Dear August Pediatric patients and families,

We understand the growing concern surrounding the Coronavirus (COVID-19) across the communities we serve. The health and safety of our patients, families, staff, and physicians are our top priorities. August Pediatrics has been preparing our office and employees to identify possible patients with COVID-19 virus and to prevent transmission to themselves, other patients, and visitors.

Please read the following important information regarding COVID-19, our training and response, additional sources of information, and actions you should take in the event your child is sick.

Patients with Upcoming Appointments

We ask that only one caregiver accompany a child/patient to the office appointment at this time. If this caregiver or the patient has traveled internationally, traveled on any cruise ship, has been exposed to someone with COVID-19 in the last 14 days, or is experiencing any of the COVID-19 symptoms of fever, cough, or shortness of breath, you MUST call our office to be advised on how to proceed further. We will be screening every patient and caregiver at check-in to identify and limit potential exposure to COVID-19 in our clinic.

A Note to our High Risk Patients

As the virus continues to spread, we want to protect and safeguard our most vulnerable patients and caregivers – the elderly and people with serious chronic medical conditions like heart disease, diabetes, and cancer. If you are the caregiver of a child and are elderly, or if your child is at risk because of a chronic disease or immune deficiency, please either arrange for a different caregiver to bring the patient to the office, or postpone and reschedule the patient’s non-urgent visits to a later date.

How is our staff being trained and how is August Pediatrics monitoring the situation? Our staff has been trained in infection control practices, standard precautions, and hand hygiene. The administration at our office is keeping up with and following the recommendations of the CDC, WHO, and state and local health departments.

How is August Pediatrics preparing for COVID-19?

• Our primary duty is to safeguard the health and well-being of our patients and staff by preventing the spread of the infection at our office.

• We are continuously monitoring, reviewing, and improving our response as the situation evolves.

• We are keeping all employees updated with any new recommendations for preventing the spread of COVID-19.

• We are encouraging sick employees to stay home.

• We are increasing awareness of all of our staff to be alert for signs and symptoms of COVID-19.

• Our practice employs proper environmental cleaning techniques.

• We are practicing safe hand hygiene.

• We are proactively alerting patients who are ill with suspected COVID-19 or who have been exposed to someone with known COVID-19 to stay home and self-quarantine.

• We are asking our well child patient visits without upper respiratory symptoms like fever, cough, runny nose or congestion to arrive through the back door of our office so you can be placed directly into a room, avoiding the waiting room completely.

• We are also notifying our patients and their caregivers that we cannot give advice regarding the safety of travel for patients and families. Patients and families are advised to utilize the advice of the CDC found at the website listed at the end of this letter.

• We have removed all magazines, toys, and books from our waiting rooms to mitigate spread of the virus by inanimate objects.

• Our medical supplies that we use to keep our patients and staff safe are in critically short supply. We ask that parents and caregivers monitor their children and do not allow them to touch or use supplies in our exam rooms because we may have difficulty restocking these supplies. If we do not have medical supplies to keep our patients and staff safe, then we will be forced to close our office until new supplies can be obtained.

COVID-19 symptoms Signs and symptoms may appear 2-14 days after exposure and can include:

• Fever

• Dry cough

• Shortness of breath

The severity of COVID-19 symptoms can range from very mild to severe. These symptoms are similar to those seen with seasonal influenza, though influenza cases are starting to lessen in this community. At this time, the CDC is noting that children are tending to be less intensely affected by the virus and are less likely to develop severe disease.

It is important to understand that, at this time, the CDC and state health department are not recommending routine testing for COVID-19. Our office does not have and does not offer testing for COVID-19, and the health departments have limited testing kits ,usually reserved for the most severe hospitalized patients.

If you are concerned that you or your child has COVID-19 and your symptoms are mild, the CDC recommends that you do NOT come to the pediatrician’s office for care. The virus is self limited in the vast majority of cases and will resolve without additional care. By coming to the office, you potentially expose multiple other children, caregivers, and staff to the virus, thus potentiating spread of the virus in the community.

You may call our office for medical advice on how to care for your child with COVID-19 symptoms. If you are concerned about your child’s severe symptoms and wish to go by ambulance to the ER, local ER departments are asking that patients notify the 911 dispatcher of their risk factors for COVID-19.

Practice Everyday Prevention

As you and your child touch people, surfaces, and objects throughout the day, you accumulate germs on your hands. You and your child can infect yourselves with these germs by touching your eyes, nose, or mouth. There is currently no vaccine available to prevent infection with the new coronavirus, but you can takes steps to reduce your risk of infection.

CDC and WHO recommend following the standard precautions for avoiding respiratory viruses:

• Avoid close contact with people who are sick.

• Avoid touching your nose, eyes, and mouth.

• Stay home when you are sick.

• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

• Wash your hands with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing, or sneezing.

• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.

• Always wash hands with soap and water if hands are visibly dirty.

• Avoid sharing dishes, glasses, bedding and other household items if you’re sick.

• Clean and disinfect surfaces you often touch.

• Stay home from work, school, and public areas if you’re sick.

The CDC has developed a website with the most current information and advice concerning COVID-19. Please refer to this website for the most up-to-date recommendations: https://www.cdc.gov/coronavirus/2019-ncov/index.html

And finally, please be aware that we will do everything we possibly can to mitigate the spread of COVID-19 within our office and our community, but if severe situations arise, we may be forced to change our patient schedules, or even temporarily suspend patient visits and close our office. We will make every effort to notify you if it is necessary for us to temporarily close our practices.

Together, we can help keep COVID-19 from spreading to our precious patients, families, and staff. Please be patient as we make necessary policy changes based on the latest CDC recommendations. We have you, your child’s, and our staff’s health as our first and primary concern.

Sincerely,

The staff at August Pediatrics