Dr. Raquel Huruta, M.D. gives us an overview of her pediatric practice as we all try to cope with this pandemic.
How can we explain to our children what’s going on?
I’ve been telling my patients that Covid-19 is a virus that is somewhat similar to a family of viruses that is already here with us. For example, kids to go day care, pre-school, school, and they share a lot of common viruses that can cause runny nose, cough, fever, nausea, etc. Most of the times, it goes away in five to seven days. But now we have this new type of virus, and many people don’t have the antibodies to fight it. I tell kids that they have little soldiers in their blood than can learn new strategies to fight Covid-19. Fortunately, many kids don’t show any symptoms at all even when they have Covid-19.
In your experience, what is the biggest challenge for young children right now?
The biggest challenge is that they want their life back. And that’s not only kids— adults too. Kids can feel very frustrated, they are very anxious and just like in adults, this anxiety can cause stress hormones to escalate. There are so many new things on the picture now: a new routine, a new way of learning online, remote working for parents, social distancing, etc. The biggest challenge is understanding and coping with this pandemic. It’s been very hard for everyone!
As the country goes back to school this fall, what are the risks that more young children will be affected by the virus. At first, this virus was not affecting children and now the report on the news is changing. That’s alarming.
There is an inflammatory response related to Covid-19 it resembles the KAWASAKY disease (an illness that causes inflammation in blood vessels throughout the body. It happens in three phases, and a lasting fever usually is the first sign. This condition often affects kids younger than 5 years old). It’s uncommon but there are a few reports starting to show up. Teenagers are more likely to test positive than young kids. For the younger kids under 10 years old, this is rare and the incidence is really low. They even test negative even with the parents test positive. Once kids go back to school, obviously there is more exposure, close contact, so we might see more cases in school. We’re all hoping and waiting for the authorities to come up to precautionary measures. Bigger spaces between desks, maybe alternative days for kids to go to school. Nobody knows yet what’s going to happen!
Some young adults, especially between 18 and 22 years old, have a difficult time practicing social distancing. What can we do to make them understand the importance of this practice and the consequences of close contact during this time?
Now that warmer temperatures are here, people are eager to go out and gather outside. Communication is key. We need to tell young adults that if they want to go out, they need to wear masks and gloves, and stay at least 6 feet apart. Also, they should try to meet small groups of people, between 6 and 10 people maximum. If everybody wears a mask, then chances are very slow that anyone will get the virus.
Do you think that the death toll in this country is being calculated accurately? When someone is ill and dies during Covid-19, it seems like every single death now is being charged on Covid-19. How can the hospital make a better distinction between deaths caused by Covid-19 and deaths caused by other illnesses?
Actually, hospitals have the control to determine if a person dies of Covid-19 or other illnesses. Anyone going to a hospital will get tested, even if you’re going for a colonoscopy or endoscopy or any other type of exam. It’s that simple, everyone gets tested. Hospitals follow the patience’s clinical progress and a lot of times doctors can easily determine if a patience died from Covid-19 or something else.
Many moms are having to work from home, and at the same time home school their young children. These are two very difficult tasks to juggle. Do you have any advice for moms out there on this boat?
The very young children, between 1-3 years old, will not fully understand that his/her parents are home but not fully available to them. If both parents are home, they should take turns so that one of them could work while the other parent takes care of the kids and vice versa. Maybe they can consider sharing a babysitter with a friend. Let’s say there are two families, each with two kids, sometimes, this might create a more controlled environment for the kids, for the parents and even for a baby-sitter. Also, nowadays with this pandemic, doctors are being a lot more forgiving with screen time for the kids, as the screen will keep the child’s attention for some time. It’s becoming more acceptable due to the harsh conditions of this pandemic. I also tell my parents to take regular break when children can have the parent’s attention.
What do you think about telemedicine? Was that in your horizon before, and then the pandemic just accelerated and made it a reality? Do you like it? In your opinion what are the advantages and disadvantages of telemedicine? Do you think it’s going to stay with us after the pandemic?
Yes, it was on my horizon, but I have never really used it intensely before. Then, around mid-March (2020), I realized I had to implement telemedicine. I didn’t set it up right away; it took me about two weeks. At first, I was just considering it, and now, just two months later, I’m using telemedicine for 50% of all my patience encounters. It became part of my office workflow. Google meets, zoom, skype, facetime… you name it! That’s the beauty technology! It’s here to help us! And the kids are already used to this whole world online!
The other 50% of appointments we are seeing in the office are for vaccinations. Especially all of the check-ups for kids two-year-old and under. We have to see them in the office. Four-year-old is another important vaccine time for chicken pox, measles, mumps, rubeola, diphtheria, tetanus, polio and whooping cough. We are seeing newborns, one month, two months, four months, six, nine, 12, 15, 18, 24, 30, 26 and 48 (4 years old). We also see teenagers who need vaccine.
And what about health insurance? Are they including telemedicine as a new modality?
Some insurances are paying for telemedicine, but it’s really a fraction. It’s more a symbolic fee. I hope it changes or else medical offices can’t survive. Some parents lost their jobs, others got furloughed; if they have a high deductible, insurances won’t pay for telemedicine. We, doctors feel sorry that parents are not working. Their income is reduced, they are living on a surviving mode. I refrain from charging them for telemedicine. There is a very practical side to this.
When do teenagers stop seeing their pediatricians? My own children are 17 and 19 and I’m still taking them to their pediatrician. Is it only me, or other moms also have a hard time making that transition from pediatrician to general clinician/internal medicine?
Just around that age is when teenagers start seeing a general doctor/internal medicine. Young adults can stay in their parent’s health insurance until the of 26 years old. I get what you’re saying. Sometimes pediatricians see kids since they were born; it’s hard to let go of that relationship, especially when the doctor is good!
Dr. Raquel Huruta, M.D. is pediatrician at Global Pediatrics in Fairfield, CT. She trained at Mount Sinai School of Medicine and is certified through the American Board in Pediatrics. She was a clinical Instructor at University of Connecticut Medical School from 2009 to 2014, when she opened her practice. She lives in Connecticut with her husband and two children.
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1305 Post Road, Suite 103