Welcome to the ESD COVID-19 Update Page
We have created this page to keep our patients updated on the most current information regarding the COVID-19 pandemic. These updates will be both informational about the condition as well as what we are doing as a practice to support our families during this challenging time. Office procedures and updates to safety measures being adopted in the office will be posted here. Scroll down for the most up to date information.
This page is written as a blog. SCROLL TO THE BOTTOM OF THE PAGE FOR THE MOST RECENT UPDATE!
Here at ESD Pediatric Group we take the health and well-being of our patients and staff very seriously. As medical professionals we are in contact with the Ohio Department of Health, Cincinnati Children’s Hospital Medical Center, the CDC and American Academy of Pediatrics.
Our physicians have met and have formulated contingency plans to do our best to help our patients. These plans are fluid and in alignment with health department recommendations. They are being updated on a daily (sometimes multiple times a day) basis.
As health care professionals our goal is to treat and prevent adverse outcomes whenever possible. During this unprecedented time, sometimes close observation and management of minor illness at home may be a better option than coming into the office for evaluation. With that said, if your child is in severe distress or pain, it would be appropriate to be seen in the office. If managing at home and the conditions worsen, contact the office to schedule an appointment.
For now, COVID-19 appears to cause pneumonia (lower respiratory illness). Symptoms would be expected to include fever, cough, and difficulty breathing. It is not clear whether COVID-19 causes other clinical symptoms.
If there is any good news, most children with the coronavirus have mild cold-like symptoms, such as fever, runny nose, and cough, according to the CDC. Gastrointestinal issues, like vomiting and diarrhea, may also occur. Some children have no symptoms whatsoever.
The coronavirus complications appear to be uncommon for those under 18 years old—even in small infants. In fact, the WHO-China Joint Mission report states that only 2.5 percent of children diagnosed with the coronavirus had “severe” symptoms, and 0.2 percent were considered "critical." The recorded complications include acute respiratory distress syndrome and septic shock, according to the CDC.
As with all communicable diseases, the following measures can help prevent the spread of Coronavirus:
- Wash your hands for 20 seconds or more with soapy water several times a day. If soap and water are unavailable, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose or mouth with unwashed hands.
- Avoid contact with people who are sick.
- Stay home while you are sick (except to visit a health care professional) and avoid close contact with others.
- Cover your mouth/nose with a tissue or sleeve when coughing or sneezing.
- Clean and disinfect frequently touched objects and surfaces each day. Use a household cleaner according to label instructions.
- Avoid large gatherings.
- Use online transactions when possible.
- Avoid visiting nursing homes -- especially if you are sick
- If you have an older person in your home or someone with compromised health, such as asthma, understand that the biggest threat to them may be you bringing the virus into the home.
- If you or a loved one is older, think twice about an upcoming trip.
We are closely monitoring the situation and updates will be posted as the situation evolves.
March 14, 2020 UPDATE
We are currently recommending that all well visits be done as scheduled. Ill visits are at the discretion of the parent as to if evaluation is necessary. For minor illnesses, we are recommending that patients be managed at home or that they be evaluated by a telemedicine appointment (see below) to decrease the patient's risk in coming to the office as well as office staff exposure to patients who may have or have been exposed to COVID-19.
To help facilitate a safe environment in the office, we have removed all toys from the waiting rooms and exam rooms. In both offices, specific exam rooms have been designated as either "well" or "ill" exam rooms. While all exam rooms are cleaned per ESD strict protocol, additional measures have been added to sanitize "ill" rooms between visits to keep our patients safe. Children will no longer be able to reach into the "treasure box", grab a sticker or a sucker. These are to be pointed to and can be handed to patient. Additional measures are currently under consideration and may be added as risk indicates. It is recommended that, if possible, only patient to be seen and one parent/guardian attend all visits.
