How Phase 2 affects you and other news.

Snooze your News! Don't believe everything you read and err on the side of caution as we begin Phase 2. Media is sending sensational information regarding safety, therapies, and policy making. Recall that the CDC has had to change its message several times and still may not have things right with its new surface hygiene message . Doctors reiterate common sense precautions: use physical distance, masking and good hand hygiene. Please voice your concerns when something doesn’t feel safe. I am here to help. I wrote my landlord to ask for safer measures for newborns coming and going. You also need to speak up. Click here for this weeks OC press conference to better understand where OC is in the big scheme.

School/Camps and Daycare - School re-opening is a Collaborative decision between the CA Dept of Health, Representatives of the state, and local school boards. Once CA moves to Phase 2 - this allows School and organized youth activities to open. For now I encourage parents to review age specific social emotional development and seek parenting resources relevant to the pandemic.

Schools will likely have adjusted requirements for re-entry including immunization compliance. This Return to School AAP webinar by Dr. Marc Lerner (min 5-25) is high yield but still leaves much to be considered. Taiwan never closed school and managed their classes with some standard precautions in this video . Current conversations suggest local classes will maintain 6 feet and thus limit numbers of attendees.

Multisystem Inflammatory Syndrome in Children (MIS-C) I n April nearly 100 cases of children ages 6 months to 9 years were reported (mostly in Europe) with this syndrome probably linked to COVID-19. 4 deaths were confirmed (1 in UK and 3 in NY). An informative webinar from 2 infectious disease experts left me with some key points: Some children had no sign of infection but family members were sick 4-6 weeks prior. Out of a French study of over 35 pts - most presented with severe abdominal symptoms that mimics appendicitis, respiratory component IS NOT prominent. Predisposing factors in these cases - 17% obese but otherwise the did not show the classic comorbidity seen with adults (DM, Lung Dx/Asthma, Hypertension). COVID19 PCR is positive (actively replicating or remnant virus) in many. The stroke and neurologic pattern is not consistently involved. This is more of cardiovascular reaction. Nonetheless many say this is very rare . Time will tell.

OCHCA Reported Numbers

In Breaking News, 3 year old James is launching his medical career with house visits, and my 4 year old Dexson is donating his pictures to medical offices to remind people to use 10ft of physical distance.

OC now has free testing for everyone and anyone! Do not get a rapid test anywhere. They are horribly unreliable and will leave you in a tough predicament. Here are sights for testing other than you primary care office. UCI and Hoag are conducting large scale serology tests to asses the change in prevalence over time. This will be a several month study but very useful. Again, we need time to get answers so be patient.

Websites for return to work:

Website for safe screen time at home

MEDICAL COVID19 RESOURCES PAGE

COVID 19 COMMON QUESTIONS

What are the symptoms of COVID 19?

Based on 55,924 lab confirmed cases symptoms were seen as follows:

- Fever (88%)

- Dry cough (67%)

- Fatigue (38%)

- Sputum production (33%)

- Short of breath (18%)

- Sore throat (14%)

- Headache (13%)

- Muscle/joint aches (15%)

- Chills (11%)

- Nausea/vomiting (5%)

- Stuffy nose (5%)

- Diarrhea (4%) (more recent studies say much more common than initially thought!)

- Coughing up blood (1%)

Some important reminders:

We are closed Monday for Labor Day but as always I am available to you 24/7 for anything urgent.

Last month national Measles vaccination dropped 50% (!!!) and this is due to skipped well visits. If you need to get back to us about an appointment please do so next week.

Lastly- We ask that only one parent come up from the car for any well visit. We do not want people in the waiting room and can only have one person in the exam room to limit our exposures.

For preschoolers: We use a daily schedule for our son so he can follow his daily routine with predictable days. Also consider using a reward chart after reading this article on rewards. Here is a blank chart you can download and use.

Self Care: 1. Eat well, 2. Take your vitamins (I can send you a link to my Metagenics and Designs for Health accounts where I do not profit), 3. Find a daily zen activity to keep you calm, 4. Get outside for 1 hour every day.

Getting Sick: As children move out of the house they will once again get fevers. I am seeing this readily.

For the safety of all, I will not see fevers in the office but can see you at your car.

If someone has a fever in your home, I consider your entire family infected with COVID19 until cleared by a doctor and testing.

Use safe practices when your children return to activities. Keep physical distance on play dates as best you can.

COVID 19 Mortality rate by age.

This will change as mild/asymptomatic cases get diagnosed with more testing!

- >80 22%

- >70 8%

- >60 3.6%

- >50 1.3%

- >40 0.4%

- 10-39 0.2%

If you are feeling despair- remember that we have one another, our health, and a beautiful world to explore. Engage in positive change and step back if you don't like who you are becoming. I was honored to be a small part of this moving video "The Fighter". Don't give up! Keep fighting and smiling.

CHOC'S FAQ PAGE CLICK HERE

Follow Dr. Vivi on Instagram and Facebook for more resources for the COVID19 outbreak - @ASKDRVIVI