Coronavirus Updates

April 7, 2021

At Fair Oaks Women’s Health, we have implemented policies to reduce the number of medical appointments, to minimize people in our waiting room and to ensure that the office is clean, hygienic and safe for our patients and staff. Please read below to see what the current policies are.

Restrictions and safety practices are in effect. All patients (and staff) are expected to wear a mask at all times while in the office. Back office staff are expected to wear face shields or goggles while in the exam rooms. We also have a written COVID-19 screening form at the front door. See below.

Thank you for your understanding and cooperation.

COVID-19 Screening Questions

A form will be provided. If you answer YES to any of the questions, a provider will determine if you can be seen or if your appointment can be safely delayed until you get tested for COVID-19.

CLICK HERE TO PRINT THIS PAGE AND FILL OUT AHEAD OF TIME

  1. Are you in isolation because you may have been exposed to a person with COVID-19 or is it possible that you may be sick with COVID-19?
  2. Are you currently waiting on the results of a COVID-19 test?
  3. Within the past 14 days, have you been in close physical contact (6 feet or closer for a cumulative total of 15 minutes) with anyone who is known to have laboratory-confirmed COVID-19 or anyone who has any symptoms consistent with COVID-19?
  4. Have you experienced any of the following symptoms today or within the past 48 hours?
  • fever, chills, sweats, or shivering
  • cough or shortness of breath
  • fatigue or weakness
  • muscle or body aches
  • headaches
  • new loss of taste or smell
  • sore throat
  • nasal congestion or runny nose
  • nausea, vomiting or diarrhea

COVID Vaccine

There has been a lot of media attention and discussion about the COVID vaccines. Since there has also been so much misinformation and confusion, I wanted to share with you my own personal views about the vaccine, including my responses to some of the concerns people have and my advice about whether people should take the vaccine.

Background

With one or two exceptions, all staff and providers at Fair Oaks Women’s Health have received the full series of COVID vaccine, either the Pfizer or the Moderna brand.

All the doctors in our practice trust the safety and efficacy of all the current COVID-19 vaccines available (Pfizer, Moderna and Johnson and Jonson).

We are potentially exposed to COVID every day, and for each of us the issue came down to answering one question: “Which risk do we choose -- the risk of getting a COVID-19 infection or the risk of the vaccine?” It is my view that for most people, not just healthcare professionals, the risk of COVID-19 (including the risk to yourself and others) is far higher than the risks of the vaccine.

What reasons might someone have for not getting a COVID-19 vaccine? Here are a few:

Reason #1: The vaccine is not safe.

Dr. Jick’s Response: Define safe. The U.S. Food and Drug Administration (FDA) has deemed the vaccines safe. So has the U.S. Center for Disease Control (CDC). President-Elect Biden has had the vaccine. The U.S. Surgeon General has had the vaccine. All the physicians in our group have had the vaccine. If you feel the vaccine is not safe, my question is this – what other person or group needs to tell you the vaccine is safe before you would agree?

Reason #2: The vaccine might cause long-term complications.

Dr. Jick’s Response: This is possible, but it can take years before those are known. There are dozens of vaccines in use for many years that have been proven safe from long-term risks. There is every reason to believe the same will occur with the COVID vaccine. But people are getting sick from COVID now, they are giving it to others now and they are dying, in record numbers, now. The vaccine will help reduce the number of cases and will reduce the number of deaths NOW. The risk of long-term side effects is remote but possible, but this should not be the basis for declining the vaccine.

Reason #3: The vaccine has side effects.

Dr. Jick’s Response: This is true for some, but these are definitely not worse than the effects of getting COVID, or the risk of transmitting COVID to a loved one.

Reason #4: Herd Immunity will protect me, so I do not need the vaccine.

Dr. Jick’s Response: Maybe. Herd immunity can provide protection but at least 80% of the population needs to be either recovered from COVID or vaccinated to provide this type of protection. Herd immunity means that so many people around you are already immune that the chance for the vaccine to spread is very low. Given the number of people refusing the vaccine, you should not count on herd immunity for protection.

Reason #5: You can get COVID from the vaccine.

