Is it safe…?

Summer 2020 has officially started and it will be different than summers past. As states begin to reopen, a lot of us are living in the gray, trying to make the best decisions for our family’s unique situation and wondering “Could we? Should we?”

We ask two Children’s Physicians pediatricians the question on every parent’s mind…”is it safe?” Every family is unique; no situation is the same, but our team is here to offer expert guidance and guidelines, sharing expertise to help your family make decisions about what is safe and what should be avoided this summer. Rest assured, our team has taken precautions to ensure that getting the health care your child needs IS safe.

Topic Breakdown

1:58 – Going to the doctor for non-COVID care
4:49 – Visiting grandparents and newborns outside of your household.
7:49 – The great outdoors and summer travel
10:02 – The risk of asymptomatic children carrying COVID-19
11:12 – Getting back to daycare and summer activities
13:49 – Starting up playdates
15:32 – Returning to sports
17:16 – The future of academics
19:02 – Staying safe at pools and playgrounds
21:15 – Planning for summer camp

Transcript

Here at Children’s Hospital & Medical Center in Omaha, Nebraska, it’s all kids — all day, every day. Our pediatric experts are here to answer your questions and weigh in on hot topics, helping you keep your child healthy, safe, and strong. We’re here for you. Listen in.

Dr. Anthony Yaghmour: Hey, welcome! My name is Anthony Yaghmour, I am a Children’s physician at Creighton University. I’ve been there for 20 years now. And I also want to introduce my partner.

Dr. Mel St. Germain: Hi, I’m Dr. Mel St. Germain. I am a pediatrician out at Children’s Physicians West Village Point. So kind of the other end of town, and I’ve been out there for 11 years.

Dr. Yaghmour: Alright I’m excited to do this, so let’s start. I’ll put you on the spot, Mel. So we got a lot of these COVID questions, and there’s so much information out there, that I thought we’d talk about it. And I thought that you seem to know a lot about what’s going on.

Going to the doctor for non-COVID care

Dr. Yaghmour: So the first question I get asked is, “Is it safe to take my child to the doctor?” So, what do you think?

Dr. St. Germain: That’s a very good question. That’s one of the easier questions, I think, to answer.

In COVID, there’s a lot of grey areas. But in general at Children’s, we’ve done — and really all the doctors’ offices — have done a lot to make sure we’re keeping everybody safe when they come in to see us. We’ve made lots of changes in the clinics, like having everyone wear masks. Even the parents, even the children, everybody in the office wear masks. We’re trying to separate when sick kids come in and when well-visits come in so that we don’t have any of those well-visits exposed to any of the sick kids. And to keep people out of the waiting room and making sure that we try to keep things as separated as possible.

Dr. Yaghmour: Yeah, I totally agree with that. I think we are doing a great job, as well as the emergency departments and the urgent cares. I know we have protocols and memos sent out — interdepartmental memos from Children’s on how to make it the safest place to go.

I would stress the fact that you want to make sure you’re going to the doctor when you need to, when the physicals are due, and call in. Because we’re good to say, “Hey, no, you can handle this via telehealth, we can handle this over the phone, you don’t need to come in for that.” We have a great screening process that makes that —

Dr. St. Germain: Yeah, that’s one of the things I love, that we’ve got — even the COVID triage line — so if you have questions about whether you’ve been exposed or whether you need to be quarantining or staying at home, we have lots of good, really smart people answering those questions and they’re available any time.

Dr. Yaghmour: So I get the question about elective surgeries a lot. Something that I tell people is that, you know, elective surgery doesn’t mean it’s surgery that doesn’t need to be done. Elective surgery means it’s something that can be scheduled. And so there’s a little difference to that that people don’t quite understand. And right now, each of the hospitals is having a little different protocol on how they decide the more important elective surgeries to do and what can wait. Emergency surgeries, necessary surgeries, are still taking place. I don’t know — what your thoughts are on that?

Dr. St. Germain: Yes, and they’ve started — because we’ve got more ability to do testing now than we did two months ago and because we’ve got all of these safety procedures in place — they’ve opened up some of those procedures a little bit more. And the best person to answer that question about whether that surgery needs to happen now is the person who’s going to do that surgery. So that’s always sort of your first go-to, is talk to the surgeon and then talk to your doctor, your primary care doctor, if you’re not sure about that.

Visiting grandparents and newborns outside of your household.

Dr. St. Germain: So then we get to the kind of tougher questions, like, “Who else is safe to go visit? Is it safe to visit grandparents?” What are your thoughts?

Dr. Yaghmour: Yeah, that is always a tough one and it depends per family, and per the health of your grandparents and the age of your grandparents. And if they’re the caregiver for you and they’re fairly healthy, then of course they can partake. But if you have a grandparent who has cancer or diabetes, is older and having trouble, it would be best to stay away from them. Or at least, if you’re going to be next to them, stay 6 feet apart, practice good hygiene — other things like that. What about you, what do you think?

