Covid 19 Update

April 2023 

Dear JCP Families:

We have Covid-19 vaccines available for children from age 6 months and older.  These vaccines are recommended, safe and effective.  COVID vaccination remains the most reliable way to reduce the risk of severe COVID and the secondary problems that can occur (including long COVID).  Testing is widely available and can be performed at home.  We understand that test results can be misleading at times, but in general, a positive antigen test (the kind that is in the home kit and in our office) indicates acute and contagious infection, the first time it is positive.  There is NOT a recommendation to have a negative test before returning to activities.  Please see below for guidelines.

Even though we are seeing significant cases of COVID, our hospitalization and mortality rates remain low.  Many of our families express concern about vaccinating children, especially young children, with a relatively new vaccine and for an illness that is typically not severe.  We have been giving COVID vaccines to older children for almost 2 years with an excellent safety record.  We have been giving vaccines to the 6 month to 4 years old age group for almost a year and it is very well tolerated.  The rates of severe illness in children is similar to that which we see in influenza. So, while not common, it does occur.  We like to say that ONE IS NOT ZERO!

If you are in the group that is considering getting the shot for your child, but have questions, please reach out to us for UNBIASED AND NON JUDGMENTAL information.

We continue to see COVID virus variants circulating in the community. Vaccinated individuals and those who have had natural COVID infection are getting COVID.  Does this mean the vaccine doesn't work?  No.  It is doing precisely what it is supposed to do, limit severe illness and death. 

COVID VACCINE INFORMATION:

covid-pediatric-vaccine-faqs.pdf

pfizer-covid-19-vaccine-fact-sheet-10202021.pdf

A few reminders:

EXPOSURE   If you are notified of an exposure and your child is well, we recommend continuing to wear a mask in public and protecting any high risk people in your home.   

WHO NEEDS AN APPOINTMENT OR TEST?  Please follow these guidelines:

Your child had an unknown or poorly defined exposure to COVID at school but is well.    You do not need a test or quarantine.  Wear a mask at school and protect any vulnerable individuals that you are around.  These recommendations are for everyone anyway so really no need to do anything different.   Do not get tested until at least 5 days after the exposure to minimize false negatives.  

Your child has mild symptoms of viral illness and no clear exposure.  Mild symptoms would include low grade fever, runny nose, slightly decreased appetite, intermittent cough, a few episodes of vomiting or diarrhea.  A low grade fever is defined as a rectal or oral temperature between 100.5 and 102 degrees (exception is if your child is 3 months old or less, please call for any fever greater than or equal to 100.4) . You do not necessarily need an appointment or testing.  Stay home until you are fever free and improving.  Wear a mask (if over age 2) as the cough and congestion resolve over the following week or two to prevent spreading whatever other viral infection you have.  Please do not come in during the first 2-3 days of a mild viral illness for a test.  A test in this setting may yield false negative results.

Your child is mildly ill and has an exposure.  We recommend testing at day 3-5 after onset of symptoms.  We can test your child in the office at the time of a sick visit.  Of course, quarantine at home and isolate from other household members to the best of your ability until you get test results.  Treat symptoms as below and monitor for signs of worsening illness that would require a visit to our office.

Your child has moderate or severe illness symptoms or symptoms that are not improving after 2-3 days.  Signs of more concerning illness include respiratory distress, dehydration, inconsolable crying, symptoms that are worsening after 2-3 days of illness.  Respiratory distress includes frequent cough, labored breathing (rapid breathing, skin pulling between ribs with breathing), low energy or interest in playing.  Signs of dehydration include poor fluid intake, decreased urine output, no tears when crying, listlessness.  Dehydration typically occurs in the setting of vomiting and diarrhea or prolonged poor fluid intake due to respiratory symptoms.  If your child seems to get better and then worsens, fever returns, this may signal a bacterial infection such as pneumonia or ear infection and we want to see him or her.   If a fever persists more than 2-3 days and is not improving, we want to evaluate your child.  If you are unsure, please ask to speak with our phone nurse and she will guide you.  If you think your child has severe symptoms (listlessness or lethargy, blue lips, worsening respiratory distress or dehydration) call 911.  

HOME CARE:  

Viral illnesses do not require antibiotics or other prescription medications.  We treat symptoms to make the child more comfortable and monitor for signs of worsening.  Control fever with acetaminophen ( Tylenol) or ibuprofen (Motrin or Advil). For infants, use saline and suction to keep the nose clear.  Obstructed nasal passages make little ones very uncomfortable.  Use a humidifier or vaporizer in the child's room (cool mist please).  You can try baby Vick's rub on the chest.  Your baby will need extra tender loving care while ill.  Make sure you have help because you need to get rest too.  For children over a year, you can try giving a teaspoon of honey by mouth to soothe the throat irritation.  For older children, try Zicam zinc nasal spray.  Cough is a protective reflex that clears mucous and is important to prevent pneumonia.  Cough can also signal a lower respiratory tract infection that requires medical attention (see signs of moderate to severe illness above).  Vomiting and diarrhea are frequent symptoms of viral illness.  Encourage fluids and a mild diet.  If children have frequent vomiting or diarrhea, we recommend Pedialyte to replace losses.  If you are concerned about dehydration from frequent vomiting and diarrhea with signs as above, please call us.  Your child may need to be seen.  

HOW TO PREVENT THE SPREAD OF COVID:

Wear your mask

Wash your hands

Watch your distance

Stay home when ill.

Get your COVID vaccine if you are age 6 months and above.

QUARANTINE AND ISOLATION: Definitions Quarantine:  You have been exposed but are not ill.  Stay home during this period of time to avoid spreading COVID to others outside your home. Isolation:  You have a COVID 19  positive test (with or without symptoms) and need to avoid spreading COVID to  household contacts and those outside your home.

Current Guidelines Please click on the links for the exact guidance from Department of Public Health.  A short reference summary follows: Exposure requiring quarantine  https://files.ctctusercontent.... If you are vaccinated and have a close contact exposure, you do not need to quarantine.  Wear a tight fitting mask when around others for 10 days (we should all be doing this right now anyway).  If available get a test at day 5.  If you develop symptoms at any point, get a test.  If you are positive, follow guidelines for positive tests below. If you are not vaccinated or incompletely vaccinated (fewer than 2 doses or 2 doses but less than 2 weeks from the 2nd dose for 5-16 year olds, or lacking a booster dose or booster given less than 2 weeks ago for 16 and up):  quarantine for 5 days.  If you remain asymptomatic you may leave quarantine.  Consider testing if available, continue to wear a mask for 5 additional days.

COVID 19 Diagnosed Illness requiring isolation  https://files.ctctusercontent....

If you become ill and test positive for COVID 19

Isolate in your home, avoiding household contacts as much as possible for 5 days from onset of symptoms.   You may leave isolation on or after day 5 if you are fever free without fever reducing medication and feeling better for 24 hours.  You may still have some symptoms.  Continue to wear a mask for 5 additional days.

If you test positive but do not have symptoms

Isolate in your home for 5 days from the positive test.  If you are symptom free at 5 days, you may discontinue isolation but continue to wear a mask for 5 days.  If you develop symptoms, your isolation restarts with the first day of symptoms and follow guidelines above.

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