Is coronavirus still a big deal? YES.

Just because we are tired of this doesn't mean it is going away. The virus doesn't care how we feel about it.

I continue to get calls EVERY DAY from families in my practice who have been exposed to or caught coronavirus.  Some family members have become seriously ill,  fortunately none of them children.  As studies have shown, symptoms in kids range from nothing at all to mild congestion and runny nose, or low-grade fever, to high fevers, coughing, vomiting, and loss of taste or smell.  So potentially any sign of illness could be coronavirus.  Please continue to wear masks and socially distance to prevent spread and stay home for 10 days if your child has any sign of illness.  1500 people died from the flu in L.A. County in all of 2019, but 5381 people have died from COVID in L.A. County as of today, only 6 months after it started. See publichealth.lacounty.gov/media/Coronavirus/data/index.htm

Back-to-school time

Because kids themselves (and people under 40 with no risk factors) are at low risk of serious illness (death rate about 0.1%), many kids may be able to return to school under careful protocols.  Each family has to consider their individual situation and risk to family members, however.  Every exposure to another person increases risk and many families have made the decision to keep their kids at home.  For those who are sending their kids to school and daycare I am concerned about exposure to grandparents, whose risk is much higher.  The risk  in people over 60 was 10% and over 75 20-30%.  Fatalities currently are going down in Los Angeles, but this is partially because there are fewer cases among the elderly, where nursing homes were hit hard at the beginning, and more among younger people, who are more likely to have mild cases. 

For more information here is a SUPER HELPFUL website!

explaincovid.org

Stay safe!

Updates from our office!

It is very quiet now in the office so we can open up to more well visits.  We are now seeing 0-4 year olds and 11 year olds for checkups. In addition, any child who is overdue for a vaccine may have a nurse-only visit at any time. Please call for an appointment. 

For everyone's safety:

We have only one patient in the office at a time.

Morning and early afternoons are reserved for well visits only.

Only one parent may attend and no siblings.

There is no check-in; you can go straight to your room upon arrival.

Only the minimum in-office is done: Maggie does the measurements and screenings and Dr. Schramm's exam, then shots.

In the afternoon a separate 15-minute video chat from home with Dr. Schramm gives you plenty of time for discussion and questions.  You can download the sprucecare app on your phone from the top of my website.

We all wear masks and we ask that you and your child do too (if they are 2 or older.) Dr. Schramm is in full PPE + n95 for every visit, but kids don't seem to mind.

We thoroughly clean & sanitize after every patient. Donations of Lysol or other EPA-registered disinfectants are gratefully accepted.

If it stays quiet, we should be able to add other ages.  

Hope to see you soon!

Stay well everyone!

We are open every day 9-5 and you can call me anytime!

We have strictly limited in-office visits so that those that need to come can be safe.

In the office, we are seeing the following:
   
MORNINGS

     - well infants and toddlers for checkups and vaccines

     - well kids of any age who are due for vaccines (vaccine visit only)

AFTERNOON

     - sick kids via telemedicine

     - not "sick" but having a problem, via telemedicine (ADHD, injury, developmental issues etc.)

     - sick kids in the office in the rare cases that telemedicine is not appropriate

COVID-19 recommendations and office changes

     As more cases of community spread have been reported in Los Angeles, it has become clear that it is time to not only be vigilant about hygiene (using hand sanitizer, soap and not touching our faces) but also to practice social distancing.  This means staying home as much as possible and avoiding unnecessary contact with others.  Please do this if you or your child shows any sign of illness, but even if not.

     Kids appear to be at low risk for serious illness, fortunately, but are frequently carriers of illness to friends and family members, as we all know.  For this reason, I recommend that as much as possible kids are kept away from older family members (over 60) who are at higher risk for serious illness.  Even kids who appear perfectly healthy can be less than 24 hours from developing fever or cough (and thus contagious during this asymptomatic time).

     If we can "flatten the curve" so that the virus spreads more slowly, then we can avoid overwhelming hospitals.  Here's a great explanation:
https://www.wired.com/story/whats-social-distancing-flattening-curve-covid-19-questions/

     If your child is sick, I am always available to talk.

Here are some FAQs:
1 - Well visits
     We are sanitizing frequently in the office and moving all well visits to the morning so babies can stay up to date on their shots and checkups as safely as possible.  We are also asking for well visits 2 yrs and up to be temporarily deferred.  Sick visits are being moved to the afternoon. Please keep in mind that patients will be asked to stay in the rooms, so try to avoid bringing siblings.

