North Atlanta Primary Care

COVID-19 Update Article

Coronavirus Update #16

Posted on August 07, 2020 by Physicians and Staff at NAPC

It has been a month since NAPC posted an update on the COVID-19 pandemic. Scientific knowledge, research, therapeutics and treatment options and vaccine development continues to advance. Unfortunately, Georgia has risen near the top of the list in number of confirmed cases of infection with the SARS-CoV-2 virus. We must all remain vigilant in our daily activities as we prepare to open more businesses and school in the coming weeks. NAPC has not stopped in its battle to confront this pandemic and its deadly effects. To date we have tested thousands of patients, provided effective care to all of our positive patients, enhanced virtual visits and remained open at all 12 locations. To date despite the huge human toile this virus is exacting on our communities we are proud to have helped our affected patients to recover. Our physicians remain active on COVID task forces and committed to bringing the latest therapeutics and care information to you.

What is the latest information on COVID testing?
Over the past month NAPC has performed several thousand Abbott ID COVID point of care tests. With results in only 15 minutes we are able to direct your healthcare, arrange for monitoring, self-isolation and provide you with a daily monitoring care plan. In addition we have allowed many individuals to travel and return to family safely by quickly ascertaining COVID status. NAPC is expanding the number of COVID rtPCR tests we can perform at all 12 clinic locations. We will continue to help guide our patients as they make difficult choices to return to work and/or school.

The Abbott rt-PCR test (https://www.youtube.com/watch?v=MqICkkOaNKo) is highly accurate for identifying a nucleic acid chain found in SARS-CoV-2. However, it does not identify infectiousness of an individual or measure viral load. You may shed virus in general for up to 10 days (very sick individuals up to 20 days), but the rt-PCR test can remain positive for months. Therefore, it is not recommended to request repeated testing after you have tested positive. Unfortunately, some nursing homes and employers are seeking negative results prior to letting you return. Please discuss these situations with our physicians.
QUIDEL diagnostics (https://www.quidel.com/immunoassays/rapid-sars-tests/sofia-sars-antigen-fiahas) has developed a rapid point of care ANTIGEN test for COVID-19. We are exploring adding this test in addition to the rapid PCR test by Abbott. The benefit of this test is rapid, low cost and antigens are only present during the infectious stages of COVID-19. More to come on this topic soon.

Quest diagnostic (https://www.questdiagnostics.com/home/Covid-19/Patients/) continues to perform rtPCR tests for our patients as well. Unfortunately the delay in receiving the results is not acceptable to us. Please know that we prioritize all appropriate specimens sent to the QUEST labs.

Serological testing is performed by obtaining a blood specimen at the time of your visit. It is an important test that can measure your development of antibodies following a COVID infection. Unfortunately, there are many factors affecting the development of antibodies and your possible immunity to coronavirus. However, if you have had a confirmed COVID diagnosis, or been exposed to an individual with known COVID, you should consider monitoring your antibodies. Use of convalescent plasma has been successful in treating patients and we are encouraging our patients to donate if possible. Participating in the Red Cross program can save lives. Information can be found at this link: (https://www.redcross.org/local/georgia.html)
In our last COVID-19 update we provided you with 6 diagnostic labs that perform home testing. To initiate a test simply go online and request a home kit and submit your specimens to the lab via overnight mail. The results are fairly quick and you do not need to leave home. Some of these kits can be purchased at your local pharmacy. Please see the NAPC Coronavirus Update #15 at www.napc.md for more information.
Can you provide an update on Virtual Visits?
NAPC continues to perform virtual visits for all of our patients. Approximately 25% of all NAPC visits are performed utilizing telehealth. Nearly all insurance payers continue to cover the costs of virtual visits and many have no copay for primary care visits performed using synchronous audio video devices. COVID care treatment and testing is covered by nearly all payers with no cost sharing. NAPC utilizes a variety of connection modalities (Facetime, Skype, Doxy.me, Doximity, and Follow My Health) to make this easy for you. Please review these virtual care guidelines on telehealth at this HHS link: (https://www.hhs.gov/coronavirus/telehealth/index.html)


In order to protect our staff and our patients we ask that all patients with symptoms consistent with the flu or COVID please contact us via telehealth first. If a face to face visit is required, a CXR, laboratory tests or a COVID test we will arrange to bring you to the office safely, isolate you and perform all necessary care. We will care for you in a responsible manner. As we near the end of summer we must all plan for the complications of the flu season and must enlist your cooperation. Thanks for all you have done to allow us to serve you and protect our communities.

Requesting a Virtual Visit is as simple as a phone call, an email or even a patient portal message. Our goal is to provide care to our patients 24/7 with our Virtual visits scheduled up to 7PM if requested.

