Commentary: Pediatric Considerations in the Time of COVID-19
Hilliary Sismondo, MD, is a board-certified pediatrician and assistant professor of clinical medicine at New York Institute of Technology College of Osteopathic Medicine at Arkansas State University.
Over the course of the last few weeks, most of our lives have changed drastically. Many adults have transitioned to working from home. In addition to adjusting to their new reality of telecommuting, they are also charged with the tasks of childcare and teaching from home.
Teenagers also are not immune to the far-reaching effects of the COVID-19 crisis. Although they may not grasp the full magnitude of the pandemic at hand, they understand - to at least some extent - the threat it poses to older loved ones and parents. Adolescence is, in itself, a time of transition. Sadly, many of the events which served to represent this transition into adulthood, such as graduation and prom, have been canceled. We, as a community, are struggling with losses of all sorts and adjusting to our current reality.
Amidst all of the stress and chaos, it can be tempting to turn a blind eye to social distancing recommendations. After all, according to the CDC, children and young adults, as a group, have been relatively unaffected by the COVID-19 crisis. However, now is not the time for teenagers to congregate at local parks or for children to have sleepovers. Although the COVID-19 virus may not have a direct impact on your child, he/she - if infected - can serve as a carrier of the virus, unknowingly infecting high risk individuals they come into contact with.
To illustrate how this works, imagine you allow your teenage son to invite a handful of friends over to play video games. All of his friends appear healthy. However, one of them is unknowingly infected with the virus. He or she would be considered a carrier of the disease. Due to the highly contagious nature of COVID-19, this carrier infects your son and his friends. Your son and his friends then spread the illness to siblings and parents. Parents then go to the office for just a couple of hours and shed the virus throughout the workplace. This ripple effect continues, and before we know it, community spread of COVID-19 is in full effect.
I also want to point out that although young people as a group seem to be in less direct harm of the novel coronavirus, you cannot predict with 100% certainty how any one individual will react to this virus. As a healthcare community, we have certainly seen pediatric cases of COVID-19 that have resulted in hospitalization and/or death. This further emphasizes the importance of social distancing and adhering to measures that reduce transmission of the coronavirus amongst all age groups.
So what can you do to keep your children safe and maintain the sanity of your household during this stressful time? Go outside! There is no better time than now to explore nature, and no better place to be than Arkansas. In our state, we have plenty of land mass to allow for six feet of separation between individuals and still have people enjoying outdoor activities.
Arrange an outdoor scavenger hunt for your children, go on a bike ride, or play catch in the backyard. Let your kids get messy! Rainy outside? Let your young child play in the mud to help develop their sensory skills. Some time outside can help improve mood, make learning more engaging, and can encourage more positive behavior.
Prevent boredom by adhering to a daily schedule. Try to keep your children’s morning routine, mealtimes, and bedtime as consistent as possible. If you are working from home, set expectations with your older children in regards to how much attention you will be able to devote to them throughout the day. You can agree to eat lunch together or organize an evening board game. Attempt to limit screen time. However, in all reality, children’s screen time will no doubt increase during this time. Seek guidance from teachers as to online learning platforms that are available for students. Monitor television and online resources for quality content. Use technology for good to socially connect with loved ones and friends.
One thing is for certain: regardless of how convenient it may be, now is not the time to ask grandparents to watch the kids while you work from home. Although many grandparents are more than willing to help, this exposure puts them at risk of contracting COVID-19. You can show your support for older family members by touching base with them frequently via telephone or videochat.
Don’t underestimate the power of hand washing. Encourage your children to wash their hands frequently throughout the day with soap and water. If soap and water are not available and your child’s hands are not visibly soiled, it is safe for children to use hand sanitizer under adult supervision. Young children should not have unsupervised access to hand sanitizer as it can be harmful if ingested.
Finally, under the American Academy of Pediatrics’ recommendations, in-person, well newborn care and well-visits for children up to 24 months should not be delayed. It is imperative that we continue to deliver vaccines according to the schedules set forth by the CDC in order to limit the incidence of vaccine-preventable illnesses during this COVID pandemic.
This is a difficult and scary time for our community, and the impact of COVID-19 - whether direct or indirect - effects everyone, from children to the elderly. We are in this together, and we will get through it, if everyone does their part to limit spread. I implore you to foster a sense of community in your household by keeping your children at home to protect those at greatest risk.
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About NYITCOM at Arkansas State University:
New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, located on A-State’s Jonesboro campus, is dedicated to improving access to health care for the underserved and rural populations in Arkansas and the Mississippi Delta Region. Arkansas ranks 48th in overall population health status due to low health indicators including obesity and number of adults who smoke. The state also ranks 46th in the number of active physicians per capita and 39th in the number of primary care physicians. NYITCOM at A-State was established in 2016 with the mission of meeting the need for more physicians in this medically underserved area.