August COVID-19 Update
- Testing updates
- Back to school guidance
- Flu vaccine coming Sept 1
- Telehealth update
- Immunity after COVID-19?
- Long term consequences of COVID-19
- Screening EKG for athletes after COVID-19
- Forecasting disease risk for Austin this fall
- Flexibility with office visits
- Testing updates: We continue to offer PCR testing for COVID-19 on Tuesday and Wednesday afternoons and as needed for patients who are ill. We currently have enough test kits to screen symptom-free patients who have been exposed to COVID-19 and those who need tests prior to school/activity participation. The turnaround time for results is about 3-4 days. We have been unable to obtain rapid in-office antigen testing thus far because vendors are prioritizing these tests for nursing homes.
- Back to School guidance: Schools are all trying to navigate the safest way for students and faculty to return to learning. But, note that even the most rigorous plans to ensure the lowest risk in a classroom setting relies on responsible student/family behaviors when off campus. Each student in a class “cohort” or social bubble also has a family cohort (who each have their own potential work and school cohorts), potential friend-group cohorts, and extracurricular activity cohorts. All of these off-campus cohorts raise the exposure risk to infection exponentially. So, it is going to take constant mindfulness and a social contract among all of us to limit social interactions, socially distance, and wear masks to reduce the spread of this extremely contagious virus. This must happen to keep schools open. The Texas Medical Association has published clear guidelines for school nurses on how to evaluate an ill student. And, Austin Public Health has created a detailed handbook for ways to return to in-person learning and school activities.
- Flu vaccine coming Sept 1: We will offer flu vaccine to our patients AND parents starting on September 1 by appointment only to facilitate social distancing. We have a limited supply of FluMist nasal spray vaccine for children ages 2 and up (without asthma), and will offer that to patients only (sorry parents!). Here is what you need to know:
- Children ages 6 months through 8 years receiving flu vaccine for the first time need 2 doses of vaccine given one month apart for optimal protection.
- We advise getting flu vaccine as soon as possible, ideally before November. Immunity from the vaccine should last through the entire flu season (now until early May).
- If your child is already scheduled for a well child visit, siblings and parents can also get a flu shot at that appointment to avoid an extra trip and limit exposure but this needs to be scheduled in advance.
- Flu shot-only appointments will be clustered in the afternoons and every other Saturday morning. The flu shot clinic dates will be posted on our website at com. We encourage the entire family to come at one visit.
- To limit the time in the office, please fill out the flu vaccine screening form and vaccine information sheet at home, print it out, and bring forms with you to your appointment. These forms are found on your patient portal: 1. Sign in to portal. 2. Find “My Health”. 3. Scroll to “Medical Forms” to find “Flu Vaccine Form 2020-21” and “Vaccine Information Sheet”. 4. Print, review, sign, and bring forms with you to the office.
- Appointments will be staggered so no one is in the waiting room.
- We bill insurance for your child’s flu vaccine so there is no out of pocket cost. Flu shot for parents and self-pay patients is $35. FluMist for self-pay patients is $40.
- We will offer flu shot to parents until December 1.
- Telehealth update: When we made the rapid transition to offering telehealth in March, we started using Zoom. Now that telehealth is part of our new normal, we will shift to either a product embedded in our electronic health record, or an app called Anytime Pediatrics. Both will allow you to upload images that can be kept as part of your child’s medical records. When you call to schedule a telehealth visit, we can walk you through the logistics.
- Immunity after COVID-19? Some of our patients have already experienced and recovered from COVID-19. The Centers for Disease Control recently issued some new guidance and media reports misinterpreted the advice to say that immunity from re-infection lasts at least three months. The CDC clarified their comments stating that if someone who has recovered from COVID-19 develops symptoms of COVID-19 again and has been exposed, the patient should be re-evaluated and tested again.
- Long term health consequences: Concerns are mounting over the chronic and possible long-term health problems that result from COVID-19, even if people have mild illness during the acute phase of disease. While there is more data in adults, concerns are being raised about children as well. A recent report from the United Kingdom cites a disturbing increase in the number of children with new onset Type 1 diabetes during this pandemic. There are also anecdotal reports of heart muscle inflammation (myocarditis), hearing loss, and chronic fatigue syndrome. We share this information not to scare you, but to be transparent that there is much to learn about this virus. It is shortsighted to let our guard down, look at the risk factors, and hope that no one in our own family will get very sick. It is really not that simple or straightforward.
- Screening EKG for teen athletes after COVID-19. Due to cases of heart muscle inflammation (myocarditis) in college athletes after COVID-19 infection, there are new recommendations for teens ages 12 and up who participate in competitive sports or high intensity exercise to have a screening EKG prior to returning to play. Athletes should also be symptom free for two weeks before returning to play. If your teen plays sports and has endured COVID-19 infection, please notify our office and we can make a referral for a screening EKG.
- Forecasting for Austin: Travis County Medical Society and Dell Medical School have been hosting a series of excellent, informative webinars to address the local implications of the pandemic. The most recent webinar invited Lauren Ancel Meyers, PhD, head of the University of Texas COVID-19 Modeling Consortium, to share her forecasting for Austin in the coming months. The above link includes all videos in this series, but the most recent webinar is the top left thumbnail. The good news: Current cases in Austin are declining and each actively infected person infects about 1 other person [reproduction number R(t) =0.99], which is encouraging. But it is hard to know if we will go up or down from here— that all depends on maintaining our social distancing behaviors. The bad news: If our reproduction number climbs over 1, the number of cases in our community will rise exponentially. Right now, we have about 2.3 Austinites who are actively infected and contagious per 1000 people or 3/1000. The Harvard School of Public Health estimates that community levels should be at 0.25/1000 to open schools without risking community spread. That said, Dr. Meyers predicts a rise in cases of COVID-19 through the fall, peaking in November if most schools re-open on September 8. And, the addition of flu season may stress our local hospital bed capacity for handling both COVID-19 and serious flu infections.
- Flexibility with office visits: In our effort to provide the safest environment for our families, we anticipate there will be times that our healthcare providers need to quarantine/isolate at home if one of us has a COVID-19 exposure. If this occurs, we may have to change the provider you are scheduled to see for an appointment. We ask for your understanding and allow us the flexibility to shift to another provider when these situations occur.
We hope you find these updates helpful! And, please feel free to share!
|COVID-19 and school, diabetes and COVID 19, flu shots, myocarditis 411 Pediatrics