Category: Disease
Covid-19: Update
Who is eligible for a Covid-19 vaccine booster?
There have been some changes to COVID vaccine & booster eligibility guidelines.
- Booster eligibility now begins 5 months after your primary series for Pfizer and Moderna.
- 12-15 year olds are now eligible for boosters with Pfizer, 5 months after they complete the primary series.
- Anyone who received J&J for the primary vaccine, is eligible for a booster of any vaccine 2 months after the primary shot.
I just had COVID, when can I get my vaccine?
You can get your primary COVID vaccine or your booster as soon as you have met the criteria to leave isolation: 5 days, fever free for 24 hours and symptoms improved.
My child tested positive for COVID, what do I do?
First of all, don’t panic! For the vast majority of children, COVID is a mild illness. Just monitor and manage symptoms as they come.
There have also been some changes to isolation recommendations.
If You Test Positive for COVID-19: Everyone, regardless of vaccination status.
- Stay home for 5 days. If your child cannot wear a mask, then they should stay home for 10 days.
- If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.
- Continue to wear a mask (ideally a good mask such as N95, KN95- since you are likely still contagious) around others for 5 additional days. Again, if your child cannot wear a mask, then 10 days of isolation.
If you have any symptoms, continue to stay home until your symptoms resolve.
My child was exposed to COVID, what do I do?
Again, don’t panic!
If they: have been boosted or completed the primary series of a vaccine and are not due for a booster yet:
- Wear a mask around others for 10 days.
- Test on day 5, if possible.
- If you develop symptoms get a test and stay home.
If they: are overdue for a booster or unvaccinated or too young to be eligible for a vaccine
- Stay home for 5 days. After that continue to wear a mask around others for 5 additional days. If your child cannot wear a mask, then they should isolate for 10 days.
- Test on day 5 if possible.
- If you develop symptoms get a test and stay home.
Overarching guidelines– stay home if sick, wear a (high-quality) mask, and get tested if possible
Should I trust a Covid rapid test?
We have become increasingly aware that rapid tests have some limitations. The rapid tests may provide false negatives with Omicron, early in the course of illness, and in asymptomatic people. This is because rapid tests are less sensitive.
What do we mean by sensitive? Sensitivity statistically means the likelihood that the test will give you a positive result when you actually have the disease. If a test has a lot of false negatives, then the sensitivity is low. For example, what do we see if we test 10 patients in the office with a rapid test, some asymptomatic but exposed, some with 1 day of mild symptoms, some with 3 days of symptoms and then also do a PCR these patients and compare the results? Anecdotally, we will get a few negative results on the rapid test that then come back positive on the PCR (when we get the PCR back 2-4 days later).
What does this mean practically?
If you are symptomatic and your rapid test ends up being positive, you have COVID. If your test is negative, we don’t know if you have COVID or not based on the rapid alone, although most likely you have a non-COVID illness or virus. In these cases, parents can go back to things we know are effective – getting children vaccinated, stay home if sick, and wear a high-quality mask.
What type of mask is best?
The Omicron variant is more contagious than prior variants. Consider using a more effective mask while we have such a high community caseload. Consider an effective mask particularly when you are in crowded settings, if it is not possible to maintain distance, or if you are indoors for long periods of time.
In order of increasing protection: least protective are cloth masks, then surgical masks then KN95s, KF94s and N95s.
When can my child return to sports after a COVID infection?
After a COVID infection, there is a very small risk of myocarditis, which is inflammation of the heart muscle. Children who play organized sports are required to get a clearance from their physician to return to playing sports. Please make an appointment with us when your child has completed their required isolation time (5 days and symptoms improved including fever resolved for 72 hours). Younger children are at lower risk since their sports are less competitive, and they are allowed to simply self-regulate their activity. If your child had mild symptoms: minimal fever, no severe cough or shortness of breath and total COVID symptoms for less than a week, then the risk of myocarditis is very low, so don’t worry! If at any point, your child develops: chest pain, shortness of breath, new heart palpitations, or near-fainting/fainting, stop exercise and call us.
