Mar 18

Mar 18 Local Pediatrician on COVID-19 and Kids

David Pollack, MD, is a senior physician in Children’s Hospital of Philadelphia (CHOP)’s primary care network at three Delaware County locations. The Swarthmorean called him for some perspective on kids and COVID-19. The conversation has been lightly edited for space and clarity.

Swarthmorean: We’d love to get your sense of what’s going on with COVID-19 right now in Delaware County and the country. What people should know and think about and do.

Pollack: As medical people, we’re trying to stay on top of this whole issue as much as the general public is. Our office functions in the CHOP sphere of the world and they are all over this. We are getting emails constantly throughout the day, even on the weekends.

Fortunately, children are not as affected themselves by this virus as adults are. When we hear about kids who have fevers and sore throats and colds and coughs, we can give advice. But right now we don’t have enough testing around to diagnose them definitively, so our advice is generally going to be the same regardless of what may be causing it: Drink a lot of fluids, take some over-the-counter medications like Tylenol or ibuprofen for comfort, and give it a few days to run its course. For the most part parents are able to deal with these symptoms at home.

I expect that over the next week or two, testing is going to become way, way more accessible. CHOP is gearing up for this. I’m hopeful that over the course of the week we will have some drive through services. CHOP is experimenting with that this weekend. Right now we’re very limited in our testing. I think we’re going to find that there are a lot of people out there who have been exposed to the virus — are testing positive for the virus — and we’ll be able to begin to truly track this throughout the region and the rest of the country.

I’ve heard from another doctor that there are no viral swab containers — no way of gathering samples and keeping them, and there are shortages of gowns and masks. Are you seeing anything like that?

Yes. We have a limited supply of gowns and masks. But we expect that over the course of the week we’re going to have more of them. But right now it’s like shopping in the supermarket — there’s a very limited supply of certain things and they’re going to have to ratchet up.

On the other hand, there may be a relaxation of how much equipment you need to wear once we determine how many people actually have this virus. I’m not sure that, in the long term, protective garb will need to be worn in all cases when you’re swabbing a patient for the test.

What kind of recommendations do you have for people who are worried about their kids? Think they might be sick?

We’re generally giving the same advice we would have given over the previous decades. We’re trying to reassure parents that, given what we know about this virus now, it doesn’t create significant morbidity in the pediatric age group. But we do know that these kids are vectors for carrying the virus to adults and to more vulnerable populations. That’s why we need to get a handle on how much of the virus is out there. I think parents are made to feel better just speaking to us, hearing how we suggest they take care of their kids. And look, we recommend isolating any kid with a fever. They’re probably contagious if they have a fever or a cough. We would normally tell them to lay low anyway.

I’m talking to a lot of parents who are trying to figure out what to do with their kids while they’re home — what’s safe to do, and what isn’t safe.

We have to practice social distancing. Certainly outdoors is better than indoors. We’re generally hounding parents even before this pandemic — getting kids out of the house has been a real priority for us. The nature of society today is to spend all your time indoors on devices, never moving, and that’s a huge problem in the pediatric world. Now, I think parents are going to feel cooped up with their kids. So yes, getting them outdoors is great.

But I think the message has to be as little social contact as possible. Kids can’t be in groups. The closer you get to another person, the greater the chance there is that this can be transmitted. We want to flatten the curve [that represents the number of people in the population that is infected at a certain time]. We want to minimize the transmission between any two people. So parents really need to be careful.

This is a time where maybe we can implement old-fashioned ways of connecting socially. Getting on the phone and talking. Arts and crafts projects at home. And we have spring weather now. So families can get on their bikes, take hikes. There’s a lot you can do outdoors as a family unit. And of course even more parents are home now. I know they are presumably home working, but they’re going to need to take breaks with their kids.

Parents are going to have to come up with creative ways of getting their kids outdoors, engaging with them without devices, and having them connect socially to the rest of the world with some restrictions that they wouldn’t necessarily have at other times.

What about kids with asthma? I would assume they are more vulnerable.

Asthma doesn’t seem to make the symptoms worse. I’m not reading about kids with asthma having the virus move into the lungs and becoming pneumonia. We’re more concerned with kids who are immunosuppressed for one reason for another. And of course we have some kids like that.

But for the run-of-the-mill kid, mostly it’s the home remedy that the parent would have given anyway.

David Pollack’s practice is now separating the functions of its three Delaware County offices to keep children and their families safe. Sick kids only will be seen in the Drexel Hill office. The Broomall office will be for well-child visits only. At the Media office, well-child visits will take place in the morning, and sick children will be seen in the afternoons and evenings.