Treehouse Therapies
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COVID-19 Updates


May 1, 2020

Dear Treehouse Families,

We have missed you and are so excited to start getting to meet with you in person again!  A recent announcement by Governor Brown has opened the door for Treehouse to begin treating our clients in the clinic setting, beginning May 4th.  
We care about your health and the health of our therapists. As such we have made temporary adjustments to our arrival/check-in procedure and have limited the number of therapists and clients in the clinic on any given day/time. Please continue to communicate your schedule directly with your therapist.
If you or any member of your immediate family (living in your home or regular visitors) have experienced any of the following in the last 14 days, please reschedule your appointment: 

  • symptoms including, but not limited to, fever, sore throat, runny nose, cough, shortness of breath, body         aches, nausea, vomiting, or diarrhea.  
  • International travel within the last 14 days.  

Until further notice upon arriving at Treehouse clients should plan to:
  1. Text or call your therapist and let them know you have arrived.  If they do not respond please text or call the front office staff at 541-389-1848. Please wait in your vehicle until your therapist comes to get you.  If you have your own face mask, please bring it with you and put it on before getting out of your vehicle.  If your child does not tolerate a mask they will not be required to wear one. Masks are also not recommended for children 2 and under. 
  2. Only one essential adult should accompany the child who is receiving treatment at a time.  
  3. Please plan for us to take your temperatures before entering the building.
  4. Please plan to enter and exit without spending time in the waiting area.  
  5. Please wash or sanitize your hands upon entering and exiting the clinic. 
  6. Each treatment session will end 10 min early to assure time to clean and sanitize between sessions. 

Please know that we care deeply about you and your families and these precautions are for your safety.  We know we can work together to reduce the spread of not only COVID-19 but other illnesses as well.  

We really look forward to seeing you soon!

March 16, 2020
​
Hello Treehouse Families and Friends,

After much discussion and consideration, Treehouse Therapies has chosen to close our clinics to in-person visits until April 1st. This means that we are moving online to a Telehealth model for our therapy visits. We are trying to be sensitive to the vulnerable population that we serve here at Treehouse Therapies and we are doing the best we can to make sure our staff, therapists and clients are safe. Please reach out to your child's therapist specifically, or call our main line at 541-389-1848, if you are unsure what is happening for your child's appointments. If you are a speech therapy client, please contact Redmond Speech and Language directly at 541-316-8078 for information regarding speech therapy appointments. Thank you so much for your patience and understanding during this transitional time.

Thank you,

Christen Eby
Executive Director 
Treehouse Therapies


March 13, 2020


To Our Families:

With the evolving news regarding COVID-19 in our area we wanted to inform you that the health and safety of our families is our top priority here at Treehouse Therapies.  We are following updates regularly from the Center for Disease Control (CDC) and the World Health Organization (WHO) and local government agencies regarding any updates and protocols needed.

Our clinics are open for business. Although we are actively responding to this public health issue, we are still working hard in all of our locations.  Our role is to be calm, focused, and empathetic as we help our kiddos reach their functional goals.

We have always practiced infection control policies, including sanitizing and cleaning of our toys, equipment, and surfaces between uses, however during this time we are increasing the frequency and extent of these cleanings and have discontinued use of any toys or equipment that cannot be disinfected after each use.
If you are concerned about symptoms or possible exposure, please stay home and contact your primary healthcare provider.

Treehouse Therapies Illness Policy

To maintain a healthy environment and prevent the spread of illness including COVID-19, please adhere to our existing policy regarding illness and cancel your appointment if your child is not feeling well. Please call us as soon as possible to cancel if you notice any of the following:
  • Fever (temperature of 100ºF or above within the past 24 hours)
  • Cough
  • Sore throat
  • Irritability, lethargy, or loss of appetite.
  • Diarrhea or vomiting repeated within 24 hours.
  • Rash (body rash, heat rash or an allergic reaction), especially if accompanied by a fever.
  • Conjunctivitis (“pink eye”) or mucus draining from the eyes.
  • Lice or scabies (children must be free from skin infestations before services resume).
  • Chickenpox

Please notify your therapist if your child or other members of your household have come down with a highly contagious illness. We will notify other families who may have been exposed. 
 
