In the wake of the pandemic, private practices have faced many struggles. We acknowledge and support the American Academy of Pediatric’s stance on providing funding so that pediatricians can continue to provide essential care to children and their communities. Click here for the official letter from the President of the AAP.
Many of you have called our offices asking about COVID testing. Antibody testing is a piece of the puzzle in determining whether or not someone has had COVID infection. The results of Antibody tests are best interpreted in the context of your clinical history. This means your pediatrician is the best person to help you decide if testing is appropriate and when it is most useful. Your pediatrician is also the best person to help you interpret the test. Please contact us before making any decisions about COVID antibody testing. We are here to help.
If you are interested in the possibility of having this test done for your children, please call or schedule a telehealth visit with your Allied pediatrician to discuss whether or not testing is right for you, and how we can make it happen. The COVID testing requires a venipuncture (blood draw) and cannot be done by fingerstick at this time. Results take 2-5 days to be reported.
While a positive antibody test may mean you have had COVID 19, no one can make any conclusions as to what the result will mean for the patient in terms of future immunity. We must all continue following the recommendations of social distancing, hand washing, and wear a face-covering while out.
Keeping you safe, healthy, and well-informed is Allied’s number one priority.
We are here for you and we will get through this together.
We have all heard a lot about the novel coronavirus or COVID19 testing lately. In fact, many of our public health experts and health professionals believe that having a strong and rapid testing infrastructure in place will be necessary before we can relax some of the social distancing protocols in place. This would allow us to quickly identify COVID19+ people in our community, isolate them and trace their contacts so that they can be isolated as well. This will help stop the spread and help us return a sense of normalcy. But where do we stand on our ability to test, treat, and even prevent COVID19?
Molecular vs. Serology Testing: What’s the difference?
There are two main ways we have to test for COVID19: molecular and serology testing. The main difference between these two is that the molecular test looks for genetic material (RNA) from COVID19 and the serology test looks for our immune response to the virus in the form of antibodies. The molecular test can tell us if someone currently has the virus while the serology test just tells us if someone had the virus at some point and produced an immune response.
What is the molecular test?
The molecular test looks for the presence of the virus in a patient and is the main testing method used by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), state and local public health labs, and commercial labs (like Quest Diagnostics). This is what is being done at drive-in test facilities. This test involves inserting a long swab into the back of the nose (nasopharyngeal) and then sending it off to the lab. The lab then performs a test called reverse-transcription polymerase chain reaction (RT-PCR) that detects pieces of the viral RNA. This test only takes a few hours, but results have been delayed because the labs are overwhelmed. While this is not ideal because it could take many days to get a positive result and start contact tracing, this test is the most accurate and is the least likely to give false negatives or false positives
Recently, the Food and Drug Administration (FDA) has given emergency use authorization (EUA) for molecular tests that are rapid and can give results in under an hour and will greatly expedite contact tracing and isolation. These are referred to as point of care testing and are very similar to the rapid strep or influenza test that is done in the doctor’s office. The most commonly discussed rapid molecular test is the one developed by Abbott Laboratories, but there are more that are being deployed across the country. They all involve the nasopharyngeal swab but instead of sending it off to the lab, it is inserted into a machine or cartridge that will analyze it and give a result quickly. While these tests are faster, they can occasionally give false positives or false negatives which are problematic for contact tracing and isolation.
What is the serology test?
When we get sick, our immune system makes highly specific antibodies to the pathogen that made us sick. The serology test looks for the presence of those antibodies to the coronavirus in a person’s blood. Unlike the molecular test, it can detect if someone had COVID19 and has recovered. It helps give us a picture of how COVID19 has spread in the community. This test is done via a blood draw that is sent off to a lab. The lab performs a test called ELISA that looks for antibodies specific to the coronavirus that causes COVID19. This is not point of care and could, therefore, take a couple of days especially if the lab is backlogged. There is an ongoing effort to develop a rapid point of care serology test that takes under an hour and can be done with a finger stick instead of a blood draw.