Other FAQs:
My family recently all had COVID, do we still need to be careful?
Most likely you have a few months of protection from COVID. That is unless a new variant comes around in the meantime. However, we urge caution; don’t forget about the other viral illnesses that are around in the winter. If you have an infant, an immunocompromised family member, or a child with asthma then consider that RSV, influenza, and other viruses are also circulating, so please don’t throw all caution to the wind!
I completed my 5 day isolation after COVID, can I go see my kids now? How do I know if I am still contagious?
The short answer is, you could be still contagious on Day 6. Some people use a rapid test as a proxy for contagiousness, but there is no solid evidence for this. We recommend wearing a high quality mask (KN95, KF94, N95) for days 5-10 of your isolation when around others.
I completed my 5-day isolation but I still feel really awful with ongoing symptoms. What should I do?
Please stay home. You are still sick and need to continue to isolate.
What are you seeing clinically in children who have COVID?
Common symptoms in young children with Omicron have been fever, a croupy (barky) cough, sometimes diarrhea and vomiting. In older children, school-aged kids, we often hear about a headache, sore throat, body aches, and occasional vomiting. We are also seeing some influenza cases; these patients often have fever, vomiting, and body aches. This is not an exhaustive list of symptoms, just our general perspective in the office.
Please do not hesitate to call your doctor, PA, or nurse if you have any questions!
Covid-19 Vaccine Clinic For Children 5-11 Years At Willows
We are excited to announce our Pfizer COVID-19 vaccines have shipped!
We will be holding vaccination clinics for dose 1 and 2 on the following evenings from 5:30 pm – 7:30 pm.
The choices are:
Dose 1: Tuesday Nov 16 AND Dose 2: Tuesday Dec 7
Dose 1: Thursday Nov 18 AND Dose 2: Thursday Dec 9
Please call our office to schedule both dose 1 and dose 2 appointments. Also, please note to ensure all patients receive both doses, we cannot accommodate families who only want their child to receive one Covid-19 vaccine dose at our office.
Please print this Covid-19 vaccine administration form to complete and bring with you for each child. Forms will be available at our office for families who are unable to print the form out ahead of time.
Children must be observed for 15 minutes in our office after receiving the vaccine. We are happy to answer any questions, please don’t hesitate to call us!
Covid-19 Vaccine for Children 5-11 Years at Willows
We are thrilled the Pfizer Covid-19 vaccine has been approved for children ages 5-11 years. We are also aware that many families have been anticipating this and want to vaccinate their children as soon as possible.
We look forward to administering the Covid-19 vaccine to our patients ages 5 through 11 years in our office. Unfortunately, we do not have an expected ship date yet from the State of Connecticut. As soon as we are confirmed on when the vaccine will arrive at our office, we will post dates for vaccine clinics at Willows.
There are also other opportunities to get the vaccine locally, including local pharmacies and hospital sponsored clinics. You can locate other sites giving the Covid-19 vaccine to children ages 5-11 though the CT Vaccine portal.
Our advice at this time is to get the vaccine at your first available opportunity wherever you and your child are comfortable.
Please do not hesitate to call your doctor, PA, or nurse if you have any questions!
Helpful Link: The CT Vaccine Portal
https://portal.ct.gov/vaccine-portal?language=en_US
Covid-19 Vaccine Clinic November 13th for ages 5-11 years
We are excited to be part of a collaborative Westport Covid-19 Vaccine clinic to be held Saturday November 13th at the Staples High School Field House in Westport. Willows Pediatrics, along with Bay Street Pediatrics, Village Pediatrics, Connecticut Children’s Medical Center (CCMC) and the town of Westport school district are co-sponsoring a Covid-19 vaccine clinic November 13th followed by another clinic Saturday December 4th for the second vaccine dose.
