Coronavirus (COVID-19) Update

 

 

 

 

*Updated March 29, 2020*

The information regarding Coronavirus (COVID-19) is rapidly changing, but we will do our best to keep our families informed with the most up to date information. Initially there were hopes that the virus could be contained, but the rapid spread across multiple countries indicates that opportunity has been lost. The goal now is to “flatten the curve” of the illness. This means taking measures to limit the spread of the illness so that the healthcare system in the United States is not overwhelmed with critically sick people all at once. If the number of people who get sick can be spread out overtime then the healthcare system is capable of caring for those who get critically ill. The current mortality rate is believed to be 2-4%, but the risk of death or serious illness varies by age. The highest mortality rates are in those age 80 and older (~20%) while those age 50 and under with no pre-existing conditions have a mortality rate around 0.2%, which is similar to the Flu. Children age 10 and under seem to do even better as they have mild symptoms or don’t get it at all. While this disease appears to be much less severe for children than adults it is still a deadly virus and has been declared a national emergency.

Dallas County is currently under a Shelter In Place order and we are advising that all of our patients comply with this directive. This means that everyone is advised to stay home except for essential activities or work to provide essential business and government services or perform essential public infrastructure construction, including housing.

“Should we travel, visit with friends, or leave our house?“ are common questions that we are being asked by parents. The truth of the matter is there is no simple answer to these questions and the answer is changing by the day as more people get infected. When assessing how we need to modify our lives in light of this pandemic, it is necessary to recognize that there are two different issues we need to consider. The first is personal safety, the second is public safety.

If we were trying to determine what to do based solely on you and your family’s personal safety, the answer would be to live your life. Unless you have a chronic medical condition, smoke, or are elderly, there is a very low risk of a bad outcome from COVID-19. Even young infants have tolerated the illness very well and there have been no deaths reported in children ages 9 and under.

If we are making decisions based solely out of a concern for the public safety then closing schools, bars, and restaurants starts to make sense. While the risk of death or serious injury is low for those that are young and healthy, this is a very dangerous illness with significant risk of mortality for those who are immunocompromised, have chronic medical conditions, or are over the age of 60. The less we all have interactions with each other, the less opportunity there is for the virus to spread, and the less likely that more people get sick than we have the ability to care for. The current recommendations for social distancing and cancelling of large gatherings can be thought of as being similar to the herd immunity that the community receives from vaccines. When we vaccinate all who are able to be vaccinated, we protect those who are not able to be vaccinated. In the same way, when we all minimize our exposure to large groups of people and avoid unnecessary social gatherings we are doing our part to protect those who are most vulnerable to COVID-19 in our community.

We recommend you follow the CDC’s guidelines for prevention of infection which now include the recommendation to avoid gatherings of 50 people or more. COVID-19 is a collective problem that requires a collective solution and sacrifices from all of us. If you are concerned about possible exposure to COVID-19 and have questions about testing please call us or schedule a Virtual Visit. If you believe you may have been exposed do not come to the office as this puts other people at risk. If it is after hours or you have questions about yourself, visit MedicalCityVirtualCare.com and select the COVID-19 option to begin a free screen courtesy of Medical City Hospital.

What if you or your child has been exposed? The good news is that 80% of people who contract the virus have a mild course and will make a full recovery with minimal intervention.

  • If your child has been exposed to COVID-19 and is well
    • Do not come to the office
    • Supportive care and self quarantine from other people is all that is required
    • If you would like your child tested, call our office for guidance.
    • We have Virtual Visits available to evaluate your child from the comfort of your own home and determine whether or not there is evidence of serious illness.
  • If your child is ill and has been exposed to COVID-19
    • Do not come to the office
    • If your child requires immediate medical attention call 911
    • If you are not sure if your child is ill we are happy to assess your child via a Virtual Visit to help you determine if a visit to the Emergency Department is necessary.
    • If you believe your child needs to be seen at an Emergency Department, call prior to going so they can make arrangements to protect themselves and other patients from possible exposure.
  • Do not come to the office without calling and notifying us first if you have done the following in the past 14 days:

What steps can you take to minimize your child’s risk of exposure:

  • Wash your hands and your children’s 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. This is especially important prior to meals or any activity when you will be putting your hands near your face. Check out this video to learn proper hand washing technique.
  • There is evidence that regular masks, often referred to as surgical masks, can provide some protection when in public places. A recent article from the New York Times reported, “When researchers conducted systematic review of a variety of interventions used during the SARS outbreak in 2003, they found that washing hands more than 10 times daily was 55 percent effective in stopping virus transmission, while wearing a mask was actually more effective — at about 68 percent. Wearing gloves offered about the same amount of protection as frequent hand-washing, and combining all measures — hand-washing, masks, gloves and a protective gown — increased the intervention effectiveness to 91 percent.”
  • If you or your child are sick with fever or cold symptoms, stay home and do not go to public places. If you must leave the house, then wear a mask to prevent the spread of infection.
  • If your child is immunocompromised or has a chronic medical condition we advise avoidance of all public areas and interaction only with people known to be free of illness. 
  • If you need to come to the office for a visit, bring the minimum number of people necessary for the visit.

For updates on the current outbreak visit the Center For Disease Control’s COVID-19 Summary Page. For updates about the virus in Texas, go here. To learn more about COVID-19 and how to protect your children, check out this website from the American Academy of Pediatrics. For answers to Frequently Asked Questions about COVID-19, check out this helpful FAQ provided by the CDC. 

For tips on how to talk to your children about Coronavirus, check out this pediatrician approved comic and video. As with all media about difficult topics, we recommend you watch these videos before you show them to your kids so you can confirm it is appropriate and be ready to answer any questions they may have. If you would prefer an article that walks you through how to talk to your child about Coronavirus as well as provide tips on how to listen to your child’s fears, check out this article.

For information about travel, check out this helpful Q&A from the Wall Street Journal as well as this guide from the CDC.

We will provide updates as they become available. If you have questions or concerns, please do not hesitate to call or message us on the portal. Please be aware that at this time our ability to test for COVID-19 is limited. We are however, still able to test for the flu as well as examine your child to determine if the source of a fever is a viral or bacterial infection. If your child has a fever don’t hesitate to schedule a visit, just be sure to let us know if your child has travelled internationally in the past 2 weeks or has had exposure to someone with, or suspected to have, COVID-19. We are working on making Virtual Visits available for those families for whom the child is believed to be highly contagious or for children who have conditions for which the diagnosis would not require an in-person physical exam. If you believe your child might benefit from a Virtual Visit instead of an in-person visit, then call and request to speak with a nurse.

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