UPDATE ON ALLERGY SHOT HOURS:

Effective March 30, we will go back to daily allergy shots Monday thru Friday.  Shot hours are as follows:  8am-3:30pm Monday thru Thursday and 8am-12:30pm on Friday. Please note:  Tuesdays and Thursdays the last allergy shot WILL BE GIVEN at 3:30pm and NOT 6pm. To help reduce frequency of visits to the clinic, we would like our patients to make the following interval changes: If you are on shots every 3-4 weeks, try coming every 5-6 weeks. If you are on shots every 2-3 weeks, try coming every 4 weeks. If you are on shots once weekly, try coming every 2 weeks.  Please do not come to get allergy shots if you have symptoms suggestive of COVID-19 (new onset cough and/or fever and/or shortness of breath and/or loss of sense of smell and taste). When you come in for an allergy shot, the reception desk will sign you in.  You will be asked to wait in your car if the lobby, with limited seating, is full.  You may also choose to wait in your car if you prefer.  As soon as the shot nurse is ready for you, we will text you to come in and get your shot.  For your safety please wait 30 mins after your shot.  If the lobby is full, you will be escorted to one of the exam rooms for your 30 minute observation time. Thank you for your continued patience with us during these difficult times.

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If you are coming in today for an allergy shot and have answered yes to any of the questions below, please refrain from getting an allergy shot until you have had medical clearance from your primary care physician. While it is not our intent to cause undue alarm or disruption to your treatment, we have decided to act conservatively and in the best interest of our community. We will continue to be transparent with you and communicate what arises as frequently as possible.

• Do you have a fever 100.4 or higher or have you had a recent fever?
• Do you have a cough or shortness of breath/breathing difficulties?
• Have you traveled to China, South Korea, Italy and Iran in the last 30 days?
• Have you had close contact (face to face contact, within 6 feet) with someone who has been ill with a cough and/or fever who has traveled internationally within the last 30 days?
• Have you been in contact with someone being investigated or confirmed for a case of coronavirus in the last 30 days?

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 COVID-19 and Asthma, Allergy and Immune Deficiency Patients

ACAAI Statement:

The recent pandemic outbreak of Coronavirus has created much uncertainty and anxiety among many of our patients. Elderly patients, as well as patients with severe asthma, immunodeficiency and other chronic conditions where their immune system may be compromised, are most susceptible to increased morbidity and mortality from viral infections in general, and we assume similar precautions should be recommended to these individuals for Coronavirus.

We recommend all patients especially those with asthma, to remain on their medications. Specifically, asthma patients taking inhaled corticosteroids (ICS) should continue these medications as they have been shown to prevent or reduce asthma exacerbations in part by reducing ICAM-1 levels and/or acidic endosomes important for modulating airway inflammation associated with viral infections.

A recent study reported that ICS inhibit the Coronavirus strain, HCoV-229E, replication partly by inhibiting receptor expression and/or endosomal function thereby modulating infection-induced airway inflammation.  To date 80% of cases are mild and self-limited, manifesting as fever, cough and shortness of breath.

Patients with severe asthma currently on a biologic therapy, there is no information at this time that these treatments should be stopped. We assume they are at increased risk of severe illness if they catch COVID-19 infection and optimal control of their chronic condition is of utmost importance.

Detailed clinical investigation of 140 hospitalized COVID-19 cases in Wuhan China suggests eosinopenia (low eosinophil count) together with lymphopenia (low lymphocyte count) may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD were not risk factors for COVID-19 infection. The authors found that older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients.

A joint statement on the current epidemics of new Coronavirus by the world's different primary immunodeficiency organizations has been published. Their recommendations for patients with primary immunodeficiencies (PID) state that there is currently no data pointing to whether PID patients are actually at higher risk of more severe disease from COVID-19. However, it is believed that PID patients might be at higher risk for this infection or a more severe course of the disease. Thus, patients with PID need to take extra care to prevent from getting this infection. Please go to the following link for more information: https://www.ceredih.fr/uploads/COVID19_WORLDWIDE_Joint_Statement_20200311_1200CET_FINAL.pdf?utm_source=College+Insider&utm_campaign=c3588448b0-EMAIL_CAMPAIGN_2020_03_12_06_37&utm_medium=email&utm_term=0_824f79a3c1-c3588448b0-43171149

Reasonable health care recommendations for asthma and immunedeficiency patients are:

-Avoid close contact (6 feet) with people who are sick.
-Avoid touching your eyes, nose, and mouth.
-Wash your hands often with soap and water for at least 20 seconds.
-Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
-Use tissues to cover coughs and sneezes, then discard tissue in the trash.
-Clean/disinfect frequently touched objects and surfaces.
-IF YOU ARE SICK, STAY AT HOME!
For up-to-date information about the Coronavirus pandemic visit the CDC's coronavirus website.