There is so much information available daily, and things are constantly changing! I feel like my family is taking things day by day, actually hour by hour! I reached out to our FCMB contributor team and collected some questions, things that we are concerned about as moms! I then had the opportunity to ask my family’s pediatrician, Lori Storch Smith, from Bay Street Pediatrics in Westport, CT. Dr. Lori noted that even medical professionals are taking things in strides because this is unchartered territory for everyone!
What medicine should we have on hand in our emergency supply?
At this time, there is no specific treatment for COVID-19. Given that, any medications would be to help your children with symptoms they develop. Good options include acetaminophen and cold/cough medicines for children over the age of six. There were reports that NSAIDS (like ibuprofen) might affect the immune response to this virus, but the World Health Organization could not find any studies to support the concern. More studies need to be done, but at this moment, out of the abundance of caution, I would recommend asking your healthcare provider. Of course, lowering a fever is not necessary if your child is well hydrated and not complaining of symptoms from the fever.
For children over 6 years, you can also have some cold/cough medicine on hand. If your child has asthma, then I would recommend having their asthma medications at home for use. Please note that there is concern that nebulizing medication can aerosolize the virus and increase its spread. As a result, I recommend using an inhaler. Finally, please do not hoard medications like albuterol – we already see short supplies in centers where they are needed for acute emergent care.
How do we continue to provide proper nutrition if we have limited access to fresh produce?
If food supplies make it difficult to obtain fresh produce, frozen fruits and vegetables are an adequate substitute. Of course, please don’t run to the store right now and buy out the whole frozen food section – we all need to keep a reasonable stock of food, and not hoard it. Also, sunlight is essential, and luckily we are moving into warmer (and hopefully sunnier) days. Although getting nutrients through whole foods is best, supplementing with vitamins could also help.
Are symptoms in children more mild?
Yes, it seems so. All of the studies so far are showing that children’s symptoms are mild in comparison to adults and that secondary bacterial infections are also low. Scientists have not yet determined why this is the case, but there are some theories. Our local children’s hospitals are doing an excellent job at hosting webinars to keep pediatricians updated on the new information being published/released in the scientific literature (it seems we have new information daily – a good sign!). I must also say that the community support I have seen as we work to keep all of our children safe and answer all of your questions is heartwarming.
What symptoms do we look for in our children? When should we really worry about them?
As mentioned above, the symptoms we are seeing in children have typically been mild. The American Academy of Pediatrics recently released a study about COVID-19 in children in China. The study looked at just over 2,000 children who tested positive or were presumed positive for COVID-19. 94% of the children did not have severe disease. The more severe cases (the remaining 6%) were substantially less than the 18.5% observed in the adult population. The symptoms noted were mild/moderate fever, fatigue, cough, sore throat, runny nose, sneezing, and body aches. Some children just had gastroenteritis symptoms like vomiting and diarrhea.
One item I would note – when they looked at the severity of disease across age ranges of children, there was a higher percentage of children under the age of 1 who had more severe symptoms. As with any viral respiratory illness, it is important to watch for any respiratory distress with symptoms like trouble breathing (for example – fast breathing or increased work to breathe). Please also make sure your child is adequately hydrated.
Should we get tested?
In an ideal world, it would be great for all of us to know if we were positive for COVID-19. And testing is definitely becoming more available. However, please rely on your physicians to determine if you need testing. There are still not enough tests, and we must make sure there are tests available for those who absolutely require it. On that note, it is also important not to hoard personal protection items (like masks) and medications, as many are in short supply already.
Should wellness appointments be rescheduled? Are there new protocols in place for visiting the office?
Wellness appointments for children who require vaccinations should not be postponed. We do not want to create another issue but having a community increase in pertussis or MMR, for example. Realizing your concerns, pediatric offices are doing an excellent job of adjusting – such as scheduling appointments so that no sick visits are scheduled close to well visits (either by AM/PM or separate offices if available). Sick visits are typically triaged (either via phone or telemedicine) since we are all instructed to keep patients with respiratory illness home. I also strongly encourage patients to take advantage of any telemedicine option offered. Of course, not all issues can be diagnosed this way, but you can discuss your concerns with your provider, and they can help determine the best course of action.
Is it safe to play with friends who are healthy?
Sadly, the answer is YES and NO… please make sure you are helping your children continue to connect with their friends. However, we strongly recommend they do so virtually. This can be a scary and isolating time for children – especially those who do most of their socializing through school, activities, and sports – activities that are not happening. I have been excited to find some interactive online activities like a jigsaw puzzle that can be worked on virtually among several people. Our family is scheduling game night with two other families tonight, and last night we had a virtual dinner party with friends via FaceTime.
It’s also a great time for families to connect like families used to do in the “good old days.” Although I’m sure that will become more difficult after more and more days of everyone being home together, try to schedule some creative ways to connect. Our “non COVID19” lives are so busy, let’s take advantage of this time together. And finally parents – please make sure you have time to do something for yourselves.
Once we return to school, should we still worry? How will they decide if it is safe to go back to school?
As we all know, the question of “when to return to school” is very complex to answer, and one where expert advice is critical. Our country has determined citizens must avoid non-essential contact outside of the immediate family. The transmission rate will decrease materially as a result of this “social distancing.” Of course, this still leaves questions about the exact impact this will have, and what period of “sheltering in place” is necessary.
Scientists are working on estimating, based on experiences in other countries like China, South Korea, and Italy, how we can expect transmission rates to decline based on measures being taken here. Today, most countries are not far enough along to provide reliable information to enable a solid prediction of the course of the disease. In addition, many, including myself, hope is that we will soon have reliable testing, treatment protocols, drugs with some efficacy, and maybe even a vaccine.
Also, there is some support to hope there is some seasonality to this virus, and we will see it dissipate in the near term. Ultimately, based on what we know, once we return to life’s regular routines, there will likely still be a low level of circulating virus. Thus, it will be important to continue with proper handwashing and hygiene and be vigilant to possible symptoms.
If you find yourself needing more answers, we encourage you to reach out to your doctors!
Lori Storch Smith, MD, known in her community as Dr. Lori, is a board-certified pediatrician who has been practicing at Bay Street Pediatrics since 1999 and is proud to be able to care for children in the community in which she grew up. She graduated from George Washington University Medical School and completed her residency at Yale Children’s Hospital. She is honored to have been chosen as a Castle Connolly Top Doctor in Fairfield County and the New York Metro Area in 2015, 2016, 2017, 2018, 2019 and 2020.
Along with her successful pediatric practice, Dr. Lori was a contributor to the Mothers of Multiples monthly newsletter, a pediatric expert in the book, Twin Set: Moms of Multiples Share Survive and Thrive Secrets and has appeared on several medical segments of News Channel 12 in Connecticut. She is a board member of the International Association of Child Sleep Consultants. Now a mother of four teenagers and 3 dogs, she successfully juggles school and sports schedules as well as happily getting to know the families she serves in her practice.