-19 with no deaths. Santa Clara County has 48 cases with 1 death. San Francisco County has 14 cases and no deaths. We are not aware of any local reports of pediatric fatalities.
• Today San Mateo County health officer Dr. Scott Morrow published an excellent update that focuses on 3 key areas: Individual and community preparations should focus on three tasks—reducing each person’s chance of getting sick… helping households with basic survival needs during a pandemic, and minimizing and coping with larger disruptions in how the normal day-to-day world works. 
• San Mateo County Health Department’s advice about not getting sick states that steps to prevent the spread of flu will also guard against the spread of COVID-19: cover your cough and sneeze, wash your hands frequently, avoid shaking hands and touching your face with unwashed hands, and if you are not feeling well or are experiencing cold, flu, or other symptoms, stay home from school or work. 
• We do NOT have access to unlimited testing for all patients for COVID-19. We are being advised that these are being prioritized for high risk patients: 1) those with a high fever, cough and trouble breathing 2) known exposure and high risk symptoms.  If we feel a test is indicated we are calling the county health department for guidance.
• We have actively been planning and working on internal procedures to help minimize exposure risks for patients, families and our office staff. You can help us by letting us know if your child has a high fever, cough or other risk factors. Please call us and we can work out a plan together.  Please do not walk in to the office as this puts everyone at risk.
• At this time we are not being advised to cancel routine well visits or defer sick visits. However, many of you are uncomfortable about visiting a doctor’s office with the current outbreak. We can arrange for video visits if needed, we can reschedule visits, and we can also sign you up for patient portal access which allows us to communicate via email. We are here to help all our patients and families through this uncertain time.
• Prevention is the key, and being prepared will help us all feel better about facing the challenges that lie ahead. This is a good time to update your earthquake survival kit, make sure you have enough supplies of key medications and supplies [for example enough diapers and formula to last 2 weeks, any prescription medication or over-the-counter medication that you use regularly, etc.], update emergency contact numbers, be prepared for events/school to be cancelled, review travel plans and consider alternatives.
• some helpful links: CDC coronavirus update, WHO coronavirus update, San Mateo County Health Department, Santa Clara County Health Department, Healthy Children AAP update.
• We will post regular updates to our pediatric wellness group Facebook page, twitter @pwgrwc, and Instagram @pwgrwc.

Remember: we are a strong community, we can and will get through this!

The best advice in a nutshell…

We’ve been getting many calls asking for information and guidance on what to do during the current coronavirus [COVID-19] outbreaks. We’ve assembled information from multiple resources and will update this as we know more. Feel free to share with your network as well!

As of today the health department has not told us to advise parents to keep their children at home instead of sending them to school. We are being asked to advise parents and patients to practice the following:

• Frequent handwashing [preferably for 20 seconds each time] and/or using alcohol-based hand sanitizer with at least 60% alcohol
• Try to avoid touching your face or mouth
• Try to avoid handshakes/close contact/hugging especially with people who are sick [Elbow taps instead of high fives, etc.]
• Cover your cough or sneeze with a tissue, then throw that tissue away and wash your hands
• Try and maintain some distance between yourself and other adults [3 to 6 feet] obviously for little children this will be very difficult to enforce.
• If you are sick stay home, do not go to work/school
• Clean/disinfect objects and surfaces you touch frequently [phones, door handles, toys, etc.]
• Check with your school or local health department for any school closures/known exposures
• Wearing a mask is not recommended, and most masks will not stop COVID-19
• Call us if your child is having a fever > 102, respiratory symptoms and trouble breathing.
• Call us if you have a known exposure to COVID-19 [you will be notified by the CDC or your local health department if this is the case] or are at higher risk due to recent travel [China, South Korea, Japan, Italy, Iran, Washington state].

Call our office at 650.216.7794 if you are concerned and we can help guide you to the right place to get the right testing and the right care. Please do not walk into the office as we may have to send you to another facility since we cannot test for COVID-19 in the office.

We recommend these resources for additional information:

• US Centers for Disease Control and Prevention
• Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and children
• California Department of Public Health
• AAP Healthy Children
• Alameda County Health Department
• San Francisco County Health Department
• San Mateo County Health Department
• Santa Clara County Health Department

PWG will be closed on Monday February 17, 2020 for President’s Day

We will resume normal business hours on Tuesday 2/18/2020

Click here for more information on After Hour Pediatrics for urgent care needs.