Dr. Jick’s Response: Absolutely NOT TRUE. There is no live COVID virus in any of the COVID vaccines. Some of the vaccines use a deactivated cold virus to deliver the COVID antigens into the cells so that the body’s immune system will activate, but there is no way to get COVID from those.

There is abundant misinformation.

But wait, there’s more! The amount and sheer outrageousness of some of the vaccine misinformation is staggering.

Here are some of the crazier supposed risks/rumors of the vaccines, all of which have already been proven false:

  • The vaccine contains a microchip produced by Bill Gates.
  • The vaccine causes infertility. read this!
  • The vaccine will allow the government to mind control us.
  • The vaccine profits are all going to Dr Fauci (or George Soros or China)

4/2: Anti-Vaccine Propaganda is EVERYWHERE

Get the Vaccine – the risks of COVID-19 far outweigh the risks of the vaccines.

There is no risk-free option going forwards. COVID-19 is never going away. That might be hard to accept given its recent appearance, but it’s true.

Measles, Whooping Cough and Chicken Pox (all viral illnesses) have been around for generations and will likely never go away. The only reason we do not see hundreds of thousands of illnesses and deaths from these dangerous and highly communicable diseases is that the majority of people in the US have been vaccinated for them, almost all as children, with boosters for adults.

COVID-19 is new and none of us have natural immunity to it, which means that every living human being can potentially get this illness. The only way to be safe from a COVID infection is to be vaccinated or to have recovered from the illness.

We do not have all the answers yet. This is not a reason to avoid the vaccine.

Experts disagree on how long your immunity lasts after a COVID vaccine or after recovering from a COVID infection and also on whether or not someone who has had COVID can get it again. Some data show that the vaccine does not prevent someone from getting asymptomatic COVID-19 and then being capable of transmitting to others (experts disagree about this).

Once more studies have been done, I believe we will determine that immunity to COVID is likely to last for many years (a whooping cough vaccine booster is advised every 10 years for example) and that it will be rare to see people who had the infection get it again. (Mutations are another issue, too complex for this article.)

Just answer this one question.

In the end, each of us needs to answer one question: “Which risk do we choose -- the risk of COVID-19 or the risk of the vaccine?” There is no risk-free option available. All the physicians here at Fair Oaks Women's Health have chosen to have the vaccine. We hope you will also and at the first available opportunity.

Links

See below for vaccine advice if pregnant or breastfeeding.

COVID Vaccine and Pregnancy, Breastfeeding (updated 3/29/21)

We are often asked our views on whether women who are nursing, are pregnant, or are trying to become pregnant should get the COVID-19 vaccine if it is available to them. With rare exceptions, our answer is yes, we support the use of COVID-19 vaccine for these situations.

Exceptions to this would include people with a history of anaphylaxis to other vaccines, those who have recently tested positive for COVID, people who have recently received a COVID antibody infusion treatment, and certain other medical conditions. Please contact us if you are not sure if you are a candidate for a COVID vaccine.

All Fair Oaks Women's Health Providers support the above views.

Absent contraindications, pregnant and lactating women who are eligible for the COVID-19 vaccine (Pfizer, Moderna or Johnson & Johnson) should be allowed to receive it without any delays or additional discussion with any of our doctors. Many women's health and other major medical organizations support this position.

We have discussed this amongst ourselves and we all agree that the risk of delaying the vaccine or not getting the vaccine - even while pregnant or breastfeeding - is much greater than the potential risks of the vaccines themselves.

Do you need a doctor's note to get a COVID-19 vaccine? Click here for the download page (password-protected, call our office at 626-304-2626 for the password) or e-mail us at obgyn@fowh.com.

***

4/7/21: Mother-to-Baby: If you would like to speak to someone about COVID-19 vaccination during pregnancy, please contact MotherToBaby. Experts are available to answer questions in English or Spanish by phone or chat. The free and confidential service is available Monday–Friday 8am–5pm (local time). Call 1-866-626-6847.

