Coronavirus Update 6: How to handle COVID-19 infection at home

Many of you are testing positive for COVID-19 or are beginning to have viral illness symptoms or have family members that are having symptoms of fever, cough and or mild shortness of breath. These symptoms are best managed at home, unless shortness of breath becomes more pronounced or severe.
I wanted to give you my general recommendations on how to handle COVID-19 infection at home. Please note these recommendations are in line with the current CDC recommendations but also include what I think is best for you as my patient.
This is IMPORTANT, just because you have been tested for COVID-19 and your results are negative does not mean you do not have COVID-19. If you are having symptoms of fever, cough or shortness breath there is still a high likelihood, given the current pandemic, that you are infected with COVID-19. The sensitivity for the COVID-19 test is around 75 to 85 percent. Sensitivity measures the percentage of sick people who are correctly identified by the test as having the condition. The true positives. The COVID-19 test helps us with surveillance but does not help much clinically. As doctors we have to make clinical judgments on your condition and not rely entirely on the test. Help me with this. If you are having symptoms assume you are positive for COVID-19
My current recommendations for in home isolation are to remain in isolation until at least 10 days have passed since symptoms first appeared AND at least 5 days have passed since recovery of symptoms i.e. no fever, cough or shortness of breath.
These recommendations apply for the following people:
1. Persons who are having symptoms but not yet diagnosed positive
2. Persons diagnosed positive but having milder symptoms that can be managed at home
3.Persons diagnosed positive that have been hospitalized but have been discharged to home
Home isolation applies for all of these cases and a strict inhouse protocols to prevent spread to household members and pets are necessary.
Call me if your symptoms are worsening. During business hours please do not send me a text or call my cell phone. I’m receiving hundreds of calls and texts and its difficult to keep up with the truly sick calls or texts. In order for me to take care of you safely and efficiently, please call the office directly at 404-257-5585. I have staff that are triaging the calls in order of importance. If you are acutely ill you will receive a call back from me within 10 minutes. After hours, please call my cell phone for acute illness.
If you are prescribed a nebulizer treatment, and I will only be prescribing this in special clinical circumstances, please note that these treatments can aerosolize the virus. Do not perform nebulizer treatments while anyone else is in your room. Caregivers should wait 60 to 90 minutes after nebulizer treatment is complete before entering the room and assume that for 3 hours post treatment, the virus is aerosolized in the room so full cover should be used. If possible, nebulizer treatment should be performed in a “dirty room’ that no other person in the home will be using and that does not have air circulating from the home air-conditioning unit or where the ventilation has been covered to prevent transmission of aerosolized particles into the air system. All surfaces should be cleaned after nebulizer treatment is performed. Stop using nebulizer treatments as soon as your symptoms or shortness of breath resolve. If you have questions about this please give me a call.
Monitor your symptoms. If cough or shortness of breath worsens or fever remains high despite Tylenol then call me.
If no allergy, take Tylenol 3 to 4 times per day for fever. Do not take more than 2000 mg of Tylenol in a 24 hour period. Do not use NSAIDS.
Wash your hands with soap and water for 30 seconds frequently. Especially if you are coughing, sneezing, blowing your nose, going to the bathroom, eating or preparing food. Routinely wash your hands every 4 to 6 hours. Soap and warm to hot water is better than hand sanitizer.
Protect your psychological health. Don’t be ashamed of having symptoms or being diagnosed with COVID-19. Most of us will experience infection with this virus at some point. It’s Ok. Stay in constant phone and video communication with your friends and loved ones. We are all in this together. We will beat this.
Stay home.
No visitors.
Avoid touching your eyes, nose and mouth.
Caregivers should wear a mask and gloves when they are around you.
If caregivers do not have gloves available, then ensure hand washing or hand sanitizer use upon entering and leaving room every time.
If caregiver or patient does not have a mask then improvise. Use a scarf or use clothing with elastic bands such as underwear or shirts over the nose and mouth. Wash these in the washing machine with hot water and detergent daily.
Goggles or glasses are also recommended. Ok to use any goggles or glasses even swimming goggles.
Make sure any shared spaces in the home between you and your family have good air flow, if possible open a window.
Have another household member pick up any needed food or medication. Do not leave the home to gather these goods.
Separate yourself from other people and animals in your home.
Stay in a specific room away from other people.
Use a separate bathroom, if available. And only you should use that bathroom.
Restrict contact with pets and other animals.
Wear a facemask anytime you are anywhere near another person or animal.
Don not share any personal household items such as drinking glasses, utensils, or bedding.
Clean all “high touch” surfaces with a disinfectant wipe or spray twice daily including countertops, tabletops, doorknobs, toilets, laptops, keyboards, cellphones.
If you do go out, when you return home, before entering the main part of your house, you should take off your shoes and all your close and place these in a hamper in the garage or foyer, or a separate room. You should then take a shower or bath to reduce the chance of bringing the virus into your home.

Stay Well and Stay Home,
Dr. Edward Espinosa
Buckhead Medicine

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FAQ

What services are provided as a part of my annual fee?
  • Same-day or next business day appointments
  • Direct access to Dr. Espinosa via his personal cell phone after hours, weekends, and holidays
  • Minimal office wait times
  • Longer, more comprehensive appointments
  • House Calls (requires additional trip fee)
  • A strong focus on preventive medicine, long-term health and wellness
  • A personal professional relationship with your physician
What is the mission of Buckhead Medicine?

We strive to provide the highest quality medical care, emphasizing a comprehensive approach to prevention and disease management. We want patients to be completely satisfied with every aspect of their care.

Where is your office and are you on the medical staff of a local hospital?

