COVID-19 UPDATES

CORONAVIRUS

COVID-19 Resource Center

The COVID-19 pandemic is changing rapidly and we are here to help. By using First Stop Health Telemedicine provided through your employer you can avoid a trip to a doctor's office, urgent care or emergency room.

COVID-19

SCREENING

TESTING

TREATMENT

FOLLOW-UP

ABOUT

VACCINATIONS

PREVENTION

RESOURCES

Last Updated 12/2/2022

FSH COVID-19 Services

Screening

Our doctors generally follow published CDC guidelines. These guidelines change as doctors and scientists learn more about the virus. Here are some common scenarios:

If a patient has COVID-like symptoms, the doctor will assess the severity of those symptoms and advise on next steps.
If a patient came into close contact with someone with COVID-19, the doctor may recommend 10 days of wearing a mask and taking additional precautions. The patient should be tested on day 6.
If the patient has severe shortness of breath, the doctor will advise the patient to dial 911 and let the dispatcher know that they may have COVID-19.

Doctors recommend isolation if a person tests positive for COVID-19, regardless of vaccination status. For isolation, doctors recommend patients to:

Isolate for at least 5 days AND until fever-free for at least 24 hours without fever reducing medications. The day that symptoms start is day 0.
If patient did NOT have symptoms when they tested positive but develops symptoms after, re-start 5-day isolation.
Wear a mask around others for 5 days following isolation. (If unable to mask, continue to isolate). Patients should also avoid:
- People who are immunocompromised or at high risk for severe disease
- Nursing homes and other high-risk settings
- Travel (If you must travel, wear a mask. If you cannot mask, do not travel.)
- Eating around others at home and in public
- Places where masks are not worn, such as restaurants and some gyms

Doctors will also recommend isolation if a patient has not been tested but has 2 or more symptoms of COVID-19, regardless of whether they had a known exposure. Common symptoms include:

Fever/chills
Cough
Shortness of breath/difficulty breathing
Fatigue
Muscle/body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
(Symptoms may include others)

Generally, FSH doctors follow CDC guidelines. These are not specific to the following populations, which have their own CDC recommendations:

Doctors recommend quarantine if a person has been exposed* to a known case of COVID-19 and are not vaccinated OR not up to date on their recommended vaccinations.

Doctors do NOT recommend quarantine for individuals who are boosted OR who have had a case of COVID-19 in the last 90 days OR who are 5-17 years of age and have been fully vaccinated, even if a person has been exposed to a known case of COVID-19. Instead, doctors instruct patients to wear a mask around others for 10 days and test on day 5, if possible. (Patients will be instructed to get a test and stay home if symptoms develop.)

* Doctors can help assess for known close contact. The CDC defines close contact as: contact with someone who was less than 6 feet away from an infected person (confirmed via testing or a doctor’s diagnosis) for a cumulative total of 15 minutes or more over a 24-hour period. (Example: 3 individual 5-minute exposures for a total of 15 minutes.)

For quarantine, FSH doctors recommend patients to:

Stay home and away from others for at least 5 days. Wear a well-fitting mask at home while around others, if possible.
Watch for fever (>100.4° F), cough, shortness of breath or other COVID-19 symptoms for 10 days after close contact.
Get tested:
- If no symptoms develop, test after at least 5 days. If you test negative, you can discontinue
- If symptoms develop, isolate and get tested immediately. If test is positive, follow isolation instructions.
Wear a mask around others for 5 days following quarantine. (If unable to mask, continue to quarantine). Patients should also avoid:
- People who are immunocompromised or at high risk for severe disease
- Nursing homes and other high-risk settings
- Eating around others at home and in public
- Places where masks are not worn, such as restaurants and some gyms

Generally, FSH doctors follow CDC guidelines, which were updated on Aug. 11, 2022. These recommendations are not specific to the following populations, which have their own CDC guidelines:

If you are experiencing mild symptoms such as cough and/or fever or believe you may have been exposed to COVID-19, DO NOT GO to the emergency room. Call your doctor or use telemedicine instead to reduce your risk of catching or spreading the virus.

If you are experiencing severe symptoms such as shortness of breath or difficulty breathing, call 911 or call ahead to your local emergency facility. Notify the operator that you are seeking care for someone who has or may have COVID-19.

Ensure you are a First Stop Health member. Our telemedicine service is provided through employers.
Take your temperature.
Download our mobile app or log in. You can call, too, but requesting a doctor visit via app or web is the quickest way to talk to a doctor.