3/6/21: HealthDay News: The sooner a pregnant woman gets a COVID-19 vaccine, the more likely she is to transfer protective antibodies to her baby, a new, small study suggests. Read More here:

4/3/21 - ACOG PODCAST: Interview with Sarah Carroll, ACOG’s Director of Immunization, where we discuss ACOG’s official position on vaccinating pregnant and breastfeeding women. Listen to it here:

4/2/21 - BusinessWeek: Facebook Built the Perfect Platform for Covid Vaccine Conspiracies. Read More here:

3/26/21 - CNN: Study says Covid-19 vaccines provide protection for pregnant and lactating women -- and their newborns. Read More here:

3/25/21: - Stat: Shattering the infertility myth: What we know about Covid-19 vaccines and pregnancy. Read More here:

3/17/21 - CDPH: On March 15, people with certain significant, high-risk medical conditions or disabilities will become eligible for vaccines statewide, to help save the lives of people who are at high-risk of death and severe complications from COVID-19. This includes pregnancy. Read More here:

3/4/21 - From NBC Washington News: A major retailer apologized to a pregnant Alexandria woman after a Virginia pharmacy erroneously denied her the COVID-19 vaccine this week. Read More here:

2/11/21 - From KPBS News San Diego, CA: Expectant Mothers Aren’t Getting Clear Guidance About COVID-19 Vaccines. Read more here:

2/10/21 - From the AMA: “Pregnant individuals who otherwise meet the criteria for COVID-19 vaccines should not be denied the opportunity to be vaccinated, should they choose to do so." Read more here...

2/3/21 - From the ACOG Maternal Immunization Task Force: "All pregnant individuals who choose to receive the COVID-19 vaccine must be allowed to do so in alignment with their state and local vaccination allocation plan. This includes the estimated 330,000 health care workers who are pregnant and should be allowed to receive the vaccine as part of the first phase of vaccine distribution plans. Reports of pregnant individuals being refused vaccination are concerning." Read more here...

2/3/21 - Excellent Review Article from VOX: "Covid-19 vaccines are likely safe during pregnancy. When will we know for sure? People who are pregnant or breastfeeding in the US could choose to get the vaccines, or wait until more data comes out this spring." Read more here...

1/29/21 - From ACOG: "Update: WHO Statement on Recommendation of COVID-19 Vaccines for Pregnant Patients

"In breaking news, today the WHO changed its recommendations regarding administration of COVID-19 vaccines to pregnant individuals. The WHO initially recommended withholding COVID-19 vaccines from pregnant individuals unless those individuals were at high risk of exposure. ACOG and SMFM strongly disagreed with these recommendations, asserting that patients should have the right to make informed decisions about their own health and health care, especially during such a critical time for public health. Our members advocated passionately on behalf of their patients when the initial recommendation was publicized.

"The WHO has modified its stance and now advises that pregnant individuals may receive the COVID-19 vaccination if the benefits of the vaccination outweigh the risks of going unvaccinated. While we appreciate this progress, ACOG will continue to work to ensure that vaccines are not withheld from patients on the basis of their pregnancy."

References:

MESSAGE ABOUT COVID-19 VACCINE AND MAMMOGRAMS

Lymph nodes in the underarms of people who were recently vaccinated for COVID-19 sometimes become enlarged and tender. This is an expected response as our bodies begin to develop antibodies to the vaccination. The underarm of the arm getting the vaccine is more likely to form swollen lymph nodes, which might appear days or sometimes weeks after receiving the vaccine.

As a result, we recommend scheduling your annual mammogram either before or at least 6 weeks after completion of COVID-19 vaccination to reduce the need for additional testing.*

This recommendation is for people who do not have any breast symptoms. If you are having any problems with your breasts, you should not delay your planned mammogram.

The Society of Breast Imaging has recommended that women undergo a mammogram screening either before receiving a COVID-19 vaccine or wait to get their breasts imaged anywhere from four to six weeks after receiving the second dose of the vaccine.

COVID-19 Vaccine Can Cause ‘False Positives’ on Breast Cancer Mammograms

*Some experts disagree:

Should I reschedule my mammogram if I recently received the COVID-19 vaccine? Mayo Clinic.

TeleHealth - Updated

TeleHealth is available by patient request, but the number of appts. will be limited. Our TeleHealth is now integrated into our new athena EMR software system.

