Covid-19 Pandemic Information
Special Notice 4/21/2020:
Due to critical PPE shortage:
1. One patient, one parent per visit. We encourage parents to wear a mask, but cannot provide them.
2. In-person visits are ONLY for newborns and for babies age 0-15 months who need vaccines.
3. Telehealth will be utilized for all other visits.
4. Patients who require COVID-19 testing will be referred to a UNC pediatric Respiratory Diagnostic Clinic.
The health and safety of your family is our top priority. We strive to do our best to keep you safe, as well as our staff and our facility. We also endeavor to keep this clinic open for your children's urgent healthcare needs in the coming weeks. The following changes are in place until the COVID-19 pandemic ends:
1. No sick walk-ins. We regret that this service is no longer available, but feel that we cannot offer it safely during this pandemic.
2. Wellness visits in the morning. As of 4/9/2020, we will only schedule wellness visits in the morning and will reserve the afternoon for sick visits. This allows more distance and time between well and sick patients and allows us to reserve a block of time for well patients. If there is time after the last well patient or there are no wellness visits scheduled, we will see sick patients in the morning.
3. Limited wellness and non-urgent sick visits. Only wellness visits for babies/toddlers due for required vaccinations and recheck visits for unstable medical problems will be scheduled until the worst of the pandemic passes. Kindergarten and school physicals will be considered on a case by case basis. Telehealth will be utilized to reduce in-person visits.
4. Phone screening questions. All callers requesting appointment or nurse triage will be asked COVID-19 screening questions.
5. Wait outside on arrival. All visitors to the clinic should call 919-825-3600 on arrival and will wait outside (or in their car). The front door is locked. The receptionist will ask COVID-19 screening questions and inquire about the nature of the visit. This allows Dr. Mack to determine if personal protective equipment (PPE) is needed on a case-by-case basis.
6. PPE may be used. Please be sure to discuss with your child that our staff and Dr. Mack will be wearing face masks and may be wearing special face masks, eye protection, yellow gowns, and gloves (PPE). This is for your child's and our safety, to keep germs from spreading. We will not provide PPE to those who do not need it. The is a PPE shortage nation-wide which will not improve anytime soon. Dr. Mack will determine if PPE is needed on a case-by-case basis. If Dr. Mack determines that you or your child need to wear a mask, we expect you to do so. If your young child cannot tolerate a mask, please tell us prior to wasting PPE.
7. Only the patient and one parent (or proxy). We are limiting unnecessary visitors per public health recommendations. Siblings and additional friends/family members need to remain at home. If siblings cannot be left at home in the care of another adult, please communicate that to the clinic prior to coming to Mack Pediatrics.
8. All patients and families will remain in their exam room. All patients will be escorted immediately to an exam room once they enter the building. Please attend to your child and do not allow your child to wander the premises. Be sure that you escort your child to and from the restroom. It is much more difficult for us to maintain a clean, germ-free environment for your child if we do not know what surfaces your child may have touched.
9. COVID-19 testing. COVID-19 testing is available (via LabCorp), but tests take 7-9 days to result. We will only test symptomatic patients who meet the current CDC criteria for testing. No asymptomatic patients will be tested.
10. Increased telephone management and portal-based E-visits. In an effort to keep you and your child at home and out of public/medical settings during this pandemic, Dr. Mack is utilizing more telephone-based and portal-based (audio-visual live-chat or secure messaging) medical management. Prior to and after the pandemic, she would manage more of these conditions as an office-visit in person. You may see these telehealth-type visits on EOBs (explanations of benefits) from your insurance.
11. New exam room for sick with fever and cough, or fever and shortness of breath. This room has a separate entrance and a bathroom. It is isolated from rest of clinic by plastic sheets.
Thank you for your understanding. Let's get through this together.
---Emili Mack, MD
What do you do if you think your child or you have COVID?
originally posted by Dr. Mack on the Mack Pediatrics facebook page 4/14/2020, revised for website.
If the symptoms are mild, stay home and isolate, no testing recommended (per CDC and NC Dept of Health & Human Services). It is OK to call your Primary Care Provider for yourself (or Dr. Mack for your child), but do expect that you will not be advised to come in for an in-person visit or to get tested. Telehealth may be helpful.
If you (or your child) are getting worse or worried, call your primary care provider (or Dr. Mack for your child). However, call 911 if you (or your child) have shortness of breath, difficulty breathing, chest pain, sudden confusion, or blue lips.
Here is the latest CDC handout on this topic, dated 4/13/2020:
Refer to this handout from NC DHHS, dated 3/23/2020:
Read below for a COVID-19 pandemic summary, written by Emili Mack, MD on 3/2/2020 (starting at "If you think") and revised multiple times, last updated 4/14/2020. The 4/14/2020 updates are noted in italics. This summary is being updated in this way for historic purposes, to appreciate the changes over time.
