Blog Series: COVID-19 Response – Pediatric Health
As COVID-19 case numbers grow in the United States, doctors
and researchers are learning more about how the virus impacts children and how
treatment may differ from adults. While mitigating the impact of this virus on
families and children is a crucial priority, doctors and families also face the
regular daily medical concerns of young children: what about health care to
make sure your child stays healthy?
The recommended schedule calls for 11
well-child visits in the first 30 months of life, followed by annual check-ins
after that. Without knowing how long this crisis will continue, families may
not be sure how to manage these visits. American Academy of Pediatrics (AAP) guidance “strongly supports the provision of well child
care consistent…In the midst of the COVID-19 pandemic, the benefit of attending
a well visit and receiving necessary immunizations and screenings should be
balanced with the risk of exposure….”
However, most practices are not just operating as “business as usual.” Both the AAP and the American Academy of Family Physicians (AAFP) have issued considerations for ensuring safety and hygiene during these visits to providers to consider. If you are a parent whose child needs pediatric care in coming weeks, consider asking your office what precautions they are taking, and be prepared to possibly see the following:
These include:
- No more walk-in
visits - Restricting well
visits to those who need it most urgently – newborns, infants, and younger
children who are scheduled for immunization, while rescheduling annual physical
for older children for a later date. - Scheduling the
morning for well visits and afternoons for sick visits - Designating
specific rooms for “sick” and “well” visits; any clinical staff are in a “high
risk” group, they should be focused on well visits only. - Increasing the
frequency of cleaning and disinfecting beyond usual. - Removing all toys
and activities from the waiting room. - Limiting
attendees to the visit to only one parent/guardian – no additional adult
or sibling - Enabling families
to complete any paperwork or payment documents in advance (physical mail or
online portal) or after the visit to reduce amount of time in the waiting room - Allow patients to
“check in” and wait from the car if parking is available rather than in a
waiting room. - Consider shifting
visits to telehealth possible.
That last recommendation might surprise you if you’ve ever argued with young children over limits on their screen time! But the current crisis in American health care caused by the spread of COVID-19 is bringing the world of telehealth to many parents in a new way and demonstrating the value of this new horizon. One family medical provider explained that the shift to telemedicine had “moderate” challenges in getting patients used to it, but that overall it has given patients and staff alike “confidence and comfort.”
What about those medical needs you can’t reschedule? Kids don’t stop getting injured just because there is a crisis and, in fact, some experts worry that the current status of kids at home while parents try to work and homeschool may create more opportunities for hijinks which lead to injury. In a recent New York Times piece, a parenting writer details her own family’s experience with a pediatric emergency during the pandemic based on how experts recommend responding:
“If your child does get hurt,
first tend to the wound and then call your child’s pediatrician — or, better
yet, set up a telemedicine appointment. Your child’s doctor will not only help
you assess whether you need in-person care but can also advise you on where to
go. Pediatric facilities are often better than general emergency rooms or
urgent cares, because they’re fairly empty and often free of coronavirus
patients….
If you do end up in an
emergency room, rest assured that most hospitals are following procedures to
keep patients safe and protected from exposure to the new coronavirus. The
Centers for Disease Control and Prevention have advised all U.S. hospitals and health care
facilities to separate patients who have respiratory symptoms from those who
don’t.”
Of course, telemedicine is not a cure-all and we need to
think seriously about who gets left out of these advances. As the widespread
closure of classrooms has reminded us, the “digital divide” is still very real,
and children without technology access for online learning may also not be able
to access digital medicine. A major article in The
Washington Post highlighted these sharp challenges, reporting
that more than 21 million Americans don’t have access to high-speed internet
despite significant large investments by government over recent years –
disproportionately low-income families and people of color. If your family, or
families you work with, are struggling to secure necessary internet access
during this time of isolation, the FCC maintains a list of internet providers
who have taken their “Keep Americans
Connected” pledge – consider starting there to find opportunities
in your area.
Many American families were already uninsured or under-insured
before this crisis, and a wave of layoffs as a result of the crisis may have
caused many more to lose private health insurance. The federal Families First
Coronavirus Response Act had a number of provisions related to Medicaid and
Child Health Insurance Program (CHIP) services and eligibility; those working
with families may find this explained from the Center
for Children and Families helpful. These programs are administered by
each individual state – you can start
here to learn more about the opportunities in your own state.
Avoiding “non-essential” procedures and medical appointments is a
key component of the national effort to slow the spread of the disease, through
reducing crowded waiting rooms and conserving supplies for essential COVID-19
treatment. However, this does not mean all routine health needs should be
placed on pause! The expert recommendations we’ve shared today can help keeps
safe and healthy through this rapidly changing situation.