Yes, Dr. Espinosa’s office is in Buckhead, a suburb of Atlanta. He is on the medical staff of Piedmont Hospital in Atlanta, Georgia and Northside Hospital in Atlanta, Georgia. If you require hospitalization, Dr. Espinosa will coordinate your patient care by working with the hospital based physicians. He will also make periodic hospital visits during your hospitalization.

Who will cover for you when you are not available?

On infrequent occasions when Dr. Espinosa is out of town or otherwise unavailable, he will have another qualified physician cover for him. Even while out of town, Dr. Espinosa will generally be available by phone to his patients and to his covering physicians. For practical reasons, we reserve the right to designate another qualified physician to perform any and all services should the need arise.

Do you accept insurance?

Commercial Insurance and Medicare:
Buckhead Medicine is an In-Network provider for Blue Cross Blue Shield PPO, Aetna, Coventry, Humana, Cigna, Tricare and United Healthcare. Our practice fully participates in the Medicare program. Buckhead Medicine accepts all other insurance as an Out-of-Network provider. We, however, do not participate in the Medicaid program. Regardless of your plan, we will bill your insurance for all covered services. It is our intention that no insurance-covered medical services are included in your annual fee.

HMO and Medicare HMO:
We do not participate in HMO programs. As such, HMO patients will not be able to join the practice until they transition to either a PPO or traditional Medicare plan.

Do I still need insurance if I enroll with you?

Yes. Personalized medical practices do not take the place of general health insurance coverage. Buckhead Medicine is a primary care medical practice, not a health insurance program. You are advised to continue your PPO, Medicare or other insurance program. If you are an uninsured individual and desire to enroll in the practice, we will provide you with a discounted fee schedule for office visits, tests and procedures.

What if I don't have health insurance?

For uninsured patients, Buckhead Medicine offers an uninsured patient plan. Although this plan is not insurance, it does cover for all clinic visits and any labs or tests that are performed in our office. In many cases this plan provides for significant cost savings to uninsured individuals. Please contact our office for additional details on this plan.

Will my insurance still be billed for my office visits?

Yes, we will bill your insurance company directly. The annual fee does not cover costs for regular exams or testing conducted inside or outside of the clinic. These costs are billed to your insurance provider in the same manner that traditional practices bill insurers.

Is there a co-payment?

If you have commercial insurance, we will collect the co-payment at the time of service. Medicare patients usually do not require a co-payment.

Do you bill Medicare for the annual fee?

No. The annual fee is not covered by Medicare. The fee only includes services that are not covered by Medicare and, as such, cannot be paid for or reimbursed by Medicare. We will bill Medicare for your sick visits and for any additional services performed at this practice that are covered by Medicare.

Will my commercial insurance reimburse my annual fee?

No, commercial insurance does not typically reimburse for the annual fee. However, some Flexible Spending Account and Health Savings Account plans may pay for all or part of the annual fee. In addition, some insurance plans allow the concierge fee to apply towards the annual deductible. Members are advised to consult their human resources representative at their place of employment.

Is the annual fee tax deductible?

In many cases the annual fee is a tax deductible healthcare expense. Patients are advised to consult with their tax consultant to clarify qualification in their particular circumstance.

Does the annual fee cover lab, x-ray, specialist fees and hospitalization?

Services such as labs, x-ray, specialty visits or hospitalizations are covered based on coverage determined by your insurance plan.

Are there age limits?

Dr. Espinosa is an Internal Medicine physician. His specialty is Adult medicine. Dr. Espinosa is trained to manage acute and chronic medical illnesses among adults. As such, the practice is limited to patients 17 years of age and older.

What if I have an emergency?

If you have a life threatening emergency, call 911 immediately. After you call 911, please call Dr. Espinosa. He will contact the hospital and notify the emergency room of your tentative arrival. In addition, Dr. Espinosa will provide the emergency room with pertinent medical history information

How far in advance do I need to book an appointment?

Dr. Espinosa is committed to providing his patients with easy access to care. All urgent visits will be accommodated either same day or next day, placing the greatest priority on the sickest patients. Annual physical exams will be booked 1 to 2 weeks in advance.

What do I do if I become ill while traveling or away on an extended vacation?

Call 911 if you have a life threatening emergency. Then call Dr. Espinosa. Call Dr. Espinosa first if the problem is minor. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If necessary, it may be possible for Dr. Espinosa to find you a resource in your area. If you seek care at an emergency room or urgent care center out of our area, we request that you have the doctor seeing you call Dr. Espinosa for coordination. Dr. Espinosa will be readily available by phone for consultation with you and/or other health care personnel. If you should require hospitalization while away, at your request, Dr. Espinosa will establish phone communication with you and your attending physician(s) to ensure continuity of care.

Do you make house calls?

House calls will be available to Buckhead Medicine members, within a limited radius from the clinic. These will be done as deemed appropriate by Dr. Espinosa on a case-by-case basis. Home visits will be billed to your insurance provider similar to an office visit. A separate trip fee is required for house calls.

What if I need to see a specialist or a surgeon?

Of course, Buckhead Medicine patients are free to see any specialist they wish. We are available to help you decide what specialists to see and to coordinate such consultations. Patients may frequently request for “doctors in my area”, and we can accommodate this. We will ensure that the most appropriate resources are used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit.

What about the cost of prescription medications?

The cost of prescription medications are the patient’s responsibility and in most cases should be covered by their insurance plans. We have expertise in assisting patients in purchasing medications in the most cost effective manner.

Will I be required to pay my annual fee even if I do not use your services?

Yes. Paying your annual fee allows you to be a member of the practice whether you are sick or well. We encourage our patients to utilize the amenities offered such as wellness consultations and emails for appropriate non-urgent health related questions, regardless of your state of health.

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