Wake County Public Schools has cancelled classes for the next 2 weeks (3/16-3/27/2020) and is moving spring break--WCPPS are closed until 5/15/2020
This is a good thing for pandemic control. This move does "flatten the curve" per the popular graphic circulating the internet. It slows down the number of new cases per day, which reduces the chance of overwhelming the healthcare system.--common knowledge by now
Mack Pediatrics will remain open. We are a healthcare facility, and we will remain available to our patients. --still open
Effective immediately, we will no longer have sick walk-ins. All patient visits will be by appointment only to allow appropriate triage and isolation procedure. Only the patient and their parent/proxy should attend any visit to the clinic.--See above more extensive changes number 1-11 at the top of this page.
We are limiting non-urgent appointments for the next 2-4 weeks to maintain availability for sick patients. Children who are due for required vaccines will not be rescheduled. We will contact you if we need to reschedule your child's non-urgent appointment. We thank you in advance for your understanding.--We extended the modified scheduling through 4/30/2020
If you think you could have a COVID-19 infection because you have symptoms and a close exposure to a confirmed case, then stay home and call your doctor. There is a safe protocol in place to get you tested at home by the health department using the free CDC COVID-19 test. Do not walk-in to the doctor's office, urgent care or hospital if you think you have COVID-19 infection. We as a society are trying not to intentionally expose other people to the virus.--This is still true, but private testing is available and generally not recommended for mildly symptomatic patients during this mitigation phase of the pandemic.
A new virus on the global scene is always scary, even if it is a mild cold virus for most people. We're going to be OK. In the US, we are not testing the general population to determine how common Covid-19 cases are. It is easy to look no further than the numbers of reported cases and deaths and begin to panic. The numbers seem scary because most people do not get sick enough to seek medical attention or get diagnosed. Most people just have a mild to moderate winter cold virus that goes away with rest and chicken soup. --This remains true.
We all know that only the most symptomatic people, those will fever and difficulty breathing, have been tested and diagnosed. Testing availability has been quite low, but has been improving locally over the past few days. The people world-wide who have become severely ill or died have had other underlying medical problems that made them more vulnerable to any illness. There is no treatment for this virus, just as there is no treatment for most non-influenza cold viruses.--This remains true, and new types of testing, including immunity/antibody blood-testing may soon become available to the public in a limited capacity.
We can swab for COVID-19 and respiratory pathogen panel, which will result in 1-2 days. However, testing is only for sick people, not asymptomatic people. The free CDC test is available ONLY for people with symptoms (fever AND cough or shortness of breath) and at least one of the following additional criteria: 1. contact with laboratory-confirmed COVID-19 patient in past 14 days, or 2. no other reason for the symptoms (flu testing and exam negative).--We still can send COVID-19 test, but CDC is test is reserved for a strict case definition only. For this reason, we started utilizing LabCorp testing on 3/27/2020. CDC or LabCorp test takes about 1 week to result. As noted above, testing is not recommended for mildly symptomatic patients anymore as it does not affect their treatment or management. Results do not arrive in a useful time-frame. Testing is for worsening patients, severely ill patients, or hospitalized patients.
For patients with private health insurance who are tested by a private (non-CDC) lab, be sure these CDC criteria are met if you seek testing. Insurance will supposedly cover the full cost of COVID-19 testing if the testing is medically necessary, per the above CDC criteria. We cannot guarantee that your insurance actually will pay for testing sent to a private lab.--This remains true.
More important than testing is prevention and isolation. Covid-19 is a mild to moderate cold virus for the vast majority of people. It is spread in the usual way of cold viruses, by cough and mucus. It is prevented by the same practices as for other cold viruses: hand-washing, staying home when sick, avoiding unnecessary contact with large numbers of people, and taking measures to improve your health, like staying up-to-date with recommended vaccines, eating healthily, reducing stress, and getting enough sleep.--This remains true and has become the new way of life since the President declared a national emergency 3/13/2020, Governor Cooper closed WCPSS 3/14/2020, and especially after the NC lockdown order began at 5pm 3/30/2020.
Be sure to wash hands for at least 20 seconds before eating, after toileting, and upon return home from being in a public place. Stay home or keep your child home from school if sick, especially if fever or poor cough/mucus hygiene. Decide carefully which large social gatherings/places to attend, weighing the risks of getting a mild-moderate cold or flu with the benefit of attendance. Take good care of yourself and your family, with good nutrition, adequate rest and minimal stress. Get your flu vaccine and pneumonia vaccine.--This will always be true.
Remember, Covid-19 is just a nasty new cold virus..."the new cold on the block." By 1 year from now, most of us will be immune to it. We take precautions now so that all of us, including our most medically vulnerable, will get through this pandemic together.--This remains true, though some people get much sicker than others even without risk factors. We should all continue home isolation and social/physical distancing until a proven treatment or vaccine for COVID becomes available and easily accessible for all people.
Here are three reliable info links, which should be updated periodically:
1. American Academy of Pediatrics HealthyChildren.org:
2. North Carolina Health and Human Services:
4. If you have or probably have COVID, check this CDC link: