Coronavirus


With advice from the World Health Organization













Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases. Covid-19 is a new strain that has not been previously identified in humans.  


Below are several questions and answers about this new pathogen:


    What is a coronavirus?


Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases. The most recently discovered coronavirus, COVID-19, causes a severe disease.


    What are the symptoms of COVID-19?


The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. Others lose the sense of taste or smell. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. A small percentage of people who get COVID-19 become seriously ill and develop difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. 


    How does COVID-19 spread?


People catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. This is why it is important to stay six feet away from a person who is sick and to wear masks in public. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. 


    Can CoVID-19 be caught from a person who has no symptoms?


The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms is lower. However, many people with COVID-19 experience only mild symptoms. This is particularly true at the early stages of the disease. It is therefore possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill.  


    How can we protect ourselves from Covid-19?


You can reduce your chances of being infected or spreading COVID-19 by taking some simple precautions:


        • Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.


        • Maintain at least 6 feet distance between yourself and others.


        • Avoid touching eyes, nose and mouth. Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.


        • Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.


        • Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance.


        • Wear a mask when out in public or when less than 6 feet away from someone who is not a member of your immediate family. 



    What we are doing at Kidfixers to keep you (and our staff) safe


        • We have continued our daily thorough cleaning and are disinfecting each room between patient visits. We also have changed our office hours temporarily, to better separate well from sick children. Well exams (and immunizations) are being done between 8:00 and 2:30. All sick visits are being done between 3:00 and 4:30.


        • ALL visits are strictly by appointment and our main waiting room is no longer being used. When you arrive for your scheduled appointment, call us from your car. As soon as a room is cleaned and available, you will be led in to your room. 


        • For your safety WALK-IN patients (those with no appointments made first by phone) will NOT be seen.


        • We are also offering CURBSIDE VISITS. If you’re still a little hesitant about coming into our office, we’ll come out to your car and examine your child through the open door. Again, call and set up an appointment, letting our staff know that you’d prefer a curbside examination. When you arrive, call and let us know you’re here and what car you’re driving. One of the doctors will come out and examine your child. Oh, and we don’t serve burgers or fries, although we wish we did!


        • Another way to keep you safe is .....Telehealth! Of course we LOVE seeing our patients and parents “up close and personal” in the office. Unfortunately, this isn’t always possible these days. To help us all keep in touch, we now offer virtual visits through the popular Zoom app. With very little effort and very little tech knowledge (thank God!), you can be speaking to and SEEING one of our medical personnel in no time flat. Simply call and speak to any of our reception staff and they can set you up with a scheduled virtual visit.


We find that these visits work particularly well for any of the following issues;


       Questions about feeding infants


        Handling behavioral issues at any age


        Refilling prescriptions or discussing medication


        Handling minor illnesses where an office visit isn’t absolutely necessary


        Helping determine if an office visit is needed


        Discussing lab results


        Ordering lab tests, including Covid-19 testing


        Managing chronic conditions, such as asthma, skin conditions, gastrointestinal problems (constipation, diarrhea)


And many, many more. In other words, instead of picking up the phone, pick up your smart phone or your computer mouse.




How to deal with your kid 'colleagues' during coronavirus shutdowns


From National Geographic










When Ashwin suddenly found out that his 11-year-old daughter would be at home after her Seattle school closed in early March, he knew—like a lot of parents facing COVID-19 challenges—that his family was in for a big change.


Granted, Sophie is still taking morning online classes, and many other parents are practicing some form of distance learning, either through their schools or various websites. But with more than 38 million public school students home because of COVID-19, this unprecedented time in U.S. education has left parents wondering: Regardless of how much “class time” their children are getting, how do you keep kids from bouncing off the walls all day?


“Parenting already takes so much energy,” says Laura Gray, a clinical psychologist at Children’s National Hospital in Washington, D.C. “For many of us who are going to be working and structuring our kids’ days at home, it’s adding a different layer of difficulty.”


No one’s sure yet how long children will be kept out of school to minimize the spread of coronavirus infection. But any amount of time is certainly a disruption. Here are some ideas to keep kids—and you—sane while in close quarters during the pandemic.


The big secret: prep work and consistency


Rao, a sports medicine physician for the Seattle Seahawks, said his family had prepared in advance for Sophie’s involuntary homeschooling by being in communication with her school about what to expect and getting their home and technology ready for online learning—both of which led to a smooth transition.


He’s also working closely with his wife, Jennifer, who’s now working at home, on tag-teaming Sophie’s care. If you do have a partner at home, Gray suggests communicating with each other every night about how to tackle the coming day.


And that day should be predictable, since children are accustomed to a regular sequence of events at daycare or school. “A daily schedule is going to be so important, especially because most of our children spend so much of their time out [of the house],” Gray says. “They’re used to a consistent routine.”


One thing that will help kids get used to their “new normal” is an official schedule so that kids won’t be knocked off their routine. Toddlers or younger elementary school kids will enjoy drawing pictures of the day’s or week’s activities; older kids can create a written one with times and activities. Try mapping out the next day’s activities the night before, or the week’s activities the Sunday before.


Some of those activities should be educational, regardless of whether your child’s school is doing formal structured education. Plan those out as well, integrating blocks of academic time into the regular routine. For ideas, check out the website Amazing Educational Resources, which maintains a spreadsheet of education companies offering temporarily free subscriptions during the pandemic; National Geographic Education for educational activity collections; and National Geographic Kids for quizzes, videos, and animal profiles.


And though it will be tempting to stay up late or sleep in, don’t shift too much from the school-night schedule. (That means you, too, Mom!) “Our bodies are designed to have specific sleep-wake cycles,” Gray says.


Throw in some surprises


Trying to use this time as “all school, all the time” will quickly get old, both for parents and their resistant kids. Gray recommends rotating in toys or activities that kids haven’t seen or done in a while. “It could be baking cookies with the family, a messy science experiment, a special craft they haven’t used, or family board games,” she says. “My kids like to put on talent shows.”


Rao likes to make sure that Sophie’s doing things like practicing piano and cooking meals for the family in addition to educational activities. “We find areas to do enriching things, as well as relaxing things,” he said. That includes things such as limited screen time to help decompress.


Gray also recommends alternating between busy and quiet activities, like doing a household chore and then reading.


Get outside


Yes, we’ve all heard the advice about social distancing and basically shunning everyone except your immediate family. But that doesn’t mean kids need to be cooped up in the house all day. It’s still important to incorporate safe exercise and fresh air, Gray says, such as giving kids a list of items to find in the backyard, like acorns or leaves.


Rao says his family spends a lot of time safely outdoors, gardening and taking short jogs around the city’s Green Lake. "It’s pretty empty now in Seattle, so it’s not hard to be distanced when we’re outdoors," he says. "And we typically keep at least six feet of space from anyone," Rao says.


Make technology your friend


Let’s face it: All those limits you’ve dutifully placed on screen time are about to completely blow up. The key now is how you use that screen time for your child’s benefit. Look for enriching yet fun content, like games and videos from PBS Kids.


It’s still a good idea to try to limit their screen time and exposure to media. Closely monitor what content they’re exposed to, and make sure time limits are set up front. “That way, it doesn’t become an argument later,” Gray says.


That said, do use technology to stay socially connected, a crucial part of both kids’ and parents’ mental health. Gray suggests having a virtual dinner party with cousins in another city.


Don’t forget you!


To keep kids healthy, parents need to stay healthy too. Make sure you’re connecting with your own social support network, and schedule some restorative time for yourself.


And of course, don’t forget that this extraordinary time can lead to useful life lessons for kids. “It’s going to be a more simplified time for children—they’re going to have time to be more creative and spend time with families,” Gray says. “This [pandemic] is something we can’t control, so we’re going to find ways to make the best of it.”


“I believe in growth through adversity,” he says. “Plus having time with your family is rare. It’s a really nice thing.”





Back to school with Covid









From the CDC



Schools are an important part of the infrastructure of communities and play a critical role in supporting the whole child, not just their academic achievement. This guidance is intended to aid school administrators as they consider how to protect the health, safety, and wellbeing of students, teachers, other school staff, their families, and communities and prepare for educating students this fall.


Critical Role of Schools


This guidance is intended, first and foremost, to protect the health, safety and wellbeing of students, teachers, other school staff, their families, and communities.


Schools provide safe, supportive learning environments for students, employ teachers and other staff, and enable parents, guardians, and caregivers to work. Schools also provide critical services that help to mitigate health disparities, such as school meal programs, and social, physical, behavioral, and mental health services. School closure disrupts the delivery of these critical services to children and families, and places additional economic and psychological stress on families, which can increase the risk for family conflict and violence.


The unique and critical role that schools play makes them a priority for opening and remaining open, enabling students to receive both academic instruction and support as well as critical services. In order to prioritize opening schools safely and helping them to remain open, communities should consider adopting actions to mitigate community transmission. The CDChas strategies for community mitigation to reduce or prevent the spread of COVID-19, which in turn will help schools to open and stay open safely. Recognizing the importance of providing safe, in-person learning, communities may also wish to help schools by examining whether additional public or private space, including outdoor spaces, that is currently underutilized might be safely repurposed for school and instructional purposes.


Returning to school in fall 2020 poses new challenges for schools, including implementing mitigation measures (e.g., social distancing, cleaning and disinfection, hand hygiene, use of cloth face coverings), addressing social, emotional, and mental health needs of students, addressing potential learning loss, and preparing for the probability of COVID-19 cases within the broader school community. This guidance provides information about:

        • what is currently known about COVID-19 among school-aged children;

        • the importance of going back to school safely;

    • what is currently known about SARS-CoV-2 (the virus that causes COVID-19) transmission in schools and its impact on community transmission; and

        • the ways administrators for kindergarten through grade 12 (K-12) schools can plan and prepare for in-person instruction and minimize the impact of potential closures.


What is known about the signs and symptoms, burden, and transmission of SARS-CoV-2 among children?


Signs and Symptoms


Common COVID-19 symptom among childreninclude fever, headache, sore throat, cough, fatigue, nausea/vomiting, and diarrhea.However, many children and adults infected with the virus that causes COVID-19 are asymptomatic (meaning they have no signs or symptoms of illness).


Impact of COVID-19 on Children


Early reports suggest children are less likely to get COVID-19 than adults, and when they do get COVID-19, they generally have a less serious illness. As of July, 2020, 6.6% of reported COVID-19 cases and less than 0.1% of COVID-19-related deaths are among children and adolescents less than 18 years of age in the United States.


Early reports suggest the number of COVID-19 cases among children may vary by age and other factors. Adolescents aged 10-17 may be more likely to become infected with SARS-CoV-2 than children younger than age 10, but adolescents do not appear to be at higher risk of requiring hospitalization.. There are currently a higher proportion of COVID-19 cases among Hispanic/Latino children as compared to non-Hispanic white children. Children with underlying medical conditions are at increased risk of hospitalization..


What is known about how schools have reopened and the impact on Covid transmission?


Internationally, schools have responded to COVID-19 using a variety of approaches.For example, China, Denmark, Norway, Singapore, and Taiwan all required temperature checks at school entry.Most countries have changed the way they operate to reduce class sizes, increase physical distance between students, and keeping students in defined groups to reduce contacts. Furthermore, many countries have staggered attendance, start and stop times, and created alternating shifts to enable social distancing. In some places this means that only certain students have returned to schools, either by grade range or need. For example, Denmark was the first European country to reopen schools. Denmark staggered students’ reentry in waves (e.g., one group started school first, followed by another group at a later date), with limited class sizes and using other social distancing measures. Younger students (under age 12) returned first based on their lower health risk and need for more supervision than older students. Class sizes were reduced to allow physical distancing. In Taiwan, students returned to school with mandatory temperature checks and use of face masks. Rather than national school closures, Taiwan relied on local decision-making to determine if classroom or school closures were needed, based on infection rates.


There is mixed evidence about whether returning to school results in increased transmission or outbreaks. For example, Denmark initially reported a slight increase in cases in the community after reopening schools and child care centers for students aged 2-12 years, followed by steady declines in cases among children between ages 1 and 19 years. In contrast, Israel experienced a surge of new cases and outbreaks in schools after reopening and relaxing social distancing measures; it is unclear what caused the increase in cases and what other mitigation measures the schools had implemented. In summer 2020, Texas reported more than 1,300 COVID-19 cases in childcare centers; however, twice as many staff members had been diagnosed as children, suggesting that children may be at lower risk of getting COVID-19 than adults.


It is important to consider community transmission risk as schools reopen. Evidence from schools internationally suggests that school re-openings are safe in communities with low Covid transmission rates. More research and evaluation is needed on the implementation of mitigation strategies (e.g., social distancing, cloth face coverings, hand hygiene, and use of cohosting) used in schools to determine which strategies are the most effective.


Why is it Important to open Schools for in-person instruction?


While opening schools – like opening any building or facility—does pose a risk for the spread of COVID-19, there are many reasons why opening schools in the fall of 2020 for in-person instruction is important.


    • Schools play a critical role in the wellbeing of communities.Schools are a fundamental part of the infrastructure of communities. Schools provide safe and supportive environments, structure, and routines for children, as well as other needed support services to children and families. Schools play a vital role in the economic health of communities by employing teachers and other staff and helping parents, guardians, and caregivers work.


    • Schools provide critical instruction and academic supportthat benefit students and communities in both the short- and long-term. The main role and priorities of K-12 educational institutions are to provide age-appropriate instruction and support students’ academic development. Reopening schools will provide in-person instruction for students, facilitate increased communication between teachers and students, and provide students with critical academic services, including school-based tutoring, special education, and other specialized learning supports.


    • Studies show that students have experienced learning loss during the period of school closure and summer months. In-person instruction for students has advantages over virtual learning, particularly when virtual learning was not the planned format for instruction, and schools may not have the resources or capability to transition fully to virtual learning. In-person classroom instruction has the added benefit for many students of interpersonal interaction between the student and the teacher and the student and peers. Teachers are able to more actively participate in student learning, provide feedback as students encounter challenges, and promote active learning among students.


    • In-person instruction may be particularly beneficial for students with additional learning needs. Children with disabilities may not have access through virtual means to the specialized instruction, related services or additional supports required by their Individualized Education Programs (IEPs) or 504 Plans.


    • When schools are closed to in-person instruction, disparities in educational outcomes could become wider, as some families may not have capacity to fully participate in distance learning (e.g., computer and internet access issues, lack of parent, guardian, or caregiver support because of work schedules) and may rely on school-based services that support their child’s academic success. The persistent achievement gaps that already existed prior to COVID-19 closures, such as disparities across income levels and racial and ethnic groups, could worsen and cause long-term effects on children’s educational outcomes, health, and the economic wellbeing of families and communities. While concern over higher rates of COVID-19 among certain racial/ethnic groups may amplify consideration of closing a school that educates primarily racial minority students, there should also be consideration that these may also be the schools most heavily relied upon for students to receive other services and support, like nutrition and support services.


    • Schools play a critical role in supporting the whole child, not just the academic achievement of students. Social and emotional health of students can be enhanced through schools.Social interaction among children in grades K-12 is important not only for emotional wellbeing, but also for children’s language, communication, social, and interpersonal skills. Some students may have experienced social isolation and increased anxiety while not physically being in school due to COVID-19. Resuming in-person instruction can support students’ social and emotional wellbeing. Schools can provide a foundation for socialization among children. When children are out of school, they may be separated from their social network and peer-to-peer social support. Schools can facilitate the social and emotional health of children through curricular lessons that develop students’ skills to recognize and manage emotions, set and achieve positive goals, appreciate others’ perspectives, establish and maintain positive relationships, and make responsible decisions. 


