It was after midnight when Leslie Rowe woke up on April 11. Her 9-year-old son, Zaiden, was in tears, saying he had an intense pain in his groin.
At any other time, said Rowe, who lives in Collierville, Tennessee, she would have headed straight to the emergency room. "He was crying, he was in pain," Rowe said. "I was scared."
But Rowe's family has been practicing strict social distancing since March 13. With close relatives whose preexisting conditions make them especially vulnerable to Covid-19, she's even limiting trips to the grocery store as much as possible.
Rowe called the emergency room at Spence and Becky Wilson Baptist Children's Hospital in Memphis, then decided it was time for Zaiden to go in. While Rowe stayed at home with her toddler, Zaiden's father took him to the children's hospital's emergency room.
Dr. Jennifer Shu, a pediatrician at Georgia's Children's Medical Group, said Rowe made the right call by reaching out to a children's hospital.
"If you can take them to a children's ER, that's the best way to go," Dr. Shu said. "Coronavirus isn't hitting children as severely as it is adults. At least in our area, that means that children's hospitals are way less busy than the adult hospitals."
As Americans adjust to social-distancing during coronavirus, many are wondering how best to care for their children's medical needs.
"A lot of them are just nervous about going out because they don't want to be exposed to anything," Dr. Shu said. "They're being very cautious, which is great."
But Dr. Shu also said that some medical issues require a face-to-face visit and doctors are taking measures to ensure patient safety at offices and hospitals.
For midnight emergencies, routine care, wellness checkups and more, here's what you need to know.
What should you do during a medical emergency?
For urgent issues, Dr. Shu said parents should still call 911 or go straight to the emergency room, preferably at a children's hospital.
In less pressing cases, she suggested starting with a call to a primary care provider, who can help determine next steps.
"Your primary care doctor is considered your medical 'home,'" she said. Like other medical providers, many pediatricians are now offering telemedicine via video call or telephone. Even if you end up going to the office or to the emergency room, calling first can help ensure you find the appropriate care.
In the weeks since coronavirus quarantines have begun, Dr. Shu said that one common problem is accidental poisoning.
"Kids are getting into things while parents are trying to work," she said. "The supervision may not be the same during the day, and everyone's a little bit off their routine." Poison control is still available by phone and online throughout the coronavirus crisis.
In addition to poison cases, Dr. Shu said her office has seen lots of household injuries. Kids are swallowing coins or falling down inside and outside the house. Some, she said, are getting hurt while riding bicycles and skateboards.
Those injuries are normal, said Dr. Shu, whose own daughter needed an ER visit after falling and cutting her arm three weeks ago.
"If you're trying to work," she said, "try having a little bit of extra supervision on your children."
What if your child has symptoms or is feeling sick?
If your child is experiencing symptoms, Dr. Shu recommended starting with KidsDoc Symptom Checker, a website operated by the American Academy of Pediatrics. There, parents can get reliable info on everything from stomachaches to sprains.
"Let's say [they have] a minor fever for just a day," Dr. Shu said. "If the child is doing otherwise well, they may be able to manage that fever at home for another day or two."
The next step is to call your doctor to see whether the issue can be diagnosed via telehealth or requires an in-office visit. Dr. Shu noted that at her clinic, a telemedicine call followed by an in-office appointment within 24 hours would likely be billed as a single doctor's visit.
Despite the dangers of coronavirus, and the challenges of parenting during quarantine, Dr. Shu said that it also means kids are shielded from some common illnesses.
"People aren't traveling as much," she said. "They're not mixing germs as much."
It's a silver lining to all that social distancing and handwashing: In the time since the quarantine began, Dr. Shu's office has seen far fewer cases of influenza, strep throat, stomach ailments, measles and whooping cough.
Managing vaccines and annual check-ups during coronavirus
With a 4-month-old baby and a 6-year-old at home, Lauren Bachan of San Jose, California, was concerned about the risk of contracting Covid-19 at a doctor's office.
Still, when her baby's regular vaccinations were due, she decided that delaying would be far more dangerous. "I don't know if she's going to catch Covid," said Bachan. "But if she catches measles she could die."
When it comes to children who are 2 years old and under, Dr. Shu agreed that it's essential to attend regular checkups and scheduled vaccinations. The vaccines administered at that age protect against life-threatening diseases including measles, polio and diphtheria.
Not only that, pediatricians use regular visits with children 2 and under to check vision, screen for autism and monitor development of speech and walking. "It's something we want to get on the radar early so we can intervene if necessary," Dr. Shu said.
For some of the CDC-recommended vaccines, children get additional booster shots at 4, 11 and 16 years old, Dr. Shu said. In a situation where seeing a provider is difficult or risky, Dr. Shu said it's perfectly fine to delay some shots.
"There's a one- or two-year leeway where you can wait a little while," she said.
For older kids who don't need vaccines, Dr. Shu said annual checkups can often be postponed as well.
"Those kids typically come in because they need to get checked out before they go to summer camp or do sports," she said. "Those aren't happening anyway, and we feel that we can delay those." If you're considering putting off booster shots or annual checkups, it's still a good idea to check with your health care provider.
What can you expect at the doctor or emergency room?
When Rowe's son, Zaiden, arrived at the emergency room in Memphis, Tennessee, he and his father had their temperatures screened before they got to the front desk.
Both father and son were wearing masks — Leslie Rowe has been working overtime to sew fabric masks for her community. After the temperature screening, they spent a few hours at the hospital making sure Zaiden was okay. All of the providers they interacted with wore masks and gloves.
Those are just some of the measures that hospitals and pediatricians have put in place to protect patients and staff from Covid-19, Dr. Shu said.
"We're looking to the CDC (US Centers for Disease Control and Prevention) for guidance on precautions to take in the office to prevent the spread of illness," Dr. Shu said.
That guidance includes extra sanitization and maintaining social distancing as patients arrive and wait for providers.
"Rather than coming to the front desk, they check in from their cars," Dr. Shu explained. "We have rooms that are dedicated to sick people that well people don't ever go in. And we're really limiting the time that they're in the actual office."
With those precautions in place, Zaiden got the care he needed then returned home, where he's now recovering with his family.
That meant his mom could get back to sewing masks. So far, she's made 360. "I just leave them in a basket at my front door for people to pick up," she said.
"They can actually pick them up and drop them off at our local hospital," Rowe said. "Beyond that, I just pray for the people that are in contact with the virus."
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