Dr. St. Germain: Yeah, washing hands. I mean it’s — masks are hard with kids and their grandparents. If you can wear masks, that helps. Washing hands helps. There’s kind of a sweet spot. If everyone’s really been quarantined for 2-4 weeks and really hasn’t left the house, or is really doing everything they should, then it might be safe to do that. But yes, recognizing that grandparents are generally the higher risk half of this dyad, and so making sure that they feel comfortable with it, too.

Dr. Yaghmour: So then you get into the pregnant women, the newborn babies…when is it safe to see them? So, what do you think about those?

Dr. St. Germain:Yeah, those are a little bit tougher. Again, everybody’s been staying home. If you’ve got a mom who has been home for at least 2 weeks, and you’ve got family members who have been home, then that might be safe to do. In general, I usually tell families, even outside of COVID, to kind of limit lots of visitors for that first month of life. Just because babies’ immune systems are still really prone to more illness, and we worry more about those babies under a month or babies with a fever, especially under a month. Yeah, it’s hard to make a firm rule on that one.

You have to think about the mental health of the mom and if she’s getting — it’s really hard to take care of a newborn, and if you’re trying to do it alone, in a vacuum, without any help, that can be really hard on moms too.

Dr. Yaghmour: And the data changes, and the research and what they’re looking at changes as to the safest way to approach things, so a lot of this is our expert opinions. There’s no black and white. I don’t want parents to think, “Well this doctor said there’s no way I can do that.” And each family needs to take their situation into play and practice the safest way you can — avoid interacting with somebody who may be vulnerable or practicing, like we said, the social distancing and the hand hygiene and the overall hygiene that you can. But there’s no hard rules.

The great outdoors and summer travel

Dr. Yaghmour: So then, everybody’s getting — with this social distancing and self-quarantining — people are getting antsy and they’re talking about, “Hey, when can we go on summer vacation? What kind of vacations? What kind of precautions should we do? Can we do road trips? Can we go outside, can we go on the playground, what is all that?” What is your take on going outdoors around other people?

Dr. St. Germain: Outside is, you know, a lot safer than inside. It’s easier to keep that 6 foot distance and it’s much, you know — more air flow, more air circulation obviously. The virus disperses and doesn’t stay on surfaces and things quite as long as it does inside. So on the risk scale, I would say outdoor activities are less risky than indoor activities, in general. So doing things outside, especially if you have kids old enough that you think they can stay 6 feet apart, are probably safer than doing things inside.

Traveling is a tricky one. I don’t know, what do you think about that?

Dr. Yaghmour: Yeah, you know, if you’re going to be on a road trip and you’re practicing good hand hygiene and you’re practicing social distancing and you’re going to places where you’re not crowded, I’m not as worried on those situations. It’s if you’re going to rock concerts or you’re going to a baseball game or a football game where the crowds are going to be intense. So it really depends on the type of — if you’re going to go camping and you’re going to be able to be away from people — I think those are okay situations to go. But, you know, I wouldn’t be going to Disney World any time soon at this point.

Dr. St. Germain: There’s a question about if you are 6 feet apart, do you still need to wear a mask? If you’re outside — probably not. It’s never wrong to wear a mask, it’s never a bad idea. But is it safe to be outside 6 feet apart without a mask on? Probably for most people.

Now again, we’re talking about healthy people, not people who are coughing. If you’re sick, that’s a totally different story. But if everybody seems healthy and is staying social distanced the way they’re supposed to, I think that’s probably okay.

The risk of asymptomatic children carrying COVID-19

Dr. Yaghmour: To me — this may be outside the realm of the question — but kids are not the biggest carrier of these illnesses and they don’t tend to get as affected as much. And in fact, what the biggest thing is, if a child gets it, who — exposing sick people, sick grandparents, those are the biggest things. But for the child themselves that are healthy, they usually aren’t as affected, and they’re less likely to have problems with it.

Dr. St. Germain: And I’ve been kinda impressed with — of course, this data is changing day by day — but originally when we first started to see COVID cases, we were worried about that. That kids would be asymptomatic carriers and that they would be kind of spreading it all over the place. That doesn’t seem to be the case. Even when we’ve seen a few cases of COVID in daycares and things like that, the data hasn’t really shown that one infected kid who is asymptomatic spreads it more than an adult would. Which is encouraging.

Dr. Yaghmour: Yeah, it is encouraging. And the only caveat I would say is that sometimes that data changes and it’s hard to know…but you’re correct, and I agree with that.

Getting back to daycare and summer activities

Dr. St. Germain: So that’s a good question about daycare and summer day camps. Are those safe? And I think that depends on a) what’s your alternative? So I think if you’re talking about sending your kid to daycare, what’s the alternative? Is the alternative that you don’t work? Well then yeah, you probably need to figure out a way to safely return your child to daycare.