Can you provide an update on Vaccines?
The flu season is rapidly approaching and it is more important to make sure we protect all of our patients with an annual influenza vaccine. (https://www.cdc.gov/flu/prevent/keyfacts.htm). Flu symptoms will mimic COVID-19 illness and complicate both testing and treatments. We expect to receive our FLU shots in early September and will make them available to all of our patients. Our Abbott ID Now diagnostic equipment can test for both Influenza A and B as well as COVID. There are several antiviral treatments available for influenza that are most effective when started at the onset of symptoms. Our best protection is to have everyone vaccinated by late October. Please make an appointment for yourself and your family.
COVID-19 vaccines (https://www.nih.gov/news-events/news-releases/experimental-covid-19-vaccine-safe-generates-immune-response) are entering phase III of testing. This is the stage where the safety and efficacy of the vaccine will be measured on large groups of individuals. The scientific experts are working nonstop to develop COVID vaccines employing the latest scientific methods. In our Coronaviruses Update # 13 (www.napc.md) we explored all the top vaccine candidates and hope you will review this information.
With “OPERATION WARP SPEED” our government has procured 100s of millions of doses for America. This means manufacturing and distribution of vaccines undergoing testing has begun. NAPC is preparing to be part of the process and will acquire FDA approved COVID-19 vaccines as they become available. NAPC medical staff will continue to educate and message our patients with the latest information. NAPC will remain at the forefront with testing, therapeutics and vaccination programs for our patients. Thank you for continuing to protect yourself, your families and your communities.
Can you provide an update on treatment options for COVID-19?
NAPC continues to monitor therapeutic options for both hospitalized COVID-19 patients as well as outpatients. We continue to place our patients who test positive in our clinics on a NAPC COVID CARE PLAN. This means you will be asked to meet in a Virtual Visit daily to access your symptoms, your progress or deterioration, your vital signs and your oxygen saturation level. If you test positive at a testing site and need advice please call and ask for a COVID care visit. We will follow up with you daily until you are improved and no longer need to self-isolate.

Many health systems have developed COVID-19 Management Protocols. While there is very limited data specifically for COVID-19, the following cocktail may have a role in prevention, mitigation, and treatment of mild COVID-19 disease at home.

  • Vitamin C 500mg 2x/day and Quercetin 250-500mg 2x/day.
  • Zinc 75-100mg/day.
  • Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 2mg/night.
  • Vitamin D3 1000-4000u/day.
  • Optional: Famotidine (Pepcid) 20-40mg/day.
  • Optional: ASA 81-325mg/day.
  • Optional: Ivermectin 150-200ug/kg single dose.
  • Optional: Methylprednisolone 40mg 2x/day increasing dose if required.

Please remember to discuss your COVID-19 care plan, testing and treatment options with your NAPC provider. Please make sure to update your immunizations and to stay on all your chronic medications for diabetes, hypertension, pulmonary disease, heart disease etc. Your healthcare is important to us and NAPC is available to help you during this crisis.


Can you provide an update on antivirals and other therapeutics for severe COVID-19?
Success in dealing with COVID-19 is being demonstrated as the mortality rate has declined from 3-4% to 0.5% by most estimates. This is attributed to better hospital/ICU care, better ventilation techniques, newer therapeutics and finally recognition and treatment of the complications caused by COVID-19. Experts have learned that earlier treatment with antivirals like Remdesivir results in quicker recovery and decreased morbidity and mortality. Newer antivirals that can be administered orally, inhaled or even subcutaneously are in development and this will help tremendously in outpatient treatment of COVID-19. (https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/)
Treatment with monoclonal antibodies that are produced in the laboratory are currently in Phase II trials with both Regeneron and Eli Lily pharmaceuticals. By providing synthetically produced neutralizing antibodies we can protect patients in high risk environments like nursing homes and provide early treatment to COVID positive patients. These trials are ongoing and early data is promising. (https://www.nih.gov/news-events/news-releases/nih-clinical-trial-test-antibodies-other-experimental-therapeutics-mild-moderate-covid-19)
Treatment with convalescent plasma is continuing with good success. Convalescent plasma is the liquid part of the blood that is collected from patients who have recovered from COVID-19. The challenge is to procure enough plasma from individuals who have had COVID-19 and recovered. The process of providing plasma is not difficult and we hope you will volunteer to donate if you have recovered from COVID-19. Ideally you are at least 2 weeks into your recovery and will be evaluated and tested for adequate COVID-19 antibodies. Please see donation information at this link: (https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/donate-covid-19-plasma.)
Final Thoughts:
At NAPC we continue to battle daily with the coronavirus referred to as “The Beast” early in the pandemic. Healthcare personnel daily put their life in harm’s way to take care of our patients. It is very easy to become complacent as we are bombarded daily by the media with so many stories, political spin and false narratives. The COVID-19 danger is far from over and the prevalence of SARS-CoV-2 in our community is nearly 11%. We ask that you continue to adhere to the 3 Ws:

  • WEAR A FACE MASK.
  • WASH HANDS FREQUENTLY.
  • WATCH YOUR SOCIAL DISTANCING.

As society continues to reopen businesses, restaurants and now schools we must commit to being responsible. COVID anxiety is still prevalent, and it must be addressed as well. If we join together, educate our friends and neighbors we will succeed in conquering this virus. We are ALL in this together. #NAPCSTRONG.
Thank you for placing your trust and health to the NAPC team.
Respectfully,

Physician and Staff at NAPC

Alpharetta: 3400-C Old Milton Parkway, Suite 270, Alpharetta, GA 30005
Braselton: 1255 Friendship Road, Suite 130, Braselton, GA 30517
Cumming: 1800 Northside Forsyth Drive, Suite 450, Cumming, GA 30041
East Cobb: 1121 Johnson Ferry Road, Suite 450, Marietta, GA 30068
Johns Creek: 4235 Johns Creek Parkway, Suite A, Suwanee, GA 30024
Sandy Springs: 1150 Hammond Dr., Building E, Suite 310, Atlanta, GA 30328
Sugar Hill: 4700 Nelson Brogdon Blvd., Suite 250, Buford, GA 30518
West Paces: 3200 Downwood Circle NW, Suite 200, Atlanta, GA 30327
Woodstock: 250 Parkbrooke Place, Suite 300, Woodstock, GA 30189

All locations: 770-442-1911