Thank you to Dr. Allison Edwards from KC DPC for her work on a majority of this information.

Good Afternoon,

We are reaching out because we know this is a confusing and anxiety provoking time for many people. As you are likely aware, Massachusetts residents have tested positive for COVID-19 (the illness caused by the novel Coronavirus) and we expect more cases to be identified as testing availability expands over the coming days to weeks. As of earlier today there are a total of 95 presumptive and confirmed cases of coronavirus in the state. Most of the these patients will do very well and will not require hospital level of care.  

As your physicians, we are committed to staying up to date on developments and changes, so that we can provide you with the most accurate and timely information possible.  We are routinely reviewing updates from the Massachusetts Department of Public Health (https://www.mass.gov/orgs/department-of-public-health) and the CDC (www.CDC.gov). If you have questions or concerns, we strongly urge you to visit and utilize these resources. We do not recommend you get your information from social media.  

This is not a time to panic, but we do all need to institute some changes in our day to day lives to try to slow the spread of the virus. Yes, it may be inconvenient, but it is necessary. We may not be able to prevent a large portion of the population from getting this infection, and the majority of people who are infected will do just fine. However, it is very important that we slow the spread so that huge numbers of people are not infected at the same time, which would overwhelm our hospitals’ ability to care for the segment of people who need hospital level care due to severe illness. We ask that everyone practice “social-distancing” and avoid non-essential large gatherings or unnecessary travel, wash your hands frequently, avoid touching your face and stay home if you have a fever or cough. This is the best way for us to ensure that there will be adequate health care resources for folks who do get very ill from the virus.

At Gold Direct Care we are fully committed to caring for our patients in the most evidence-based, safest capacity possible. We want to make sure that you know how we plan to serve you as COVID-19 spreads through our community, so we’ve put together the following information to explain what you can expect from us over the next few weeks to months.

As of today, March 12, we are asking those with respiratory symptoms (cough, shortness of breath, wheezing) and/or fever to first call the office (781-842-3961) or text message your physician.  DO NOT walk-in to the office without first calling. If you walk-in you are potentially putting our staff and other patients at risk unnecessarily.  We will reach out to you for more information and determine the best way and place to evaluate you.  If you have a regularly scheduled visit for a routine, non-urgent issue and you want to cancel in light of current events, please call the office and Lauren will reschedule you. Many issues can be handled over the phone, so we can always arrange a phone-visit between you and your doctor. In addition, no patients will be given an appointment without providing a brief reason for the visit. This helps us from being surprised by someone’s symptoms. Please do not “back-door” us and say you are coming in for a benign reason when really you have respiratory symptoms that should be handled as stated above. When in doubt, call the office and we will triage you appropriately.

The key points of the triage system we have put in place to keep everyone safe are as follows:

    •    If you have mild, isolated, upper respiratory symptoms (runny nose, nasal congestion, post-nasal drip, sore throat), but NO fever or cough, and have NOTbeen in close contact (within 6ft for at least 15 minutes) with someone diagnosed with COVID-19, nor recently returned from travel to a high transmission country (China, Iran, Italy, South Korea and Japan) or the Northwest US, we will recommend home care and that you not come in for an in-person visit.  You are always welcome to schedule a phone visit with Dr. Mancini or Dr. Gold to talk through things.  

    •    If you have lower respiratory symptoms (deep cough or shortness of breath) and/or fever your physician will recommend a telephone visit to ascertain if an in-person visit is warranted.

    •    If we determine that you need an in-person visit, the visit will occur in your vehicle in the parking lot of our clinic so as to prevent potential spread and exposure to others in the office. While this is not how we usually do things, it’s the most effective way to prevent the spread in the clinic.

    •    If you have severe symptoms, we will likely refer you directly to a hospital.  

    •    Currently, we do not have the COVID-19 test kits in our office.  All testing as of today is still being done through the Mass Department of Health. We are working with our lab vendor to confirm the exact specifics of when commercial testing will be available. When testing becomes more readily available we will continue to work with the Mass Department of Health and the CDC to determine who needs testing.  We will not be recommending testing for just anyone with symptoms of respiratory infection; we will make this decision on a case-by-case basis using sound medical evidence and our clinical judgement. 

I cannot be more explicit than this: if our staff comes into contact with someone who is symptomatic and positive for COVID-19, we may be required to be in quarantine for 14 days. As we are a small office, this may lead to a situation where we will have to close for all in-person interactions for up to (and potentially longer than) a 14-day period.  If this were to occur, we would attempt to still offer telephone triage and telemedicine visits.

We are taking an abundance of caution by putting these guidelines in place to prevent the spread of this illness to the most vulnerable around us.  We appreciate your understanding, patience, and effort to keep everyone in the community healthy as we all see our routines upended a bit by this virus.

Don’t hesitate to ask questions or reach out.

Carmela Mancini, DO and Jeffrey Gold, MD

For additional information please visit:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.mass.gov/resource/information-on-the-outbreak-of-coronavirus-disease-2019-covid-19

Updated Testing Guidelines for More Information

https://www.mass.gov/doc/covid-19-pui-criteria/download