Belmont Medical Associates

IMPORTANT
ANNOUNCEMENT ABOUT OFFICE VISITS

NO PATIENTS (WITHOUT EXCEPTION)
WILL BE SEEN AT OUR BMA OFFICE
UNTIL FURTHER NOTICE
In light of the current world crisis, insurance companies in the United States are allowing telephone (and video) virtual visits to occur.
We can put you on the schedule for a telemedicine consultation and with your permission your insurance company can be billed and we will have the doctor call you at a designated time.

Think you may have, or have been exposed to, the Corona Virus?

Symptoms associated with COVID-19

Fever (>100.4) or feverish
Cough
Sore throat
Shortness of breath
Unusual fatigue
Chills
Body aches
Vomiting
Diarrhea
Nausea
Chest pain
Abdominal pain
Loss of smell or taste

As OUR office does NOT have test kits, there is NO point in coming to the office to be evaluated. Have us call you back about your concerns.
Testing sites are opening up and will become more easily available. Fortunately the criteria for testing have been loosened up so more folks can get tested. Remember that testing positive does not change any treatment as no current anti-viral agent that we have is effective.

At Mount Auburn Hospital they are currently only testing: patients with symptoms (Cough, SOB, Sore throat, fever or feverishness, unusual fatigue, body aches, nausea, vomiting, diarrhea or abdominal pain.) AND with other high-risk conditions:
Chronic lung (such as asthma, COPD and cystic fibrosis
Endocrine (such as diabetes mellitus)
Cardiac disease (such as congenital heart disease, CHF, CAD)
Hematologic malignancy
Immunosuppression (due to disease or medication)
Liver disease
Chronic kidney disease
For patients who do not fall into these testing categories, but their provider or patient still wants to be tested, please click on link below for alternative testing sites in MA. Please note that supplies are limited in some locations and these sites also have priorities for testing.
https://www.mass.gov/doc/ma-covid-19-testing-sites/download

HOW to SET UP TESTING at MAH - How the COVID 19 HOTLINE Works
If a PCP or patient has concerns for Covid19 infection, their PCP should first evaluate the patient by telemedicine or phone.
If the PCP then feels a patient cannot remain at home without an evaluation then the clinician should call the Covid19 Hotline themselves at 617-492-3500 x3647 to refer the patient for car side ILI evaluation.
The Hotline staff then contacts the patient, orients patient to drive-up process, and collect some basic information from patient.
Patient then presents for a CAR-side evaluation which includes an O2 sat, heart rate and temperature along with an in person visual evaluation by physician on site - with the possibility of transfer to the ED.
If the PCP thinks the patient is too sick to be seen curbside then they should either have the patient call 911 or again call the hotline and explain this to RN staff on phone. The hotline will alert the ED front desk for patient arrival.
The Mass Dept of Public Health (DPH) are also doing testing. Their HOTLINE telephone line is 617-983-6800

ANTIBODY TESTING:
At this time, we are not routinely recommending that patients get COVID-19 antibody testing. None of these tests have been FDA approved, and we do not know how often these tests give a false result about whether someone was infected or not. It is also not clear that the antibodies being measured in these tests actually give you immunity to COVID-19 infection. Eventually, when we have a better understanding of these tests and have guidelines from the FDA and our infectious disease specialists, we will know when and how to order antibody testing for COVID-19.
Quest Labs are performing these tests by appointment. Use their website for how to go about finding a site near you.

IF YOU ARE SICK:

Stay at home and do not go to work if you are sick.
Avoid socializing. Maintain social distancing. Take this seriously.
Wash your hands with soap and warm water often.
Use an alcohol based hand sanitizer like Purell often.
Keep your hands away from your face (mouth, nose and eyes).
Cough into your elbow.
Wear a mask if you are coughing and around others.
Avoid shaking hands. Use a fist or elbow bump!
Try to maintain a 6 foot distance from others if you are sick.
Wipe down surfaces using Chlorox (or equivalent) wipes.
AVOID USING IBUPROFEN for fever or body aches. Tylenol is safe and effective.
SYMPTOMS THAT REQUIRE OUR ATTENTION:

shortness of breath; wheezing, difficulty breathing
persistent pain, tightness or pressure in your chest
Persistent significant fevers of over 100 and heart rate over 100
persistent cough especially if productive of thick yellow or green phlegm.
new confusion or inability to arouse
bluish lips or face.
Inability to hydrate or eat appropriately, decreased urine output
Inability to care for oneself at home

Steps to help prevent the spread of COVID-19

If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community. Older adults and people with severe medical conditions such as heart, lung or kidney disease are advised to ‘‘stay home as much as possible’’ and avoid crowds especially in poorly ventilated spaces.

Stay home except to get medical care
You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from other people and animals in your home
People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.
Animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a facemask.

Call ahead before visiting your doctor
If you plan on making a medical appointment, CALL the healthcare provider FIRST and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Wear a facemask
You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.

Cover your coughs and sneezes
Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

Clean your hands often
Wash your hands often with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items
You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.

Clean all “high-touch” surfaces everyday
High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

Monitor your symptoms
Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.
If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a facemask before emergency medical services arrive.

Discontinuing home isolation
Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

IMPORTANT NOTICE

THE DOCTORS ON THE 4TH FLOOR HAVE MOVED UPSTAIRS TO
THE 6TH FLOOR
AND ARE NOW SEEING PATIENTS IN SUITE 6100

EXCEPT FOR
DR KOWALOFF AND DR GREEN
WHO HAVE MOVED TO THE 5TH FLOOR