Preparing for the winter surge
The winter COVID19 surge is rapidly approaching. Of significance we are not able to trace half of all new cases. This means that community spread is a driving factor. You must stay cautious as numbers creep but stay sane with these tips:
- Refrain from using strong language when you see poor public hygiene while your children are present. Make clear rules about playdates that everyone must follow. Make exceptions rarely and only when requests are made well in advance so that a safe plan for activities can be achieved.
- Make sure you and your loved ones are getting Vitamins C, D, A, Zinc and any herbal blends that you tolerate well (echinacea, elderberry, etc). Feel free to email me if you need some ideas/brands of what might work for your family and how much your children need of each vitamin.
- Make time for a mental health check in. Indulge in a nap, meditate or go for run. Consider enrolling in a free mental health webinars. A recurring webinar that I like: Wednesday, October 28th. at 8:00 pm, sign up for Mindfully Managing Family Burnout.
- Eat healthy, sleep well and don't let stress takeover!
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Please take note that the state and county only take into account PCR tests. This is not the rapid testing done at some doctor offices and urgent cares. If you have a negative rapid test you cannot be certain you do not have the virus. If it is positive you need to confirm with the nasal PCR. I strongly advise to go straight to PCR testing when wanting to know if you truly have the virus. We are now getting turn around times of 10-30 hours. When necessary we can drop specimens at noon for results by 7 pm. Several locations offer free testing with appointments. |
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by Dr. David Nunez (COVID19 School Response Team) and Dr. Weiss
Main Points:
- The county has 2 criteria for schools to remain open. Cases per 100,000 < 7 and Percent positive of PCR tests < 8%.
- Every Tuesday the county reviews criteria to maintain being out of Tier 1.
- There are over 1,100 Deaths in OC and over 4,300 children in OC have contracted Sars-CoV2 COVID19
- Infants are < 5% of all numbers and children in general have a low prevalence of disease until 11-14 years of age. The highest numbers of infection are seen in ages above 15 years. This trend nationwide is the reason for the TK-6 waivers.
- Santa Ana, Anaheim and Garden Grove remain the leaders in postive cases.
- Overall pediatric cases in OC is 6.8% versus state numbers tracking at 11%
- the number of MISC cases under 10
- Pediatric risk factors: Older age (teens), Obesity and Hispanics (82% of pediatric hospitalizations).
- One pediatric death of a teen with underlying conditions.
- 135 school waivers have been approved. 140 schools applied. Schools can stay open if we move back to Tier 1 but they will be monitored closely if so.
- 3 cases in a school means that school will have to be closed. 2 or more cases in a school, an investigation will be held and OCHCA can recommend School closure.
- Free testing is available on the OCHCA site (see above)
- Dr. Weiss and Dr. Cooper in collaboration with UCI, CHOC and OCHCA Physician Counseling are available for schools and review any Back To School Plan. They are available for a Presentation and Physician education for school staff.
- 1-844-GET-CHOC (Free nurse line regarding COVID19 questions and resources AND schools can use the same line to talk to a physician and get a decision tree.)
- Schools are required to notify HCA about COVID-19 cases in students or staff by the next business day via HRL (800) 564-8448 (option 2)
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Who is at risk for complications of Influenza?
-Children younger than 5, but especially children younger than 2 years old.
-Adults 65 years of age and older.
-Pregnant women (and women up to two weeks postpartum).
The fatality rate of flu is less than 0.1 percent, roughly 10 times less than that of COVID-19 ( current estimates range from 0.5 percent to 1 percent), but it still kills 30,000 to 60,000 Americans every year. The pediatric flu death count per year in OC ranges from several children to over a dozen. We have a vaccine that’s pretty effective so the current goal is to save room on the ICUs for people with COVID-19.
For both the flu and COVID-19, the elderly and those with underlying conditions are more susceptible, but the flu also hits children particularly hard and spreads readily in schools. The more people in all age groups who get a flu vaccine, the more protected these vulnerable populations will be.
And the time to get a vaccination is late September or early October in order to ensure that you have at least two weeks to develop an immune response for protection throughout the entire flu season.
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The flu shot, is approved for over 6 months and contains an inactivated virus or components of the virus.
The nasal spray is approved for people ages 2 to 49, and contains live, attenuated flu viruses (doesn't cause disease) like measles.
Per a recent NPR article, there's a chance the nasal spray could offer some protection against COVID-19 itself. Scientists believe the inherent advantage rests in how the vaccine primes different parts of the immune system. |
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Click here for a printable
This is a great resource to guide you and your school on managing colds and return to school.
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Concierge Pediatrics started with you.....
