Coronavirus (SARS-CoV2/COVID 19) Update

May 1, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #7

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases persist in Arizona. Many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

TO SEE ALL THAT WE ARE DOING TO KEEP YOU SAFE, VISIT OUR WEBSITE @ WWW.AZSNEEZE.COM

Summary:

  • There are lots of questions surrounding coronavirus (COVID-19) testing. You may have heard news report about PCR testing, antibody testing, and lots of testing.
  • There are many opinions about the importance of these tests, who should get them, and what you and your doctor will learn from the tests.
  • If you are interested in being tested, Board Certified Allergists/Immunologists are the best trained and the most experienced physicians to help you choose the right test or tests and to interpret the results.
  • Please schedule an appointment with AAAI (in office or telemedicine) by calling 602-843-2991. We have 5 offices around Maricopa County to serve you.

More Details (for those that want them):

COVID-19 testing update:

There are two types of COVID-19 tests: PCR (Nasal swab) and Antibody (Blood)

  1. PCR testing (Nasal swab): Tests viral particles from a nasal swab.
    1. This test is meant to measure if your body IS infected with the virus or not.
    2. This test is most accurate when a patient has active symptoms (identified below).
  2. Antibody testing (Blood): Tests your antibody response to the virus from a blood sample.
    1. This test is meant to measure if your body WAS infected with the virus or not.
    2. Test 14 days after symptom onset or later. IgG antibodies may not be present in the first 2 weeks of infection.
    3. Antibody testing may not be accurate in the following types of patients:
      1. Patients with immune deficiencies and some autoimmune diseases.
      2. Patients on immune-modulating drugs including Xolair.

We highly recommend COVID-19 tests be ordered and interpreted by one of our Board Certified Allergists/Immunologists or a physician with experience in interpreting PCR and Antibody testing.

If you would like to receive COVID-19 testing:

  1. COVID-19 tests will be performed at an offsite testing location and results sent to the ordering physician.
  2. COVID-19 tests are covered by all insurances per federal guidelines.
  3. COVID-19 appointments may have co-pays depending on insurance and federal guidelines.
SYMPTOMS OR HISTORY CONCERNING FOR COVID-19

– Active Fever ≥  100F or in the past 2 weeks
– Chills and Myalgias
– New diarrhea
– Sudden loss of sense of smell or taste
– New cough & shortness of breath with no prior history of allergies or asthma
– Significantly worsening cough and shortness of breath with a history of allergies or asthma
– Severe fatigue with or without pounding headache.
– Exposure to someone with known COVID-19 infection, active fever, or fever in past two weeks.

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

April 20, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #6

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases persist in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

TO SEE ALL THAT WE ARE DOING TO KEEP YOU SAFE, VISIT OUR WEBSITE @ WWW.AZSNEEZE.COM

SYMPTOMS OR HISTORY CONCERNING FOR COVID-19
  • Active Fever of 100 or greater
  • New cough and shortness of breath with no prior history of allergies or asthma
  • Significantly worsening cough and shortness of breath with a history of allergies or asthma
  • Exposure to someone with known COVID exposure, active fever, or fever in past two weeks.
  • Fever in past two weeks
  • New diarrhea
  • Severe fatigue with or without pounding headache. 
  • Sudden loss of sense of smell or taste
PATIENTS OVER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep an in-office follow up OR schedule a TELEHEALTH follow up appointment.
PATIENTS UNDER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep in-office follow up appointments.
PATIENTS WITH IMMUNE DEFICIENCIES:
  1. Contact our office prior to your appointment to discuss options. 

***WHEN YOU COME TO YOUR OFFICE VISIT, PLEASE WEAR A CLOTH FACEMASK PER CDC GUIDELINES***

***IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER***

WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

April 6, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #5

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

CONCERNING COVID-19 SYMPTOMS OR EXPOSURES

– Active Fever of 100 or greater
– New cough and no prior history of allergies or asthma
– Worsening cough with a history of allergies or asthma
– Exposure to someone with known COVID exposure, active fever, or fever in past two weeks.
– Fever in past two weeks
– New diarrhea
– Severe fatigue with or without pounding headache.
– Sudden loss of sense of smell or taste

PATIENTS OVER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Re-schedule follow up appointments as a TELEHEALTH evaluation. 
PATIENTS UNDER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep in-office follow up appointments.
PATIENTS WITH IMMUNE DEFICIENCIES:
  1. Contact our office prior to your appointment to discuss options. 

***WHEN YOU COME TO YOUR OFFICE VISIT, PLEASE WEAR A CLOTH FACEMASK PER CDC GUIDELINES***

***IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER***

WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

March 30, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #4

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

IF YOU DO NOT FEEL SICK AND DO NOT EXHIBIT CONCERNING SYMPTOMS (SEE LIST BELOW), PLEASE COME INTO OUR OFFICES FOR YOUR FOLLOW UP OR NEW APPOINTMENT AS SCHEDULED. 
IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER.
CALL IF YOU HAVE ANY OF THE FOLLOWING CONCERNING SYMPTOMS OR EXPOSURES:
  1. Active Fever 
  2. New cough and no prior history of allergies or asthma
  3. Worsening cough with a history of allergies or asthma
  4. Exposure to someone with known COVID exposure, active fever, or fever in the past two weeks.
  5. Fever in the past two weeks
  6. New diarrhea
  7. Severe fatigue with or without a pounding headache. 
  8. Sudden loss of sense of smell or taste
WHAT WE ARE DOING
  1. Telehealth and In-Office Appointments
  2. Outside screening of all persons entering our office.
  3. In-office sanitation and infectious disease prevention protocols (N95 masks for physicians and staff; Hand washing, frequently scheduled disinfection of office surfaces; face masks; eye shields and gowns where necessary)
  4. Social distancing and infection disease prevention protocols. (Waiting room occupancy limited to ten with spaced seating arrangement, ability to wait in the car for shots and appointments)
WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

