Coronavirus (COVID-19)

COVID-19 is a disease caused by a respiratory virus first identified in Wuhan, Hubei Province, China in December 2019. COVID-19 is a new virus that hasn't caused illness in humans before. Worldwide, COVID-19 has resulted in thousands of infections, causing illness and in some cases death. Cases have spread to countries throughout the world, with more cases reported daily.

Other coronaviruses are common in children, usually causing mild cold-like symptoms. Because children are likely to have had other, similar viruses, they seem to be less likely to become seriously ill than adults. As of January 25, 2023, there are 640 deaths for ages 0-4 and 993 for 5-18 years old involving Covid-19 disease in the United States. For more information about Covid-19 pediatric data, please visit the CDC wepage. 

Ways COVID-19 is thought to be able to spread:

• Coughing and sneezing, which creates respiratory droplets
• Close personal contact, such as touching or shaking hands
• Touching an object or surface with the virus on it

Symptoms of COVID-19 include:

• Fever
• Coughing
• Shortness of breath
• In more severe cases, pneumonia (infection in the lungs)

The vast majority of people recover from this infection. Most people will have mild or moderate symptoms. Older people and those with pre-existing medical conditions have a greater risk for more serious illness.

Measures we are taking to safeguard you and your family's health until further notice:

• We are offering telehealth for many appointments. Please call our Care Line at 410-721-2273 to ask them to relay a message to your provider to see if this is an option for your child's symptoms.
• Walk-in sick visits are suspended at all offices; however, we can still care for your child with an appointment, often the same day. Please call our Care Line at 410-721-2273 to make appointment for any type of visit.
• All offices have modified hours and will close by 5pm, possibly earlier if scheduled appointments end earlier.
• We are not planning to cancel your scheduled visits. Well checks and follow up checks help maintain your childrens’ health. Preventing complications during serious outbreaks is much easier when your child is up to date on developmental checks, immunizations, and testing. 
• If you would like to reschedule a well visit, please continue to follow our posted cancellation policies, letting us know 24 hours in advance. This will give us time and space to see other families in need. 
• Please call before coming to drop off or pick up forms.
• Please do not bring additional family members or persons to our offices when you come to visits.
• Many toys and books are absent from exam rooms and waiting areas to prevent the spread of COVID-19.
• Each of our two offices is separating sick, well, and immunocompromised children. If you have questions about these procedures, please reach out through your portal to your provider and his or her team.
• If and when the situation changes, we will be in touch to keep you up to date as we continue to work to meet your needs in the safest way possible for your family.
• If you or your child are exhibiting sudden onset of COVID-19 symptoms, including fever and body aches, fatigue, or cough, please call us at 410-721-2273. We may meet you at your vehicle before you come in. 

Preventing coronavirus and other viruses:​

Following are recommendations from the CDC for staying healthy:

Hand-Washing Guidelines

• Wash for a minimum of 20 seconds, focusing on fingertips (fingertips contain 10x the germs of anywhere else on your hands)
• Hold one of your thumbs with the opposite hand and twist vigorously, then repeat for the other thumb
• Bend fingertips down on each hand and grasp the fingertips with the opposing hand to twist back and forth
• Rub backs of fingers on opposing palms for several seconds
• Rinse well and continue to rub hands together
• Dry hands and get a disposable towel to turn off the faucet and to open the door

Hand Sanitizer Guidelines

• Hand washing is best for germ prevention but using a hand sanitizer properly is almost as effective
• Read the label and choose one that is at least 60% alcohol
• Use several pumps to get a nickel-sized amount so your hands are thoroughly wet and the sanitizer is almost dripping off
• Rub hands in a circular motion, working it through your fingers until the sanitizer dries, at least 20 seconds
• Rubbing it through your hands and fingers makes it most effective
• Stays effective until the next time you touch a soiled surface, such as a cell phone

Surface Cleaning Guidelines

• Viruses can live for different lengths of time on surfaces; coronavirus can live up to 9 days
• Regular household products will work to kill all viruses, including human coronaviruses
• Sprays penetrate more surface area while wipes are more convenient
• Apply the product and let it dry without wiping it off (after 10 minutes, it can be wiped dry if necessary)
• Focus on items and areas that get touched frequently: cell phones, landline phones, door handles, remotes, sinks, handles and knobs

Other Useful Information

• Keep hands away from the face, which includes the eyes, mouth, and nose
• Clean your cell phone and frequently touched surfaces every day
• If local supplies of disinfecting solution are sold out, you can make a homemade bleach solution to kill viruses. Use 5 tablespoons of bleach to 1 gallon of water or 4 teaspoons of bleach to 1 quart of water as an alternative to wipes.
• The CDC requests that face masks be used only for people who are sick and healthcare workers in order to save the supply; masks for people who are well aren’t effective at preventing catching coronavirus or other infections
• Zinc and other products sold as immune boosters, including Emergen-C and Airborne, contain antioxidants for overall health but don’t prevent getting sick
• There is no magic bullet to prevent getting sick but you can boost your immune system with simple, proven strategies: frequent, proper handwashing; getting adequate sleep (minimum of 7 hours for adults and minimum of 9 hours for children); eating plenty of fruits and vegetables; taking steps to lower stress; and exercising at least 30 minutes a day (60 minutes a day for children)
• While the CDC does not generally issue advisories or restrictions for travel within the United States, it requests that you keep updated about outbreaks at your destination; if you must travel by air, know that most airplanes are fitted with HEPA filters, which filter circulated air 20-30 times an hour to remove up to 90% of particulates; however, if you travel to a location that experiences an outbreak while you are there, you should plan for the possibility of being quarantined for up to 2 weeks before being allowed to return home

Multi-Symptom Inflammatory Syndrome in Children (MSI-C)

In rare cases, a condition associated with COVID-19 called Multi-Symptom Inflammatory Syndrome in Children (MSI-C) has occurred where different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. We do not yet know what causes MIS-C although the Centers for Disease Control and Prevention (CDC) is investigating. However, many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.

We partner with Children's National Medical Center to evaluate and care for MIS-C, as well as other serious illnesses. For more information about MSI-C, please visit our web page.

Call 911:

If you feel that your child needs immediate medical care, including having trouble breathing.

Call our office emergency line at 410-721-2273 if:

• Your child has a fever (104°F or higher for children over 3 months or a rectal temperature of 100.4°F in children under 3 months)
• Your child is crying inconsolably.

This information was updated on March 26, 2020, and will continue to be updated as often as necessary.

REFERENCES AND RESOURCES:
Centers for Disease Control and Prevention
https://www.cdc.gov/coronavirus/2019-nCoV/index.html

American Academy of Pediatrics (Health Children Program)
https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx

Maryland Department of Health
https://coronavirus.maryland.gov/

Talking to Kids About the Coronavirus (from Child Mind Institute)
https://childmind.org/article/talking-to-kids-about-the-coronavirus/

WebMD
https://www.webmd.com/lung/news/20200310/know-the-symptoms-of-covid19

World Health Organization
https://www.who.int/emergencies/diseases/novel-coronavirus-2019