Date and Time:
Saturday November 13, 2021 from 9 am to 5 pm for Dose 1
Saturday December 4, 2021 from 9 am to 5 pm for Dose 2
Who may sign up:
Children ages 5 years through 11 years who are patients of any of the three pediatric practices in Westport AND children who are students in the Westport school system who are not patients at a Westport pediatric practice.
Location:
Staples High School Field House (Westport, CT)
How do I sign up?
Click this link to sign up. Be sure to sign up for both the November 13th and December 4th dates (click “Next” at the bottom of the signup site to advance to the December date).
Please Note:
- Appointments are limited, please sign up as soon as possible.
- The pre-vaccination patient authorization form is available on the signup site under “Related Files”.
- Please print this form for each child and bring it with you to each clinic.
You can also locate sites giving the Covid-19 vaccine to children ages 5-11 though the CT Vaccine portal
Please do not hesitate to call us if you have any questions. We are proud to work as part of community wide team to keep our children healthy. Please note all children will need to remain on-site for 15 minutes of observation after they receive their vaccine.
Helpful Links:
For appointment sign up:
https://www.signupgenius.com/go/10C0F4BA4A82DA1FAC43-westport
For the CT Vaccine Portal:
https://portal.ct.gov/vaccine-portal?language=en_US
Covid-19 Testing Sites in our Community
Below is information on where families can obtain Covid-19 testing in our community. This list is not inclusive of all sites in our area, but includes sites many of our families have used. For the latest information and hours of operation, please call the testing site.
Please note:
-Covid-19 rapid refers to the “quick” test. The rapid test is an antigen test that indicates if specific proteins on the surface of the virus are present.
-Covid-19 PCR testing refers to the non-“quick” test. PCR is a molecular test that indicates if RNA (genetic material) of the Covid-19 virus is present. The time taken to get results can vary.
WESTPORT
Willows Pediatric Group
1563 Post Road East, Westport, CT 06880
Phone: 203-319-3939
NOTES (please note, we can only offer testing to our patients)
Willows offers Covid-19 testing to our patients of any age who are asymptomatic, and to our patients of any age who are symptomatic. We test asymptomatic patients by appointment as outside “car visits”. We see symptomatic patients by appointment in areas of our office that are physically separated from the rest of the office and accessed by a separate entrance. Please call with questions or to make an appointment. Testing, both Rapid Antigen testing (done in our office) and PCR testing (sent to an outside lab), is done on weekdays and weekends during our regular office hours.
St. Vincent’s – Hartford Health Care
47 Long Lots Road, Westport, CT 06880
Phone: 833-621-0600
NOTES
Pre-registration with Hartford Health Care
No order/prescription required
Children 6 months of age and older
Performs Covid-19 PCR test
Receive results through MyChart app or by phone
FAIRFIELD
DOCS Urgent Care – Fairfield
525 Tunxis Hill Cut Off, Fairfield, CT 06825
Phone: 203-301-8483
Fax: 203-870-1976
NOTES
Walk-in only, no appointments
Performs Covid-19 rapid and Covid-19 PCR test
No order/prescription required
Children over 2 years of age
May pre-register online
Yale New Haven Health
140 Mill Plain Road, Fairfield, 06824
NOTES
Performs Covid-19 PCR test
Self-schedule appointment on-line
Yale Urgent Care – Fairfield
309 Stillson Road, Fairfield, 06825
Phone: 203-331-1924
Fax: 203-331-1450
NOTES
Performs Covid-19 PCR test
Prescription required
Please call your Willows nurse/PA/physician
NORWALK
Community Health Center
Drive through at Veteran’s Park
42 Seaview Avenue, Norwalk, CT 06855
No order,prescription, or appointment needed
NOTES
All ages, receive results through CHC’s on-line portal
Performs Covid-19 PCR test
DOCS Urgent Care – Norwalk
677 Connecticut Ave
Norwalk, CT 06854
PHONE: 203-298-9752
FAX: 203-301-8483
NOTES
See above under DOCS Urgent Care – Fairfield
BRIDGEPORT
St. Vincent’s – Hartford Health Care
2979 Main Street, Bridgeport
NOTES
See above under Westport
Optimus Health Care
982 E. Main Street
Bridgeport, CT
Phone: 203-696-3260
NOTES
Performs Covid-19 PCR test, No prescription or appointment required
DOCS Urgent Care – Bridgeport
1677 E Main St
Bridgeport CT, 06608
Phone: 203-612-7929
Fax: (203) 612-7931
NOTES
See above under DOCS Urgent Care – Fairfield
Miscellaneous- CVS Minute Clinic
Please go to the link below:
https://www.cvs.com/minuteclinic/covid-19-testing
NOTES
Only ages 18 and over
Check website above for locations and hours
Covid-19 Vaccine Information
Many of our parents have received one of the three available Covid-19 vaccines, and families are looking forward to having their adolescent or young adult receive a Covid-19 vaccine too. As of now, the youngest age an individual can receive a Covid-19 vaccine is 16 years.