Testing

First Stop Health doctors cannot directly order your COVID-19 test, but there are a few options available to you as a consumer. Read on for more info.

There are two types of tests to diagnose a current COVID-19 infection: At-home rapid tests and PCR (laboratory) tests. At-home rapid tests provide same-day results, but false negatives can occur. PCR tests are much more accurate, but results can take days.

To get tested for COVID-19, you can:

Purchase an at-home rapid test at your pharmacy or online
Order an at-home collection kit for a mail-in PCR test
Find an in-person PCR test site

CDC: What You Need to Know About COVID-19 Testing

At-home, or “over-the-counter” (OTC) COVID-19 antigen tests can typically be purchased at local pharmacies as well as online at Walgreens, CVS, Target and more. Supply may be limited – particularly during times of increased infection rates – but here a few examples of FDA-approved products:

Abbott BinaxNow COVID-19 Antigen Self Test
Access Bio CareStart COVID-19 Antigen Home Test
Acon Flowflex COVID-19 Antigen Home Test
iHealth COVID-19 Antigen Rapid Test
And many more — look for FDA approval on the package label ("FDA approved and cleared for use under emergency use authorization" or similar wording.)

Resources and Tips for At-Home Testing

At-Home COVID-19 Antigen Test Kits: Where to Buy and What You Should Know (Wirecutter)
COVID-19 Self-Testing (CDC)

Reasons to get tested for COVID-19, according to the CDC:

If you have COVID-19 symptoms
At least 5 days after known or suspected exposure to COVID-19
For screening (schools, workplaces, congregate settings, etc.)
Before and after travel
When asked by a healthcare professional or public health official

It’s also a good idea to get tested before indoor gatherings with members who do not live in your household.

Treatment

The FDA has authorized Pfizer’s Paxlovid and Merck’s molnupiravir (for use when Paxlovid is unavailable) pills to be used in specific patient groups at high risk of serious complications from COVID-19.

These treatments may be prescribed by FSH doctors to prevent severe COVID-19, when appropriate. Treatment is approved for individuals who a) have tested positive for COVID-19 and b) are at increased risk of complications from COVID-19. The Pfizer and Merck pills:

Do NOT replace vaccines – they can NOT prevent COVID-19
Must be prescribed within 5 days of the onset of symptoms
Have negative side effects when taken with certain other drugs, which may disqualify patients on certain medications

Paxlovid FDA Fact Sheet for Patients, Parents and Caregivers

Molnupiravir FDA Fact Sheet for Patients and Caregivers

Updated July 1, 2022

The FDA has authorized certain antiviral medications and monoclonal antibodies to treat mild to moderate COVID-19 in people who are more likely to get very sick.

Monoclonal antibodies help the immune system recognize and respond more effectively to the virus.

Here’s how it works. Monoclonal antibodies are typically less effective than Paxlovid (see question above) and must be administered in person. First Stop Health doctors cannot order infusions for patients.

Be sure to coordinate with your personal doctor before contacting a location to receive treatment. For questions and more information on monoclonal antibody therapeutic treatments, call 1-877-696-6775.

Here are some helpful treatments for your symptoms:

Sore throat: Saltwater gargle every hour
Runny nose/congestion: Antihistamine-decongestant combination medication such as Zyrtec D or Claritin D.
Cough: Cough medicine such as benzonatate (prescription only)
Difficulty breathing: Inhaler with albuterol (prescription only)

A pulse oximeter, which you can buy online or at most pharmacies, is also useful. If your oxygen saturation goes below 94, go to the ER. If it goes below 90, call 911.

No. The evidence that these medications are effective in treating COVID-19 is currently lacking – and some have the potential to do harm. First Stop Health will not prescribe treatments that are not approved by the FDA or recommended by the CDC or infectious disease authorities.

If you are interested in new and developing treatments, you can explore clinical trials through the ACTIVE 6 study.

Follow-up

For the general population, returning to work or school is considered safe when you:

Have not been recommended to quarantine or isolate, or
Have completed recommended quarantine following exposure, or
Have completed recommended isolation.

Refer to the CDC for more on how to discontinue self-quarantine. There will be setting-specific instructions for healthcare workers, K-12 schools and other populations.

Note: FSH doctors cannot order COVID-19 tests and therefore cannot confirm whether or not a patient has COVID-19.

