Closer to Normal?  Heritage recommends caution:

We are far from back to normal.  But, some things feel a little bit more normal.  Most daycares have been open for several months now.  Most preschools, primary and secondary campuses are open and many students are now face to face.

     There good reasons for many families to keep children at home this fall and we support you.   Likewise, there are many benefits of kids being in in-person environments as the AAP and CDC have pointed out.  Regardless of our personal decisions, school administrators, teachers, preschools and daycares have gone to enormous lengths and costs to try to make as safe a place as possible for children to interact and learn.  In light of these efforts, Heritage wants to encourage all of us to be especially cautious as we go through the next few weeks.  Please wear your mask when out in public, practice social distancing and try to limit your contacts (remember when you are around a person you are around everyone they have been around in the past 14 days). 

Return to School Criteria:

     When a child is sick they will likely get sent home from school or screened out before they even arrive. To get back daycare, pre-school or school this year, most children will need a note from your doctor stating you have an “alternative diagnosis” to COVID-19.  When children can present with COVID-19 with such mild symptoms as runny nose, sneezing, coughing, headache, sore throat, diarrhea, it will be really hard to sign a note without 1) most likely seeing you 2) performing a COVID-19 diagnostic test.  Some with mild symptoms, no direct contact with known or suspected COVID-19 individuals, resolution of symptoms in 72 hours, and no one else in the immediate family sick, will receive a note after one negative test.  The COVID-19 Rapid Antigen test that we run states their accuracy in regards to false negatives to be 93% of the accuracy of the PCR COVID-19 test.  This is pretty good, but both tests have false negatives.  So, if your child has more extensive symptoms (fever, a lot of coughing, etc) or prolonged symptoms (longer than 72 hours), we may need to do a 2nd rapid antigen or send off a PCR (we swab at the office but that is sent to a lab to be run).  If others in the family develop symptoms, we may need to test all those with symptoms (yes we are testing parents as it helps in the management of our patients).  All of the above may need to be done to have us sign our “alternative diagnosis” form to return to school.   We know all of this is a lot of work and an inconvenience, but again it is the reality of 2020 and one of the costs of attending school this year.  The other alternative is to stay home for 10 days after the onset of the symptoms. 

Preventative Reminders (i.e. How do I limit doctor sick visits this year?):

     Prevention always starts with diet, exercise and sleep.  A good night’s sleep and a healthy diet give us energy to exercise.  Exercise helps us to fall asleep quicker and helps our sleep quality.  Enforce bedtimes this year.  Lack of sleep can affect your immune system and make you more prone to get sick after exposure to a virus.

    When in contact with others or outside your house, masks are the most important way to reduce the spread of COVID-19.   Handwashing is still important.  Though, thankfully, surface to surface transmission is not as common as initially feared.  However, other viruses and bacteria can be more easily transmitted from surface to surface.  We don’t want you to get sick and have to come to the doctor’s office.  So, remember to keep washing your hands!!

     Get your flu shot this year.  This vaccine won’t prevent COVID-19.   However, there are so many reasons to get one this year.   First off, it will reduce the flu in our community.   That in turn reduces healthcare resources, absent days from school and work, and reduces unnecessary visits to test and rule out COVID-19.  Flu will also reduce your immunity to other illness, including COVID-19.  Getting influenza during a case of COVID-19 will likely be much more severe.  The flu shot may not be your thing, but we hope that this year you would consider being a good neighbor and taking one for the team.

     We would recommend a more aggressive treatment of your allergies.  Since a couple of sneezes may get you sent home which will mean a visit and nasal swab, this is the year to be preventative in terms of allergies.  Talk to your doctor if you have more questions about how to best treat your child’s allergies. 

      Finally, we recommend that you keep your regular well visits.  It’s one thing for parents to tell their kids to go to wash their hands and go to bed; it’s reinforced when they hear their doctor (and teachers, coaches and youth workers–it takes a village) give them the same message.  And, it is important that you keep up with your regular vaccines.  The last thing we need is measles or pertussis outbreaks on top of COVID-19.

    Remember, this season will end.  Take a deep breath.  Enjoy a little extra time with your family.  Stay rested.  We live in a “me” society.   We need to take care of our family.  But, we should also remember how to be a good neighbor and support our community.

As always, Heritage finds it a privilege to partner with you in the care of you children,

Heritage Pediatrics