March Viral Madness & Covid Update

LA County Dept Pub Health Covid Stats for 3/23/23
4 year old in the ER getting medication and oxygen via a mask
4 year old in the ER getting medication and oxygen via a mask

COVID has had a significant impact on children’s lives, but the world seems to be moving on and returning to a pre-pandemic baseline. Still, there are many things we have learned from the pandemic, and should continue to do to keep ourselves, our children, and our communities safe from catching Covid-19, influenza, RSV, norovirus, adenovirus, and all of the other viruses currently spreading like wildfire through schools and daycares. Please remember that antibiotics do NOT treat viruses. We do have a medication to help treat some cases of influenza, and if you or your child is sick, please see your physician to rule out a bacterial illness, which may need antibiotics.

The pandemic is a fluid situation, and recommendations for children may change as more is learned about the virus. It is important to stay up-to-date on the latest information and to talk to your child’s pediatrician if you have any concerns. Below the infectious disease tips I have some suggestions on helping anxious kids.

Here are some tips on how to not catch infectious diseases:

Corsi Rosenthal Box Directions
Corsi Rosenthal Box Directions
  • Get vaccinated. Vaccination is the best way to protect yourself from COVID-19, influenza, and a variety of other diseases, like Hepatitis A, which was recently spread to a bunch of unvaccinated people through delicious frozen berries.
    • Get boosted. If you have been vaccinated with the initial two COVID-19 shots and even the original spike booster, you should get an Omicron bivalent booster shot (and later, whatever is the latest strain). The booster shot will help protect you from the latest COVID variant, as well as give you longer immunity from COVID in general.
  • Use an air purifier. Use a HEPA-grade air purifier to clean the air of any rooms you stay in for prolonged periods of time, like your office, dining room, child’s classroom, etc. You can buy one, or make your own Corsi-Rosenthal Box, which uses HVAC filters and a box fan to clean the air. Read more about why this works, and how to make one at this article from Columbia University
  • Wear a well-fitting, medical-grade mask. Masks help prevent the spread of respiratory viruses (any virus spread by saliva, snot, etc, like COVID and influenza). When you are in public, wear a mask over your nose and mouth. Make sure it is tight against your face – any space where air leaks also allow viruses to get in. Try to get one that is N95 grade, or as close as possible. But keep in mind the adage, “My mask protects you, your mask protects me” – if you are the only one wearing a mask, it is much less effective.
  • Wash your hands often. Wash your hands with soap and water for at least 20 seconds. This helps prevent the spread of all kinds of germs. Do not substitute hand sanitizer unless there is no water available, since there are germs, like norovirus, that are not killed that way.
  • Stay home if you are sick. If you have a fever, cough, sore throat, runny nose, or are ill, PLEASE stay home and isolate yourself from others. Even if you get over your illness quickly, there are vulnerable babies and people out there who may catch it and not recover like you. If your child has fever, vomiting, diarrhea, or any symptom bad enough to keep them home from school, they must stay home for at least 24 hours after the symptom goes away, before returning to school. This is because if they have a fever at night and do not in the morning, they are likely still contagious and will just get a fever at school and spread their germs to classmates. The same goes for vomiting.
  • Have your child bathe and change clothes when they come home from school. This one may sound silly, but most kids are bringing home germs, as well as allergens, from school, and washing them off, as well as putting on clean clothes when they get home, really can reduce the spread of both microbes and allergens.
  • Get tested if you have symptoms. If you have nasal congestion, cough, fever, fatigue, a sore throat, or do not feel well, talk to your doctor about testing for COVID, among other things, like influenza and strep. Many people have different symptoms with each COVID infection. In addition, the tests often do not come back positive until a few days into the illness, or if you have a fever, so if you tested a day before you got sick and got a negative result, it does not actually mean that you are negative for Covid.
  • Follow the advice of your doctor. If you have any questions or concerns, talk to your physician. Also check out your local department of public health for the latest recommendations. For Los Angeles, click here.

By following these tips, you can help reduce your risk of getting COVID-19, influenza, RSV, and other viruses.

While the pandemic itself has been difficult for children, there are some positive steps that can be taken to help them cope with anxiety.

One important thing to remember is that children are resilient and can adapt to change. They may be feeling anxious or scared, but it is important to reassure them that they are safe and loved. Parents and caregivers can help children cope by providing them with a sense of normalcy and routine. This could include continuing with regular activities like bedtime stories, meals together, and playtime.

It is also important to talk to children about COVID-19 and what it means for them. Children should be aware of the virus and how it spreads, but they should also be reassured that they are not in danger. Adults can help children cope by providing them with accurate information and answering their questions.

