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.).

For Sick Visits: After checking in by phone (call the number printed on the building wall: 919-828-4747 during regular business hours, and 919-828-7563 during after-hours), 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: Don't call-- just follow 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 4-5 after the exposure.   The CDC website says that testing is recommended for all close contacts of confirmed or probable COVID+ cases, and is best done around day 5-7 after contact.  

3.  My child has symptoms that are concerning for COVID-19.   What should we do?
Call us to talk to a nurse about your situation.  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, 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 (or since the time of the test, if asymptomatic then)?
• 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 people with chronic health conditions appear to a higher risk of more severe illness if they get COVID-19, however the data show that most kids with mild asthma do pretty well with COVID.    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.   

3. I am breastfeeding.   Should I still get a COVID vaccine when it's available to me?   Is that safe for my baby?

It's not a surprise that pregnant and breastfeeding women weren't including in the vaccine studies; they usually aren't in nearly any medical trial (and FWIW, rarely are kids either).   So often safety is extrapolated using the science of how a treatment works.   Safety with a vaccine should also be compared against safety of acquiring the illness.    We do support getting the vaccine to protect the life of the breastfeeding mother, to reduce the spread of COVID to susceptible people, and to "cocoon" protection around the breastfeeding infant.   For further discussion, here is the link from the American College of Obstetrics and Gynecologists.

Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients | ACOG

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

Last updated 03/19/21.