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The “New Normal”

For many, it is the first week of school. Your child may have attended 1 or more days, they may have experienced their first “virtual” day or may be attending 100% virtually. Some have opted to pursue a formal home school program. Whatever the environment, it has been about 6 months since our schools have seen the smiling faces of children. We are all cautiously optimistic that we will move forward without stirring up the COVID-19 pot. I have already received calls from students who have been exposed to someone who tested positive or students who have “failed” the morning prescreen because of mild symptoms. We need to stay careful.

The NYS Department of Health has issued some very stringent guidelines that require a negative COVID test and a note/examination by a physician, NP or PA before returning to school if they failed a screen or were sent home with symptoms. This is challenging and means that we will be sending off large numbers of tests.

So… here’s to a successful and uneventful return to school. Hopefully, all the modifications and precautions will keep us all safe and healthy.

Flu Before Boo. 2020

In keeping with the American Academy of Pediatrics recommendations to get your flu vaccine before the end of October, we announce our Flu Before Boo Campaign. We have received our first shipment of influenza vaccine and given the obstacles of trying to immunize our patients efficiently, we have started offering influenza vaccine now. (much like the pharmacies have). It is safe and effective to immunize this early in the season.  We also hope that social distancing and wearing masks will cut down on influenza transmission (like last spring).

Call now to schedule your children’s immunization.

Dept of Health and Human Services Approves Pharmacists Vaccinating Children

I need your help!

The Department of Health and Human Services has just approved an amendment that will allow pharmacists to adminster routine vaccines to children 3-18 years. This misguided move is one more way that affects pediatricians’ abilities to best care for our patients.

Please contact your congressional representative and our senators Schumer and Gillibrand stating your opposition to this measure.

This is the AAP’s statement in response:

The American Academy of Pediatrics (AAP) opposes today’s announcement from the U.S. Department of Health and Human Services (HHS) authorizing state-licensed pharmacists to order and administer all vaccines to children and adolescents ages 3-18 years.

“This move is incredibly misguided. In the middle of a pandemic, what families are looking for is reassurance and clinical guidance from the doctors they trust most to care for their children: pediatricians,” said AAP President Sally Goza, MD, FAAP. “Pediatricians’ offices are open and safe. We have all necessary childhood and adolescent vaccines in stock with trained medical professionals who can administer them. We know that the best, safest place for children to get vaccinated is in their medical home.”

Creating a new vaccine system is not only unnecessary, but it will not provide children with the same level of optimal medical care they receive from the pediatrician who knows the child’s medical history. Most children and adolescents receive vaccines as part of routine well-child check-ups, when other important health care is provided, including developmental and mental health screenings, counseling about nutrition and injury-prevention, and chronic disease management. Conversations about immunizations are part of those visits, and can be tailored to respond to parents’ unique questions.

Given how few pharmacies participate as Vaccines for Children providers – a federal program that provides vaccines at no cost to children who are Medicaid-eligible, uninsured, underinsured, or American Indian or Alaska Native – today’s announcement only widens the health inequities children have faced throughout the COVID-19 pandemic. Data show that the Vaccines for Children program has increased vaccination rates across all races, ethnicities and income groups, and reduced racial and ethnic disparities.

“This unprecedented expansion of pharmacies’ ability to administer vaccines to children is not a solution to the vaccine hesitancy that is driving down rates of childhood immunizations in the U.S.,” Dr. Goza said. “Many parents have questions about their children’s vaccines, and pediatricians are ready to talk with them. It’s what we do, every day, one-on-one with thousands of parents, as part of the long-term trusting relationships that families have with their physicians.”

Today’s action supersedes state laws governing the scope of pharmacists’ ability to administer vaccines, using the COVID-19 pandemic as justification to make policy change that goes well beyond care related to COVID-19. Many states currently restrict pharmacists from administering vaccines to children of any age or limit the age range or type of vaccine that can be administered by a pharmacist.

“Now more than ever, parents trust their children’s pediatrician,” Dr. Goza said. “Rather than create an unnecessary alternative method to deliver immunizations to children, our federal government should invest in the one we have: pediatricians.”

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

Face Masks and COVID-19: Facts vs Myths

With the return to school more certain now, the importance of properly wearing face masks becomes a very important topic. As is true with almost everything about COVID-19, there is a huge amount of “disinformation” out there, even some coming from apparently “reputable” sources.  Here is a link to a column by fellow pediatrician, Dr. Vincent Iannelli, addressing the mask question.  Click on the link below.

KeepKidsHealthy

 

Stay Calm and Look Forward

The Governor reported new “lows” of hospitalizations, intubations and deaths from COVID-19 today. This is great news since everyone anticipated an increase after “reopening” across NY state. We need to pat ourselves on our backs for accomplishing this. But, we also need to continue to be cautious as we look towards the return to school. I have already received some questions about dealing with kids (as well as parents) who are anxious about returning to school. Children about to start kindergarten are even more at risk to experience worries about going to school

We are also receiving inquiries about the safety of schools’ plans.  So far they all need to be approved by the state, but moving forward, I anticpate that all districts will have plans in place that will address the safety of students, faculty and staff. There will most likely be a spectrum of plans with student attending classes 4 days a week (Wednesdays are scheduled to be cleaning days), a hybrid model or a full virtual model.  The American Academy of Pediatrics still feels it is best for children to return to school if it can be done in a safe manner – that is the $64,000 question.