It was a great honor to be a guest on the SheBuiltIt podcast last week. While I shared my story of growth, I was filled with gratitude for each and every amazing patient I have been able to help. To all the entrepreneurial women and hard working mothers in my life, may we continue to lift one another to new levels. It ain’t easy! Melanie Barr and Dr. Michele Cooley-Strickland have collected pearls of wisdom to share with like minded overachievers. We all need to hear the vulnerability that comes before change, the pain that comes before pride, and the failures that come before growth. Listen here: Libsyn iTunes Spotify Stitcher. You can find SheBuiltIt on IG as well |
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What to do when the air quality index (AQI) is 100 or higher:
Avoid exercise outdoors, put on your home fan and close windows. If anyone in the family is wheezing or short of breath consider buying a HEPA filtration unit for your home.
OUTSIDE we worry about: ground-level ozone, particle pollution (also known as particulate matter, including PM2.5 and PM10), carbon monoxide, sulfur dioxide, nitrogen dioxide. Inside we worry about particulate matter (including PM2.5 [fine] and PM10 [coarse]), formaldehyde, mold, and pollen. Indoor air quality will vary from home to home and over the course of a day within a home. Since most people spend about 90% of their time indoors, mostly in their homes, much of their exposures to airborne pollutants will happen in the home.
Here are consumer reports top ranked home filters. list from Consumer reports. This filter is a good option but there are many out there. Feel free to reach out to me or you can use the top link to better understand what you need. Since most people spend about 90% of their time indoors, mostly in their homes, much of their exposures to airborne pollutants will happen in the home.
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FOLLOW UP FROM SEPTEMBER'S CHOC MEETING
Regarding my request for more stringent precautions in the ICU, the hospital wrote that they are trying to keep a stockpile of PPE in case of a surge. Unfortunately, like many other hospitals, the ICU will not initiate widespread use of N95s. In my meeting I had offered to donate N95s for use, as there is no shortage that I am aware of, however their cost adds up. They wrote that they are willing to accept donated medical supplies. If you are interested in making any donations I am happy to connect you with their business development. My only request is that you ask that they consider using them at all times in the ICU or any floor with COVID19 patients or high risk patients. I have no plans to send them masks so that they can keep them for future use. They did confirm however, that if a patient was potentially exposed by staff they will contact that patient.
Regarding my concern that there is poor protocols regarding hand sanitizer (most dispensers were empty when I was there) they stated that they have sinks, and resources in rooms, the cafe and the main entry/exit. They did not discuss filling the empty dispensers by elevators etc. I will reach out to their Business Development to find out how the community can support or fund hand sanitizer to fill all empty stations. If you or your company would like to donate please let me know.
The Fountain Valley Hospital had an outbreak that could have been avoided so I hope doctors and nurses in the hospitals will unite and speak up for their own good. I know it is not easy and I hear that some fear for their jobs.
Click here to read more on the how Fountain Valley failed to control an outbreak among patients and staff.
AND THANK YOU to those of you who sent their love and support for DEX. He is surfing, hiking and biking with Type 1 Diabetes and learning his new normal little by little. This has been a long month and we truly appreciate everyones support. We found a concierge endocrinologist which has been invaluable! It is so nice to know our doctor is only a phone call away! Hooray for that :)
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PATIENT SPOTLIGHT- She’s talented, driven and beyond creative:
Maddison (Maddy) Nideffer, age 16, has been juggling her academic coursework with her APA “Academy of Performing Arts” since 9th grade. She has excellent grades and continues to do so even through virtual learning. She’s currently taking physiology and loving it! She’s in her third year of American Sign Language and will be certified after her 4th year with social recognition at her graduation. She is taking AP psychology, CP English, History and Algebra 2 along with her APA costume design courses!
Maddy's Tip For Other Teenagers: “Keeping engaged in your classes is really important in online learning. It’s really helpful to keep your camera on and participate in zoom calls, answering questions asked by the teacher, so it feels like actual school rather than just watching a video. My grandma told me to sit at a table and point a fan at your face during school so you don’t fall asleep during class, It works!”
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Halloween may look different this year but there are plenty of ways to have fun without spreading the virus. Most importantly, keep doing what you have been doing: avoiding large gatherings, keeping six feet from others, wearing cloth face coverings (think superhero!), and washing hands often.
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Rash from West Nile Virus |
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- Wear long-sleeves, long pants and socks when outdoors, whenever possible.
- Consider using oil of lemon eucalyptus to exposed skin whenever you go outdoors. Be sure to follow the product directions for use.
- Avoid outdoor activities from dusk to dawn, which are peak mosquito biting times.
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CHOC'S FAQ PAGE CLICK HERE
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Follow Dr. Vivi
for up to date information and resources on COVID19
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