Coronavirus Disease 2019 (COVID-19)

Update for Patients

Johnson & Johnson Vaccine Pause 

Updated April 15, 2021

Earlier this week, it was announced that a rare type of blood clot has been linked to people who have received the Johnson & Johnson COVID-19 vaccine. This blood clot development has been recognized in six people of the seven million doses given. All six have been seen in women, age18-48 years, 6-13 days post injection, with a diagnosis of thrombocytopenia (low platelets).  

If you have received the Johnson & Johnson COVID-19 vaccine and develop a severe headache, abdominal pain, or leg pain within three weeks after vaccination, you should contact your R-Health provider immediately. 

Please remember that these blood clots are extremely rare and have no impact on the effectiveness of the vaccine. 

There are a few important factors to consider as the FDA and CDC re-evaluate the Johnson & Johnson COVID-19 vaccine. Individuals hospitalized with a COVID-19 infection have a 20% likelihood to develop a blood clot and, in the US, alone, 300,000-600,000 develop blood clots every year, without COVID-19. 

The pause itself is a sign that our nation’s safety measures are working and keeping everyone as safe as possible as we continue to deal with the COVID-19 pandemic. To that end, if you are in an eligible group and have not yet gotten a COVID-19 vaccine, we strongly encourage you to do so with either the Pfizer or Moderna vaccine.  

We expect more information on the FDA and CDC’s findings in the next week and will provide further updates at that time. 

As always, if you have questions about this or any other COVID-19-related questions, please do not hesitate to contact your R-Health provider or send a message via the Spruce mobile app.  

Updated May 27, 2020

We hope this letter finds you healthy and safe. We would like to take a moment and address our clinical services with respect to your medical care and our plan to gradually move from virtual to more in person care. Our entire nation, in fact the world, finds itself in a time of uncertainty at this moment. The best we can do right now is to prepare for the changes that are inevitably ahead of us as we continue to provide you with the very best access to healthcare.

Continuing Your Care

It is essential that you can continue to be seen and treated for any chronic health conditions and other medical concerns you may have. While providing virtual and remote access to care has been necessary and will remain a significant part of how we provide you with care, there is no replacement for dealing with your complex medical issues and preventative care in person. That is why we want to share our process of moving forward and gradually relaxing and returning to in-person care delivery.

Your Safety Is Our Top Priority

We understand that this is not a time to let our guard down at the expense of your health and safety. This is why we are implementing new and additional safety protocols to keep you and your family, as well as our staff, healthy and safe. R-Health will be planning a 3-phase approach to re-opening that is safe, efficient, and puts the care team at the least amount of harm while providing the best possible care and access to our members. While we do not yet have a date to “re-open” for full in-person care, here’s what you can expect from us as we start to plan for this next transition. Please note, that it is fully at the discretion of your provider if you are seen in person or virtually.

What You Can Expect from Us

  • Extensive Cleaning. Cleaning of exam rooms and surfaces touched between each patient visit, as well as frequent disinfecting of our reception area and high-touch surfaces such as door handles.
  • Enforcement of social distancing. There will be guidelines in place in our reception areas and exam rooms to ensure that we are still following safe social distance guidelines, such as floor markings for 6 feet of space, designating certain exam rooms for sick and well visits, and removing any communal objects such as reading materials or toys in the reception area.
  • Patient Screening. We will continue to screen all patients with our COVID-19 screening questions before scheduling an in-person appointment. For in-person appointments, temperature checks will be given and if you have a fever >100.4, you will be asked to return to your car and your provider will call with further instructions.
  • Staff Screening. All staff members will be screened daily for symptoms of COVID-19 and will have regular temperature checks. Any staff member that exhibits any symptoms or have an exposure, will be quarantined according to current CDC guidelines before returning to work.
  • Personal Protective Equipment. All staff members will be wearing appropriate personal protective equipment during patient visits and will be wearing face masks at all times.

How to Prepare for Your In-Person Visit

  • Wear a mask. All patients will have to bring a face mask or covering, that covers your nose and mouth, to wear at all times while in the office. We will be unable to see you if you do not have a face mask and will offer to reschedule the appointment.
  • Don’t bring additional visitors. Please do not bring additional visitors with you to your appointment to limit risk of exposure. Exceptions may be made for necessary medical assistance or the patient is a minor.
  • Stay home if you feel sick. If you are feeling unwell and are exhibiting symptoms of COVID-19 such as fever, cough, or shortness of breath, please call us to reschedule or change your appointment to a virtual one.