2 - Mild runny nose/cough, no fever or low fever (under 102)
     Ideally, I would love to test everyone for COVID-19, but we have very few test kits.  I am looking forward to wider availability of testing, either in our office or drive-through. As of today, we are being asked to limit testing to those who have fever, cough AND a known contact with COVID-19 or recent travel from Italy, Iran or China.  For now, children with mild respiratory illnesses should stay home and avoid contact with others until they are completely well. They may also be brought to the office if you are concerned and would like them to be seen.

3 - Moderate respiratory illness (fever over 102 or lasting >72 hours, fever that started after 3 days of a cold, cough more than every 10 minutes, labored breathing that is relieved by asthma medicine)
     Should come in & be seen in the office or at urgent care.

4 - Severe respiratory illness (labored breathing, decreased drinking so not urinating at least every 8 hours, lethargy even after ibuprofen)
     Call me but may need to be seen in ER.

Coronavirus recommendations

The Los Angeles County Dept. of Public Health website is the best way to stay informed!
Here is a wonderful, detailed guide to what you can do to protect yourself: http://www.publichealth.lacounty.gov/media/Coronavirus/GuidanceParentsEnglish.pdf
You can also subscribe to their twitter feed for updates!

Coronavirus update 2/8 from the LAC Dept of Public Health

Public Health Statement About the Facts of Coronavirus

LOS ANGELES - In the face of a significant increase in the numbers of confirmed cases of novel coronavirus (2019 nCoV) in mainland China, many LA County residents are worried and fearful. The Los Angeles Department of Public Health (Public Health) urges residents and visitors to get the facts and take positive steps to reduce their risk.

There is only 1 case of novel coronavirus in LA County, in a non-resident traveler from Wuhan City, and there has been no subsequent community transmission of the virus.  There are only 12 cases of novel coronavirus across the entire United States and while it is likely that there will be additional cases, actions have been taken to limit the spread of the virus in our country.  Recent travelers who have visited mainland China are screened at the airport and provided with information about restricting their movements, monitoring their health and connecting with their provider and local public health department should they feel ill for 14 days after last being in mainland China.  Guidance has been sent to school districts, universities and colleges explaining the new directives which restrict staff and students who returned from traveling in mainland China after February 2, for 14 days after leaving mainland China.  These actions can help identify individuals who may have been exposed to the virus and reduce the spread of the virus to others. 

With rising reports of reduced patronage of Chinese owned businesses, bullying and stigmatization on school and college campuses, and rampant xenophobia on social media, Public Health is encouraging people to focus on facts, not fear.  The fact is novel coronavirus is NOT currently spreading in the community in Los Angeles County nor in the United States, and immediate risk to the general public in Los Angeles County is low. Residents can continue to enjoy all their usual activities and feel comfortable eating and shopping at restaurants and stores that are owned and operated by our Chinese neighbors and friends.

“Discrimination targeting our Asian American and Chinese American friends, neighbors and businesses is harmful to our entire community,” said Barbara Ferrer, PhD, MPH, MEd. “This is not the time for the perpetuation of stereotypes and misinformation about novel coronavirus.  Public Health encourages everyone to continue to enjoy all that our Asian communities have to offer.”

“People have a right to be afraid, but must understand that outbreaks and pandemics are human tragedies that impact us all directly or indirectly as ONE diverse community,” Dr. Muntu Davis, County Health Officer, added. “Embracing, not stigmatizing, others and spreading accurate information about what’s happening locally is what helps manage our fear and both the individual and collective actions needed to protect our entire community.”

Public Health continues to recommend that the public do the following to protect themselves from all respiratory illnesses:

• Stay home when you are sick.
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Limit close contact, like kissing and sharing cups or utensils, with people who are sick.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If you do not have a tissue, use your sleeve (not your hands).
• Facemasks are most effective when used appropriately by health care workers and people who are sick.
• Get a flu immunization to prevent influenza if you have not done so this season.

Please continue to offer welcoming environments for ALL members of our community. Neither the California State Public Health Department, nor Los Angeles County Public Health recommend that any normally scheduled events be cancelled due to novel coronavirus. There is no community spread of the novel coronavirus in the Unites States at this time, and the risk to the general public remains low.

Always check with trusted sources for the latest accurate information about novel coronavirus

• Los Angeles County Department of Public Health

http://publichealth.lacounty.gov/media/Coronavirus/

• California Department of Public Health

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/nCOV2019.aspx

• Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov/coronavirus/novel-coronavirus-2019.html

• World Health Organization

https://www.who.int/health-topics/coronavirus