    • Continuity of other special services is important for student success.Students who rely on key services, such as school food programs, special education and related services (e.g., speech and social work services, occupational therapy), and after school programs are put at greater risk for poor health and educational outcomes when school buildings are closed and they are unable to access such school health programs and services. During periods of school building closures, students had limited access to many of these critical services, potentially widening educational and health disparities and inequities.


How can K-12 schools prepare for going back to in-person instruction?


Expect cases of COVID-19 in communities.International experiences have demonstrated that even when a school carefully coordinates, plans, and prepares, cases may still occur within the community and schools. Expecting and planning for the occurrence of cases of COVID-19 in communities can help everyone be prepared for when a case or multiple cases are identified.


    • Coordinate, plan, and prepare. Administrators should coordinate with local public health officials to stay informed about the status of COVID-19 transmission in their community. Additionally, planning and preparing are essential steps administrators can take to safely reopen schools:


    • One important strategy that administrators can consider is cohorting(or “pods”), where a group of students (and sometimes teachers) stay together throughout the school day to minimize exposure for students, teachers, and staff across the school environment. At the elementary school level, it may be easier to keep the same class together for most of the school day. In middle and high school settings, cohorting of students and teachers may be more challenging. However, strategies such as creating block schedules or keeping students separated by grade can help to keep smaller groups of students together and limit mixing. Strategies that keep smaller groups of students together can also help limit the impact of COVID-19 cases when they do occur in a school. If a student, teacher, or staff member tests positive for SARS-CoV-2, those in the same cohort/group should also be tested and remain at home until receiving a negative test result or quarantine. This helps prevent a disruption to the rest of the school and community by limiting the exposure. Schools should have systems in place to support continuity or learning for students who need to stay home for either isolation or quarantine. This includes access to online learning, school meals, and other services. The same holds for students with additional needs, including children with a disability, that makes it difficult to adhere to mitigation strategies.


    • Prepare for potential COVID-19 cases and increased school community transmission.Schools should be prepared for COVID-19 cases and exposure to occur in their facilities.  Having a plan in place for maintaining academic instruction and ensuring students have access to special services is also critical.


    • Assess the level of community transmission. There are specific strategies schools can implement based on the level of community transmission reported by local health officials:

        If there is no or minimal community transmission: Reinforce everyday preventive actions, ensuring proper ventilationwithin school facilities, including buses, and maintaining cleaning and disinfection practices remain important. These actions can help minimize potential exposure. Schools should also monitor absenteeism among teachers, staff, and students to identify trends and determine if absences are due to COVID-19, symptoms that led to quarantine, concerns about being in the school environment and personal health and safety, or positive test results. Anyone who tests positive for COVID-19 shouldstay home and self-isolate for the timeframe recommended by public health officials. Anyone who has had close contact with someone who has tested positive or is symptomatic for COVID-19 should be tested and stay home until receiving a negative result, or stay at home and monitor for symptoms.

        If there isminimal to moderatecommunity transmission: Schools should follow the actions listed above, and continue implementing mitigation strategies such as social distancing, masks, reinforcing everyday preventive actions, and maintaining cleaning and disinfection. This also can include ensuring that student and staff groupings/cohorts are as static as possible and that mixing groups of students and staff is limited.

        If there is substantial controlledtransmission: Significant mitigation strategies are necessary. These include following all the actions listed above and also ensuring that student and staff groupings/cohorts are as static as possible with limited mixing of student and staff groups, field trips and large gatherings and events are canceled, and communal spaces (e.g., cafeterias, media centers) are closed.

