Pediatric COVID-19 Updates

COVID Testing Options, School Notes and Flu Vaccines!

Chilly fall greetings!

We hope you and your family are doing well. We understand that “pandemic fatigue” is a real thing and we are all growing weary of our new normal. Austin area experts are predicting a rise in COVID cases in the coming weeks. We are also starting to see more typical pediatric illnesses in the office. We encourage you to be mindful of this in your lives. The schools are doing a great job of limiting the spread of COVID-19 on campus, but we need to be careful in our social circles as well.

We are now offering both nasopharyngeal PCR swabs (the “brain tickle”!) and the rapid COVID test. The PCR swab is currently coming back in 24-48 hours but that could change at any time. This test is required for asymptomatic patients who have been exposed to COVID. The rapid test is run in the office and results are received in 15 minutes. This test can be used for symptomatic patients only. There are a wide variety of rapid tests available, ours is the Sofia SARS Antigen FIA. It is approved for use by the FDA and is highly reliable compared to the PCR, however, in certain situations the PCR may still be preferred. If we feel like there may be benefit to one over the other, we will tell you! There is a misconception that the local schools will not approve the rapid test. That is true without a physician evaluation, however a note from us indicating that you have seen a provider clears a student whether or not they have had any testing. Therefore, we can use the test to aid in our evaluation and clear them for school based on another diagnosis (allergies, headache, stomach virus, etc).

Flu vaccines are available and highly recommended for this season. We are offering nurse visits by appointment only this year to limit the number of patients in the waiting room. Please call to schedule yours today before we run out! Self-pay cost is $30 and most health insurance carriers cover it with no out of pocket cost.

Thank you for your trust in us and for your patience as we navigate frequent changes.

Dr. Thompson, Kristin, and team

Premier Pediatrics Is Here To Support You During The Coronavirus Pandemic

We continue to encourage all patients to stay home when possible to minimize the spread of the virus. If you are out in public, we encourage wearing a mask for anyone over the age of 2 years and continuing to social distance. We expect that your children will have health care needs during this time and we have a variety of ways that we can help!

We are open and seeing patients of all types! We are scheduling the majority of our well visits and physicals during the mornings to reduce any sick exposures, but we do also have afternoon appointments available if you prefer. We strongly advise that all children continue on the recommended vaccine schedule at this time, so please do not delay your appointments. If they will be enrolled in public school this fall, they will still need all school required vaccines to be current and up to date (even if your school has advised an online learning start). We also expect you to need refills on medications for allergies, asthma, anxiety, and depression, ADHD, etc and this can be accomplished through a virtual visit or in-person visits in the office.

If your child is sick, we are here! We are no longer conducting car visits, however, we have a separate entrance and designated space for our sick patients who need appointments. We will give you instructions when you schedule on how to take advantage of this. Please rest assured we continue our heightened cleaning procedures inside our office and have separate entrances for sick and well visits to keep our staff and patients healthy!

As always, we are happy to help, and are here for you! Please call to schedule an appointment or click here to schedule online!

Please reach out to us if we can help in any way! Stay safe and enjoy your time home with your children.

Carly Thompson and Kristin Campbell

Back To School Considerations

Topics

• Going back to school during a pandemic
• Risk factors for more severe illness
• Face coverings at school
• Sick children - return to school/daycare and COVID testing

Going back to school during a pandemic

The Texas Education Agency, American Academy of Pediatrics, Centers for Disease Control and Greater Austin Pediatric Society all recommend returning to school in person. However, Austin Public Health and other health experts are concerned about a rise in cases and the safety of our children and teachers. What do we do?

The best available evidence shows that following exposure, young children are less likely to become infected with COVID-19 compared with adults. Children and adolescents < 18 years of age currently only represent 9% of the 5 million cases in the United States. If children are infected with COVID-19, symptoms are generally mild. Less than 0.5% of COVID related deaths have occurred in children (70 total pediatric deaths). As a comparison, influenza caused 174 pediatric deaths during the 2019-2020 season and the H1N1 influenza pandemic in 2009 caused 358 pediatric deaths. Scientific studies also suggest that children are less likely to transmit infection, especially in younger children. These studies are mostly from international schools who have remained open during the pandemic. Most transmission occurring in schools is between adult staff, not from adult staff to children or children to each other or their teachers. This risk is not zero, however, and likely higher in adolescents. We fully expect cases of COVID-19 to occur in schools once doors reopen. This is where risk mitigation such as physical distancing and face coverings in schools becomes important.