Why is there so much talk about serology tests? They identify individuals that had the virus and recovered or individuals that had an asymptomatic infection. The presence of antibodies suggests these people are immune to the virus, however it is unclear how long immunity lasts and if it is possible to get re-infected. Rapid deployment of serology testing could unveil that a lot more people than we thought had COVID19 and could, therefore, be immune. This could help inform decisions about relaxing social distancing.
Are there any treatments for COVID-19?
As of now, we have no approved drug that can directly target the virus. However, there are drugs and treatments in a clinical trial. A couple of the ones in active trials in the US are described below but there are more in clinical trials across the globe. Additionally, scientists are working tirelessly to develop new drugs and see if drugs that work on other viruses can be “repurposed” to treat COVID19.
Convalescent Plasma: Individuals who were sick with COVID19 made antibodies that helped them recover. These antibodies could also help individuals currently sick with COVID19 recover by boosting their ability to fight the virus. This was done for some Ebola patients treated in the United States and had some success. This treatment is currently in clinical trials across the nation including many in NYC. Another goal of this treatment is to determine if convalescent plasma can prevent exposed individuals from becoming sick.
This treatment requires individuals who recovered from COVID19 to donate plasma. If you had confirmed or presumptive COVID19 and it has been at least 14 days from your last day of symptoms contact the American Red Cross to donate.
Remdesivir: This medication is an antiviral drug that was developed to treat Ebola. It forces the machinery that copies the viral genome to prematurely stop replicating the viral genome which stops the virus from making more of itself. There are reports that patients who received Remdesivir through compassionate use recovered. Medications provided through compassionate use are given outside of clinical trial when then are no other treatment options. There are currently clinical trials being conducted to determine if Remdesivir is truly effective against COVID19.
Chloroquine and Hydroxychloroquine: These are drugs used to treat auto-immune diseases like lupus and rheumatoid arthritis. They work by dampening down the immune system, preventing it from attacking the patient’s own body. Why could these be effective against COVID19 if we need our immune system to fight the infection? The answer is that many patients with severe COVID19 have what is called a cytokine storm. The immune system goes into overdrive causing so much inflammation in the lungs that fluid fills the lungs causing respiratory failure. The hope is that chloroquine and hydroxychloroquine would dampen the immune response so it does not go into overdrive. However, this could also be detrimental because we need the immune system to fight the virus. Nonetheless, these medications are in a clinical trial as well.
When will we have a vaccine?
An approved vaccine is likely more than a year away. We first need to find a candidate vaccine that is safe and elicits a protective immune response. COVID19 is caused by a novel coronavirus and we have no existing template for coronavirus vaccines to build from. We do not know what is safe and effective. For example, in the case of the 2009 swine flu pandemic, we already knew how to make safe and effective influenza vaccines because we do it every year when we make each year’s vaccine. This allowed us to develop and produce a vaccine for large scale distribution so quickly. However, for COVID19 we are starting from “scratch” and need to figure out what will make a safe and effective vaccine. Scientists are working around the clock to get there. Once there is a promising vaccine candidate it needs to pass Phase I, II, and III clinical trials that fully evaluate safety and efficacy. After that, the infrastructure and manufacturing need to be ramped up for large scale production and distribution. As of now, there is a candidate vaccine that has begun a Phase I trial.
This is a difficult time, but we will get through it together. Reach out to your Allied Pediatrics pediatrician via telehealth for guidance and support. For children who are interested and want to learn more about viruses, vaccines, and our immune system encourage them to reach out to their science teachers.
To Donate Plasma:
Worry and fear are normal during the Covid-19 pandemic. Routines are disrupted. Grandparents and extended families are not around. Finances are changing. People we know are sick.
Your Allied physicians are here to provide mental and emotional support for your family during this stressful time. Telehealth is the perfect way to safely connect. We can help you and your children manage your thoughts and emotions and recommend resources to learn coping skills.
Many are unsure on how their child/teen is coping with all the change. Check-in with them.
How do they answer the following questions? How would you answer for them? How would you answer for yourself?
Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious or on edge?
Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying?
Over the last 2 weeks, how often have you been bothered by little interest or pleasure in doing things?
Over the last 2 weeks, how often have you been bothered by feeling down, depressed, or hopeless?
Symptoms of anxiety or depression may be present if the answer to any of these questions is “more than half the time.” Symptoms of anxiety or depression are not the same as a diagnosis of anxiety or depression, but they do mean that your child may need your help. You can use these questions as an opening to a meaningful conversation, and/or as a reason to suggest a telehealth visit with a trusted caregiver.
Your Allied physicians are here to support you. We will get through this together.
Based on new recommendations from the CDC, we are now asking everyone, coming into our office, to please wear a face covering. If you have a mask or equivalent (face covering), we would be grateful if you would wear it to the office. We understand that not everyone has a “hospital type” mask, but any cloth face covering is ok. For our younger patients, pretending to wear “superhero costumes,” can make this seem fun!
We appreciate your help in keeping our Allied patients, families, staff, and our country, safe and healthy.
Recommendation Regarding The Use Of Cloth Facemask Coverings From The CDC:
Surgeon General Shows How To Make Facemasks, By The CDC:
Remember, we will get through this together!
Being a parent is difficult under normal circumstances; it is even harder right now. Our own stress levels are high, and we see signs of anxiety in our children. Is this normal? Is there anything we can do? Your pediatrician, as always, is a great resource for anything having to do with your children. Telehealth visits are a perfect way to touch-base with your pediatrician over specific concerns related to your child and stress, anxiety or depression. Allied telehealth visits are covered by all insurance plans and there is no co-pay to use this service.
These general guidelines may be helpful as well:
We listen to news broadcasts and read online about COVID-19 illnesses and how our country is responding, our anxiety levels will tend to increase. We hunker down with our families and worry about our kids, elderly relatives and ourselves. Many parents are essential workers and worry about bringing home the illness to their families. Being a parent is difficult under normal circumstances, even harder today.
While our anxieties will increase at these times, we should remember our children will follow our lead. Parents should take the quantity and content of information that their children hear and adjust it to their child’s individual emotional needs. Enjoy some time as a family. Keep an eye out for problems.
Young children are wondering why there are no activities, school or playdates. Reassure them that they are safe, and everyone is staying home to keep everyone healthy. Stay calm and use words and tones that will make them feel a sense of calm. Mr. Rogers quote “Look for the helpers, you will always find people who are helping”, seems like the appropriate quote for calming young children. Tell them people like doctors and nurses are working hard to keep everyone safe. It’s ok to say you don’t have all the answers.
Older children are more aware of what is going on. Let them ask questions. Validate their feelings, give simple direction and reassuring answers. Repeat what we are hearing from the professionals. “Wash your hands, don’t touch your face and social distancing are most important to prevent the spread of the virus.” Encourage them to do schoolwork and help out around the house. Actual teaching/learning does not always happen in the “classroom.” Cooking and baking are great ways to learn math, fractions, and for older kids, Chemistry. If your family thrives on routine, make sure you keep it. If your family excels in chaos, enjoy this time and don’t set that schedule. If possible, virtual playdates are great. Showing your children their friends are fine, and doing the same as they are, can be very reassuring. If they are showing signs of anxiety such as sleepiness, sleeplessness, jumpy, decrease in appetite, you should reach out to your pediatrician. These discussions can be done by telehealth with the pediatrician that knows your family.
Your teens are online and probably giving you more information than you want. Talk about what the trusted information sources are and what is possibly fake news. Teens can get nervous and many of their end of school year plans have been disrupted and they are feeling angry. Teens might want to see their friends beyond Facetime and Zoom. Discuss the safety issues and reinforce the stay at home orders that we are under. Empathize with them. We cannot really understand what they are going through since these are unique times. Physical activity can help. When the weather is nicer, encourage them to get outside. Talk about plans for the future and how any event missed might be made up or delayed. Again, reach out to your pediatrician if you think your teen is experiencing depression or anxiety
Your pediatrician is your first and most trusted resource. They will help, if more help is needed, and will find the right person for your child. These are hard times for everyone. Don’t forget that parents should take time for themselves. The better you are, the better you are to take care of your family.