        If there issubstantial uncontrolledtransmission: Schools should work closely with local health officials to make decisions on whether to maintain school operations. The health, safety, and wellbeing of students, teachers, staff and their families is the most important consideration in determining whether school closure is a necessary step.Communities can support schools staying open by implementing strategies that decrease a community’s level of transmission. However, if community transmission levels cannot be decreased, school closure is an important consideration. Plans for virtual learning should be in place in the event of a school closure.







Bike Safely


From Kidshealth.org













It's a beautiful day — what could be more perfect than a bike ride? But wait! Before you pull your bike out of the garage, let's find out how to stay safe on two wheels.


Why Is Bike Safety So Important?


Bike riding is a lot of fun, but accidents happen. The safest way to use your bike is to get places, not to play. Every year, lots of kids need to see their doctor or go to the emergency room because of bike injuries.


Why Should Kids Wear a Bike Helmet?


Wearing a helmet that fits well every time you're on a bike helps protect your face, head, and brain if you fall down. That's why it's so important to wear your bike helmet whenever you are on a bike.


Bike helmets are so important that the U.S. government has created safety rules for them. Your helmet should have a sticker that says it meets the rules set by the Consumer Product Safety Commission (CPSC). If your helmet doesn't have a CPSC sticker, ask your mom or dad to get you one that does.


Wear a bike helmet every time you ride, even if you're going for a short ride. And follow these rules:


        •Make sure your bike helmet fits you well.


        •Always wear your helmet the right way so it will protect you: Make sure it covers your forehead and don't let it tip back. Always fasten the straps.


        •Don't wear a hat under your helmet.


        •Take care of your helmet and don't throw it around. If it's damaged, it won't protect you as well when you need it.


        •Get a new helmet if you fall while you're on your bike and hit your head.


        `•Put reflective stickers on your helmet so drivers can see you better.



What's the Right Bike for Me?


Riding a bike that is the right size for you helps to keep you safe.


To check the size:


        •When you are on your bicycle, stand straddling the top bar of your bike so that both feet are flat on the ground.


        •There should be 1 to 3 inches (2.5 to 7.6 centimeters) of space between you and the top bar.


Making a safety checklist is important. Ask your mom or dad for help:


•Make sure your seat, handlebars, and wheels fit tightly.


•Check and oil your chain regularly.


•Check your brakes to be sure they work well and aren't sticking.


•Check your tires to make sure they have enough air and the right amount of tire pressure.



What Should I Wear When I Ride My Bike?


Wearing bright clothes and putting reflectors on your bike also can help you stay safe. It helps other people on the road see you. And if they see you, that means they're less likely to run into you.


You'll also want to make sure that nothing will get caught in your bike chain, such as loose pant legs, backpack straps, or shoelaces.


Wear the right shoes — sneakers — when you bike. Sandals, flip-flops, shoes with heels, and cleats won't help you grip the pedals. And never go riding barefoot!


Riding gloves may help you grip the handlebars — and make you look like a professional!


Don't wear headphones because the music can distract you from noises around you, such as a car blowing its horn so you can get out of the way.



What Road Rules Should I Know?


If you're allowed to ride on the street, follow these road rules:


        •Always ride with your hands on the handlebars.


        •Always stop and check for traffic in both directions when leaving your driveway, an alley, or a curb.


        •Cross at intersections. When you pull out between parked cars, drivers can't see you coming.


        •Walk your bike across busy intersections using the crosswalk and following traffic signals.


        •Ride on the right-hand side of the street, so you travel in the same direction as cars do. Never ride against traffic.


        •Use bike lanes wherever you can.


        •Don't ride too close to parked cars. Doors can open suddenly.


        •Stop at all stop signs and obey traffic (red) lights just as cars do.


        Ride single-file on the street with friends.


        •When passing other bikers or people on the street, always pass to their left side, and call out "On your left!" so they know that you are coming.




     Home            Meet the Docs       Information           Myths              Telehealth       Where to find us

The Kidfixer Newsletter            Summer, 2020