The CDC recommends employers not require a doctor’s note during the COVID-19 pandemic. Doctors’ offices may be unusually busy, which means getting a note may require a long wait on the phone or follow-up visits.

To help our patients who need documentation, we will continue to issue “excuse notes” for those patients that request one during a telemedicine visit. Typically, we only issue these notes for up to 4 days. Given the CDC recommendations around 5-day quarantines for those that are exposed to COVID-19, we have temporarily lifted the cap to 5 days when appropriate.

basic information

COVID-19 Basics

About COVID-19

The virus is airborne, which means it spreads from person to person through coughing, sneezing and simply talking. It can be spread through contact with infected surfaces or objects, as well.

The most common symptoms are:

Fever/chills
Cough
Shortness of breath/difficulty breathing
Fatigue
Muscle/body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
(Symptoms may include others)

After exposure, symptoms typically appear within 2 to 14 days.

Yes, but COVID-19 is primarily spread through exposure to respiratory droplets carrying the infected virus – in other words, by breathing the same air as an infected person.

It’s a good idea to keep surfaces clean. The best way to kill germs is by cleaning and disinfecting surfaces with household cleaning sprays or wipes.

Vaccinations

Proactively seeking out vaccination from COVID-19 provides the best chance for you and your family to lead longer, safer lives. Read more on why our Chief Medical Officer recommends getting the vaccine.

People who have had a serious reaction to the first dose of a vaccine
People who are allergic to polyethylene glycol (PEG)
People who are allergic to polysorbate
Anyone who has had a recent case of COVID 19 (either confirmed by testing or suspected)
Pregnant women
Anyone with a history of serious allergic reactions (anaphylaxis)

The answer to this question depends upon the state in which you live. Each state health department has its own rollout plan. There are also several search tools available to find vaccination locations near you, including:

Vaccine Finder - Type your zip code to find vaccination locations near you.
Plan Your Vaccine - Enter your state, occupation and age to learn your eligibility status and where to get a vaccine.

Currently available vaccines in the US include:

Pfizer-BioNTech
Moderna
Novavax
Johnson & Johnson’s Janssen (J&J/Janssen) (However, CDC recommends that the J&J/Janssen COVID-19 vaccine only be considered in certain situations, due to safety concerns.)

Learn more from the CDC.

All the approved vaccines provide significant protection. The best advice is to get the first vaccine available to you.

Get the latest info on who is eligible, when to get your booster and more HERE.

There is no reason to take any medication before getting vaccinated. Significant pain, fever or discomfort afterwards can be treated with Tylenol unless your doctor recommends otherwise. Local swelling and pain at the site of vaccination can be treated with an ice pack.

You will be given a CDC COVID-19 vaccination card at the time of vaccination that records the type and lot number of the vaccine you are given. Keep your CDC COVID-19 vaccination card for proof of vaccination. Consider taking a picture of your card after each of your COVID-19 vaccination appointments as a backup copy.

If you have questions about vaccination records, please contact your state health department. Your local or state health department can also provide more information about the laws or regulations in your area.

Every vaccine has potential side effects, both major and minor, since it stimulates the immune response. Minor side effects (pain and swelling) are treated symptomatically. Major side effects (high fever, severe allergic reactions, anaphylaxis) are less common, but do occur. Patients with more severe reactions should consult a physician or go to the ER.

First Stop Health doctors can provide advice on at-home treatment if you have minor side effects such as pain or swelling. We can also help you determine next steps such as seeing a doctor or going to the ER if you experience more severe side effects.

Yes, breakthrough infections – which is when a fully vaccinated person gets COVID-19 – happen. When they do get COVID-19, people who are fully vaccinated:

Are less likely to develop serious illness, be hospitalized or die from COVID-19
Tend to have less severe symptoms

Like all vaccines, the COVID-19 vaccine is not 100% effective at preventing infection. The CDC has advised those who have been vaccinated to continue taking precautions. After you get your vaccine, you still should:

Wear a mask and practice social distancing
Avoid traveling outside of local areas

The CDC says that it is safe to:

Be indoors with other vaccinated people without wearing masks.
Be indoors with unvaccinated people without wearing a mask.

You still should comply with legal and business requirements to wear a mask and social distance. Check your local COVID-19 Community Level for recommendations on when to wear a mask indoors and additional precautions you can take to protect yourself from COVID-19.