Please remember, we are not stuck at home, we are safe at home.
We will get through this together.
Hello Allied Families,
We hope the new normal finds you well and you are enjoying this valuable time with your families.
We want to remind you that we are here for you and your children. Routine visits with your pediatrician are an essential part of good health and well-being. Well visits and vaccines are very important. When we finally get through the current pandemic, we certainly do not want to see an increase in vaccine preventable diseases, such as whooping cough (pertussis) and measles. These diseases can be extremely dangerous to your children. Most of our offices are still open, but office hours might have changed. Keep your well visits, it’s important.
Most of our offices, that are open, are separating well and sick visits by either time or space or both. We are doing everything to keep our patients, families, and staff safe. The offices are cleaned often, and you will see the staff working hard to make sure you feel at ease.
Additionally, all our offices are doing daytime telehealth visits, it’s the new 21st century house call! Download the Anytime Pediatrics App, (directions below), or call your pediatricians office for help making these appointments. We also have evening after hours telehealth visits from 6:30pm to 10:30pm, 7 nights a week. In addition to providing this awesome service to our own patients, Allied is now offering our telehealth service to non-Allied patients. If your friend’s pediatrician does not have telehealth, please let them know an Allied pediatrician is here to help during this crisis.
Remember to reach out to your pediatrician to get the true information on COVID19. We will have the most current information and recommendations. We are posting on Facebook about up-to-date news, homeschooling tips, and entertainment suggestions for your families. If you are not already following your doctor’s office on Facebook, now is a good time to start. If someone in your family has allergies or asthma, we suggest you follow Strauss Allergy and Asthma for recommendations and for important information about COVID19 and patients with allergies and asthma. Please also check the Allied Website for important information about Epipens. Click here for important Epipen update!
Remember we are not stuck at home; we are safe at home!
We will get through this together.
Dr. Raphael Strauss talks with romper.com about COVID and children with asthma. He is a trusted resource for all families! Click here for the article,
Is Coronavirus More Dangerous In Kids With Asthma? Doctors Weigh In.
Dr. Strauss says the recommendation is for kids and adults to take their asthma controller medications as recommended by their doctors. If you are looking to schedule an appointment with the team at Strauss Allergy and Asthma, he recommends visits by telehealth, when possible, rather than office visits for evaluation of kids and adults who have concerns. For more information about telehealth, visit, https://bit.ly/2JjingC
Dear Allied Families,
We are all struggling with the new normal and hope you and your families are safe.
Your Allied offices are open for your children. Our offices are creating safe ways to see patients for the important well visit and vaccines that your children need. We need to remember vaccines are necessary, so we don’t eventually see a return of illnesses, which we can prevent.
Your pediatricians are available for needed sick visits. We ask that you call your pediatricians office first. The staff is taking precautions to separate well and sick patients by either appointment times and/or space. We ask that you limit the number of people coming into the office with the patient. We are cleaning and sanitizing often. We are grateful that Allied Physicians Group has the resources and access to needed supplies that keep your children and our staff safe.
Telehealth visits are a great way to access your pediatrician right now and are covered by most insurances. We can see you virtually for sick visits or to discuss anxiety and concerns about COVID19, or to make sure you are ready for allergy season. Call your regular office for daytime telehealth. Our after-hours telehealth has expanded to 7 days a week, 6:30-10:30PM and can be accessed directly from the Anytime Pediatrics app, or by calling 833-269-2444. Allied telehealth is better than those offered by urgent cares or insurance companies because Allied telehealth connects you with a board-certified pediatrician who has your child’s medical chart and history. Also, tell your friends that due to the COVID19 crisis, Allied is offering our telehealth to non-Allied families as well. Non-Allied families should download the Anytime Pediatrics app or call 833-269-2444, enter practice code 2444, to be connected with an Allied pediatrician near them! Visit our website for more information.