Help Prevent the Spread of Viruses

The same good health habits that prevent other viruses like the flu also prevent COVID-19 spread. We will be reinforcing these habits with the families and children we serve, and ask that you reinforce them at home:
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer, with 60% alcohol, if soap and water are not available.
  • Cough into a tissue or your elbow (not your hand), then throw tissue away and wash hands.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Avoid contact with people who are sick and stay home when you are sick.
  • Keep students home if running a temperature or they report not feeling well, appear weak or ill.
  • Consult your health care provider if you or your child has health conditions that put you at increased risk. 

Frequently Asked Questions:
(information taken from CDC)

Q: Who is at risk for COVID-19?
A: Currently, those at greatest risk of infection are persons who have had prolonged, unprotected close contact with a patient with symptomatic, confirmed COVID-19 and those with recent travel to China, especially Hubei Province. Children do not seem to be having as many symptoms or as severe an illness as adults. It is not currently known why. 
 
Q: Who is at risk for severe disease from COVID-19?
Using current data, older adults, and persons who have underlying chronic medical conditions, such as immunocompromising conditions, may be at risk for more severe outcomes. 
 
Q: When is someone infectious?
A: The onset and duration of viral shedding and period of infectiousness for COVID-19 are not yet known. It is possible that COVID-19 RNA may be detectable in the upper or lower respiratory tract for weeks after illness onset, similar to infection with MERS-CoV and SARS-CoV. However, detection of viral RNA does not necessarily mean that infectious virus is present. Asymptomatic infection with COVID-19 has been reported, but it is not yet known what role asymptomatic infection plays in transmission. Similarly, the role of pre-symptomatic transmission (infection detection during the incubation period prior to illness onset) is unknown. Existing literature regarding SARS-CoV-2 and other coronaviruses (e.g. MERS-CoV, SARS-CoV) suggest that the incubation period may range from 2–14 days.
 
Q: Which body fluids can spread infection?
A: Very limited data are available about detection of COVID-19 and infectious virus in clinical specimens. COVID-19 RNA has been detected from upper and lower respiratory tract specimens, and COVID-19 has been isolated from upper respiratory tract specimens and bronchoalveolar lavage fluid. COVID-19 RNA has been detected in blood and stool specimens, but whether infectious virus is present in extrapulmonary specimens is currently unknown. The duration of COVID-19 RNA detection in upper and lower respiratory tract specimens and in extrapulmonary specimens is not yet known but may be several weeks or longer, which has been observed in cases of MERS-CoV or SARS-CoV infection. While viable, infectious COVID-19 has been isolated from respiratory, blood, urine, and stool specimens, in contrast – viable, infectious MERS-CoV has only been isolated from respiratory tract specimens. It is not yet known whether other non-respiratory body fluids from an infected person including vomit, urine, breast milk, or semen can contain viable, infectious COVID-19.
We are working closely with our cleaning crew during this time. Currently, all our cleaning protocols met CDC criteria for appropriate cleaning of COVID-19. 
 
Q: Can people who recover from COVID-19 be infected again?
A: The immune response to COVID-19 is not yet understood. Patients with MERS-CoV infection are unlikely to be re-infected shortly after they recover, but it is not yet known whether similar immune protection will be observed for patients with COVID-19.
 
Q: How should healthcare personnel protect themselves when evaluating a patient who may have COVID-19?
A: Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to persons under investigation (PUI) for COVID-19. Healthcare personnel evaluating PUI or providing care for patients with confirmed COVID-19 should use Standard Precautions, Contact Precautions, Airborne Precautions, and use eye protection (e.g., goggles or a face shield). 
 
