Protecting Little Patients

Protecting Little Patients

By Laurel Thompson

August 30, 2021

Summer is coming to an end, signaling the return to in-person school for many kids who spent the last year adapting to virtual classes and hybrid learning models. But not everything has reverted back to the way it was pre-pandemic, and many parents are looking to their pediatricians for advice as we head into a school year that could very well be just as unpredictable as the last.

At the same time, the world of pediatrics endured its own set of changes over the last year-and-a-half as doctors, nurses and support staff worked tirelessly to keep families safe. In many cases, that meant leaning on technology like never before, with video conferencing and photo submissions flooding online portals. And when patients were permitted to enter doctor’s offices for in-person visits, additional entrances were often used to keep the healthy apart from the sick.

So where are we now in this ever-evolving landscape? What changes are here to stay? Local pediatricians answer these questions and give parents a heads up on what to expect this fall.

A new era of telehealth

Of all the new developments we’ve seen in the health system since the start of the pandemic, one of the most significant has been the emergence of telehealth as a primary form of communication between doctor and patient. A lot of this technology already existed, but it had always taken a backseat to in-person visits—that is, until much of the world shut down and doctors were in high demand.

Dr. Jennifer Markley, owner of Pediatric Associates of Northern Colorado in Fort Collins, says telehealth was an integral part of the clinic’s COVID-19 strategy: “It was amazing to have our patients and their parents feel safe at home and still be able to connect with us virtually. I’m sure telehealth will be here to stay; it has been a good tool for quite a few visit types, and I’m happy we have that as an added benefit for our patients and their families.”

Markley also notes that portal use has increased substantially over the last year, which has made it easier for physicians to communicate about lab results and provide return-to-school letters from a distance. In fact, nearly every health practice is implementing some kind of portal system for patients to access from home, including UCHealth’s My Health Connection.

“Something I’ve seen that hasreally changed is what I call ‘photo health,’” says Dr. Christian Pariseau, pediatrician at UCHealth Pediatric Care in Loveland. “Parents can use My Health Connection to submit photos of rashes and things for us to look at. The number of photo submissions has always been miniscule compared to what we’re seeing now; our nurses will often grab me and have me look at a photo, and I was hardly doing that at all just a few years ago.”As it turns out, patients aren’t the only ones benefiting from this surge in virtual communication. Dr. Brian Money, pediatric hospitalist at the North Colorado Medical Center in Greeley, says telehealth has also made it easier for him to connect with specialists at children’s hospitals, like Children’s Hospital Colorado in Denver, so he can provide emergency care while keeping patients local. This allows patients in Northern Colorado to receive life-saving treatment without having to travel to a dedicated pediatric ICU—which, as we now know, can fill up quickly. It goes without saying that telehealth has come a long way in the last year, and it’s a testament to just how adaptable even the most formal institutions can be in dire situations. Adaptability and resourcefulness have been the key for each of these pediatricians as they navigate the unknown impacts of COVID-19 on our youth, which we haven’t seen the last of despite the false sense of security summer brought.

Back-to-school precautions

Many parents have additional concerns for their kids’ safety as we gear up for a new school year, and rightfully so, with inconsistent mask requirements across school districts, a highly anticipated vaccine for kids ages 2 to 12 that has yet to roll out and an extremely contagious Delta variant spreading through the U.S. Fortunately, we’re already familiar with a lot of the things doctors are recommending: wear a mask, get vaccinated (if you’re eligible), remain socially distanced and maintain other areas of overall health.

While there may be a lack of appetite for these precautions at this point in the pandemic, pediatricians are standing by their effectiveness at slowing the spread of COVID-19 in high-transmissibility settings like schools. This is particularly true for masks, which Money says drastically lower rates of infection: “We know masks are a very powerful tool in preventing the transmission of the virus, and it’s something that I as a pediatrician have encouraged in my own school district as well as the county to adopt masking for the upcoming school year.”

And he’s not alone—in late July, the American Academy of Pediatrics (AAP) released their own interim guidance, which recommends masking for both vaccinated and unvaccinated individuals in the school system. Pariseau says that should be no problem for kids because masking is second nature to them at this point, and it’s helping to protect them against other respiratory illnesses besides COVID-19.

According to Pariseau, respiratory syncytial virus (RSV) and influenza mostly took a year off last fall, and now that many of us have grown accustomed to not wearing masks over the last few months, he’s concerned that one or both will come back with a bit of a vengeance: “I think I saw one case of influenza last year, and I have never in 20 years had a fall and winter season where we weren’t just jammed with RSV and flu. What we don’t want to end up with now is the nightmare scenario of influenza and COVID cases exploding at the same time.”

Not only will masking be just as important as it was last year, but pediatricians are also encouraging parents to make sure their kids are up to date on routine vaccinations, including the flu vaccine.

Many kids and teens skipped yearly physicals last year due to the pandemic, and with virtual school and very few sports and activities, there was little need for routine check-ups. But now that class is back in session, it’s time to pay attention to other areas of overall health.

A new focus on mental health

Prior to the pandemic, mental health issues had been on the rise for kids and teens, and unfortunately the sudden switch to online learning and distancing from friends exacerbated the situation. Dr. Virginia Kee, another pediatrician at Pediatric Associates of Northern Colorado, says the increase in anxiety and depression in kids is a major byproduct of the isolation caused by the COVID-19 pandemic that cannot be ignored, and that parents should pay extra close attention to their child’s behavior as they head back to school.

“Kids don’t always show anxiety or depression in the same way as adults, so if they are showing any signs of being more withdrawn or agitated, those are important reasons to talk to your pediatrician,” she says. “While the mental health system is very taxed in the country right now, even for children, we do have wonderful resources to help families get plugged in.”

Another way to help kids who may be struggling is to ease them back into their regular routine, whether that be playing a sport, creating art or getting involved with other extracurriculars. Kee says it’s important to take things slow at first and keep the pressure low when returning to physical activity. In fact, the AAP recommends that kids start out at 25 percent of their normal exercise intensity and increase that by 10 percent every week to avoid injury.

The same goes for in-school performance—after an especially difficult year, many kids are tired and will need some time to adjust back to a normal school setting. Their grades may not be what they once were, but part of that is because kids aren’t meant to learn in front of a computer 100 percent of the time. They need social interaction and hands-on activities, not only for retention of class material, but for mental and emotional development as well.

Parents are encouraged to give their children support as they head into a new school year still marked with a great deal of uncertainty.

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