The Pfizer vaccine (two doses 3 weeks apart) is authorized for people age 16 years and older. The Moderna vaccine (two doses 4 weeks apart) is authorized for ages 18 years and older. The Johnson and Johnson vaccine (one dose only) is authorized for ages 18 years and older.
All individuals receiving a Covid-19 vaccine must receive the vaccine at a site specified by the State of Connecticut. Currently, individual medical practices, e.g. Willows Pediatrics, are not included in the State program to administer Covid-19 vaccines. Thus, we cannot give your adolescent or young adult a Covid-19 vaccine even if he or she is eligible to receive a Covid-19 vaccine.
Information on how to schedule Covid-19 vaccinations is available on the State of Connecticut Covid-19 vaccine website. Beginning April 1st, individuals 16 years and older who live or work in the state are eligible to receive the Covid-19 vaccine in the State of Connecticut.
Research has shown Covid-19 vaccines are remarkably safe and effective. Clinical trials are now underway using Covid-19 vaccine in children under 16 years of age. Below are answers to some common questions, please let us know if you have any additional questions or concerns:
Q.My child already had a Covid-19 infection. Should he or she still get the Covid-19 vaccine?
A.Yes! Even though having had Covid-19 may provide some protection from getting sick again, we don’t know how long that protection will last. (Please note, if you were treated for Covid-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a Covid-19 vaccine.)
Q.Are there side effects after getting the Covid-19 vaccine?
A.The most common symptoms after getting vaccinated are a mild to moderate headache, muscle aches or fatigue, and sometimes a low fever. These usually don’t last more than a day to two.
Covid-19 Testing For Asymptomatic Patients Now Available
We are happy to provide Covid-19 testing at our office for asymptomatic patients of Willows Pediatrics of any age by appointment. These appointments take place outside in our parking lot, at your car, to keep everyone safe.
Asymptomatic patients include anyone who wants Covid-19 testing, but does not have symptoms at the time. This includes testing for travel clearance or for exposure to a positive contact.
We offer both PCR and rapid antigen testing and can help you decide if one or both are better depending on your situation.
Can my child get tested at Willows if he or she is sick?
Of course! If your child is sick, we are available to examine him or her in our office and conduct any workup needed including rapid Covid-19 Antigen testing and PCR testing.
Please remember: It is important to schedule an exam if your child is unwell. We continue to find cases of strep, mono, ear infections, and many other treatable non-covid illnesses in our patients who present with signs and symptoms of illness.
Change in Quarantine Guidelines
As you may have heard, on December 2nd, 2020 the CDC revised the COVID-19 quarantine guidelines. The changes shorten the required quarantine after a known exposure to COVID. However, the incubation period for the virus is 2-14 days. So a 14 day quarantine is still the most effective!
The Connecticut Department of Public Health (DPH) released a statement December 16, 2020 updating the CT rules to be the same as the CDC rules.
