Updated Saturday 12/3/2022

Safety of patients, staff and families is essential

Dr. Tsung and Dr. Virmani have been constantly reading the new information about COVID-19 since February 2020. We have reviewed all the recommendations from the AMA, CMA, CDC, WHO, public health departments, Stanford and UCSF in order to treat our patients as safely as possible.    Our scrupulous attention to detail will minimize COVID risk not only to our patients but also to our staff, our nursing homes, our families, and the community at large.  Safety of our patients and staff is our foremost priority. 


Is your office open/when will you open?

We have been open throughout the entire pandemic with precautions.We do mostly telemedicine (phone or video per patientís preference) and have been seeing patients in the office for physical examinations if needed after the telemedicine visit.Frankly, talking in an exam room with PPE and an air filter running is difficult for both the patient and the doctor so the televisit is a much more pleasant way of communication.†† We have not changed how we are doing things with the ups and downs of case counts because COVID keeps changing and to change protocols every few months doesnít make sense.

Note:The CDC has not changed its guidance on how medical facilities should see patients.Please remember, we have to accommodate vaccinated, unvaccinated, sick, immunocompromised and healthy patients in our office while keeping everyone separated.The vaccines are good but arenít perfect so we still have to be careful in close prolonged contact, small indoor areas.There is still risk of exposure to other patients and to us.


Now that there are vaccines, why canít I just come to the office in person for routine appointments?

We are not returning to pre-COVID routine in-office appointments given the ups and downs of the virus.Omicron is the most recent example of this.This does NOT mean we will not see patients in the office in person.We will just start with a telemedicine visit first and then bring patients into the office as needed for an exam.Since we are a small office, we are able to be flexible and do it this way.Some of our patients are vaccinated, some not.Some are ill and immunocompromised, some are healthy.A percentage of those who have had the vaccine still are not immune.We donít want anyone exposed at our office to anyone else who may be infected.We have seen many breakthrough cases in our patients because many of our patients are doing so many things without protection (weddings, travel, large gatherings).Because of outside exposures, we have had to go without any staff in the office for many months.We need to minimize this risk as it is extremely difficult to function with no staff.Prior to COVID, 90% to 100% of the time of an office visit was spent in discussion which can be accomplished with a phone or a video visit.Many fewer in person patient contacts means a much lower risk of new variants developing in our staff, patients, and family.


        Patients cannot hear us well with our masks and face shields.In person visits still require PPE.We both can be more comfortable and share many more facial expressions on video than in person.

Even with some people vaccinated, we will still need to wear facemasks and face shields and keep air filters running in our exam rooms.Even our patients with normal hearing find it difficult to understand every word we say through our PPE.Our patients with hearing impairments find it very hard to understand us even though we are literally yelling to make ourselves heard.A prolonged conversation with PPE does not facilitate good communication.Most of you have probably experienced what sort of conversation you can have yelling through facemasks from a distance in the setting of background noise!

On the phone or on video we can speak freely without masks and face shields blocking communication.For those of you who prefer to see our faces, video works great for that.You will actually get to see much more of us on video than for an in-person visit.With PPE, you only see our eyes!


        We are not out of woods yet Ė there are still many deaths a day in the US from COVID.

Of course, it would be nicer and definitely easier for us to return to the pre-COVID ways, but we have to do what is right to protect our patients, our staff, our families and the world.This is extremely time consuming and tiring for us so please be patient.


        We simply cannot afford to get COVID in the office.

We had no staff for many months due to a COVID infection and exposure already.†† Other facilities donít close when they have staff with COVID.We feel itís the responsible thing to do.If we get infected with COVID, we could give COVID to our patients Ė many of whom are elderly and at high risk.We would have to completely close our office for a minimum of 3 weeks.Patients depend on us and they would have no one here to help them.Our exposures as healthcare workers are much higher than yours.†† Healthcare workers have a 3 times higher risk of COVID infection and a 7 times higher risk for severe COVID.1 in 7 healthcare workers are experiencing lingering long COVID symptoms. If we get long COVID (PASC) we will not be able to treat anyone and will have to close our office.


        We are responsible for keeping our families safe.

Family members of healthcare workers have 2 times higher risk of COVID than an average person.Our responsibilities do not end with our patients but also include our own families. Dr. Tsung has a 106 year old grandmother who lives with her.Throughout COVID, we have heard many sad stories of how an elderly relative died as an unintended consequence to laissez faire behavior.We do not want to be responsible for harming our own families.


What else are we doing to optimize patient and staff safety?

We have researched and invested in equipment and supplies that optimize patient and staff safety.  Swiss made HyperHepa air purifiers (able to filter out SARS-COV2 virus particles) have been placed in our exam rooms and front desk area. 

Appointments that do not require an exam are being done as telemedicine visits Ė either on video or phone Ė per patient preference.  When patients do need to come to the office for an exam after the telemedicine appointment, patient flow inside our office is as contactless as possible. All patients are questioned about possible COVID symptoms, have temperature checks, use hand sanitizer, and wear face masks in our office.  Only furniture that can be completely disinfected are used for patient areas. Interaction is limited to as few staff as possible.

A sneeze guard has been placed at the front desk for just in case.  Updates to insurances, scheduling, and payments are done over the phone. The waiting room is no longer used as such since we are asking patients to wait in their cars until called into the office.  Magazines and other ďtouchablesĒ have been removed.