We anticipate starting influenza vaccines after Labor Day if our inventory comes in on time.  I also have an order in for reagent to perform rapid COVID-19 antigen testing in the office.  I am just waiting for the supplies to become available.

In the meantime, let’s stay calm and look forward to continued reopening of our state.

COVID-19 Testing Changes

Over the past few weeks, I have received a number of requests for COVID-19 testing for return to college, for patients who have been exposed at outings and are without symptoms, and for a number of other reasons. I have tried to accomodate these requests in the office. However, it turns out that there is again a shortage of tests in the area due to needs elsewhere in the nation.

Rochester Regional Health Labs are no longer able to provide asymptomatic testing for the following indications:

  • Close Contacts Close contact with a COVID positive individual (“close contact” meaning less than 6 feet for at least 10 minutes, both parties not masked)
  • Quarantine Individuals subject to a mandatory or voluntary quarantine (includes return from travel to restricted states, including RRH employees)
  • Other Includes students, faculty or staff returning to schools/colleges/universities, those needing testing for travel to other states, countries etc.

For the above three categories asymptomatic patients should be directed to utilize testing services available at Monroe Community College, or other testing sites at pharmacies and urgent care centers.

I will need to abide by these new criteria and will only be able to test and send for patients who are symptomatic.

School – What To Do?

The quick answer to this question is “I don’t know?” As I have previously stated, the American Academy of Pediatrics advocates for the return to school in person if possible, taking into account the safety of the children, teachers and staff. NY has finally started to outline some of the requirements to do this. But, it remains up to the individual districts to come up with plans and contingencies.  I really cannot provide guidance when I don’t know what we are looking at.

I also have been fielding questions about the possibility of a vaccine and whether or not children should receive it. Again, we don’t have a vaccine, don’t know how available it will be, what populations will be targeted to receive it, will it be available for children. So, again, I don’t know. Theoretically, if there is an effective safe vaccine that is indicated for children and available, I would “theoretically” say, yes it is a good idea to immunize children.

In the meantime, use your commonsense and stay safe.

School Reopening – The American Academy of Pediatrics’ Position

As a pediatrician, father, and grandfather, I recognize the struggles that many families had with distance learning this spring. In response, my national organization, the American Academy of Pediatrics (AAP), has released a document that supports a return to in-person learning by emphasizing the following:

1)     It appears that schools were not significant contributors to the initial spread of the coronavirus or spread to adults.

2)     Studies have shown that children tend to become infected from adults with whom they live, not from other interactions.

3)     There is significant emotional and family stress that occurs in the distance learning environment as implemented in the spring of 2020.

4)     Changes in the physical environment of the school, the schedule, and class rules (such as masking, spacing, and keeping children in smaller groups) can further protect the children, teachers and staff from COVID.

The full document can be found at https://qrgo.page.link/gKYXb or you can scan the QR code.

I feel that local, state, and national leaders need to dedicate more resources and funding to address this challenge so that children and families have adequate education plans and resources for the upcoming year. Please help us direct their attention to this pressing need by sharing the document on your social media feeds and tagging your local (school boards, mayors), state (governors, education departments), and federal (representatives, senators and president) leaders, using the hashtag #SafelyOpenSchools.

Finally, the best way to ensure that we can reopen in the fall is to mask up, maintain physical distance and avoid large gatherings.

 

Stay Calm and Careful

The questions of the past week have been related to exposures to someone who tested positive for COVID-19. Basically, “we have been exposed to someone who subsequently tested positive, what do I watch for? What should I do?”

There are 2 aspects to this issue. 1) As we start to expand our social contacts, it is only logical that we will be more likely to come in contact with someone who tests positive. Hopefully the people you are meeting with are conscientious about their contacts too. 2) With more people being tested at the suggestion of our governor to get teste.

d or because of preprocedure testing, we see more positive tests in people who do not have symptoms.

So, what to do? If you are exposed to someone who tests positive, you need to quarantine yourselves for 14 days. You do not need to be tested unless you develop symptoms and the results of the test will help determine how you are treated. If you want to seek out a test, you can, but the results will not necessarily change how you are treated.

If you have questions about what to do, the best source of information is the Monroe County Health Department’s COVID-19 Hotline at 753-5555.

But avoiding unnecessary contact with others is the best way to keep yourselves safe. The “pandemic” is definitely not over.

Return to School and Childcare

The American Academy of Pediatrics has published 2 articles addressing return to school and childcare with COVID-19 infections on the rise nationally. (although at a new low in NY State and the finger lakes region).

Please check out the following at www.healthychildren.org

Return to School.

Return to Childcare

And as always, please stay calm, stay safe and carry on cautiously.