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Stay Calm and Give Thanks

Happy Thanksgiving to all. We certainly have much to be thankful for despite how much our lives have changed. The numbers of positive COVID tests in Monroe County are increasing, but hopefully, the percent positives will drop as we test more students. We know that schools have a very low rate of COVID-19 and if the percent positive of those tested is less than that of the community after 2 weeks, we can stop screening our students.

In my humble opinion, we should screen patrons in bars and restaurants or even in shopping malls or stores.  But that is another story.

We have tested over 200 patients since the start of school and over 60 tests in the office since we obtained reagents for PCR testing 3 weeks ago. We, too, are seeing a little uptick in positives with about a 4.6% positive rate in in office testing and about a 3.3% rate overall since the start of school.

We continue to receive a number of calls about children who have been exposed to someone in school or at sporting event. By strict definition, a contact occurs when within 6 feet for 15 minutes of someone who tests positive. If masks are involved, the risks are reduced significantly. Contact tracing by the county Health Department should reach out to you within 3 days of being notified.  In general, anyone with an exposure needs to quarantine for 14 days. A test is not necessary and will not reduce the length of quarantine. A test is indicated if symptoms develop.

In the meantime, as Thanksgiving approaches, let’s take a minute or two to give thanks for all the good things that we still have in our lives.  Despite all the bad that we have experienced, let’s think about some of the unique opportunities that “staying at  home” have provided us.  So, stay calm, stay careful and give thanks.

Stay Calm and Be Really Careful

According to the American Academy of Pediatrics, there have been 853,000 cases of COVID-19 in children and adolescents as of October 29th. There were 200,000 cases reported in October alone and the week ending October 29th saw the largest number of cases in a single week in kids – 61,000. Those numbers are staggering and sobering. We need to have our youth in school and we need to try to get back to a semblance of normal, but we cannot do it by blindly opening up the country. We need to be careful. We need to avoid unnecessary risks.

Even in Monroe County, the “positivity” rate of tests has increased from ~0.7% to 2.6% in October.  We are doing relatively well in our area, but the rate of positive tests has TRIPLED. I am not an alarmist and believe in “everything in moderation.” However, given these statistics, I also need to be realistic.  Please be careful. Make sure you and your kids wear masks and avoid crowds. Limit contacts and make sure they are being socially responsible.

We are heading into the winter with much more knowledge about the coronavirus, but COVID-19 is pretty sneaky and not going to go away quietly.

We at Lewis Pediatrics continue to provide health care to our patients in a responsible manner. Do not hesitate to reach out to us.

In Office COVID-19 Testing Is Available

We are excited to announce the availability of  COVID-19 testing in the office. It is a combined influenza A & B and COVID 19 PCR test. This is the test that is currently the most accurate test available and required by the health department to return to school. The test takes ~20-30 minutes so we will have results the same day (exact timing depends on the number of tests being performed).

We are not sure, however, if insurance will cover in office testing. If not covered, the test costs $75.

We still will obtain swabs and send out to the UR Medicine laboratory if you choose to not have the testing done in office. Currently we receive test results in approximately 24-72 hours.

In either scenario, as soon as we receive results we will let you know and forward the appropriate documents to the school.

Please continue to “socially distance” and minimize your exposure risks.

 

Stay Calm and Get Out the Vote

Mrs Lewis and I voted today. The first time we have done it prior to the actual election day.

Growing up in the 60s and 70s, I have experienced some pretty tumultuous times in my life, but the current state of our country may surpass those decades. Just look at the news, COVID-19 (it is not a hoax), climate change (it is real), social unrest and disparity, and unemployment rates still at all time highs.  I also don’t think I have ever felt that our leaders have been so divided based on “party lines.” Without getting into politics,  I can’t emphasize how important it is to get out and vote this year.  Without sounding like a cliche, our future and the futures of our children depend on it.

Stay Calm & Stay Smart

In the words of my favorite baseball catcher, Yogi Berra, “it’s deja vu all over again.” Well, maybe not quite but if you track COVID statistics, we are seeing a mild uptick in the number of cases in Monroe County. We still hold the distinction of being a county with the second lowest incidence of COVID-19 in the US. We have seen a resurgence because of cases in colleges. We are seeing some sporadic cases in most, if not all school districts. But, unlike the spring when we were not sure of where we were going, we have a better understanding of how we can contain the spread. Public schools are not shutting down when someone tests positive.   We are not “freaking out” with the upward trend we are seeing.  These are positive steps. But at the same time, we really do not want to have to retrace our steps and shut everything down. So please stay calm and stay smart when it comes to being socially responsible.

And remember to get your flu vaccine. It is even more important this year.

It’s Been A While – COVID-19 Testing

We are a month into the school year and we seem to be doing “okay.” We are seeing a rise in new cases in NY, but most are downstate.  Monroe County and the surrounding areas continue to have less than a 1% incidence of positive cases.  However, we are seeing a large number of children requiring COVID testing because of failed screens. To date, I have performed about 100 tests without seeing a positive test.  The turn around time for these tests have unfortunately risen from 24 hours to over 48 due to the large volumes.

The Department of Health has recently released new guidelines that provide a little relief from previous mandates, but these only allow us to skip a COVID test if we can establish another diagnosis with a test such as strep, influenza or mononucleosis for example.

I am all set to start performing tests in the office. I am just waiting to receive the kits. These are PCR tests which are comparable to those run in the hospital lab and are accepted as valid tests by the health department. They take about 30 minutes to run and given the numbers of tests I have been sending off over the past 4 weeks, we should be able to handle them in the offfice.  I am not sure if they will be covered by insurance and I estimate that the cost to be no more than $75 if not covered by insurance. We will still have the option of sending the tests to the hospital lab with the 48 hour wait time.

I will keep you updated.

 

 

When Should Kids Get The Flu Vaccine?

This year in particular, parents should be vigilant about finding out when their kids should get the flu shot and how many shots they may need. Certain children will need two shots for total protection. Read on to find out when should kids get the flu vaccine and at what age.

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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.