Covd 19 Updates

Covid-19 Update 5/11/20

Dear JCP Families:
We hope you enjoyed a beautiful weekend and were able to honor all mothers, near and far, with us in person or only in spirit.  Thanks especially to our JCP moms.  You all work hard each day, loving and caring for your children and giving of yourselves.  Here’s to all our great moms!

I am happy to receive feedback on my emails and while most of it is positive and encouraging, I have received some great constructive criticism. A journalist reminded me that journalists are hardworking professionals dedicated to bringing us facts.   Another reminded me that I am a pediatrician and to stick with information about children’s health.  Agreed!

Here is what you need to know this week:

• Atypical Kawasaki Syndrome or Multisystem Inflammatory Syndrome and COVID-19 in Children

Researchers in the UK published a report in The Lancet, a respected medical journal, that identified a series of 8 children with atypical Kawasaki syndrome, when in a similar time frame only 1 or 2 cases would have been expected.  One of these children died.  They urged pediatricians worldwide to be on the lookout for such cases.  

Last week the New York Times reported that at least 50 children in NYC and Long Island developed an inflammatory syndrome resembling Kawasaki or toxic shock syndrome.  As these cases occurred about a month after the initial surge in cases in NYC, it is postulated that it may be an after effect of COVID-19 infection.  Most of these children tested negative for COVID-19 antigen, but some tested positive for coronavirus antibodies, suggestive of past infection.  No children in the NY report died.  Other cases that are similar have been described throughout the US and Europe.

1.  What is Kawasaki Syndrome?  Kawasaki Syndrome is a multisystem inflammatory syndrome that was first described in 1967 in Japan.  Typically affecting young children this disease presents with 5 days or more of high fever, characteristic rash, red eyes, and cracked, swollen lips.  Untreated, it can cause cardiac complications.  It is on our pediatrician list of “Though Shalt Not Miss This.”  

2. What is Atypical Kawasaki?  It does not meet all the criteria for the full syndrome but can cause cardiac complications.  In the cases recently reported, patients were aged 4-14 years and had prolonged fever, swollen eyes, conjunctivitis, gastrointestinal symptoms and cardiac complications.  

3. What do pediatricians think?  There is concern that this severe inflammatory syndrome is a complication of previous, mild COVID-19 infection.  We await more information about the NY series in terms of lab testing, clinical features, etc.  

4. What should parents keep in mind?  COVID-19 infection is rare in children and almost always mild.  Kawasaki Syndrome may be a rare complication of a rare infection.  Inform us about fevers lasting more than 3 or 4 days.

Getting back into the world

Is it safe to return to work, daycare, summer camp, tennis lessons, etc.?  These are great questions, not simply answered.  We all take risks every day.  A switch will not flip and say it is safe.  We will each need to make our own judgement about returning to activities.  Trust your judgment and do what is right for your family.  Keep an eye on case rates, which continue to decline.  Keep an eye on hot spots, such as Gainesville.  Wear your mask, wash your hands and don’t touch your face.  Stay 6 feet away from those outside your home.

IT IS SAFE and IMPORTANT TO COME TO OUR OFFICE for well checks, sick visits, minor injuries, behavior concerns, etc.  
We are here for you!

Dr. Dewling and JCP Staff

COVID-19 Week of 4/20/20

Dear JCP Families:

We are now in week 6 of our “house arrest” and I think we are all finding our new normal. I have some good news to report from a webinar I just attended with experts at Children’s Healthcare of Atlanta.

•The current data indicate that in Georgia we had our peak back on April 7th. Social distancing is working!
•Children continue to have extremely low rates of serious infection (less than 1% of cases in the state).
•Availability of testing is improving, but still limited to hospital inpatients for children.

•CHOA, Emory and Georgia Tech are in collaboration on research in areas including vaccine development, antibody testing and interpreting results, identifying risk factors for people who are more likely to develop serious disease, risks for health care workers.

In addition, we are now starting to hear rumblings of getting back to normal. What will that look like? I do not think we will just wake up and go back to pre-COVID-19 days.  Surely, we will phase back in slowly. Our practice will keep you informed about our interpretation of recommendations and how they apply to you and your family.

Remember:
•We are here to help you. Please call us with questions about COVID-19, behavioral and emotional adjustment, and any health-related concerns.

•We still encourage keeping up with well visits. If your child is due for vaccinations, it is important to come in. Once we do get back to business, we want kids protected from vaccine preventable illnesses.  Otherwise, we will have another big problem on our hands.

•We see telemedicine appointments for a variety of sick concerns as well as well checks. There is more that we can do than we cannot do via telemedicine. We offer curbside visits too and your child can receive shots, strep tests, etc. without even coming into the office.

•We are following strict infection control guidelines, clustering sick and well patients by time, location, and staffing in the office.

Some great resources:
Sesame Street has a series of videos that address quarantine on the toddler and preschooler level.  These are well done, as expected, by the Sesame Street familiar friends.  https://www.sesamestreet.org/caring

Check out our doctors reading stories to the kids on our Facebook page. 

 https://www.facebook.com/JCPSuwaneeandCumming

and frequent updates about the COVID-19 pandemic. Suggestions for topics you would like us to address or questions you would like answered are appreciated!

Thank you for all your support, kind words, masks, food and flowers during this difficult time.  Our staff greatly appreciates your thoughtfulness. We are here for you!

Stay home and healthy!

Love,
Dr. Karen Dewling and staff at Johns Creek Pediatrics