When you book the TeleHealth appt., you will receive a link from athena. Hold onto that link until your appt. time. Then click that link and you will enter our digital "waiting room." The Provider will be notified. If you lose the link, call us and we can send a new one anytime.

The video chat works very well on iPhone (7 or up) or Android cell phones. If using a PC, you need a webcam, speaker and microphone, and Google Chrome browser.

We can look at a wound or a skin problem, and of course it's nice to speak face-to-face for any medical interaction with a patient. TeleHealth is for Established FOWH patients only. We cannot do an annual well-woman exam via TeleHealth and we are not able to use TeleHealth for breast or vaginal problems.

Gyn TeleHealth visits for Gyn problems are billed like office visits. Also, there is no separate fee for TeleHealth prenatal or postpartum care.

Using TeleHealth Visits we can help you with:

  • Birth control choices or problems
  • Pre-pregnancy or fertility counseling/advice
  • Menopause or peri-menopause concerns
  • Pelvic pain, painful periods, painful intercourse
  • Irregular periods or PCOS
  • Review of recent abnormal labs or imaging
  • Possible UTI or bladder infection
  • Coronavirus-related concerns

FOWH Visitors Policy

FOWH VISITOR RESTRICTIONS

Out of an abundance of caution, and in order to keep our rooms less crowded and reduce potential staff or provider exposures, we have implemented the following policies:

  • No visitors allowed in the waiting room. Patients only.
  • No visitors for ANY office visit (including prenatal). FaceTime, Skype or audio by phone is allowed. Due to our small exam rooms, we are not able to provide proper distancing for visitors.
  • Exceptions are for a parent of a minor or someone accompanying an individual who cannot be left alone. Also, exceptions for special circumstances will be considered on a case-by-case basis.
  • All patients will receive text messages asking them to wait in their car (or nearby) until we are ready for their appt. (Click here to read about our Text Message Appt Notification).
  • ALL patients (and guests when allowed) will be screened before they are allowed into the office. We will do a quick "no-touch" temp. We will ask you to sign off on some screening questions. If your temp is 99 degrees or over, you will have to wait outside the office until a provider can evaluate the situation. There is ample space in the lobby downstairs for visitors to wait.
  • All staff are being screened the same as our patients and guests.
  • Call us if you have a scheduled appointment and wish to convert it to a scheduled TeleHealth with a Doctor or Nurse Practitioner.

Well Woman Exams Provided

We are now providing all routine gyn care including Well-Woman exams and pap smears. Cancer screening with a pap smear is an important preventive measure and our patients need access to this important medical test.

Previously booked appts are still on the schedule, so openings may be limited for a while. We will monitor the number of appt requests. If necessary, we may extend our hours by opening earlier or staying open later.

To help limit the number of people in our waiting room, we have a procedure using text messaging to communicate to you when we are ready for you to check-in for your appointment. Click here to read about our Text Messaging Appointment Notification process.

Postpartum and Post-Op

We have resumed our routine prenatal and post-op/postpartum schedule and will see you in person for these visits, unless you prefer a phone call. If so, please let us know.

To all 4-6 week Post-Partum Patients: Please complete this brief depression quiz (see below) ahead of time. This will help us prepare for our visit with you. For patients we are following with postpartum depression, please do the same.

Submit the quiz to us by email, fax or submit it online:

Postpartum Depression Test

Here is the quiz to be filled out if you are 4-6 weeks postpartum or are being followed for postpartum depression.

PP Depression Quiz Online FOWH PP Depression Quiz pdf

Texting for your Appt.

Here is how our text system works (see images below):

  1. The day before a Tuesday to Friday appt. you will receive a text message. For a Monday appt. the text will be sent the Friday before.
  2. When you arrive for your appt. and park, reply to the text with the word "ARRIVED" and also which PROVIDER you are seeing.
  3. Note that the signal in the parking structure is sometimes weak. If we do not reply within 5 minutes, please call us at (626) 304-2626 to let us know you have arrived.
  4. We will send you a text which asks you to wait in your car (or nearby the office) until we send "READY".
  5. When we send "READY", please make your way to the waiting room. There may still be a brief wait to see the Provider.