While these new precautions may feel more “antiseptic” and less personal than before, this is out of an abundance of caution in order to keep you safe as we interact together. Our ultimate goal will be to maintain and strengthen the connection we have established in order to care for you and your family even better.

We will make sure to communicate as best we can with you any changes that are taking place in our practices so that we can continue to provide the kind of terrific medical care that you’ve come to expect from us.

Updated May 5, 2020

As COVID-19 antibody testing in the United States is starting to ramp up, we wanted to address some common myths and misconceptions with all of the information coming out. Here is a Q&A on some common antibody testing questions and how it can help with risk assessment and management.

What is a COVID-19 antibody test? Will it tell me if I have COVID-19?

The antibody tests are not diagnostic, meaning they don’t tell you if you are currently positive for COVID-19.  There are several kinds including pinprick, blood draw, immediate read, etc. For each of these tests, the antibody won’t provide you with information that you currently are infected. That is what the diagnostic test (swab/saliva) is for. The antibody tests can be used, in the right circumstances, to indicate that you have been exposed to Coronavirus-SARS-CoV-2 in the past, the virus that causes COVID-19.

I want to go back to work, shop, and see people in my community with confidence. Should I get it?

In the near future, we all should. The tests will be good enough to provide us with that information. However, for now, the tests work best on people who were hospitalized and people who were very sick from COVID-19.

How accurate are the antibody tests?

Many of the tests that came out initially came out in a hurry and have a general lack of validation to know whether the tests were working. Another issue is that some tests, especially the rapid ones, may be falsely detecting antibodies to other coronaviruses (not COVID-19), including ones that cause the common cold. They could yield a high false positive rate, which could be dangerous if people believe they are immune, providing a false sense of security.

Why is this a problem?

Human nature tells us that this measure of security, real or not, will lead to more people decreasing their social distancing and hygienic practices. The relaxing of social distancing behavior is still an issue for those of us who have antibodies because doctors aren’t sure about how protective the antibodies are yet, meaning how much immunity a person will have from COVID-19. This is a far greater issue for the large number of false positives in these early tests because these people may relax their behavior, inadvertently contract the virus, and further spread the Coronavirus before they realize the test was faulty.

Even if it’s a good antibody test, what are some of the reasons that I should question the result?

It may be too early in recovery when you test and the test might indicate that you have not had COVID-19 when in reality, you had. However, the opposite can also be true. Other common Coronaviruses (not COVID-19), such as some of the common cold viruses, may cross-react and make it appear that you have had COVID-19 when, in fact, you did not.

This is all so confusing? How can I know what to do?

Work with your healthcare providers, they can help you determine if these tests are right for you, right now.  The technology is evolving rapidly, and we are watching this very closely. We will continue to evaluate and incorporate this rapidly changing science for your safety and security.

Do antibody tests mean we can start getting back to “normal”?

Unfortunately, just because there is a presence of antibodies in someone, does not mean we can begin to safely reassume our previous “normal” activities. There are a few factors to consider with antibodies and resuming our previous activities:

  1. Antibodies do not guarantee immunity
  2. People with antibodies might be able to spread the virus unknowingly since they are asymptomatic
  3. People may have a wide range of response to the virus – meaning some who tested positive and recover may show little to no antibodies in their system.

However, it is important to mention that there is not enough research to back up all of these claims, but it is worth thinking about these concerns in terms of risk management and risk assessment as we all think about resuming our normal activities. Until there is more information and antibody testing are further developed, it is critical to continue to follow social distancing and stay at home measures.

Updated April 8, 2020

With the new guidelines for wearing masks out in public from The Centers For Disease Control and Prevention, we have been getting a lot of questions related to the new guidance. The purpose of wearing a mask in public is so that we can decrease the spread of respiratory droplets, therefore further reducing the spread of the Coronavirus to others. Please remember that you do not need to wear a medical-grade mask while out in public, those should be reserved for healthcare workers. Some other materials for DIY masks that cover your mouth and nose are silk, cotton, unused vacuum cleaner filters, hydroknit shop towels, and nylon.

While it is important to wear a mask while you are out in public, please remember this is not a replacement for active social distancing measures. It is also important to remember not to mask your feelings. This is a difficult time and we want to remind you that we are here to help support your mental health too. If you are having difficulty coping with the Coronavirus pandemic, please do not hesitate to reach out to us. We are here to support your physical AND mental health.

