In the clinic

We are accepting new patients 18 years of age and older.

Please call the office to schedule an appointment.

We are screening ALL patients for COVID19 symptoms at the time of appointment confirmation.

If you would like to be seen in-person, we are seeing asymptomatic patients in the office. If you are ill, please let us know at the time you schedule your appointment. We have a separate protocol to see you if you are sick.

We are also conducting televisits. Please sign and return these forms: About Telemedicine. Consent for telemedicine.

Update 9/10/2021:

COVID vaccines are recommended for individuals >12 years old to prevent severe disease and death. Keep in mind that vaccination has decreased efficacy against variants compared with the original strain, and the current circulating variants result in a much higher viral load than the original strain.  Therefore, you can still contract COVID after vaccination.  Most vaccinated COVID cases appear to be mild cases, but you are still contagious and, although rare, you may still develop severe disease and should still seek care with your doctor.  This virus does not care about your species, age, gender, beliefs, health, prior infection or prior vaccination status. With each infection, this virus is mutating and outpacing the gains we have made in our diagnostics, treatments, and vaccination efforts.  Therefore, please continue to mask (n95/kn95 or equivalent) and distance.  It is critical that everyone do their part at this time. 

COVID vaccine appointments

  • You can register with LAC DPH at a location of your choice. You can also register with your local pharmacy

  • If you are in Pasadena City, you may call PPHD at 626-744-7311 to register for an appointment. 

We have 3 vaccines that are being administered in the US:

  • Pfizer/BioNTech (mRNA vaccine): 2 doses 21 days apart, indicated for 12+ yo with full FDA approval for 16+ yo

    • For mRNA vaccines, current adverse event concerns​ being investigated are:

      • Anaphylaxis​

      • Myocarditis/Pericarditis in males < 30yo

  • Moderna (mRNA vaccine): 2 doses 28 days apart, indicated for 18+ yo

    • For mRNA vaccines, current adverse event concerns​ being investigated are:

      • Anaphylaxis​

      • Myocarditis/Pericarditis in males < 30yo

  • Johnson&Johnson (adenovirus vector vaccine/DNA): 1 dose, indicated for 18+ yo

    • For adenovirus vaccines, current adverse event concerns being investigated are:​

      • Anaphylaxis

      • Thrombosis with thrombocytopenia (TTS) in females <50yo

      • Guillain-Barre syndrome

Boosters:

  • At this time, boosters are recommended for moderately to severely immunocompromised individuals.

  • The CDC has a plan to recommend boosters for 8 months after the 2nd mRNA dose.  The anticipated rollout date for this is 9/20/2021.

  • There is evidence of persistent adequate neutralizing antibody titers at 6 months after Moderna.  Pfizer also submitted a similar update.

  • There is evidence of decreased protective antibody production in patients with blood cancers such as CLL or multiple myeloma.

  • There are preliminary results of a study regarding a Pfizer booster after AstraZeneca enhancing antibody response 100+ fold compared with a 2nd booster of AstraZeneca.

  • The safety of mixing vaccines is unknown and not recommended at this time.  

  • The distribution of vaccines to those who are yet unvaccinated is an important priority as this pandemic's future is a worldwide concern. A concerted effort across the globe with vaccines, masking, distancing is critical to stemming this virus's mutations and continued survival.

Things everyone should do

  • Wear a mask. This is the #1 most effective way to prevent transmission.

    • All masks reduce transmission of diseases. This is critical to limit asymptomatic spread.

    • Do not touch the outside of your mask. It is considered contaminated. There are many videos on proper mask wearing.

    • With mask wearing, most people forget to hydrate. Please remember to drink adequate amounts of fluids

  • Social distance. Stand >6 feet from other people (when outdoors).

  • Stay in well-ventilated environments. Invest in a HEPA air filter, which can help filter viral (and bacterial) particles.

  • Clean your hands and environment.

    • Wash your hands with soap and water for at least 20 seconds. Hand sanitizer is ok to use if your hands are not soiled. Hand sanitizer should have >60% alcohol content to be effective.

    • Avoid touching your eyes, nose or mouth with unclean hands.

    • Disinfect frequently touched surfaces (ie. doorknobs, computer keyboard, phone).

    • Put the lid on the toilet before you flush to prevent aerosolization of toilet bowl contents.

  • Avoid close contact with people who are sick. If you came into contact with someone who tested positive or who is suspicious for COVID19, please isolate yourself and notify Dr. Poon. You should be tested.

  • Get plenty of rest.

  • Do not do anything risky. This is the time to focus on taking care of yourself. Please do not ignore any health concerns. Please call the office as you would normally for any problems that may arise.

  • This is a good time to complete your advanced directives, POLST, and will.

  • Get a pulse oximeter for your home. Every household should have one.

  • Please follow the trends of COVID-19 going on at the National level, state level, county level, and city level.

  • Get vaccinated for COVID and influenza.

About Sars-CoV-2/COVID-19

Our goal is to limit the spread of SARS-CoV-2. We estimate incubation period to be about 5.5-6.5 days, but the range is 2-14 days. This virus is very smart. Data collected in places were testing is robust show that about 20-30% of people with COVID can spread this before they even show symptoms (pre-symptomatic spread). Another 40-75% of people with COVID can spread this and remain asymptomatic (asymptomatic spread). This virus is also quite contagious. Since this virus spreads by close contacts and what epidemiologists call "family-clusters", the goal is to disrupt the transmission. To do this, asymptomatic patients should wear their mask and physically distance (outdoors is much safer than indoors) with those outside your family cluster. It is critical for symptomatic patients to prevent spread by properly isolating.

More common symptoms (you can have one, all, or none of these and still be contagious):

  • fever and/or chills

  • cough (dry or productive)

  • shortness of breath

  • chest pain

  • fatigue

  • body aches - joints and muscles

  • headache

  • loss of sense of smell

  • loss of sense of taste

  • confusion

  • coughing up blood

  • abdominal pain

  • diarrhea

  • nausea and/or vomiting

  • pink eye

  • nasal congestion

  • skin rash (eg. chilblains or livedo retiuclaris seen in young adults with no other symptoms)

  • diseases from blood clotting problems - stroke, heart attack, or pulmonary embolism

  • Kawasaki-like/inflammatory illness

  • blood clots

It is common for mild cases (including COVID cases in vaccinated patients) to present as:

  • allergies

  • sinusitis

  • headache

  • sore throat

  • runny nose

Respiratory illness etiquette:

  • Remember that you are contagious. Wear a mask.

  • Isolate away from other mammals for a minimum of 14 days AND until no longer symptomatic irregardless of your PCR test result. Those in the home should be separated from you.

  • Get groceries/food delivered to your home.

  • Cover your mouth/nose with a tissue when you cough/sneeze.

  • Get a pulse oximeter to measure your oxygen levels and heart rate. Do this at rest and with activity.

  • Take slow-controlled deep breaths in every hour while awake. An incentive spirometer may help.

  • Stay active.

  • If you have COVID-19 and you have mild disease, we are recommending isolation at home. Dr. Poon will monitor you regularly. You may qualify for Regeneron monoclonal antibodies. Data is indicating contagious period is about 10-14 days in immunocompetent individuals.  For immunocompromised individuals, this virus can be contagious for months. PCR testing often remains positive for several weeks.

  • If you have severe disease with symptoms such as shortness of breath, chest pain, confusion, or coughing up blood, please go to the ER. Please also notify Dr. Poon. Please call first to notify and protect our community and the healthcare team.