What are the new guidelines for quarantine after COVID exposure?
The new guidelines for quarantine after an exposure are:
Option 1: 10 days quarantine, no test required
- Self-monitor for symptoms for 10 days, if no symptoms develop, then you can stop quarantining after 10 days.
- However, on days 10-14 follow all your usual COVID precautions – masks and distancing – AND monitor for symptoms.
Option 2: 7 days quarantine, test day 5-7
- If testing is available, then you can get tested on day 5 or later. If your PCR or Antigen/Rapid test is negative, you can leave quarantine on day 7.
- Again, continue to monitor for symptoms until day 14 and always follow COVID precautions.
What are the chances of becoming positive after leaving a shorter quarantine?
This helpful table above from the CT DPH summarizes the various options and residual risk of positivity.
What are the new guidelines for travel?
There is a Travel Advisory in CT; anyone traveling into the state from states on the Advisory List is required to quarantine for 10 days. (Note the length of quarantine after travel has also been decreased.)
The Advisory List includes all states except New York, New Jersey and Rhode Island. It also includes ANY international travel.
A negative PCR or Rapid/Antigen test will exempt you from quarantine. The test has to be obtained in the 72 hours prior to your return to CT or anytime following your return to CT. Wait until you get your negative result to leave quarantine.
What is Willows’ office policy regarding coming to the office?
We will adopt the CDC and CT DPH guidelines for quarantine after travel and exposure for families coming to our office for “well care”. When you bring your child to our office for a well visit, it should be 10 days after a known Covid exposure or travel, or sooner if you and your child were exposed and tested negative.
Please remember if your child is sick we can accommodate you at any time! Please just let us know and we can arrange to see you child in our area reserved for “sick care”.
Covid-19 Exposure Guidance
I was notified that my child was exposed to COVID, what should we do?
As rates of COVID-19 increase in our area, more and more families are facing this situation. Parents may be notified through school, extracurriculars, or social contacts that they or their children have been exposed to COVID-19.
Families have been asking Willows Pediatrics what to do when they find out they have been exposed to someone who has a confirmed COVID-19 infection. This post will try to give you some guidance. We understand this can be scary and we are happy to talk you through the specifics of your situation, just give us a call at (203) 319-3939.
What counts as a COVID exposure?
According to the CDC, exposure to COVID-19 is defined as having close, prolonged contact, being within 6 feet for greater than 15 minutes, with a person who tested positive either while that person was symptomatic or in the 48 hours prior to that person becoming symptomatic.
If the person who tested positive was never symptomatic then consider any contact with that person within a few days of their test to be a possible exposure.
One of the members of my household was exposed to COVID. What should we do?
If a member of your household was exposed to COVID-19 then that person should quarantine for 14 days from their last contact with the positive person. Try to limit the spread of COVID in your household by having the exposed person self-isolate in one area of the house, wear a mask when in common spaces, and have their own bathroom, if possible. Of course, self-isolation is not an option for a young child so the parent should wear a mask around the child.
If the exposed person is asymptomatic, we recommend they get a PCR test 5-7 days from their exposure. Rapid tests have a high false negative rate in asymptomatic people and are not approved for this use. If the exposed person develops symptoms, then a rapid test is appropriate.
We were exposed but tested negative. Do we still have to quarantine?
It is very important to know, a negative test after an exposure does NOT exclude COVID-19 and you must continue to quarantine for 14 days from your last exposure.
Like other viruses, COVID-19 stays in your body and replicates over several days (for up to 14 days). Unfortunately, even a COVID-19 PCR test may not detect an early infection.
For example, if you were exposed on Monday, you could test negative on Thursday, but still be contagious or symptomatic by Saturday. So, even if you test negative, you should still continue to quarantine after an exposure.
COVID 19 Testing: Antibody and Viral tests
There are two kinds of tests for COVID-19: a viral test and an antibody test.