TeleMedicine is here! Starting Monday, March 16th, ESD will offer telemedicine visits to our patients who would like to be evaluated by a physician but feel that not coming into the office is best. A telemedicine visit is exactly what it sounds like. It is a visit with a physician using your smart phone or computer to do a HIPPA compliant (appropriate privacy) "facetime" visit. These visits are scheduled as regular appointments and will be billed appointments. While there are many advantages to a visit like this (convenience, decreased risk of exposure of patient in office and decreased risk of physician exposure to patient), there are also inherent disadvantages. One cannot listen to a child's chest or look in a child's ears via a smartphone or computer. Some physical evaluation can be done through video but it is limited. Based on the visit, evaluation decisions can be made. Medications can be prescribed. Documentation within your child's chart is done... to name a few advantages. If it is determined that an office visit is necessary, you will not be billed for the telemedicine visit.
Social Distancing/Flattening of the curve: This is a thing. It is important. While at this point in the pandemic, a complete lockdown is not necessary, do your best to minimize interaction with others. This limits the rate at which the disease spreads which will allow our current healthcare system to have the capacity to deal with ill patients when they arrive. As evidenced by China and Italy, recent history tells us that things are fine... until they are not. This happens quickly. Currently, the whole country of ITALY is locked down. Limiting large gatherings, strict hand washing/sanitizing, not touching your face, keeping 6 feet away from others, avoiding travel unless necessary, etc. Decreasing all of these close human interactions decreases the ability for the virus to spread from person to person. We know that COVID-19 is MORE contagious than seasonal flu, meaning it seems to spread easier. Close contact can cause someone to contract COVID-19, even before the contagious person is symptomatic. The virus is transmitted by respiratory droplets (coughing or sneezing) and can live on surfaces for a period of time. Read this article: https://www.npr.org/sections/health-shots/2020/03/13/815502262/flattening-a-pandemics-curve-why-staying-home-now-can-save-lives for a quick run down of the concept of "Flatten the curve". While most young adults and children are at relatively low risk, those with underlying conditions and seniors are at significant risk. PLEASE. Do your part!
Testing: Routine testing is not yet available but will be coming at some point. Currently, it is recommended that patients with known exposures to a test positive individual or have a concerning travel history should be tested. Likely, in coming days and weeks this will expand. Currently our office (all private practices) and Cincinnati Children's DO NOT have the ability to run a test for COVID-19.
Here is a useful, basic video about coronavirus... worth the few minutes to watch https://youtu.be/OPsY-jLqaXM
March 15, 2020 UPDATE
The Governor has now closed all restaurants and bars other than carryout. This is important because many in our state and country have not heeded the social distancing recommendations to "flatten the curve". These recommendations are important. The State of Ohio is out in front of many other states in managing public health at this time and we should all be grateful for that. The state of Ohio also has a COVID-19 Call Center @ 833-427-5634. We will be available during business hours to do our best to answer specific questions about your child. A physician/NP will be on call as usual outside of business hours. As per usual, the after hours calls should be kept to true EMERGENCIES. It is not designed for "regular non-urgent questions". Please don't overuse these resources even in a time like this as it will hinder the response time necessary for the true emergencies and will fatigue the system. Remember that nursing staff on the phones will do their best to help with specific situations while general information can be learned here and from other online resources. If you would like to have a more detailed discussion with one of our physicians, please schedule a telemedicine appointment.
Specific interventions being activated at ESD starting tomorrow, Monday, March 16, 2020: Continuing designation of ill and well rooms. Enhanced cleaning of rooms. Additional PPE (Person Protective Equipment) will be used by ESD staff. Waiting rooms WILL BE CLOSED. When arriving for an appointment at either office, text the name of your child and to which office location you have arrived (Milford or Hyde Park) to 513-248-1210. The front desk staff will check you in and you are requested to remain in your car until you are texted back to come in to the waiting room. These interventions, and additional interventions to be made as necessary, will help to keep all of our patients safe in these extraordinary times. Consider telemedicine as an option for evaluation. We will be ramping up telemedicine availability based on demand and it is a good option if you would like to have a more detailed discussion about the current state of illness along with direct evaluation of your child.
Stay safe. Follow the recommendations of public health officials. Reach out to ESD if you need our help. Additional updates will be posted here as new information or office policy changes is/are available.
