Personal Physicians
David Katzman, MD & Jennifer DeLaney, MD Internal Medicine Specialists
I've Been Exposed! Now What?
David Katzman, MD

With the number of cases of Covid-19 rising everywhere, we receive many calls every day about patients who are exposed to others who later test positive for the virus. Here are general guidelines and thoughts regarding this scenario.

The CDC defines exposure as the following:
  1.  An individual with close contact—within 6 feet for more than 15 minutes over a 24 hour period of time. It does not matter whether this contact was masked or unmasked, indoors or outdoors.
  2. Contact within 2 days of the individual developing symptoms, or within 2 days of a positive test if the person had no symptoms. This would also include exposure to an individual who tested positive while on home isolation or supposed to be on home isolation.
If you meet these criteria, the CDC recommends a 14-day quarantine whether you test negative over this 14-day period of time, as infections can develop anywhere from 2 to 14 days from exposure. We agree with these recommendations if it is a high-risk exposure, such as household members, intimate partners, or more prolonged unmasked exposures. Guidelines for the 14-day quarantine are as follows:
  • Stay home for 14 days
  • Stay in one room of your house
  • Use a separate bathroom – do not share towels, toiletries, etc.
  • Clean all surfaces daily with a disinfectant
  • Use careful handwashing/hygiene
  • Stay at least 6 feet away from others – no physical contact with others
  • Wear a mask if you have to be in the same room with others
  • Do not share food or drink
If it is a lower-risk exposure which we consider a briefer masked or outdoor exposure, we feel we can limit the quarantine duration given that a very large majority of infections occur within 10 days of “high-risk” exposures. In this scenario we suggest testing at day 9 or 10 and ending quarantine then if testing is negative. Some may also choose to test at day 5 from exposure if they have had many contacts or work in settings where it would be useful to inform others. They should still quarantine for the full 10 days though even if they test negative.

We also are frequently asked about exposures to people who were “exposed” to someone who tested positive. We feel that if the “exposed” individual had high-risk exposure such as household contacts, prolonged unmasked exposure, etc., then the person who was exposed to the “exposed” should quarantine until the status of the “exposed” is known. If this is not possible, then the testing and discharge from quarantine strategy noted above for high-risk exposure should apply.

These should serve as general guidelines, but we are always available to discuss and guide you through your particular situation. Always remember, though, the best way to avoid exposure is to continue to social distance and wear masks! Stay Safe.
We Did It!
Jennifer DeLaney, MD
Hard work pays off! Seven months after our first appeal for snorkel masks and CPAPs, we have achieved what at times seemed impossible! We are proud to announce that our Powered Air-Purifying Respirator (PAPR) has passed 3 weeks of extensive safety testing from the US government and is now approved to protect health care workers from COVID-19 infection. This device uses a CPAP motor to blow pressurized air through a special filter that removes 99.97% of viruses and bacteria into a special hood that the caregiver wears. These devices are estimated to be 10-100 times more effective than an N95 mask and face shield combination in preventing infection in the people wearing them. We are beginning manufacturing and hope to start distributing these to local hospitals in the next few weeks.

This project was only possible due to the generosity of the members of our practice. We asked, and you answered our call. We received 100s of CPAPS, snorkel masks, face shields and monetary donations. The snorkel masks are protecting healthcare workers in El Salvador and Peru. The face shields are protecting nurses, EMTs and fire fighters throughout the region. Your support of the Powered Air-Purifying Respirator project has allowed an idea I had one dark night to become a reality.

The first prototype was taken by Hunter Engineering and made into an amazing product. They spent hundreds of hours developing and improving our prototypes and incorporating additional safety features. Their enthusiasm and expertise took this project from a prototype to full scale manufacturing with the potential to protect 1000s of lives.
We also received amazing support from local robotics teachers, the 3-D printing community, Zone enterprises, AG Industries and Brentwood plastics. We'd like to also thank all those who donated. This truly was a community project.
St. Louis County Issues New Restrictions
Jane Kozlowski, RN


The number of cases in St. Louis is rising quickly and hospitals are filling up. New research has shown that most transmissions currently are from small gatherings of friends and family. Dinner parties, game nights, and sleepovers are cited as frequent causes of infection. Remember that the longer the period of time you are with someone, the higher the risk of transmission. Keep get togethers outside. Eating together is a high-risk activity if your companion does not live with you. Keep your mask on!


In order to help reduce strain on hospitals and to decrease the number of positive coronavirus cases in the area, St. Louis County is instituting some new restrictions beginning Tuesday, November 17.
Three new orders have been released: a Safer at Home Order, a Face Covering Order ammendment, and a Quarantine and Isolation Order ammendment. Below is a summarization of each.
We realize these restrictions put a new burden on all of us and many are getting exhausted with all the distancing and masks. We do feel, however, that by following these new guidelines and restrictions we will see a decrease in cases and hospitalizations and will help protect our community.

Some of the Safer at Home restrictions kicking in next week:
  • Residents are instructed not to leave their homes expect for specific purposes such as medical care. For a comprehensive list of allowed activities, please click here and read Section III.
  • We are asked to form a Support Bubble of 10 family members and friends or less and limit our socialization both inside and outside to this group.
  • Gatherings are to be kept to 10 individuals or less.
  • Most businesses are limited to 25% of occupancy.
  • Indoor dining is not allowed at restaurants. Outdoor dining (properly distanced), carryout, and delivery are still allowed. 
  • Employees are encouraged to work at home if possible.
  • Car parades and drive-in entertainment are encouraged as long as safe distances are maintained.
Face masks are now required for:
  • Anyone 5 and older whenever interacting with someone outside of their household whether indoors or outdoors
  • All persons at a gym or fitness facility even when actively exercising
  • All students in K-12, except for in certain school situations and according to DPH’s Youth Sport Guidelines.
  • Businesses must deny entry to anyone not wearing a mask unless refusal is based on a medical reason. 
For more information, please read the Face Covering Order here.
In addition, the quarantine and isolation order has been updated to clarify the following:
  • Anyone with definite exposure to a positive person must quarantine for 14 days regardless of receiving a negative test. (This would be anyone with a high-risk exposure as listed above.)
  • Anyone who is being tested due to exposure to someone positive or development of symptoms must isolate until test results are back.
  • People who are tested for reasons other than exposure or having symptoms do not need to quarantine until results.
  • Whether quarantined or isolated, you are allowed to go outside but must wear a mask, stay more than 6 feet from others, and stay within your property.
  • Their recommendations for isolation are consistent with what was recommended in our Covid Care article in the previous newsletter.
  • Since they have been overwhelmed with cases, they are requesting that if you test positive, you contact anyone who may have been exposed to you 48 hours prior to your developing symptoms or testing positive if asymptomatic.
For more information on the Quarantine and Isolation Order, please click here.
As always, please call us if you have any questions or concerns. We are here to listen.
Please visit our website if you have missed any past newsletters. The newsletter archives can be found by hovering your mouse over the "Medical Links" tab.

11709 Old Ballas Rd. Suite 101, St. Louis, MO 63141

Unsubscribe | Manage Subscription | Forward Email