What Our Ohio AAP Members Need to Know About COVID-19

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New Guidance Issued for Outpatient Providers Evaluating Patients for Coronavirus (COVID-19)

Ohio Department of Health several health care organizations issue “Guidance for Outpatient Providers Evaluating Patients for Novel Coronavirus Disease 2019 (COVID-19).”
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What Our Ohio AAP Members Need to Know About COVID-19

By: Michelle Pintea, MD MPH & Deanna Dahl-Grove, MD

Background:
The novel coronavirus (COVID-19) is now spreading internationally and has reached the United States, prompting The Health and Human Services Secretary to declare a public health emergency on January 31, 2020 [1]. While the risk of contracting COVID-19 to the general public is currently low in the United States, we have to prepare for an emerging public health threat [1]. According to the WHO-China Joint Mission on Coronavirus Disease, only 2.4% of all reported cases of COVID-19 involved children under the age of 18 [2]. Most cases involve patients ages 30 to 79 years old [3]. No deaths have been reported of 9-year-old or younger with COVID-19 [3]. While information about COVID-19 is still evolving, the general pediatrician can take a few steps to protect themselves and their patients from COVID-19.

Preparing your office:
The first step is to screen patients over the phone when they call for appointments, asking about recent travel, fever or respiratory symptoms [4]. If the patient indicates that they have traveled to a known COVID-19 infected area and have respiratory symptoms, the patient should be instructed to stay home to mitigate spreading the virus until the pediatrician has contacted the local health department to determine the next best step [4]. If the patient is low risk for COVID-19 and is determined to have mild symptoms, but the patient/family would like to be checked, consider instructions to come early or late to the office when the exposure to other patients is lowest. Additionally, if resources allow, a separate waiting room for patients with respiratory symptoms should be established and masks provided to patients with symptoms to help reduce the spread of respiratory illnesses. Unless there is a medical emergency or the local public health department indicates, it is important that pediatricians do not send patients to the emergency department just for testing of COVID-19 or if deemed mild symptoms.

Prevention and preparing for widespread outbreak:
The general pediatrician should continue to emphasize the importance of preventive measures against respiratory disease, such as washing hands, covering the face when coughing and sneezing, and avoiding sick contacts [5]. Influenza continues to be a greater threat to the general American public than COVID-19, especially for children, with a very high hospitalization rate this year [6]. 125 pediatric influenza deaths have been reports this season, the highest since 2009 [7]. Patients should be provided with the local health department website as well so that they can continue to be informed. It is also imperative that pediatricians discuss the possibility of school and work closures with families, as countries such as Italy and Japan have already quarantined towns and closed schools to try and control the spread of the virus [8]. This will allow families time to establish an emergency plan for continued education, food and child care if this were to happen [9]. Social distancing, just as avoiding large gatherings, should also be discussed as a way to help prevent the spread of COVID-19.

At the time of this article, there are currently 4 confirmed cases of COVID-19 in Ohio and 24 persons are currently under investigation [10].

References
1. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Situation Summary. Retrieved fromhttps://www.cdc.gov/coronavirus/2019-ncov/summary.html
2. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 28 Feb 2020. Retrieved fromhttps://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
3. Wu Z, McGoogan J. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 24 Feb 2020. Doi:10.1001/jama.2020.2648
4. Centers for Disease Control and Prevention. What to Do If You Are Sick With Coronavirus Disease 2019 (COVID-19). Retrieved fromhttps://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html
5. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Prevention & Treatment. Retrieved fromhttps://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html
6. Livingston E, Bucher K, Rekito A. Coronavirus Disease 2019 and Influenza. JAMA. 26 Feb 2020. Doi:10.1001/jama.2020.2633
7. Centers for Disease Control and Prevention. Weekly U.S. Influenza Surveillance Report. Retrieved fromhttps://www.cdc.gov/flu/weekly/index.htm
8. Chappell B. Coronavirus Updates: Italy Reports 650 Cases And 17 Deaths. NPR. 27 Feb 2020. Retrieved fromhttps://www.npr.org/sections/goatsandsoda/2020/02/27/809984502/coronavirus-update-japan-is-closing-all-its-schools-for-a-month
9. The National Child Traumatic Stress Network. Parent/Caregiver Guide to Helping Families Cope With the Coronavirus Disease 2019 (COVID-19). Retrieved from https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf
10. Ohio Department of Health. COVID-19. Retrieved fromhttps://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Novel-Coronavirus/2019-nCoV


One thought on “What Our Ohio AAP Members Need to Know About COVID-19

  1. One of the many reasons I am a member of the AAP is their prompt response in times of need as well as the wealth of information provided and the proactive nature of the response to critical situations. Much appreciate all of the work you guys are doing in the background!.

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