It was a family emergency both timeless and very much of this coronavirus moment.
“Last Monday, my lovely 10 1/2-year-old was standing on a chair in her room while doing a Zoom call with friends when she fell off a chair and fractured her wrist,” Samantha Southall said.
Normally, a situation like that would merit a trip to the pediatrician. What’s to think about?
Now, in the middle of a pandemic, it’s something a parent considers carefully.
“We called CHOP Urgent Care out in Brandywine Concordville, and they said it was empty,” Southall said. “We popped on down, went in for a consult, got our X-ray taken, everything was seamless.”
Empty waiting rooms are intentional these days, especially at pediatricians’ offices.
“When you’re talking about a waiting room, we don’t have them anymore,” said Gerard Margiotti, a pediatrician at Margiotti and Kroll, whose practice has offices in Philadelphia, Bucks and Montgomery counties.
Instead, he said, families wait in their cars until it’s time for their appointment.
As a follow-up, Southall said, she and her daughter had a telemedicine appointment, during which an orthopedist checked the X-rays and said they didn’t need to go back in again.
“It was much easier than it was six months ago, with the 5-year-old who fractured his wrist the second week of kindergarten,” she said.
Pediatric telemedicine is proving to be the breakout star of the pandemic. For parents and health professionals alike, getting and providing care from home is seen as a positive.
Jay Greenspan, CEO of the Nemours children’s health system in Delaware, New Jersey and Pennsylvania, said that last year it conducted five telemedical appointments.
“In the last month, we’ve done 1,600,” Greenspan said.
Still, some in-person visits are unavoidable — broken bones are one example. Vaccines are another.
“There are many vaccines that if not given would leave us with a population that’s very susceptible to very serious illnesses, maybe even more serious than coronavirus,” Margiotti said.
Nemours is offering outdoor immunization stations to give vaccinations.
“We ask that children stay on schedule for their shots.” Greenspan said. “Don’t speed it up. It’s really most important for the first several series of shots, up through the first two years.”
But in other situations, it may not be as obvious whether a child should see the pediatrician in person.
“Kids might need to see the doctor for any number of reasons,” Margiotti said, adding that for some conditions, there is no stand-in for an appointment.
“You have to be seen and be examined. Telemedicine is good, but it isn’t a magic bullet,” he said.
Greenspan’s advice is to be bold: If you think something is wrong, and you want to see a doctor in person, make that clear: “We’re doing a lot to keep our doors open and business as usual.”
For kids, however, everything may look really different — and frightening. No amount of stickers is going to fix the fact this isn’t what they’re used to.
Ariella Cohen Turner, managing editor of WHYY’s PlanPhilly, had to take her 4-year-old daughter to the doctor recently for a strep test.
“When she saw the mask, she was recoiling, and she didn’t want to have the mask on her,” Cohen Turner said. “And then she was much more scared of the doctor than she usually is because she couldn’t have that same warm exchange with them.”
“She’s 4, so she’s not really understanding the details of everything, but she knows what coronavirus is,” Cohen Turner added. “She knows that she can’t see any of her friends or go to school, and she knows that there was a great deal of preparation for us to leave the house.”
It was a “very anxiety-making experience,” Cohen Turner said.
Margiotti said lots of his staffers are wearing kid-friendly masks – it’s harder to be afraid of someone when there are Disney princesses all over their personal protective equipment.
And through telemedicine, Greenspan said, a health care practitioner can show a child what they look like in their mask, and explain to them what will happen at the appointment.
But kids might still find it all a lot to process. And can you blame them, when so much of everyday life has changed?
“There are many true facts about this problem that can be brought out in a positive way to reassure children,” Margiotti said.
Both he and Greenspan suggest giving your kids honest but age-appropriate information. Let them know that the risk to children from the coronavirus is very very small, but don’t overload them with facts.
“We have talked about it at a 10,000-foot level in general terms because, of course, it is affecting their lives. They can’t see friends, they can’t see family members, they are stuck looking at parents who they now are sick of,” Southall said, describing her conversation with her kids.
Take advantage of the new time you have at home, Margiotti suggested. And give kids the space to be sad or worried.
“For my 10 1/2-year-old, she’s a fifth grader, so she’s missing out on all of those fifth-grade milestones, with graduation and field trips, and is having a very hard time with that,” Southall said.
According to an April 6 report from the Centers for Disease Control and Prevention, only 1.7% of COVID-19 cases in the United States were in patients under 18 — something both doctors agreed shouldn’t be blown out of proportion.
But if you have concerns, talk to your doctor, and take precautions. Children over 2 can wear masks. Be sure to check the fit, as some adult masks may not fit their faces or offer the same protection.
If you have a situation where you would normally go to the pediatrician, call first, but going might still be the best option.
“Ultimately, we were glad that we went,” Cohen Turner said. Her daughter didn’t have strep but still needed treatment. “She had another infection that could be treated with antibiotics and, had we not gone, we wouldn’t have found it because it needed to have that live testing.”
Avoiding treatment out of fear of COVID-19 isn’t a good idea.
“My biggest fear isn’t what they’re [parents] doing about minor issues,” Margiotti said. “My biggest fear, in my years of experience, is that we may miss a major issue.”