We have been following the details surrounding the novel Coronavirus (COVID-19) outbreak closely with nearly daily updates from state and federal authorities.

I wanted to inform all patients about how we will be handling any “Persons Under Investigation” (PUIs) who are part of LHS when the virus starts to enter our community.

First and foremost, I would like to gently remind everyone to remain calm, follow the best personal hygiene recommendations, and enforce these measures with your family, friends and loved ones. Just like other infectious diseases out there, MANY can be just as concerning as COVID19, if not more so. We are still in the middle of an Influenza outbreak which is also very harmful to the elderly and young children.

Please remember, the majority of individuals with COVID-19 symptoms are recovering. Many have mild symptoms. There are those with proven infection exhibiting no symptoms as well.

For those patients that are unable to receive immunizations for a medical reason or who choose to be under immunized, I recommend extreme diligence and caution for personal hygiene.

The chances of spreading COVID-19 can be reduced by the following measures:

  1. Hand washing–tell the kids to wash their hands while singing “Happy Birthday to You” twice. This will ensure a good length of time to wash off pathogens. There can be asymptomatic spread of virus from people who have little to no infection.
  2. Stay away from those that have any symptoms of a respiratory infection.
  3. Try to stay at least 6 feet away from anyone with a cough.
  4. Practice good cough hygiene which includes coughing into your elbow.
  5. Use one of the recommended cleaners on the list below to frequently clean all surfaces at home/work:


Reports are that the virus can live on surfaces up to 9 days.

Covid-19 symptoms onset is between 2-9 days post-exposure with a median of 5 days.

The most common presentation was one-week prodrome of myalgias, malaise, cough, low grade fevers gradually leading to more severe trouble breathing in the second week of illness. It is an average of 8 days to development of dyspnea and average 9 days to onset of pneumonia/pneumonitis.

Please remember that the odds are low that everyone with COVID19 infection will progress to the stage requiring hospitalization. I am giving you this information, so you are aware and informed not to induce panic!

Please take a moment and read these links from the CDC which are providing even more information, and save the links for reference:



Signs and symptoms of a possible COVID19 infection include:

  1. Cough
  2. Fever
  3. Shortness of breath
  4. Body aches
  5. Sore throat
  6. Nasal congestion
  7. Vomiting/Diarrhea (rare symptoms)
  8. Known contact with a PUI with a confirmed case of COVID-19 or known contact with a PUI who is waiting for testing results.
  9. Known contact with anyone who has traveled to one of the Level 3 countries in the past few weeks which includes China, South Korea or Europe.
  10. Those with known contact with anyone who has traveled to a Level 2 country (which includes Japan) are asked to monitor themselves closely for signs or symptoms of COVID-19.

If you have recently traveled to any of the Level 3 countries, you are directed by the CDC and DOH to self-quarantine for 14 days and should have been issued a card from the CDC upon re-entry to the US stating this. If anyone does not follow these precautions, it is reportable to the PA DOH.

Anyone with one or more of these signs or symptoms is asked to call the office immediately, ESPECIALLY IF YOU HAVE ONE OR MORE OF THE FOLLOWING     co-existing medical conditions:

  1. Heart condition
  2. Lung condition
  3. Kidney condition
  4. Immunocompromised condition (chemotherapy, lack of a spleen, lymphoma, leukemia, HIV, inherited immune-deficiency syndromes, etc.)

If you are moderately short of breath with a cough and fever, which we will assess by phone, you will be directed to the Emergency Room for prompt evaluation.

Starting today, we will be screening non-life-threatening conditions at the office and have access to the COVID-19 test from LabCorp. We do not have a cash price yet but expect to do so shortly. For patients with insurance, Washington DC has assured us that insurance carriers will be handling the test as “covered health benefit”.



We will not be seeing any patients in the office with any potential COVID-19 symptoms.


The screening involves a nasal swab with a Q-tip (just like the flu screening test).

Turnaround time for test results is 3-5 days.

If you are screened in your car, that means you are considered a PUI. You will be asked to self-quarantine until the test results are reported to us according to the CDC and Department of Health.

We all want to do the right thing with responsible diligence and prevent transmission to those who are vulnerable.

Thank you and we will keep you updated!


Dr. Nina Maouelainin