February 26, 2020
After yesterday’s CDC advisory, we have received some questions from families about how they can best prepare for COVID-19.
To summarize, there is not yet community spread of COVID-19 virus occurring in the United States, including the Bay Area. It is occurring in other countries around the world, and based on the patterns of spread in other countries, we anticipate that there is likely to be community spread in the United States at some point. The CDC is still restricting travel, quarantining, and tracking cases and contacts in an attempt to contain spread of cases within the US. This strategy is expected to slow the introduction of virus to the US. Yesterday’s message was a signal to businesses, schools, health care and other organizations to start planning for mitigation strategies to use in the case of community spread.
The good news is that currently, there are very few cases in the US and there has not been any community spread in this country, and therefore it is currently safe to continue your usual routines. In addition, children have comprised very few cases of COVID-19, and children positive for the virus have often been asymptomatic. Mortality and severe cases of COVID-19 have typically been in elderly and those with underlying medical conditions.
Many families have asked about individual preparedness for possible COVID-19 spread. We currently recommend the following:
- Continue usual health maintenance, including very regular hand washing, influenza vaccination (if not already done for this season), stay home if you are sick, cover your cough, and clean frequently touched surfaces.
- Make sure you have a supply of any regular medications needed, especially inhalers if you use them, ibuprofen and acetaminophen for fever control, oral hydration fluids, and a working thermometer.
- A portable pulse oximeter is an optional piece of equipment you can consider adding to your medical kit (especially if there is any history of asthma or pulmonary disease), as this can measure oxygen saturation in the case of pneumonia.
- The pneumonia from COVID is a viral process and antibiotics would not be expected to help; however it would be reasonable to have a course of antibiotics on hand in case of a secondary bacterial infection.
- Consider avoiding international travel.
- If you or a household contact have had international travel in the past 2 weeks, please advise us when scheduling an appointment, so that we can screen for any possible cases and keep our office safe for all patients.
If we begin to see community spread in our local area, other measures may be necessary, including tele-school, tele-commute working, tele-health visits with us, and avoiding mass gatherings. However, as there is no local community spread these aren’t currently necessary. We will continue to monitor the situation closely and update you with new developments and recommendations.
February 12, 2020
Please note that Burgess Pediatrics will be closed on Monday, February 17 for the President's Day Holiday. Our answering service will be able to reach the doctor on call if you need to reach us.
January 31, 2020
We are reaching out to provide information on the coronavirus (2019-nCOV). Today we participated in a live CDC conference call for health care providers, and we are regularly receiving information directly from CDC and other government and health care organizations.
Today on the call we learned that the 6 cases in the United States have all had a mild course so far. It is not yet known whether the virus can be transmitted asymptomatically, or only by people who are ill with it.
2019-nCOV is a lower respiratory tract virus that typically has an incubation period of around 5 days (range 2-14 days) and usually presents with fever, cough, or shortness of breath. Pneumonia can develop during the second week of illness. Only CDC (accessed via the public health dept.) can test for it, as our usual viral swabs do not detect it. No specific antiviral treatment is available for it; Tamiflu is not effective.
People who have traveled to Hubei province, China in the past 14 days or have had contact with a known case, and have fever, cough, or shortness of breath should be evaluated for the virus.
The first case was just reported in Santa Clara County late this afternoon.
There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:
- Avoid travel to China and contact with possible cases
- 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.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact with people who are sick.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces.
- Masks may be used in health care settings to prevent transmission.
We have received many questions on virus preparedness. At this point we suggest making sure you have any regular medications you need available, including inhalers if you have used them in the past, hydration fluids, fever medicines and a thermometer.
Links for further information:
When to call us: If you become ill during the first 14 days after arrival from Asia, or contact with someone who has recently arrived from Asia, please let us know by telephone. If there are risk factors present for 2019-nCOV infection, we will recommend a home visit rather than an office visit.
We will continue to monitor the situation closely and update you as new information becomes available.
We have updated our website to provide current and future patients with helpful information and resources. Appointments can now be requested and forms completed online. The new site is mobile phone- and iPad-friendly and works in all browsers.
You will find important announcements here. Other new content includes links to valuable resources, an analgesic dosing chart, and articles from the American Academy of Pediatrics (AAP).
Please take a look around our site and let us know what you think. We’d love to get your feedback at [email protected]
Posted January 8, 2019 by leigh
We hope you all had a wonderful holiday season!
