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COVID-19 Testing

I recently have received calls about testing for COVID-19. Here is a article from the American Academy of Pediatrics that might help clear some things up. 

What type of coronavirus test should my child get?
Trisha Korioth, Staff Writer
June 23, 2020
Editor’s note: For the latest news about the COVID-19 pandemic, visit https://www.aappublications.org/news/2020/01/28/coronavirus.

Families across the U.S. are talking about whether their children should be tested for COVID-19.

The American Academy of Pediatrics (AAP) encourages parents to talk to their child’s pediatrician about testing.

There are two types of COVID-19 tests: diagnostic tests and antibody tests. It is important to know what each test can and cannot do.

diagnostic test can show if your child has COVID-19 infection now.

One kind of diagnostic test is a molecular test. It uses a nasal or throat swab or sometimes saliva. You might get results the same day or up to a week later. The molecular test is very accurate and tells you if your child has SARS-CoV-2, the virus that causes COVID-19. It will not tell if your child had COVID-19 in the past. It also will not tell you that your child will not become infected in the future.

Another kind of diagnostic test is an antigen test. It uses a nasal or throat swab. Results take an hour or less. Positive test results are very accurate. But if the test result is negative, a molecular test might be needed so you know for sure that your child does not have the virus that causes COVID-19.

An antibody test looks for antibodies in your child’s blood. The body makes antibodies to fight off viruses like SARS-CoV-2. An antibody test uses a sample of blood. It shows if your child was infected by coronavirus in the past. It cannot detect current COVID-19 infection. This is because it can take up to three weeks after your child first shows symptoms of being sick before the test can find antibodies in the blood sample. Many test locations can give you results the same day or within one to three days. Sometimes, a second antibody test is needed.

The AAP does not recommend testing every child. It is important to talk with your pediatrician about whether testing is necessary and if so, what option is best. Testing might be recommended for a child who currently has symptoms of COVID-19 or who was in close contact with someone with COVID-19. After testing, it is important to follow up with your pediatrician. She or he can explain positive or negative test results and answer questions. It is not known if people who had COVID-19 can catch it again.

If you have any concerns about your child’s health, call us. We are open and available for any concerns or questions. 

Continued Good News

Listening to Governor Cuomo, NY state continues to have a good handle on COVID-19 for now.  The rate of postive tests in the Finger Lakes Region continues to drift downward. The number of positive tests has dropped from 2.6% to 2.5% over the past month. A seemingly small drop, but certainly not an increase as we begin to resume more “normal” activities.  Overall, the number of deaths in the US has exceeded those as a result of WW I.  Nationwide, the number of new cases and deaths continues to rise, especially in states that reopened without any specific plan. 

We have been “on pause” for 95 days. With school now “officially out,” and a strong desire to do more, please be careful.  Welcome to summer 2020.

A Note of Caution

As the Finger Lakes region moves into phase 3 of the reopening, I want urge you all to be cautious. Although all the indicators in our area are moving in the right direction, the nation is seeing some surges in states that reopened “early” and “quickly.” The number of cases has topped 2 million. Locally, the percentage of positive tests has been at an all time low since the beginning of the pandemic. Monday 1%, Tuesday 0.3% and Wednesday 1.1%. There has been a slight, possibly not significant, uptick in the rate of postive tests across the state. Hopefully, this is not a new trend. But, as we continue to move through the reopening with more potential contacts with others, please be careful. 

Stay Calm, We Are Moving in the Right Direction

Day 100 since the first identified case of COVID-19 in NY state and the news is promising. Positive test rates in Monroe County are now around 1% and, overall, since the start of the pandemic are at approximately 6%.  Also, the CDC has revised the criteria for “contact” with someone who is positive. Less than 6 feet for more than 15 minutes, up from 6 minutes. And, drum roll please, if both people have masks on, the risk of contracting COVID-19 are minimal if any…

But, do not take this good news as license to go crazy. As we move through the phases of “reopening”, use your common sense. Please be cautious. 

Stay Calm and Pay It Forward

“Paying it forward” has been something our family has tried to do for years. Last night, Mrs Lewis and I watched the 2000 movie “Pay It Forward” and were reminded of how, even seemingly small, kind, actions can have a ripple effect throughout our community. Given all of the unrest we are witnessing, I suggest we all try to look for ways to “pay it forward.”

On another note, the number of postive COVID-19 tests are down to about 2% in western NY, from a high of 15 %.  Sounds promising, but remember this improvement was made possible by following social distancing and stay at home guidelines. It is not a green light to ignore all the precautions.  Please use your common sense.

Lastly, as western NY “opens” up, more families are wondering about sending children back to daycare and what that will mean. Daycares have been open over the last 96 days of the pandemic and we have seen almost no spread of COVID-19 in them. The NY Times published an interesting article about what daycares might look like in the “new reality.”  https://nyti.ms/2XQGHNy 

Stay safe, calm and try to pay it forward. 