- A viral test (nasal or oral swab) tells you if you have a current infection
- An antibody test (blood test) tells you if had a previous infection
Viral Tests: Testing for current infection
To learn if you have a current infection, viral tests are used. A viral test is collected by a nasal or oral swab at a testing center in our area.
Who should be tested?
- The decision to get tested depends on several different factors including how sick the patient is, what medical problems the patient has and who resides in the patient’s household (e.g. an immunosuppressed family member, a parent who is a health care worker)
- At this time, we still encourage testing only if you have symptoms suggesting a COVID-19 infection.
- If you have symptoms suggesting COVID-19 and want to get tested, please call our office.
- If you have gotten tested and are awaiting the results, please isolate/quarantine to avoid possibly spreading the infection to others.
Interpreting the results
- If you test NEGATIVE for COVID-19 by a viral test while you have symptoms, then you likely do NOT have COVID-19. Though we know that there are some false negatives, meaning people who actually DO have COVID but get a negative test result, a false negative result is unlikely.
- If you test POSITIVE for COVID-19 by a viral test then you have an active infection. Please quarantine in your home and isolate as much as possible from others in your home. If you test positive, we can discuss with you how to minimize spread within your home and when you can safely leave isolation.
Antibody Tests: Testing for past infection
Antibody tests are blood tests that check if your body has antibodies from a previous infection with the virus. Antibodies are proteins our immune system makes when we are exposed to a virus and continue to circulate in our blood after we have recovered from the infection. COVID-19 antibody tests cannot be used to see if you have a current infection, as sometimes the antibodies cannot be detected for weeks after the initial infection.
We use antibody testing for many other diseases to tell us if a patient has had an infection or has immunity to a disease. For diseases that have been studied over time we know what level of antibody is effective and we know whether that antibody can give you temporary or permanent immunity. However, since COVID-19 is a new disease we don’t have all the facts yet.
Cautions regarding antibody tests:
- We do not know at this time if antibodies provide immunity against getting re-infected
- We do not know how specific the antibody tests are for detecting antibodies to SARS-CoV-2 versus closely related coronaviruses such as the common cold.
- There are many tests available right now but few of them have been FDA approved, meaning we do not know how accurate these tests are. In other words, if the test says you have antibodies, or don’t have antibodies, how likely is that to be true?
Given all of these cautions, we are not currently recommending antibody testing for most people. The only scenario in which we DO recommend testing is if you have had a positive COVID-19 viral test and are interested in plasma donation.
Why we don’t think you should get an antibody test now:
- We are concerned that you may get a “positive” result when you don’t actually have antibodies to COVID. This could happen because these tests are still very new, they were released to the market before the FDA validated them and you may have very similar antibodies from a very similar virus you’ve had in the past. If you got a positive result you may interpret that to mean you are immune, when in fact you are not. This could be dangerous as you may not be as rigorous about wearing a mask or social distancing and accidentally expose yourself or others.
- We don’t know yet what having antibodies to COVID-19 means. We don’t know if those antibodies confer immunity and, if so, how long that immunity lasts.
- Antibody tests are usually expensive. Since many of the tests on the market are not FDA approved they may not be covered by insurance.
- Antibody tests require a blood draw in a doctor’s office or hospital. We usually do everything we can to minimize blood draws in kids to avoid discomfort.
Looking forward:
The scientific community is working furiously to learn more about COVID-19 each and every day. We are hopeful that soon we will know more about COVID-19 antibodies and immunity. We are also hopeful that the FDA will review the tests on the market and guide us to which tests are the most accurate. We will continue to follow this issue closely to give you the best guidance and we will update you when our recommendations change.
For now, please continue to social distance, stay home if you or anyone you’ve been in contact with is sick, and wear a mask when social distancing is not possible.
Sources and Suggested Reading
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html
https://www.scientificamerican.com/article/what-covid-19-antibody-tests-can-and-cannot-tell-us/