March 16, 2020 UPDATE
Waiting rooms are currently closed for your safety. Text check in at both office is up and running. We are working through some glitches in the system so please be patient with us. When arriving at either office, text your child's name and office location to 513-248-1210. You should get an acknowledgement text back. It may take a second. When your exam room is ready, you will be texted to come to the entrance and will be met by a nurse who will walk you back to your room. Thank you for your patience and flexibility as we continue to evolve with the ever changing landscape of the current pandemic.
Telemedicine is now available. Telemedicine appointments can be scheduled by calling our office. This allows HIPPA compliant "facetime" visits. While there are limitations to these visits, they may be a good choice if you would like to avoid coming into the office or you find it more convenient.
March 18, 2020 UPDATE
No additional updates regarding current COVID-19 recommendations. Testing is still not widely available here in Cincinnati for children and in most cases isn't necessary. Both ESD offices are still seeing both ill and well visits with appropriate precautions to keep our patients safe. It is very important that, especially young infants and babies (up to 2 years old), continue with well care and vaccinations per recommended schedules. We are encouraging ill patients to use our new telemedicine services if possible as it can decrease risk to both patients, families and our providers. Much of what needs to be done with children can be handled in a live telemedicine visit. At a minimum, patients can be evaluated to determine if additional evaluation or testing may be necessary. We will continue to ramp up availability on this option as demand dictates. We intend to continue to provide appropriate services through this unprecedented time. Thank you to our families and staff for being flexible as we continue to adjust to the ever changing landscape.
March 19, 2020 UPDATE
Testing for COVID-19 is still not available for most kids in Cincinnati and isn't necessary unless a child is ill appearing.
NEW! ESD will start performing in car "drive by" testing for influenza and strep to compliment a telemedicine visit. This will be done at the Milford office location only. Either before, if requested, or at the recommendation of the physician, testing for either influenza or strep can be done in the comfort of your car to complement that telemedicine evaluation. We will NOT be doing testing only. The testing must be done in conjunction with a telemedicine visit.
The procedure for this testing is as follows: Once the telemedicine visit is scheduled, either before the visit or once the visit is completed, parent/guardian will drive to the ESD Milford Location. They will drive around the RIGHT side of the building to the back where once at the back of the building, family can either press button by the back glass door to alert the front desk that they have arrived or they can text 513-248-1210 a message with the patient's name and that they have arrived at the back of the Milford location for testing. A nurse will be alerted to come to your car and perform the desired testing. If testing cannot be completed in the car, a patient can come in the back door of the office to an exam room to have testing performed more traditionally.
As we all continue into the prolonged isolation of staying home and social distancing, the stress will build for both parents and kids. This is a link to a good article about talking to your kids about COVID-19: www.pbs.org/newshour/health/10-tips-for-talking-about-covid-19-with-your-kids At ESD we want to support our families mental health through this time as well. We have expanded our behavioral health services to telemedicine. Our ESD Behavioral Health specialist, Gretchen Dorman is available to help families and patients through this stressful time. Please call our office to schedule a telemedicine visit with her to help with the emotional distress caused by the pandemic.
March 20, 2020 UPDATE
Beginning Monday, March 23, 2020 ESD Pediatric Group will be making some significant changes to office operations to keep our patients, families and staff safe during the current pandemic.
We will be going to a 2 office system in which one office (Hyde Park) will become a "well only" office and one office (Milford) will become an "ill only" office. This is being done to preserve limited PPE (personal protective equipment), and minimize risk to staff and to families.
As supported by AAP and CDC recommendations, it is still vitally important that even in these unprecedented times, well care and routine childhood vaccinations should continue. It is safest that when providing well care, patients are protected as much as possible from ill exposure. The Hyde Park Office will function as "well only". Ill patients will not be allowed to enter this location. As we have been doing for the past week, the waiting room will remain "closed". Patients on arrival will text 513-248-1210. They will be texted when an exam room is available. The family will then be met at the office front door by a nurse. Patient and parent/caregiver will have their temperature taken. Anyone with a temperature of >100.5 will not be permitted to enter the office. All staff at both locations are also having temperatures taken daily as per the Ohio Governor/Ohio Department of Health recommendation. Care will be given to practice social/physical distancing when possible. Obviously this cannot be done during vitals and performing a physical exam. Strict handwashing and limited contact will be also be observed.
