North Atlanta Primary Care

COVID-19 Update Article

Coronavirus Update #11

Posted on April 30, 2020 by Physicians and Staff at NAPC

NAPC is closely monitoring Governor Kemp’s decision to reopen Georgia. Tonight at midnight Governor Kemp has chosen to end his directive to shelter in place. Last week he opened many nonessential businesses that allowed a person to obtain a haircut, manicure, a massage or even a tattoo. While we understand the immense complexities in reopening Georgia businesses, we know our patients and our practice will be affected by the outcomes of these decisions. Our health systems have been meeting daily to address COVID care and also to reopen the hospitals to routine care and surgery. We are developing protocols that will allow us to pre-operatively evaluate patients for COVID prior to having a surgical procedure.

Opening in the Ambulatory Office Environment

At NAPC we have never closed. We have developed procedures to allow us to safely see patients for essential medical care. In addition we have successfully performed 100s of diagnostic tests for COVID and now are testing for SARS-CoV-2 antibodies. We are separating patients based on symptomatology, reason for visit, COVID exposure and of course objective findings such as fever. Our offices are large and we will maintain social distancing. Our office are modern and we are cleaning and sanitizing them after every patient encounter. Our lab techs and medical assistants are continually updated and trained in best practices. Most importantly we are here for the needs of our patients. We will continue to keep you educated, keep you safe, and of course protect the health of our staff and caregivers.

Healthcare Heroes Day

Friday we celebrate Healthcare Heroes Day. NAPC is proud of our staff and physicians and how they have continued to serve our patients and our community. No medical practice in Georgia has achieved the level of success in delivering quality care to its patients. Our COVID patients have remained out of the hospital and continue to recover. We have grown our telemedicine program and can offer same day appointments for both acute and chronic care to over 750 patients a day. Despite the expiration of shelter in place, NAPC believes we should continue to employee mitigation and continue to social distance at this time. We believe that using telehealth modalities will allow us to continue to treat you safely at home. We believe if you need COVID testing, diagnostic tests and X-rays, and laboratory tests, we can arrange this for you in our offices. Please let us meet first “Virtually” on a telemedicine call and make arrangements to see you in the office. We will control the flow of patients so there is minimal waiting, continued physical distancing and of course intense sanitization as we render care to you.

Can You Have Coronavirus Without Symptoms?

As we expand testing in our community and in our offices we continue to learn more about the prevalence of patients with asymptomatic and pre-symptomatic COVID. This question arises daily in our COVID meetings both in the office and at the hospital. As society is reopening to business , this topic is of concern to you as well.

SARS-CoV-2, the coronavirus responsible for the global COVID-19 pandemic is far more contagious than the flu. Symptoms usually start 4-5 days after a person is infected with the virus. In some individuals, it can take even longer for symptoms to appear. And during this time, the infected person is shedding viral microscopic particles to anyone they come into contact with. This level of infectivity in people who do not yet know they are sick is what has allowed the virus to spread all over the world.

CDC believes that some people infected with the coronavirus do not develop any symptoms at all, or get symptoms so mild that they don’t notice them. For those of you who are still COVID-less, we all desperately hope this will be us. But the truth is, no one knows how common asymptomatic coronavirus infection is-yet.

How often is coronavirus asymptomatic in humans?

We do NOT know. There has been much data collected over the last several months on this subject. Cases of asymptomatic coronavirus cases have been reported in families in Wuhan, on the Princess cruise ship quarantined off the coast of Japan, and in a nursing facility in WA State. Based on this observational data it would appear that anywhere between 5% and 80% of people positive for SARS-CoV-s could be asymptomatic. Dr. Robert Redfield, director of the CDC think the number is around 25%. The evidence also seems to suggest that children and young adults are more likely to be asymptomatic with SARS-CoV-2 infection than older age groups.

Why the variability in how common asymptomatic cases are?

    • It depends on where the data was collected and whether it’s a virus hotspot or not.
    • It depends on how widespread testing is in that place. We are only testing patients at high risk with symptoms and therefore not getting good counts of asymptomatic persons.
    • Coronavirus has a long incubation period. This means we may just be missing PRE-symptomatic persons.

If I am asymptomatic, can I still spread coronavirus?

We know that presymptomatic folks are highly contagious right before they start feeling unwell, and we think-but we don’t know-that asymptomatic people can spread the virus too. The uncertainty over this comes back to how little we really know about true asymptomatic cases of coronavirus infections versus those who just haven’t developed symptoms yet.

What to do if you’re asymptomatic for coronavirus?

At NAPC our recommendation is to continue to shelter in place, continue with social distancing and avoid nonessential services at this time. If you must be out in public use of a facemask and good hand hygiene is essential. From a public health perspective, it’s a huge challenge to try to contain a highly infectious virus that is at its most contagious before someone gets symptoms. Continue to follow CDC recommendations:

    • Slow the spread: practice social distancing and stay home if you are sick or someone in your household is sick.
    • Wear a cloth face covering in public if social distancing is difficult, such as the grocery store or pharmacy.
    • Watch for symptoms as listed in our COVID updates, and use the CDC self-checker at:

Final Thoughts:

NAPC continues to remain open at all 12 locations. We have begun serology testing for antibodies and have found that some patients may have developed antibodies to COVID during the recent flu season. We are not sure if this will confer immunity to reinfection with coronavirus. We recommend all persons practice social distancing.

We continue to have limited access to diagnostic testing through Quest Diagnostic labs. We hope to have point of care testing with Abbott ID Now Diagnostics next week. Please stay healthy, stay home and be safe. We will keep you posted and we will remain open to provide answers to your questions and essential healthcare to you. NAPC is proud to be a part of your healthcare team and thank you for your trust and support.

Respectfully,

NAPC Physicians and Staff

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