Please do not use the texting system for other messages to us. Thank you for your understanding. This system will help us to keep the occupancy of the waiting room low so people can maintain proper social distancing.

appt tom 11.14 250H.png

First Text (Tues-Fri Appt)

Before your appt. you will receive this text message:

"from FOWH: For your appt. tomorrow, please wait in your vehicle upon arrival. Reply to this text with "ARRIVED" and also WHICH PROVIDER you are seeing. Only reply to this text message. Thank you."

When you arrive for your appt. and park, please reply to the text with the word "ARRIVED" and tell us which provider you are seeing. Thank you.

Note that the signal in the parking structure is sometimes weak. If we do not reply within 5 minutes, please call us at (626) 304-2626 to let us know you have arrived.

appt mon 11.14 250H.png

First Text (Monday Appt)

For a Monday appt. this text message will be sent the Friday before:

"from FOWH: For your appt. Monday, please wait in your vehicle upon arrival. Reply to this text with "ARRIVED" and also WHICH PROVIDER you are seeing. Only reply to this text message. Thank you."

When you arrive for your appt. and park, please reply to the text with the word "ARRIVED" and tell us which provider you are seeing. Thank you.

Note that the signal in the parking structure is sometimes weak. If we do not reply within 5 minutes, please call us at (626) 304-2626 to let us know you have arrived.

thank you 250H.png

Second Text

When we see the ARRIVED text (or when you call us) we will respond with:

"Thank you for your reply. After "READY" is received, please head up to our waiting room. There may still be a brief wait for the Provider. Thank you."

Do not come to the office just yet. Please wait for the READY text. This helps to minimize crowding in the waiting room.

ready 11.14 250H.png

READY TEXT - Come on Up

When it's time to come to the waiting room we will send:

"We are READY. Please head up to the waiting room now. There may still be a brief wait for the Provider. Thank you."

When you get this text, please make your way to the waiting room. There may still be a brief wait for the Provider. Thank you for helping us minimize the number of people in our waiting room.

Huntington Hospital

HH L&D COVID Testing

The following testing protocol has been established in the Labor and Delivery Department:

"In response to the current community surge in COVID-19, we will implement testing of ALL birth partners and certified doulas as a requirement on the unit. All birth partners and/or certified doulas will be required to take a rapid Abbott ID COVID test upon admission to the birthing unit.

The healthy birth partner will be admitted with the patient into OBED, where the swab will be obtained simultaneously and await results. If a doula accompanies that patient, the doula will be escorted to an open OBED room for COVID testing and results.

If the birth partner or doula test positive, they will not be permitted to stay in the hospital. Masks are required to be worn in the hospital at all times and doulas are asked to wear face masks & face shield or googles at all times.

Statement from CDPH (Cal Dept Public Health) on Doulas

Labor and Delivery Patients

  • The presence of a partner or support person is essential to the mental health of patients who are in labor and delivery. CDPH recommends that one support person be allowed to be present with the patient. In addition to the support person, CDPH recommends that a doula, if desired by the patient, be permitted to be present if prior arrangements have been made with the hospital and the doula complies with hospital PPE and infection control guidelines.

California Dept. of Public Health Policy on Doulas (10/23/2020):

HH BIRTHING SUPPORT

The visitation practice in L&D includes a healthy birth support person in addition to the healthy birth partner. The birth support person may either be a doula or another individual of the patient’s choice.

The healthy birth support person will follow the same guidelines as the birth partner:

  • **Note New COVID testing program - see prior item.
  • COVID screening will take place prior to entry to L&D and every 12 hours.
  • Masks are to be worn while in the hospital and in the Labor Room.
  • Prior to the transfer of mother, newborn and birth partner to the Mother-Baby unit (Maternity), the birth support person has to leave the hospital.
  • The birth partner and birth support person may go to the cafeteria and gift shop during their stay at the hospital, but not leave the hospital.
  • In addition to standard medical care by RN's, the hospital has created Birth Support Teams to provide extra support for laboring patients who need it. These are hospital employees knowledgeable about birthing (not nurses) and they are also available to assist women giving birth and afterwards.