As the schedule changes quickly, unfortunately, we will not be able to guarantee provider requests during this time. Please, if possible only have 1 parent/guardian and the patient to be seen present at a visit.
We are continuing to ramp up telemedicine as it has been going well so far and it is the best and safest way to evaluate patients and limit exposure to both patient, family and staff. Effective Monday, March 23, 2020, no "in office" ill evaluations will be scheduled without a telemedicine visit first. If it is determined that in office evaluation is necessary, a patient will not be charged for both visits. These visits can be scheduled by calling the office and act as virtual office visits. Routine testing (strep tests, flu tests, mono tests, urine tests, etc.) are currently being done for patients without leaving their car at the Milford location. This testing can only be ordered in conjunction with a telemedicine visit. Testing can be done before or after the virtual visit and will be included in that evaluation. When arriving at the Milford location, drive around the RIGHT side of the building and stop in the back at the "stop sign". Text the front desk at 513-248-1210 that you have arrived for testing and a nurse will come to your car to perform the testing. You can then drive away and will be contacted with results.
The patient portal is still available for simple questions. More detailed concerns should be addressed at telemedicine visits.
The office will continue to adapt the rapidly changing recommendations as new information becomes available.
Stay safe! Stay home!
March 21, 2020 UPDATE
Well visits! Now is actually a good time (and a good field trip to get out of the house) to do well checks. Well visits are an important part of keeping your child healthy. It is especially important for the young (<2 years old) so they can keep up on their vaccination schedule and monitor growth and development. ESD is committed to continuing to provide this service and meet the needs of our families. It is important to do this as safely as possible. We are in the process of moving all "well visits" to the Hyde Park location. If you regularly go to the Milford location, all of your information and many of the same staff (nurses and providers) are available at the Hyde Park location. The Hyde Park office is easily accessible and about a 15-20 minute drive from our Milford location. It is located at the Smith/Edwards exit off of I-71 in the Cornerstone Office tower (4000 Smith Road, Suite 175). As has been recent policy at Milford, the waiting room will remain closed to reduce contact with other clients. Upon arrival, text 513-248-1210. You will be texted back when your exam room is available and a nurse will meet you at the entrance. The entrance is locked for your safety. This location will not see any ill patients going forward until the pandemic has passed. Keeping all ill patients and parents completely away from this facility and combining that with enhanced cleaning protocols should make this a safe and low anxiety experience.
Stay safe! Stay home! This cannot be repeated enough. Only essential trips out of the home (grocery, pharmacy, doctor's office, etc.) are recommended. We do not recommend travel at this time unless absolutely necessary. There are hot spots around the country that are known and some that are yet to be known. Travel may put you unknowingly at additional risk. This risk is to you as well as the ones who you may visit upon your return.
Do your part. #flattenthecurve
It is hard sometimes to differentiate the flu vs. a cold vs. COVID-19. Here is a table that might be helpful.
March 22, 2020 UPDATE
As the first day of our split office strategy comes to a close, we would like to thank our staff, patients and families for their understanding and flexibility. THANK YOU! Things have gone well with having our Hyde Park location "all well", and all ill visits and med rechecks to be done via telemedicine. We appreciate our families flexibility as we continue to expand our telemedicine strategy. We are pushing toward primarily telemedicine for all ill visits. Necessary testing can be done via drive through at the Milford location. Telemedicine is the strong recommendation of Ohio's governor and ODH leader, Dr. Amy Acton. Our phone staff is diligently working to adjust schedules to keep all patients safe and will be calling to reschedule/relocate appointments. This strategy will be in place for the next 2 weeks and will roll forward week by week as necessary.
While the "Stay at Home" order is in place in Ohio, PLEASE follow it. Leaving the house to go to the grocery, the doctor's office or other very necessary reasons is all that is recommended. You should NOT be doing play dates, visiting friends, etc. This is what increases the risk of spread and will prolong and exacerbate the pandemic. Do your part to keep everyone safe. Additional information about Ohio's response to COVID-19 and the Stay at Home order can be found at www.coronavirus.ohio.gov.