We are excited to announce that we have hired Leslie Orban, a Registered Nurse, to be a part of our Burgess Pediatrics family. In addition to hospital work, she has experience as a school nurse and is fantastic with kids and families. She is really looking forward to meeting you all! You can read about her at our website: or on our Facebook page. She will be replacing Rachael Horn, who is stepping away from nursing for the time being to focus on her family (but has promised to stay in touch and stop by with her new puppy.) Of course, Mary Hansen, RN and Laura Lombardi are still here to help take great care of you and your family.
We also wanted to share with you that we have some openings for new patients in Dr. Shelly Miller’s practice, and offer these up to your friends and contacts first. If you would like to refer a family to us, please ask them to call to schedule a complimentary informational meeting with Dr. Miller, and to let us know whom we can thank for the referral.
We have been improving our Facebook page – if you follow us, you will find find medical news, announcements, holiday schedules, articles recommended by our physicians, photos, etc. We always love to see your posts and check-ins there too!
As always, please reach out if you have any questions or concerns.
All of us at Burgess Pediatrics wish you a happy, healthy new year!
Posted September 28, 2018 by leigh
It’s time for flu vaccine!
We have this year’s quadrivalent injectable influenza immunization in stock, and we recommend receiving it in October or early November.
We agree with the Centers for Disease Control recommendation for universal influenza vaccination, and highly recommend flu vaccine for everyone over 6 months old. Although it is only about 50% effective in preventing influenza cases, it is extremely effective in preventing severe complications, hospitalization, and death from influenza.
This year, the injection form is highly recommended. FluMist nasal spray is once again available and approved for use, but due to unknown effectiveness, it is only recommended for those individuals who would otherwise receive no vaccination.
We are also offering a special Saturday Flu Clinic – by appointment only on October 13, from 12-3pm in our office. Please call (650) 321-9555 or e-mail us at [email protected] to schedule your family’s immunizations for either this Saturday clinic or for regular office hours.
Posted August 23, 2018 by leigh
We wanted to let you know about the current EpiPen shortage and how to proceed. As you may have heard, there is a nationwide shortage of EpiPens and many pharmacies are out or have low and intermittent supplies. This is expected to be alleviated in a few months when the new generic EpiPen becomes available. Currently, there are three options if you have expired EpiPens:
- FDA has extended expiration dates of many lots of EpiPens so you can check your lots against their website here to see if you can use your current pens for school, etc. this year. EpiPens have been studied and found to have active medication in them for years after their expiration dates if stored at room temperature (not in a hot car, etc.), so this is a very reasonable option.
- Call local pharmacies to see if they have any today and we can send or transfer the prescription. Pharmacies are getting some limited shipments but are running out quickly.
- Go to the AuviQ website auvi-q.com and direct order AuviQ injectors. This is a different type of epinephrine injector and there are instruction videos on the website; we also have trainers in the office and are happy to help instruct new users. You sign up online for their program (to mitigate cost as they are extremely expensive and not covered by insurance) and they should contact us for the prescription and then deliver to your home.
Posted July 26, 2018 by leigh
The doctors at Burgess Pediatrics have extensive book collections and suggested reading on everything from general parenting, divorce, autism, feeding, new siblings, etc. And now they’ve put together a list of some of their favorite recommendations for your easy reference. You can find it under our Resources page here along with links on where to buy them.
Check it out!
Posted April 19, 2018 by master
We are thrilled to welcome Shelly Miller, MD, MPH, to Burgess Pediatrics as our new partner. She has a wealth of pediatric knowledge and experience, and a wonderful sense of humor. We are sure you are going to love her as much as we do. Most importantly, she loves working with children and their families.
Dr. Shelly started out as an anthropologist and worked in archeology for a few years and then moved into public health. After completing her master’s in public health at UCLA, focusing on international health, maternal and child health, she attended medical school in Colorado. She spent her senior year working in Zimbabwe and Malawi before returning for residency at UCSF Benioff Children’s Hospital in Oakland. Following that adventure, she completed a fellowship in pediatric infectious disease. Dr. Shelly says, “There is always more to learn!”
After working over a decade in a private clinic in San Francisco and Marin, practicing both primary care pediatrics and infectious disease consulting, Dr. Shelly moved to the East Bay and has been working in pediatrics with Stanford Children’s Health.
Dr. Shelly is very excited to join Burgess Pediatrics and cannot wait to get to know all of you. Stop by and say hello when next you visit and feel free to give her tips about her new home in Menlo Park!