March 23, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #3

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! The general population remains at low risk for serious complications from exposure to Coronavirus. Nevertheless, cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

OUTSIDE SCREENING OF ALL PERSONS ENTERING OUR OFFICE CONTINUES

 

IN-OFFICE SANITATION AND INFECTIOUS DISEASE PREVENTION PROTOCOLS CONTINUE

 

SOCIAL DISTANCING PRACTICES INCLUDING IN-VEHICLE WAITING FOR APPOINTMENTS REMAIN IN PLACE

 

IF YOU FEEL SICK WITH A COUGH AND FEVER:
  1. At this time, we define a fever as a temperature of 100 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots within 14 days of your most recent FEVER.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.
WE ARE UP TO DATE ON ALL ACTIVE THERAPY CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE UPDATES AS FURTHER INFORMATION IS AVAILABLE. 

We, the physicians at AAAI, daily review all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

March 16, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update #2

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! Arizonans remain at low risk for serious complications from exposure to Coronavirus. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

OUTSIDE SCREENING OF ALL PERSONS PRIOR TO ENTERING OUR OFFICE
  1. You will be asked four simple questions regarding your symptoms.
  2. Your temperature will be checked.
  3. You may be asked to enter our office through an alternate entrance.
  4. You may be given printed instructions and asked to reschedule.
  5. You may be asked to wait outside to consult with a provider.
SOCIAL DISTANCING THROUGH LIMITATION OF UNNECESSARY PERSONS ENTERING OUR OFFICE:
  1. We request that you bring only one additional family member or friend to your appointment or when you are receiving allergy shots.
  2. Number of persons allowed in shot lab at any given time will not exceed 50 per CDC guidelines.
  3. Patients are allowed to wait in their cars for 30 minutes after receiving their shots.
IF YOU ARE ON ANTIBODY INFUSIONS FOR AN IMMUNE DEFICIENCY:
  1. Contact our office for further instructions.
IF YOU FEEL SICK WITH A COUGH AND FEVER:
  1. At this time, we define a fever as a temperature of 100 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots if you are recovering from a FEVER WITHIN THE PAST FIVE DAYS.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.

We, the physicians at AAAI, daily review all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.

March 13, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update

WITH THE UNDERTAKING OF RIGOROUS ADDITIONAL CLEANING PROCEDURES, AAAI DELIVERS CLEAN WORKSPACES AT OUR CLINICS.

IN ORDER TO CONTINUE TO PROVIDE A SAFE ENVIRONMENT FOR OUR PATIENTS AND STAFF, WE HAVE IMPLEMENTED THE FOLLOWING PLAN:

Daily
  1. Staff temperature checks with ear thermometer. If temp above 100.5, evaluated by PA and sent home until fever is subsided for 2 days
  2. Handwashing upon arrival into the building (morning, after lunch, after any errand)
  3. Drug reps with samples will stay at the front desk. Front desk staff will bring iPads to the providers for signatures.
  4. For now, drug reps can still bring in food but they must wash hands and undergo temperature check.
Several times daily
  1. Using 1:40 bleach/water blend, Front desk wipes down lobby chairs, keyboards,  front door and other door handles (inside and out), back of clipboards, etc.
  2. Back office wipes down exam room chairs, bathroom door knobs and faucets, door handles, keyboards, etc.
  3. Confirm that hand sanitizer bottles are available at front desk and allergy lab sign in. Wipe these bottles down with bleach solution.
  4. Cell phones should also be wiped down as frequently as possible, but at least in the morning and after lunch if used.
Between patients and patient interaction
  1. Wash hands between each patient
  2. Ask patient to use their own pen/pencil to fill out forms. If not available, provide a pen but wipe down afterward.

March 9, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update

Dear patients of AAAI

Your health and the health of our staff is our highest priority! The general population is at low risk for serious complications from exposure to Coronavirus. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

Common Sense Self Protection:
  1. Take your prescribed medications daily. Do not miss a dose. This is a time for strict compliance.
  2. Frequently wash your hands with soap and water for 30 seconds.
  3. Cover your nose and mouth with your elbow fold when you cough or sneeze.
  4. Do not shake hands.
  5. If you are over the age of 50, avoid elective large gatherings such as sporting events, concerts, and movies.
Fever:
  1. A fever at this time is defined as a temperature of 100.5 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots if you have had a FEVER WITHIN FIVE DAYS.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.
What we are doing:
  1. Daily screening of staff.
  2. Frequent sanitation of common areas with approved disinfectants.
  3. Daily review and updates (if necessary) of the current standard of care protocols.
  4. Continued updates and communication with you.

We, the physicians at AAAI, have carefully reviewed all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.
Kevin M. Boesel M.D.
Mark E. Rose M.D.
Ryan M. Casper M.D.
Levente E. Erdos M.D.
Eiza L. Ching M.D.
Joseph Mittel M.D.