Updated April 1, 2020

As we continue to help you through the Coronavirus pandemic, we wanted to make you aware of many health tips and resources that are available to you. Today, we have launched a library of fact sheets on COVID-19 on our website. This includes topics such as Work and COVID-19, Family & COVID-19, Behavioral Health, Prevention and Wellness, and frequently asked questions. You can find these on the right-hand side of this page.

In addition, our Chief Medical Officer, Dr. Randy Robinson, will be hosting a Facebook Live session on April 2nd at 5 pm EST to answer any questions you may have on COVID-19. Like our page and join this live session at

Finally, please remember that we are here for you – whenever and wherever you need us. We have virtual visits available and you can use the Spruce mobile app to send messages to your provider at any time – whether it is COVID-19-related or any other health issues or questions. Thank you.

Updated March 26, 2020

We know that Coronavirus is top of mind for most people right now, but we want to remind you that we are still here for any other healthcare needs you may have as well.

Need a prescription refill, have a chronic condition, have a medical issue, or just have a question for us? We are here to help you. Call us at the office or send us a message using the Spruce mobile app and we can schedule a virtual video visit or phone appointment with your R-Health physician.

Of course, we are here if you have questions related to the Coronavirus, but we wanted to assure you that we’re still here for all of your other healthcare needs too. Thank you.

Updated March 17, 2020

We understand that there is currently a lot of fear and anxiety and we are here to help.

If you are experiencing any symptoms, such as a dry cough, sore throat, a fever or trouble breathing, and you are worried, please call your R-Health doctor immediately or send us a message using the Spruce mobile app. It is important that you do not come into the office if you are experiencing symptoms as you could increase the spread of this highly contagious disease in your community.

However, by having a phone conversation or virtual visit with us, we can and will assess your symptoms and come up with a personal care plan to help.

Also please note, that at this time R-Health practices do not currently have any Coronavirus testing kits. This may change in the near future, but if you need testing, your R-Health physician will help direct you to a testing facility if possible. Please do not hesitate to contact us at any time with any questions. We are here to help.

Actualización de coronavirus,18 de marzo de 2020

Nos estamos acercando para proporcionar una actualización importante relacionada con el Coronavirus.Entendemos que actualmente hay mucho miedo y ansiedad y estamos aquí para ayudar.

Si tiene algún síntoma, como tos seca, dolor de garganta, fiebre o dificultad para respirar,y está preocupado, llame a su proveedor de R-Health de inmediato o envíenos un mensaje utilizando la aplicación móvil Spruce. Es importante que no vaya a la oficina si tiene síntomas, ya que podría aumentar la propagación de esta enfermedad altamente contagiosa en su comunidad. Sin embargo, al tener una conversación telefónica o una visita virtual con nosotros, podemos evaluar sus síntomas y elaborar un plan de atención personal para ayudarlo.

También tenga en cuenta que en este momento nuestra práctica actualmente no tiene ningún kit de prueba de Coronavirus. Esto puede cambiar en el futuro cercano, pero si necesita pruebas, su proveedor lo ayudará a dirigirlo a un centro de pruebas si es posible.

No dude en contactarnos en cualquier momento con cualquier pregunta. Estamos aquí para ayudar.

Para escuchar este mensaje, use el botón de abajo:

Updated March 12, 2020

We wanted to provide a new update related to the Coronavirus (COVID-19). As you are aware, this is a rapidly evolving situation, so the steps we are outlining below, may continue to change as more information becomes available. We will keep you updated as we have new information.

There have now been confirmed cases in each of the states that R-Health operates. Although the risk is still low, R-Health continues to follow the Centers for Disease Control and Prevention (CDC) recommendations for evaluation of patients who may be at risk of developing COVID-19.

Members of our clinical leadership team are communicating with the state and local departments of health to monitor and respond to this evolving situation.

Patients who have appointments should be assured that all operations continue as usual, and our practices remain ready to provide care to all our patients. The only change is that when scheduling appointments, you will be asked some additional screening questions to determine if you are at risk for exposure or symptoms of COVID-19.

Signs & Symptoms 

Signs and symptoms of infection with COVID-19 may appear two to 14 days after exposure and can include:

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing

The severity of symptoms can range from very mild to severe, even death. Importantly, most patients with COVID-19 have only mild respiratory symptoms and do not require hospitalization. However, it is important to limit contact with others to prevent further exposure.

