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Writer's pictureDr. Speir

It's starting to hit home. Guidelines for COVID + patients.

Updated: Jul 3, 2020

I will also post these guidelines in another location under patient education. However, as we start to see a rapid rise in patients who are positive for COVID or have positive exposures I wanted to put these out there. If you are in your third trimester, please be extremely cautious with gatherings and travel. I know, it is so hard to continue to put our lives on hold but new research does suggest women who are pregnant in their third trimester are at higher risk of needing hospitalization for COVID. New data should be released this week.


For known positive patients / Persons under investigation ( testing pending):


HOSPITAL GUIDELINES:

  • Call L&D 949-764-5789 from your car when you arrive at the hospital to be safely escorted to Labor and Delivery, OB Emergency Room, or Fetal Diagnostics

  • Patients will be considered positive until 10 days after positive test and 72 hours of improving symptoms ( the recommendation is separation from the infant for 10 days- however this can be discussed with your pediatrician in a shared decision making manner)

  • If Partner of patient is positive- they will not be allowed in the hospital until 10 days after positive test and 72 hours of improving symptoms

  • If Partner of patient ( who is positive) is negative or unknown they will still be allowed to be with their partner, however they need to stay with the patient the whole admission and they will not be allowed into the NICU (updated 7/2/20)

  • If Partner has had an exposure to COVID or any symptoms please do not have them come to the hospital, they should be quarantined away from the patient for 14 days

  • No COVID positive patients or partners in contact with a COVID + patient in the last 14 days will be allowed in the NICU, regardless of testing. A family representative will be allowed in NICU if they have had no contact with the infected patient.

This last point is especially important because we are seeing higher rates of preterm labor or patients needing to be delivered early due to COVID.


PACWHA OFFICE GUIDELINES:


* Please do not come to the office if you have tested positive for COVID or have had an exposure without being testing. Any scheduled visits will be done via telehealth, you can send us an email so we can schedule that visit.

*You should quarantine for 14 days if your symptoms are mild or manageable with over the counter cough medications please see our list under patient education. If you are having trouble breathing please call L&D and discuss whether you should go to the ER ( less than 17 weeks) or the obstetrical ER (usually over 17 weeks of pregnancy).

* Testing is available at the Hoag Urgent Care / Emergency Room

* If you are having obstetrical symptoms such as decreased fetal movement or contractions in addition to symptoms of COVID ( nausea/vomiting/Diarrhea, fever, chills, sore throat , cough, loss of taste or smell) please call L&D 949-764-5789 in advance so they can prepare for your arrival. You can also call the doctor on call at our regular number 949-644-2722 so they can let the hospital know.

* Any additional monitoring such as Non-stress tests will be done at Fetal Diagnostics on the 6th floor of Hoag and not in our office until 14 days after the positive test.

* If you have had a COVID positive test at any point during the pregnancy we will recommend additional fetal monitoring starting at diagnosis or 34 weeks whichever is later.

* If you have a positive test or are under investigation for COVID and are pregnant or have been pregnant in the last six weeks please enroll in the national pregnancy COVID registry by calling 415-754-3729 or email prioritycovid19@ucsf.edu.

* We will continue our no visitor policy and mandatory masking policy for everyone.


If you get diagnosed with COVID during pregnancy there is a national registry you should enroll in so we can collect data regarding outcomes and complications ( or none!)



Stay safe. We are all tired of this virus, but it is not tired. We need to go back to the vigilance we had at the beginning of this crisis. Just because political and economic pressures have re-opened our society does not mean that we are safe or that anything has changed the course of the virus.



My only critique is that I think travel is higher risk than this chart makes it out to be.






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