March 25, 2020 UPDATE
The "well office" in Hyde Park is up and running well. We are doing all well visits as scheduled. If your child is due for a well visit, we are recommending that you proceed with doing those visits as likely there will be a backlog in the well visit schedule for older children once COVID-19 clears. We have very stringent processes in place to keep you safe when doing these visits. Remember that, especially for young infants, it is important to keep them on their vaccine schedule.
Vaccinating during the pandemic: click below
Drive through testing is also functioning well. All testing must be in conjunction with a telemedicine visit. Please call to schedule that appointment if you are concerned about fever. strep, influenza, etc.
For drive through testing, drive around the right side of the building and follow the signs around to the back. Stop at the "stop sign" and text 513-248-1210 to let them know that you have arrived for testing. A nurse will be notified to come to your vehicle. Stay in your vehicle. If no one comes out in a reasonable time frame, you can retext.
March 28, 2020 UPDATE
Well checks continue! Please call to schedule if your child is due for routine well care. Things have been going well with our split office plan as we close out the first week of this new strategy. Our "clean" office has been well received and we are encouraging all patients who are due for well checks to go ahead and come in.
Because of the strategy, which includes: closed waiting room (text to come in), no ill children or parents allowed at this location, temperatures being taken at the front door for all patients and families, additional cleaning of exam rooms even with only well patients, enhanced cleaning of medical equipment between patients, staff wearing surgical masks to "protect families from us", keeping physical contact with patients to an absolute minimum(physical exam and gathering vitals, strict handwashing protocols, all staff being monitored and having temperatures taken daily, patients and families are not allowed to linger in the halls, all exam room doors kept closed, only one parent/caregiver per patient, social distancing when possible between staff and families... among other interventions.
Please call the office to schedule your child's well visit or request via the patient portal at your convenience.
March 31, 2020 UPDATE
Social distancing is working! We (Ohio) are flattening our curve. Keep up the good work. Stay home. Wash your hands. Don't have meet ups at the park. Don't have playdates. Spend time with your family. Make good choices.
Looking for things to do with your kids? CLICK HERE
April 3, 2020 UPDATE
With the extension of the Ohio Stay at Home order through May 1, the ESD Pediatric Group will continue to provide essential pediatric medical services in the same fashion as it is currently providing until that time (and possibly longer).
We will continue to have our Hyde Park office remain as a well only office. We have added additional safeguards to keep this location clean and safe including additional screening upon arrival. Children and parents who do not pass the screening questions upon arrival will not be admitted to the office. If you feel that your child is ill or may have had a recent exposure, please call the office to see if it is likely that we will be able to proceed with your child's well visit. Final decisions are made on site by a physician or a nurse practitioner.
We will continue to operate the Milford location for ill patients and testing of ill patients including drive by testing for strep, influenza, mono, urine, etc. Ill patients can be seen at this location, but before an ill appointment can be scheduled in person, a telemedicine appointment must be done first to assess if this is necessary or appropriate. Before any testing is preformed, a telemedicine appointment must also be scheduled. We are not doing test only visits. We are also doing our best to handle most acute visits via telemedicine to decrease risk of exposure to patients, families and staff.
Thank you for working with us on these temporary changes while we all work to be available during these challenging times to help all ESD families safely.
Stay safe. Stay home. Be social... from a distance!
April 6, 2020 UPDATE
Regardless of your child’s age, he or she may feel upset or have other strong emotions in response to COVID-19. Some children react right away, while others may show signs of difficulty much later. How a child reacts and the common signs of distress can vary according to the child’s age, previous experiences, and how the child typically copes with stress. This is a link to a helpful article about how to manage worry in relation to COVID-19 https://childmind.org/article/
April 8, 2020 UPDATE
Facemasks are currently recommended by the CDC for people who need to leave the home. They should be worn when leaving the house and in contact with other individuals. They do not need to be surgical or N95 as those should be reserved for healthcare workers. Here is a link to the CDC recommendation. CLICK HERE
The best way to stay safe is to stay at home. Children should remain at home and should only be around the immediate family that they live with. While out, 6' distancing should continue to be practiced.