Stay Calm and Move Forward

First, I apologize for not posting for several weeks. We slowly move into Phase 2. As eager as we are to move forward, I am glad that people are being cautious. Although the number of new cases continues to rise (because of more testing), the rate of  postive tests has dropped. Recently less than 2% of the tests in Monroe County were positive. Overall, less than 7% of the total number of tests done over the past 94 days have been positive. 

With the announcement of the availability of antibody tests, I have received a number of requests to have the test done. They are only available through the hospital and on a limited basis. They still have limitations and may have a false positives (showing immunity but to other strains of the virus). 

I also continue to receive questions about the safety of children starting to play with others, seeing grandparents, etc. My only advice is do what feels comfortable to you.  This virus is not going away and we are going to have to learn to live with it. It certainly isn’t going to learn to live with us. However, reports from Italy suggest that the virus is becoming a little less virulent. Time will tell.

So as we move forward, please stay safe. We continue to be here for you. 

Pediatric Multisystem Inflammatory Syndrome

Pediatric Multisystem Inflammatory Syndrome or PIMS is a very rare syndrome similar to Kawaski Disease and Toxic Shock syndrome, which most of you have never heard about.  While extremely rare, about 100 children have been affected. The syndrome is thought to be a post-viral process, most likely related to COVID 19.  The majority of patients with PIMS are are not positive for the infection, but antibody tests show they had the infection or were exposed to someone with the infection and developed an antibody response. 

Children with PIMS look sick.  There is usually a history of  fever greater than 101, and  symptoms that include abdominal pain, vomiting, diarrhea, headache, rash, red eyes, swollen hands or red cracked lips.   Younger children may not want to drink.  Few patients actually have the respiratory symptoms we see in adults.

The concern is the syndrome may affect heart function requiring hospitalization and ICU care. The  majority of children do well with this syndrome but they need special attention and supportive care.  PIMS is new and we are learning more about it. Physicians at Golisano Children’s Hospital at Strong (where there may have been up to 5 cases) are working with the state Dept of Health, the CDC and physicians and scientists across the country and globe to learn more about it and how to best treat it.  

Until then, I want to reassure parents that most children are not affected by the coronavirus, and reports of children who become seriously ill remain rare and unusual cases. Many children have red eyes, or rash or diarrhea without fever or looking ill.  These children do not have PIMS.  What should parents do?  If you are concerned, contact the office.  We can set up a telehealth visit to evaluate your child and answer all your questions.

The Great Realisation

What more can be said? NY State is seeing declining numbers of hospitalizations and deaths. I don’t think you can draw any conclusions about positive tests since the more you test, the more you will diagnose. Actually seeing the number of cases rise but hospitalizations fall suggests that there can be mild illness. But cases across the US are rising. We need to continue to listen to the recommendations of the experts. Social distancing and staying home has worked. This is not over. 

However on a different note, a friend forwarded me a link to an extremely well done, touching video.   The Great Realisation.

2 Months and Counting

NY state diagnosed its first case of COVID-19 61 days ago.  But, looking at some of the flu like illness we saw in January and February that tested negative for influenza, chances are the virus has been here for a longer period of time.  61 days of “NY on Pause” is beginning to try some peoples’ patience. We are all eager to start getting back to “normal” (which is going to be a “new normal.”) We read about other states opening back up and become impatient.  Please do not rush things.  The number of new cases of COVID-19 in NY is down to 933 yesterday (still almost 1000 new cases in 24 hours) and deaths are down to 306 (still a large loss).  Other states that have opened back up are still seeing the number of cases rising, not falling. What is the logic in that?  Which is more important, physical health or financial health? I don’t have the answer to that. I don’t know anyone who has not been affect financially by this pandemic and the stay at home order (other than maybe Amazon and supermarkets). But our financial health means nothing if we are too ill, or even dead, too benefit from it. 

Please Stay Calm, Stay Home and Socially Distanced and Stay Patient.  

We at Lewis Pediatrics are here continuing to do what we do best, look after the health and well being of our patients and their families. Stay in touch. 

Stay Calm and Keep Your Fingers Crossed

Both local and statewide reports continue to be optimistic. I think we can safely say we have “flattened the curve” and have probably passed the apex of the “surge.”  Hospitalization rates, ICU admissions and intubations are down. Deaths, still at 481 yesterday, are trending downward but still represent tragic loss from this virus.  Locally the numbers reflect these trends too although the number of deaths from over the weekend are up. 

I think all of you/us who have heeded the recommendations to stay home and socially distance can pat yourself on the back. BUT… it is not over. This is a virus unlike any most of us have ever seen and it will not take much for it to rear it’s ugly head again.  Just like spring is “sort of” here, and we see intermittent sunshine, we can start to look for some hope that NY state will “reopen” in May. 

Please take a moment to, once again, count your blessings, no matter how few or small they might seem at this point in our lives.  John Krasinski (Office and Jack Ryan fame) has started the Some Good News Network on Youtube. Take a minute or 20 to watch them. They are entertaining and uplifting. 

We at Lewis Pediatrics remain here for you. Please do not hesitate to reach out. 

Harper misses you all.