Aside from concerns about medical risk, we believe that extended school closure is harmful for children. The effects of typical summer breaks from in-person schooling on academic progress, known as the “summer slide” is well documented in the literature and may be exacerbated by an extended absence from the classroom. This is especially true for children who need additional academic support. Schools also play a critical role in supporting the whole child, not just the academic achievement of students. Social interaction among children in grades K-12 is important not only for emotional wellbeing, but also for children’s language, communication, social, and interpersonal skills. Some students may have experienced social isolation and increased anxiety while being at home due to COVID-19.

However, all recommendations stated above come with a caution that school should restart in an area with low community transmission. Austin had a surge in July which prompted great concern with schools in our communities starting on time and further spreading the virus. We have seen a decline in the number of daily cases for the last 2 weeks and hope to see that continue. As we have all seen since March, this is a constantly changing situation and we will all have to be flexible throughout this school year. We believe that healthy families without high-risk individuals in their family circle should feel safe in their decision to send their children back to school in person. Local health officials will be closely monitoring the capacity of our healthcare system should we see a rise in cases following the start of school.

Risk factors for severe disease in children

Children with complex medical problems, a compromised immune system and/or obesity are at risk for more severe disease due to COVID-19. Hispanic and African American children are disproportionately affected with higher risk of hospitalization. While severe respiratory disorders may also put children at risk, mild to moderate asthma alone does not appear to be a risk factor. While we would like our patients with asthma to be diligent with their medication regimen this winter (and every winter!), asthma in and of itself is not a contraindication to going to school.

School environment and face coverings

While all schools will have their own specific guidelines this year, we expect these plans to look similar. The most universal requirements will be physical distancing, face coverings, increased cleaning practices and hand washing. Masks will be important when distancing is not possible - drop off/pick up, hallways, etc. Masks will likely not be necessary outdoors, during exercise or at lunch. You as a parent can always ask your child to keep their mask on at all times if that is your preference. As a general rule, children tolerate masks well and notes will not be written to exempt our patients from wearing masks at school. Very few exceptions may be made for children with special needs. Your school district will be sending you their preparedness plan so you can make the best decision for your child. We believe that most children have adjusted to our world’s “new normal” and will tolerate these changes well. However, some anxious children may do better with a more predictable experience at home. You know your child best!

Sick children and return to school/daycare + COVID-19 testing

We expect things to become a bit more complicated during this winter’s cold and flu season. The common cold, strep throat, flu and COVID-19 as examples, all have similar symptoms. Your school or daycare may require a note to return to school if your child exhibits these symptoms. We currently offer nasal PCR testing through our lab (CPL) and will soon be offering in house rapid antigen testing. The current recommendation for return to school after COVID infection is 10 days from the onset of symptoms, 24 hours fever free without medications AND improvement in symptoms.

We know that you are your child’s best advocate. We are here to support all of our patients and their parents. We know that each household has a different circumstance, such as:

• Dual working parents with rigorous jobs
• Children with learning differences who need to see their teachers in person
• Anxious children who thrive in a safe space at home
• Sad and lonely children who need to get back to their routine, sports and friends
• Families with a compromised parent or grandparent who cannot take the risk of contracting COVID-19 at school

There are many “right” answers in this uncertain time and no rule book to follow. We encourage everyone to love and support your neighbors and friends as we all think about and make hard decisions for our families. We hope this has given you some additional helpful insight from us. Feel free to reach out to us with any further questions.

Pediatric Meet and Greet Update During Coronavirus Pandemic

If you would like to meet Dr. Thompson and her team prior to your upcoming delivery, we would be happy to schedule a meet and greet in person or via virtual visit! Meet and greets are held every 3rd Tuesday of the month at 5:30 pm. Please call our office to indicate that you are interested so we can coordinate a visit for your family with our team.