When to Contact a Healthcare Provider 

Call us right away (do not immediately come into the office) if you have symptoms of COVID-19. Call us first and ask to speak to a healthcare provider to tell us about your symptoms, recent travels, and possible exposure before you make an appointment or before you go to the ER. Coming into the office in person may spread the virus to others who are already sick.

Virtual Care 

One of the benefits of R-Health is our access to virtual tools for patient communication. This includes the Spruce mobile app and the Elation Patient Passport. We encourage you to use these virtual communications tools, along with the phone, to communicate with the practice or have a virtual appointment, if medically appropriate. Call us if you need information on how to download Spruce or access the Elation Patient Passport.

Preventing the Spread 

Please note that even if you are not experiencing symptoms, we each have an important role to play in preventing the spread of COVID-19.  Simple hygiene can be very helpful in preventing transmission of many illnesses. This includes:

  • Washing hands frequently (with soap for 20 seconds)
  • Utilizing hand sanitizer when soap and water are not readily available
  • Covering a cough/sneeze with shirt sleeve or tissue (not hands)
  • Avoiding touching your face

In addition, social distancing is an important protective measure. This includes avoiding mass gatherings, avoiding crowds, and staying home if you’re not feeling well.

Additional Information 

Additional up-to-date information is available from the Centers for Disease Control and Prevention (CDC) at

Actualizado el 12 de marzo de 2020

Enfermedad por coronavirus 2019 (COVID-19) Actualización para pacientes

Queríamos proporcionar una nueva actualización relacionada con el Coronavirus (COVID-19). Como sabe, esta es una situación que evoluciona rápidamente, por lo que los pasos que describimos a continuación pueden seguir cambiando a medida que haya más información disponible. Lo mantendremos informado a medida que tengamos nueva información.

Ahora se han confirmado casos en cada uno de los estados en los que opera R-Health. Aunque el riesgo aún es bajo, R-Health continúa siguiendo las recomendaciones de los Centros para el Control y la Prevención de Enfermedades (CDC) para la evaluación de pacientes que pueden estar en riesgo de desarrollar COVID-19.

Los miembros de nuestro equipo de liderazgo clínico se están comunicando con los departamentos de salud estatales y locales para monitorear y responder a esta situación en evolución.

Se debe asegurar a los pacientes que tienen citas que las asignaciones continúen como de costumbre, y nuestras prácticas permanecen listas para brindar atención a todos nuestros pacientes. El único cambio es que al programar citas, se le harán algunas preguntas de detección adicionales para determinar si está en riesgo de exposición o síntomas de COVID-19.

Signos y síntomas

Los signos y síntomas de infección con COVID-19 pueden aparecer de dos a 14 días después de la exposición y pueden incluir:

  • Fiebre
  • Tos
  • Falta de aliento o dificultad para respirar

La gravedad de los síntomas puede variar de muy leve a grave, incluso la muerte. Es importante destacar que la mayoría de los pacientes con COVID-19 tienen síntomas respiratorios leves y no requieren hospitalización. Sin embargo, es importante limitar el contacto con otros para evitar una mayor exposición.

Cuándo contactar a un proveedor de atención médica

Llámenos de inmediato (no entre de inmediato en la oficina) si tiene síntomas de COVID-19.

Llámenos primero y solicite hablar con un proveedor de atención médica para contarnos acerca de sus síntomas, viajes recientes y posible exposición antes de programar una cita o antes de ir a la sala de emergencias. Entrar en la oficina en persona puede transmitir el virus a otras personas que ya están enfermas.

Cuidado virtual

Uno de los beneficios de R-Health es nuestro acceso a herramientas virtuales para la comunicación con el paciente. Esto incluye la aplicación móvil Spruce y el pasaporte de paciente Elation. Le recomendamos que use estas herramientas de comunicación virtual, junto con el teléfono, para comunicarse con el consultorio o tener una cita virtual, si es médicamente apropiado. Llámenos si necesita información sobre cómo descargar Spruce o acceder al pasaporte de pacientes de Elation.

