UPDATE: COVID-19

THE CLINIC IS NOW OFFERING Regen COV, the potentially life saving monoclonal antibody treatments, for patients with mild to moderate COVID at high risk for complications.  The patient fact sheet can be found here.  mAb is also recommended to high risk patients who are not fully vaccinated but have a known exposure to a COVID patient, even before they test positive or have symptoms themselves.  Appropriate patients diagnosed with COVID in the clinic or with high risk exposures can receive mAb treatment at the time of their visit, if staffing and space permit.  In some cases, patients will be scheduled to return for treatment.  In either case, there is no additional charge for the medication or it’s administration.  From the FDA:

“Treatment
This EUA is for the use of the unapproved product, REGEN-COV (casirivimab and imdevimab) co-formulated product and REGEN-COV (casirivimab and imdevimab) supplied as individual vials to be administered together, for the treatment of mild to moderate COVID-19 in adult and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and
who are at high risk for progression to severe COVID-19, including hospitalization or death [see Limitations of Authorized Use (1.1)].

Post-Exposure Prophylaxis
This EUA is for the use of the unapproved product, REGEN-COV (casirivimab and imdevimab) co-formulated product and REGEN-COV (casirivimab and imdevimab) supplied as individual vials to be administered together, in adult and pediatric individuals (12 years of age and older weighing at least 40 kg) for post-exposure prophylaxis of COVID-19 in individuals who are at high risk for progression to
severe COVID-19, including hospitalization or death, and are:

• not fully vaccinated1 or who are not expected to mount an adequate immune response to complete SARS-CoV-2 vaccination (for example, individuals with immunocompromising conditions including those taking immunosuppressive medications2) and- have been exposed to an individual infected with SARS-CoV-2 consistent with close contact criteria per Center for Disease Control and Prevention (CDC)3 or
– who are at high risk of exposure to an individual infected with SARS-CoV2 because of occurrence of SARS-CoV-2 infection in other individuals in the same institutional setting (for example, nursing homes, prisons) [see Limitations of Authorized Use (1.2)].

Criteria for Identifying High Risk Individuals
The following medical conditions or other factors may place adults and pediatric patients (age 12-17 years and weighing at least 40 kg) at higher risk for progression to severe COVID-19:

• Older age (for example, age ≥65 years of age)
• Obesity or being overweight (for example, BMI >25 kg/m2 , or if age 12-17, have BMI ≥85th percentile for their age and gender based on CDC growth charts, https://www.cdc.gov/growthcharts/clinical_charts.htm)
• Pregnancy
• Chronic kidney disease
• Diabetes
• Immunosuppressive disease or immunosuppressive treatment
• Cardiovascular disease (including congenital heart disease) or hypertension
• Chronic lung diseases (for example, chronic obstructive pulmonary disease, asthma [moderate-to-severe], interstitial lung disease, cystic fibrosis and pulmonary hypertension)
• Sickle cell disease
• Neurodevelopmental disorders (for example, cerebral palsy) or other conditions that confer medical complexity (for example, genetic or metabolic syndromes and severe congenital anomalies)
• Having a medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related to COVID 19))

Other medical conditions or factors (for example, race or ethnicity) may also place individual patients at high risk for progression to severe COVID-19 and authorization of REGEN-COV under the EUA is not limited to the medical conditions or factors listed above. For additional information on medical conditions and factors associated with increased risk for progression to severe COVID, see the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medicalconditions.html. Healthcare providers should consider the benefit-risk for an individual patient. “

JUNE 1, 2020

Thanks for being patient with us as we begin to resume our semi-normal operations.  We are now opening until 6:00 pm and hope to get back to our extended evening hours shortly.  We are now cautiously bringing patients into the clinic to be treated but are asking  each patient to call from the parking lot.  Sign in and wait from your car.  As soon as a room is available, our staff will bring you straight to a clean room.  For your safety and the safety of our staff, we are not having patients sit in the waiting room.  While we are happy to accommodate these requests whenever we can, please understand that some illnesses or injuries simply have to be seen to be cared for properly.  Please wear a face-covering while in the building.

MARCH 26, 2020

The Coronavirus is affecting every aspect of American life.

Your safety is of paramount importance to us, so we have fundamentally changed the way we practice medicine these days. As of this week we have been seeing patients in their cars in the parking lot. It’s not quite like zipping through Sonic used to be (do you all miss that as much as we do?), but thus far this has worked out surprisingly well. You even get blood draws and flu tests from the comfort of your automobile.

I actually diagnosed illness through a car window while standing in the rain today. That was a first for me.

When you get to the clinic call 234-1090 ext 2 and the receptionist will walk you through the process. It’s honestly kind of fun.

Fret not, everything is still discreet, and nobody has to disrobe in the parking lot. However at least for the rest of the week we will have to stop taking patients at 4 pm. We will figure out next week when we get a little closer.

Please be patient with the chaos. We’re figuring this out as we go along. Well visits and regular checkups we are doing by telemedicine visits, so call to set one up with your UCCO provider. If your care requires more than we can do in the parking lot (suturing, x-rays, etc) then we’ll run into the clinic to do those necessary things. Hang in there. We’ll all get through this together.

Dr. Dabbs

March 17, 2020

As of this week we have been seeing patients in their cars in the parking lot. It’s not quite like zipping through Sonic used to be (do you all miss that as much as we do?), but thus far this has worked out surprisingly well. You even get blood draws and flu tests from the comfort of your automobile. Well visits and regular checkups we are doing by telemedicine visits, so call to set one up with your UCCO provider. If your care requires more than we can do in the parking lot (suturing, x-rays, etc) then we’ll run into the clinic to do those necessary things. Hang in there. We’ll all get through this together.