COVID-19: A message from Pulmonologist, Dr. Brooke Moore

We, along with the infection prevention and control team at Children’s Minnesota, have been keeping a very close watch on the COVID-19 situation. We cannot stress enough, because this is a rapidly changing situation, the CDC, the MN department of health, and Children’s MN websites are your best sources for the most up-to-date information. They will provide more accurate information than even our doctors and nurses are able to provide. We are doing our best to stay up to date, but this is a rapidly changing situation.

Is your child considered high risk?

Every child who comes to our clinic can technically fit under the high-risk umbrella because they have lung disease. Fortunately, very few children, even those with underlying health problems/special needs, have been diagnosed with COVID-19. The reason for this remains unclear. Children at all ages appear susceptible to COVID-19, although clinical manifestations of children’s COVID-19 are generally less severe than those of adults’ patients. In a recently published article from Pediatrics that looked at over 2,000 children, over 90% of all pediatric patients were asymptomatic or had mild to moderate symptoms. To date, Children’s Minnesota has not had any inpatients who have been positive for COVID19.

We are receiving a lot of questions about testing.

As of 3/16/2020, the Minnesota Department of Health is only running testing on specimens for patients who are hospitalized, for sick health care workers, or patients who live in congregate living settings (nursing homes/group homes). Rapid testing is available from commercial labs (Mayo, Quest), but that, too is currently being limited because the same reagent is lacking. Your child will only be tested if they are hospitalized. The emergency department is not going to be testing for COVID19 in children they plan to send home – they will test for influenza, RSV, and Strep if indicated. If children are symptomatic (fever/cough), but not in distress, they should stay home, for at least 7 days after symptoms onset and 3 days beyond resolution of fever and respiratory symptoms (whichever is longer). Diligently follow your child’s action plan. If symptoms increase, call us back for further guidance, or if in distress to come to the Children’s ED.

Additional frequently asked questions:

• Peak flow meters –although some primary care providers recommend peak flow meters, we do not routinely use these in our practice. They are very technique and effort dependent, and in kids do not provide reliable information/results.

• Oxygen prescription – in patients who have never been on oxygen before. If your child is in respiratory distress (breathing fast, retracting) or you are concerned their oxygen level is low, they should be brought to the emergency department for evaluation.

• Preventative medications: If your child is healthy, we currently do not recommend making any changes to your children’s Green Zone medications. If they are not typically on medications in their Green Zone, there is no evidence to support starting something now. If they are on medications in their Green Zone, continue to give them regularly as prescribed. If your child becomes sick, aggressively follow your child’s action/sick plan, escalating from their Green Zone, to Yellow, and Red Zones as you always would with any respiratory illness, as indicated by their symptoms. Do not hesitate to call us if you have any concerns about your child’s breathing.

Finally, to protect our patients, staff, and providers, and conserve personal protective equipment, all our clinic visits through the end of April have been changed to Televisits.

What can you expect during a Televisit?

Like an in person visit our nurses will start the visit by reviewing your child’s medication list and allergies and finding out if you have any specific questions or concerns. The doctor will then enter the Televisit. Much like Skype or FaceTime, you will have a video chat directly with your doctor. Your doctor will be able to do a visual exam of your child and get a complete history. They can watch your child breathe, may ask you to have them open their mouth, show them any rashes, and hear a cough if your child is sick. The doctor and nurse will then create or adjust your child’s treatment plan. Your visit summary will be posted to the patient portal and our nurses will email you any documents needed from the visit. We are happy to be able to continue to provide care to our patients via televisits during the COVID-19 pandemic.

Categorized in: Health