Prevención de la propagación

Tenga en cuenta que incluso si no está experimentando síntomas, cada uno de nosotros tiene un papel importante que desempeñar para prevenir la propagación de COVID-19. La higiene simple puede ser muy útil para prevenir la transmisión de muchas enfermedades. Esto incluye

  • Lavarse las manos con frecuencia (con jabón durante 20 segundos)
  • Utilizar desinfectante para manos cuando no hay agua y jabón disponibles.
  • Cubrirse al toser o estornudar con la manga o pañuelo de la camisa (no con las manos)
  • Evitar tocarte la cara

Además, el distanciamiento social es una medida de protección importante. Esto incluye evitar reuniones masivas, evitar multitudes y quedarse en casa si no se siente bien.

Información Adicional

Hay información actualizada adicional disponible en los Centros para el Control y la Prevención de Enfermedades (CDC) en

Updated February 27, 2020

As you know, there is currently much anxiety and information circulating in the media about the coronavirus disease 2019 (COVID-19). While there have currently been no confirmed cases in the states that R-Health operates, we believe that it is important that we communicate to our patients to help alleviate concerns and serve as an important healthcare resource, should you need it.

R-Health is following the Centers for Disease Control and Prevention (CDC) recommendations for evaluation of patients who may be at risk of developing the 2019-novel coronavirus first identified in Wuhan City, China. This includes travel to an area or contact with an individual who has been exposed to coronavirus. We will continue to monitor this situation and share updates with you as new information becomes available.

Signs & Symptoms

Signs and symptoms of infection with COVID-19 may appear two to 14 days after exposure and can include:

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing

The severity of the new coronavirus symptoms can range from very mild to severe, even death. Although our understanding of this disease continues to grow, most people with severe illness have been of an older age or have other significant pre-existing medical conditions. This is similar to what is seen in people who have severe infections with other respiratory illnesses, such as influenza.

When to Contact a Healthcare Provider

Call us right away (do not immediately come in to the office) if you have symptoms of infection with COVID-19 and you are concerned about the possibility of having been exposed to the virus. Tell us if you have recently traveled internationally or been with people who have.

Call us first and ask to speak to a healthcare provider to tell us about your symptoms and recent travels and possible exposure before you make an appointment or before you go to the ER. Coming into the office in person may spread the virus to others who are already sick.

Additional Information

Additional up-to-date information is available from the Centers for Disease Control and Prevention (CDC) at

Actualizado el 27 de febrero de 2020

Description General de la Enfermedad de Coronavirus 2019 (COVID-19)

Si bien no se han confirmado casos de la enfermedad por coronavirus 2019 (COVID-19) en los Estados Unidos donde opera R-Health, estamos siguiendo las recomendaciones de los Centros para el Control y la Prevencion de Enfermedades (CDC) para la evaluación de pacientes que pueden estar en riesgo de desarrollar el nuevo coronavirus de 2019 identificado por primera vez en la ciudad de Wuhan, China. Continuaremos monitoriando esta situacion y compartiremos actualizaciones con usted a medida que haya nueva informacion disponible.

Signos y Sintomas

Los signos y sintomas de la infection COVID-19 pueden aparecer de 2 a 14 dias despues de la exposicion y pueden incluir:

  • Fiebre
  • Tos
  • Falta de Aliento o dificultad para respirar
  • Viajar a una area o estar en contacto con un individuo que ha estado expuesto al Coronavirus

La gravedad de los nuevos sintomas del Coronavirus puede variar de muy leve a grave, incluso la muerte. Si bien nuestra comprension de esta enfermedad continua creciendo, la mayoria de las personas con esta enfermedad grave han sido mayores de edad o tienen otras enfermedades medicas preexistentes importantes. Esto es similar a lo que se ve en personas que tienen infecciones graves con otras enfermedades respiratorias, como la gripe(flu).

Cuando Contactar a su Healthcare Provider

Llamenos de inmediato (no venga inmediatamente a la oficina) si tiene sintomas de infeccion  del COVID-19 y le preocupa la posibilidad de haber estado expuesto al virus. Diganos si ha viajado recientemente internacionalmente o ha estado con personas que lo han hecho.

Llamenos primero y solicite hablar con un proveedor de atencion medica para informarnos sobre sus sintomas y viajes recientes y la posible exposicion antes de programar una cita o antes de ir a la sala de emergencias. Venir a la oficina en persona puede transmitir el virus a otras personas que ya estan enfermas.

Informacion Adicional

Informacion adicional actualizada esta disponible en los Centros para el Control de Enfermedades y Prevencion (CDC)