If children are feeling anxious or scared, there are a number of things that parents and caregivers can do to help. One is to provide them with a safe and comfortable place to talk about their feelings. Be patient and understanding. Another is to help them develop coping mechanisms, such as deep breathing or meditation. Adults can also help children by modeling healthy behaviors, such as getting enough sleep and eating a healthy diet.

The pandemic has been a challenging time for children, but there are many things that adults can do to help them cope. By providing children with a sense of normalcy, reassurance, and support, adults can help children weather this difficult time.

Please note that this post was written by Dr. Shaham, with some assistance from a beta version of Bard, Google’s AI. 

2 adults wearing medical masks that are fitted
Fun times with masks

Covid-19: What We Know & What We Should Do Fall 2020 Edition

We are learning new information about the pandemic and Covid-19 everyday, so this information is what I know as of October 1, 2020. Please check out all of the linked articles – they are underlined in this blog post, and should open in a new window when you click on them.

As a reminder, here is a good website for general information about coronavirus and the pandemic: Johns Hopkins Medicine.

COVID-19isolateExposure

Covid-19 is still much rarer in children than it is in adults, but cases have risen sharply since schools have opened, and overall cases have gone up. As this AP article pointed out, younger children were less likely to be affected, but teenagers were more likely than young kids to get sick, and cases are really going up in young adults (age 18-22).  Children are also less likely to be hospitalized, but if your child is one of the rarer cases to get sick enough to require hospitalization, to get MIS-C from exposure to covid-19, to get heart damage from covid-19, or even die, then exposure was not worth it. This is why I am currently NOT recommending in-person school or daycare for anyone. Another thing to consider with daycare or in-person school, is that for every regular cold/fever your child gets, they will likely need to stay at home and isolate for 14 days (this varies, please see the chart below and speak to your doctor for individual advice), since covid tests still have a pretty high false negative rate, and it is difficult to rule out covid without a 2 week wait. This generally means paying for daycare/school, but still needing to find alternatives for your child at home for weeks at a time. For a good blog post going over most scenarios of illness in a state with open schools, please see Dr. Stuppy’s recommendations. Here are 2 images copied from her blog about common scenarios for her school district:

I know virtual school is not fun – I’m having a very hard time with it myself! However, the risks of my child getting covid-19 are not worth the benefits of learning or socialization at this time. I enjoyed this comic from Vox about the stress of remote learning on parents. school_meme_18_1

Another reason you do not want your child (or anyone) having covid is that it can damage the heart. Even if someone just has a fever and sleeps it off at home with covid, and does NOT need to be hospitalized, the American College of Cardiology recommends a gradual return to play protocol. This is similar to what we do after someone has a concussion, so please see your pediatrician, and have them do a cardiac exam (listening to heart with a stethoscope, checking pulses with their hands, looking over the child in person), before resuming any strenuous physical activity.

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The safest thing everybody can do at this time, is continue to stay home and limit contact with other people. The biggest risk is spending time together with other people – the virus is spread by breathing in germs that are breathed out by other people, especially “superspreaders”, – so wearing masks and staying away from others is the only way to prevent the spread right now. Cleaning surfaces is nice, and may help prevent other infections, like staph, e coli, and RSV, but it is not a good defense against covid. Some even refer to this obsessive surface cleaning as “hygiene theatre“. UCSF has a nice summary of how masks protect us, and Johns Hopkins Medicine has a good blog with graphics on how to properly wear masks.

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Finally, now (as always), is a good time to talk to your kids about living a healthy lifestyle. Virtual school can lend itself to too many hours of screen time, too little time being active, and overeating. Combat this by setting up limits on your devices, using apps like Family Link on Android devices / Chromebooks (I like the features on this, espeically the ability to make time limits on individual apps), parental controls on Apple devices, Family Safety on Microsoft/ Windows devices (I find these controls to be very limited, and work best from the website, but not the app), and the Bark App for overall monitoring (I like the ability to designate certain apps during school hours, certain apps for free time, and the monitoring of text messages and websites by the app for dangerous content).

Winter-is-coming-FluShot

Encourage kids to be physically active for at least an hour a day. Take walks, jump around, do free yoga classes on zoom, or whatever you can manage. Remind your tweens and teens of the dangers about smoking or vaping, and that it can be especially harmful if they get covid (see the article linked here).  Encourage them to drink a glass of water instead of reaching for a snack. When they do want a snack, make fresh fruit and vegetables readily available. Encourage them to eat the rainbow! Don’t forget to keep everyone in your family up to date on all of their vaccinations! The last thing you want is to have a fever or cough or rash for any reason during a pandemic – even if you don’t have covid, you will miss school / work, and increase your chance of catching covid by needing to go out to the pharmacy and other places for help.

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