We are posting frequent updates on your pediatric offices’ Facebook page. Please check it often. We plan to post suggestions for keeping your children entertained, safe ways to combat everyone’s stress, and more! We are open to any suggestions our families can share with everyone. We need to work together.
What’s new information concerning COVID19? Persons with a COVID19 like illness, not requiring hospitalization, should stay home and self-isolate. It is not recommended that those with mild COVID19 like illness be tested at this time.
What else can you do? If you have a business that uses mask or gloves, that is closed due to government orders, consider donating them. If you drop these items at one of our offices, we will make sure to get them to the healthcare workers that need them most. Check on your elderly neighbors, offer to go food shopping or pick up needed medications. Get outside if you can.
We will get through this, together!
Dear Parents & Patients,
It’s Tuesday and your pediatric clinicians are on the job and at your service! While our “routine” is not quite the same as last week’s or last month’s routine, we remain ready to help you care for your children.
In order to continue practicing safely, you will see our staff using plenty of hand soap and sanitizer, disinfectant wipes and spray. Nothing that’s not new for us, especially during cold and flu season, but something that we are practicing with extra diligence for the care of all concerned. Our offices are also instituting scheduling changes and other protocols to keep us all safe. Call your office to find out what specifically they are doing to help keep us all safe.
While the current COVID-19 outbreak is top of the mind for all of us, life does go on and other illnesses do as well. It’s important that we continue to protect our children from the many other diseases that we take for granted. Keep your regularly scheduled checkup appointments and keep your child’s immunizations up to date. It is not too late to get a flu shot, and this year, in particular, we all very strongly recommend it.
With springtime, besides flowers, we also usually see more children with strep throat, allergies, and other illnesses. If your child seems ill and it’s something you would normally see us for, we are here.
We also ask that you call the office before your appointment if your child or you have any respiratory or flu-like symptoms. Most of our offices can handle many of these appointments remotely via our telehealth services. Please visit https://alliedphysiciansgroup.com/telehealth/ and get set up today.
If your children are home from school, and you’re still at work, why not see if you can hire a friend’s college-age student to help you out with childcare. Take advantage of the beautiful weather today and get outside!
As you can imagine, with COVID-19 dominating the news, hackers are working to find ways to exploit the fears of those of us who are working remotely. Phishing email scams have been reported where the hackers are claiming to be from legitimate organizations with information about coronavirus. As you seek information, please always remember to visit ONLY trusted sites such as the Centers for Disease Control (www.cdc.gov), the World Health Organization (www.who.int) and the New York State Department of Health (www.health.ny.gov).
And once again, please remember that children with coronavirus are not getting very sick.
We will get through this… together.
Stay well, Allied family!
3/13/2020 Update: Information for patients with Asthama
By: Dr. Raphael Strauss, Dr. Robyn Kreiner, and Dr. Khalid Ahmad (Strauss Allergy & Asthma, Commack & Woodbury, NY)
Allied Physicians are getting many questions related to patients with asthma and coronavirus COVID-19. Fortunately, Strauss Allergy and Asthma is a great resource. While this is an evolving situation and information may change, our current recommendations are:
1 Take your controller asthma medications regularly as prescribed.
2 Have medication available but there is no reason to stockpile extra medication.
3 Children with asthma that is well-controlled do not appear to be at higher risk for severe outcomes. We are not hearing about excessive hospitalizations or severe cases in children in general in China, South Korea or other countries that have more cases.
We are concerned with the overall health and well-being of people and especially children in general at this time. The anxiety over this infection far exceeds the actual personal risk. We recommend keeping your kids in school if school is open. Follow public health recommendations regarding avoiding large gatherings, frequent hand washing, and reasonable social distancing. Above all, remain calm, rational and we will get through this together.
School closings, containment zones, and quarantines are ramping up Coronavirus anxiety amongst all of us, from the youngest, who respond to our stress, to the elderly, who are most affected, to those of us in the middle, who feels responsible for the whole family.