Q: Should any diagnostic or therapeutic interventions be withheld due to concerns about transmission of COVID-19?
A: Patients should receive any interventions they would normally receive as standard of care. Patients with suspected or confirmed COVID-19 should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed. Healthcare personnel entering the room should use Standard Precautions, Contact Precautions, Airborne Precautions, and use eye protection (e.g., goggles or a face shield).
 
Q: How do you test a patient for COVID-19, the virus that causes COVID-19?
A: See recommendations for reporting, testing, and specimen collection at Interim Guidance for Healthcare Professionals. The test is currently sent to the CDC. It is a Real-Time Reverse Transcriptase (RT)-PCR.
 
Q: Will existing respiratory virus panels, such as those done at St. Charles, detect COVID-19 virus?
A: No. These multi-pathogen molecular assays can detect a number of human respiratory viruses, including other coronaviruses that can cause acute respiratory illness, but they do not detect COVID-19.
However, it should be noted in the update screening protocol that the recommendations for testing are if no other reason for symptoms is identified. Thus, it is reasonable to use the viral panel to look for other etiologies of their symptoms. 
 
Q: How is COVID-19 treated?
Not all patients with COVID-19 will require medical supportive care. Clinical management for hospitalized patients with COVID-19 is focused on supportive care of complications, including advanced organ support for respiratory failure, septic shock, and multi-organ failure. Empiric testing and treatment for other viral or bacterial etiologies may be warranted.
Corticosteroids are not routinely recommended for viral pneumonia or ARDS and should be avoided unless they are indicated for another reason (e.g., COPD exacerbation, refractory septic shock following Surviving Sepsis Campaign Guidelines).
There are currently no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat COVID-19. Some in-vitro or in-vivo studies suggest potential therapeutic activity of some agents against related coronaviruses, but there are no available data from observational studies or randomized controlled trials in humans to support recommending any investigational therapeutics for patients with confirmed or suspected COVID-19 at this time. Remdesivir, an investigational antiviral drug, was reported to have in-vitro activity against COVID-19. A small number of patients with COVID-19 have received intravenous remdesivir for compassionate use outside of a clinical trial setting. A randomized placebo-controlled clinical trial of remdesivirexternal icon for treatment of hospitalized patients with COVID-19 respiratory disease has been implemented in China. A randomized open label trialexternal icon of combination lopinavir-ritonavir treatment has been also been conducted in patients with COVID-19 in China, but no results are available to date. trials of other potential therapeutics for COVID-19 are being planned. For information on specific clinical trials underway for treatment of patients with COVID-19 infection, see clinicaltrials.govexternal icon.
 
Q: Should post-exposure prophylaxis be used for people who may have been exposed to COVID-19?
A: There is currently no FDA-approved post-exposure prophylaxis for people who may have been exposed to COVID-19.  
Q: Do patients with confirmed or suspected COVID-19 need to be admitted to the hospital?
A: Not all patients with COVID-19 require hospital admission. Patients whose clinical presentation warrants in-patient clinical management for supportive medical care should be admitted to the hospital under appropriate isolation precautions. Some patients with an initial mild clinical presentation may worsen in the second week of illness. The decision to monitor these patients in the inpatient or outpatient setting should be made on a case-by-case basis. This decision will depend not only on the clinical presentation, but also on the patient’s ability to engage in monitoring, the ability for safe isolation at home, and the risk of transmission in the patient’s home environment. 
 
Helpful Websites:
Center for Disease Control and Prevention- 
https://www.cdc.gov/coronavirus/2019-ncov/index.html
COPA- https://www.copakids.com/healthcare-news/bend-novel-coronavirus-covid19/
Oregon Health Authority-https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx
Descutes County- https://www.deschutes.org/health/page/hot-topics-covid-19-novel-coronavirus
World Health Organization- https://www.who.int/emergencies/diseases/novel-coronavirus-2019
St Charles restricting visitors policy- https://www.stcharleshealthcare.org/news/restricted-visitor-policy-and-entrance-screenings
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