If you have further questions, please contact the Labor and Delivery Manager Amy Pendleton by email at amy.pendleton@huntingtonhospital.com.

HH OB Policies

Labor and Delivery Department Policies

COVID TESTING

  • Universal COVID testing (nasal swab) for ALL obstetrical patients presenting to Labor and Delivery is being done. Results are available in about 1 hour.
  • Scheduled C/S patients and scheduled induction patients will be tested after they arrive.
  • If the patient tests COVID-19 POSITIVE, the birth partner will be unable to stay with patient and will be sent home, and NICU will attend the delivery and transport the newborn to the Isolation Nursery. We know this sounds harsh but COVID is too contagious to risk anyone else getting sick.

SIGNIFICANT OTHER (Birth Partner)

  • All patients (labor checks, C/S, or OB problems) will check-in to the OB ED (Obstetrical Emergency Department)
  • ONLY the patient will enter the OB ED (the Birth Partner and birth support person (if present) will have to wait outside the Unit until the patient is admitted or is discharged home).

  • If the patient is admitted, their healthy birth partner will then be allowed into the Labor and Delivery Unit. In addition to the birth partner, one birth support person is also allowed into the Labor Room.
  • Patients have to limit personal belongings brought from home to ONE bag per family (not one bag per person). Bring this with you when you arrive at the Hospital, since you are not supposed to leave after you arrive.
  • The Hospital will provide meals* and toiletries.
  • All labor rooms and all maternity rooms have bathrooms with showers. (See below for information about the High-Risk OB Unit (PHRU))**
  • After the delivery, the birth support person has to leave. The birth partner remains with the patient when she transfers to the Maternity Unit.
  • All L&D patients have a Registered Nurse (RN) assigned to them.

    At Huntington Hospital nobody will give birth alone.

*meals are ordered using "room service". This shuts down at 7 pm, and reopens at 6 am. Until further notice, outside food is not allowed. Late night snacks are also available, ask your nurse. Cafeteria access has been granted for birth partners and birth support persons.

**For patients admitted to the Perinatal High Risk Unit (PHRU), the birth partner has two options:

  1. First Option - the support person may stay for the entirety of the hospital admission with meals and toiletries provided, with the understanding that they will not be permitted to leave the room.
  2. Second Option - one designated healthy support person will be allowed 2 consecutive hours per day visiting. This person must be the same person each day and an assessment will take place upon arriving to PHRU.

OB Classes at Huntington (HH)

During COVID, the classes are all virtual. Classes will be delivered live by certified and credentialed instructors. Registration is free but required.

Here are the Virtual Classes available:

  • Pregnancy & Newborn Nutrition
  • Childbirth Preparation: A Three-Part Series
  • Breastfeeding: A Three-Part Series
  • Caring for Baby: A Three-Part Series
  • Parenting Preemies: From NICU to Home

The Maternity and L&D Tours have all been cancelled due to COVID.

HH Hospital Policies

ALL PATIENTS, STAFF, PHYSICIANS and GUESTS must wear a mask the entire time while in the hospital.

  • Upon arrival to our campus: all staff, patients and the very limited visitors who are permitted will complete the screening procedure and obtain a surgical mask.
  • Surgical masks are required to be worn in all areas of the hospital.
  • Masks must be kept in a paper bag when not worn.
  • Upon Departure: Soiled masks should be thrown away in receptacles or indicated bins.

Visitor restrictions

Click here for Huntington Hospital COVID-19 information

You can call the HH COVID-19 phone line with questions at (626) 397-3777.

CORONAVIRUS VIDEO - STUNNING GRAPHICS

Kurzgesagt – In a Nutshell, creates beautiful videos to share their passion for knowledge. They value quality over quantity, always. Nothing in the universe is boring if you tell a good story.

"Usually it takes many months to make a video – the script goes through many revisions and then the Kurzgesagt team turns it into their famous, beautiful animations (from https://ourworldindata.org/kurzgesagt-coronavirus-video)"

"This video was produced incredibly fast. Virologists and epidemiologists were very responsive and fast in their feedback so that we could ensure that the science is correct and the Kurzgesagt team then worked day and night to produce the video. "

California Dept. of Public Health