Your doctors at Allied Physicians Group are here for you, not only for medical care but as a source of reliable and sane information. We suggest you look at COVID-19 information from two perspectives.
1 Personal Safety: the vast majority of people infected by COVID-19 will have a mild illness, especially children.
2 Community Responsibility: the CDC and Health Department are trying to limit spread, or at least slow it down. Self-quarantine, containment areas, and social distancing are being implemented for these purposes.
The best way to stay healthy is by practicing good hand washing, remembering not to touch your face, and staying away from large gatherings when possible. Take advantage of the nicer weather and socialize outdoors. If you or anyone in your family is sick, stay home. When needed, cough into your elbow.
Your Allied physicians will help you through this crisis, as we have so many times in the past. Our doctors were on the front line of H1N1 infection – we made it through that, and together, we will make it through this.
If your child is sick, please call us. We are all screening patients carefully and doing what is needed to keep our families safe. Many of our offices currently utilize daytime telehealth or will soon implement telehealth. There is also After-Hours Telehealth offered from 630p-1030p Sunday to Friday for all Allied patients.
Allied Telehealth, day or night, is much better than the many other virtual visits you are hearing about because we use pediatric providers who have access to your full medical history. Call your Allied office with specific questions. For more info go to alliedphysiciansgroup.com/telehealth.
Keep your scheduled appointments. Children still need to get physicals and vaccines that protect them from illnesses much more serious than coronavirus. All of our offices have implemented procedures to keep you safe. We are following appropriate CDC recommendations. We are cleaning intensely and often.
What else can you do? Shut off the TV and give yourself and your children a break. Look for anxiety symptoms – such as moodiness, trouble sleeping, and separation anxiety. Talk to your children about their fears. Reassure them.
Check on your elderly neighbors, family, and friends. These people are most at risk for complications of Coronavirus. Ask if you can get them food, medicine or anything else they need. We are a community; we need to take care of each other.
As always #alliedcares.
We would like to give an update about how Allied Physicians Group is handling the Coronavirus- COVID19 infections in our area. Our main concern is the health and wellbeing of our patients and their families. The situation is evolving rapidly and we are making every effort to implement protocols to maximize safety within our 33 locations.
We understand there is a lot of fear and concern right now. The sensationalism and nonstop coverage from the media are making it difficult to respond rationally.
Fortunately, children have been having less severe infections. Children are exposed to many other coronaviruses every winter and this is thought to be one of the reasons why the infection is less severe in younger people. However, they can expose others who may be at greater risk for more severe outcomes.
In order to reduce the risk to our patients and their families, we are strongly encouraging the following:
We are asking families to limit the number of caregivers bringing the child to the office.
We are asking families to bring only the patient to the office, no siblings.
We are asking people over 60 to avoid the office unless there is absolutely no alternative.
We are asking all families to download our telehealth app, Anytime Pediatrics. To learn how to download the Anytime Pediatrics App, please see the directions at the end of this email.
If your doctor’s office has daytime telehealth visits, we strongly encourage considering virtual visits when appropriate. Check here to see if your practice offers telehealth during the day. Our after-hours telehealth practice is always open on Sunday – Friday, 6:30 – 10:30 pm.
If your child has a fever and coughs and is not ill-appearing, it is best to avoid our office. We are making every effort to safely keep these children out of the office. Currently, we are not able to test for COVID-19 in the office, and most hospitals are not testing unless there is a travel history or known direct exposure. Most ERs consult with infectious disease specialists and local Departments of Health. You cannot just walk in and ask for a test. If you think your child needs medical attention, please call us and we will arrange appropriate care.
Remember that washing hands and being aware of our surroundings is very important to staying healthy. There is no current need to wear masks unless instructed by medical professionals.
The most important aspect is to remain calm and rational. Allied physicians will continue to be accessible and provide the level of care you have come to expect. Our divisions are still doing well visits.
As things change, Allied will update our families as quickly as possible.
We are taking all the appropriate steps. Please still come see us, we are your best option.
Thank you for trusting us with the care of your families.