During these unprecedented times, we are changing a lot:  Hours, Office arrangements, Check-in Procedures, Masks.

What remains a constant?   The smiles, brains, and love behind the masks.

Adjusted Hours:

Well Child visits/ Newborn checks                 Mon - Fri: 8 am- 5 pm
Sick Child evaluations                                      Mon - Fri: 8 am - 5 pm; Sat/Sun 10-2 (scheduled by RN)
Telemedicine visits                                           Mon - Fri: 10 - 6 pm

We are currently NOT doing Early Morning Walk-in clinic (7-8:30 am) nor Weekday Evening Clinic (5-7 pm).

Office Arrangement:

We have the office physically divided into a subsection for potentially contagious patients, and the remaining 80% of the building is for well child visits and non-contagious visits (headaches, injuries, developmental concerns etc.).

When you arrive for your appointment, stay in your car and call 919-828-4747 to check in and pay your copay over the phone.  

For Sick Visits: After checking in by phone, your nurse will phone you to meet her at the Sick Entrance (our former front door).   She will check the parent's temperature before entering the building, and if the parent has a fever then a different adult will need to return with the patient.  ONE adult may accompany the child.

For Well Child visits: After checking in by phone, follow the dotted black line on the sidewalk AROUND the building.   At the white tent outside of the new Well Child entrance, your nurse will check the temperature of the child and parent, and ask COVID screening questions.    Bring only ONE family member (2 parents are allowed for babies less than 2 months old).   
All of our staff will be masked.   We require that you wear a mask from home and that children > age 2 wear a mask.

COVID-19 testing:

ORP physicians will work with local and state health departments and CDC to determine if testing is required based on your child’s symptoms and potential exposures.  The tests for antigen (to test for current acute infection) or antibodies (to test for past infection) are rapidly evolving.  We can swab for COVID antigen testing (for current infection) and send the swab to Labcorp.  We do not have "on site" testing with rapid results, nor do we draw blood at the office for antibody testing.   

1. What is considered a "close contact" for COVID-19 exposure?
For COVID-19, a close contact is defined as any individual who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection) until the time the patient is isolated.   Currently, the CDC does not modify this definition if the people were or were not wearing cloth masks.

2. My child had a close contact with a person that is COVID+ (or with a person who started to have symptoms in the 48 hours after the time together).  What should we do?  Should we get my child tested, and when?
The most important thing to do is to quarantine your child (and your family, if your child is not of an age to essentially isolate alone) for the 14 day observation period.   The average time before presentation of symptoms is often 5-7 days after the exposure.   Testing for COVID is likely falsely inaccurate before about day 7 after the exposure.   The CDC website says that testing is recommended for all closed contacts of confirmed or probable COVID+ cases.   However, our current turnaround time for getting back lab results from Labcorp is variable and unpredictable, and has ranged from 2-7 days of turnaround.   So, currently testing an asymptomatic patient at day 7 usually does not significantly shorten the quarantine time.

3.  My child has symptoms that are concerning for COVID-19.   What should we do?
Self-isolation is recommended for people with probable or confirmed COVID-19 who have mild illness and are able to recover at home.  If your child is medically complicated, living in crowded living conditions (including being a member of a large family), has a household contact with someone at higher risk of developing complicatations from COVID, or other factors then getting true test results may be more important and may change the care of those high risk contacts.   Call us to talk to a nurse about your situation.   Remember that we still have a significant lag time before getting the results; in the meanwhile, consider the child infectious and all household members as close contacts and start isolation/quarantine.     

4.  My child or I have tested POSITIVE for COVID-19.   Now what?
Following CDC guidelines, if your test comes back positive and you had symptoms, you should stay home and, as much as possible, avoid others in your household until you can say yes to ALL THREE of the following questions:

• Has it been at least 10 days since you first had symptoms?
• Has it been at least 72 hours (3 days) since you have had a fever without using fever-reducing medicine?
• Has it been at least 72 hours (3 days) since your other symptoms have improved (such as coughing and shortness of breath)?
Following CDC guidelines, if your test comes back positive and you did not have symptoms, you should stay home and isolate (avoid anyone in your household) until 10 days have passed since the  date of your first positive COVID-19 diagnostic test, assuming you did not develop symptoms since your positive test.

Life in the time of COVID:

1.  What do the ORP physicians advise about sending my child to school or daycare?

This is a question we are getting from a lot of concerned ORP parents, so the doctors met and developed a consensus statement to share with you.  We agree with the American Academy of Pediatrics advice that children learn best when they are in school.  However, it is important that this be done following careful safety guidelines and with each individual's health history, and that of immediate family members taken into consideration. Our guidance is based on our experience at ORP and the more global infectious disease evidence which shows that so far, children and adolescents are less likely to have symptoms or severe illness from infection with COVID-19.  They also appear to be less likely to become infected or spread the virus.  Schools provide more than just academics. School is where children also get exercise, interaction with peers, access to healthy meals, mental health support and other services that cannot be provided with online learning. There are few exceptions to our guidance to send children back to school and daycare, such as youth with special health care needs, chronic or medically complex conditions and disabilities.  Finally, it may help you to know that all ORP doctors with school-age children are sending them back to the classroom.

2.  My child has asthma.   Does this change your recommendation?

There is still a lot we don't know about COVID-19.  What we are seeing is that peope with chronic health conditions appear to a higher risk of more severe illness if they get COVID-19.   It is not clear wheter this is the case for asthma, but in most cases we are recommended that even asthmatic child can safely return to school, provided their asthma is well controlled and that they follow the 3W's of Washing hands, Wearing a mask and Waiting 6' apart when possible.

The most commonly seen disease that puts children at high risk for complications is obesity.   

The CDC has additional information about complication risk and safer behavior practices for people with a variety of medical conditions here.   

Medical questions about COVID-19:  
This remains an emerging, rapidly evolving situation and the Centers for Disease Control and Prevention (CDC) will provide updated information as it becomes available.  

Last updated 8/11/20.