Dr. Yaghmour: I mean, I think it’s very important to ask the places that you’re going to, whether it is to a summer camp, “What protocols do you have in place?” A lot of these people should have protocols in place. I know with soccer, with the Nebraska State Soccer Association, they are having protocols in order to start sports back up. So just as long as you’re going to a place — whether it’s a swimming pool, whether it’s an outdoor activity — what do they have in place? I know the zoo has installed certain precautions to allow it to open up.

The people in the state and across the nation — a lot of people are looking at the data, looking at the information, providing guidance for these. And as long as these places are following that guidance and you feel comfortable that they are adhering to that, I feel like if you’re comfortable as a family, I don’t see that that is not a possible place that your child can go.

Dr. St. Germain: So here’s a couple questions I would recommend that parents ask if they’re thinking along these lines of, is it safe for my child to go to daycare? So ask — are they screening every kid every day to make sure that kids don’t have symptoms when they’re coming in? Have they limited the number of kids that are in each room (and that’s not a set number, that kind of changes. Initially, I think they were saying 10 kids per daycare room, now it’s up to 15, so just depending on what the current regulations are) but are they following those? And are they doing hand hygiene? Are they reminding kids to wash their hands or use sanitizer more frequently? And are they trying to keep kids from sharing food, toys, those sorts of things? Are they making sure that they are limiting exposure? Any others that you can think of?

Dr. Yaghmour: No, you’ve hit the nail on the head. Those are exactly the way parents should address it. And be proactive, don’t just assume these are being done, but to investigate. I think that’s excellent.

Starting up playdates

Dr. St. Germain: What about playdates? How do you feel about playdates?

Dr. Yaghmour: I’m okay with that. You had mentioned that earlier — playdates, playing outside — and I think that is an excellent point that needs to be stressed. I don’t think that completely social isolating your kids, especially during the summertime, and only to video conference, is enough. They need to have that interaction. So as long as you keep the numbers down, as long as they’re practicing good hand hygiene, I think it’s okay to parents to start allowing playdates,

Dr. St. Germain: And I think it’s important to ask those same questions. “Have you been sick? Have you had any symptoms?” And I know sometimes that feels a little awkward to ask those questions, but the same way you’d ask if they’re going somewhere if they’re going to be in a booster seat. All of those safety questions, I think, we have to get comfortable with asking that. “Has everyone been healthy? No? Well then we’ll reschedule for another time when everybody is.”

Dr. Yaghmour: Yeah I must confess, we have done a playdate already. And it worked well. It was good for my son. He was going stir crazy and it was tougher to discipline. So after we got the friend over, it seemed to be a little bit easier. So I do recommend it. At least try it out at a small level, not having a bunch of kids over at once.

Dr. St. Germain: Yes, and that is absolutely true. If you are going to do playdates, it might make sense to have each one pick just one friend or a couple of friends that they want to see, that they really want to see, because the fewer families you interact with, the less risky that is.

Returning to sports

Dr. Yaghmour: So of course, I remember back when we really started getting information on this, I was devastated when the NBA and the NCAA stopped their tournaments and their seasons. So this is a big issue for parents, especially as competitive sports, even recreational sports, come back into play. And they were talking about starting baseball this summer. So what are your thoughts about organized activities? Summer sports, restarting this in Omaha?

Dr. St. Germain: Well I think they’re doing the right — they’re taking the right steps to ensure that this is as safe as possible. Baseball is one of the least contact sports, I mean, each kid is touching a ball. [Laughs]. Well maybe, depending on what level you’re at. Maybe you’re looking at the ball. But those I think — because you can spread them out. I know they’re limiting the number of people who can be at those events so that we don’t get big crowds. I’m hopeful that this continues to go well and that they can open up some of the other sports. Because I know those who don’t play baseball thought that was maybe not fair to start that sport. But I do think that was the right way to approach it.

Dr. Yaghmour: I completely agree with that. That is a great point. Some of the very much contact sports where saliva is being expressed out — those I would still worry about that, because that is an easy way to spread the coronavirus. Because they’re saying more and more this is really more respiratory spread, it’s not as much touching as much as respiratory spread.

The future of academics

Dr. Yaghmour: And as far as learning, you know, we’ve had to deal with this e-learning over the spring, and parents were kind of going nuts encouraging kids to do that, so they’re worried. Are their kids going to be behind? Are they going to be lagging?

And I think, regardless, in the summertime, kids need to be engaged, whether it’s COVID season or not, and some kind of thing to keep their academic skills up. There’s a variety of apps and activities. And it doesn’t have to be a lot, it can be scheduled in a day, an hour here, an hour there — just skills, making sure your child reads, making sure they can do interactive material online. There are a lot of avenues to approach that.

Now as far as if schools are going to be re-open — that’s still up to debate. I know a lot of parents are going stir crazy and want that, so I don’t know what your thoughts are on that?

Dr. St. Germain: I think there’s going — it’s going to look different for different schools in the fall. I think each district is trying to figure out what makes the most sense and each school is trying to figure out what makes the most sense, so I dont think we’ll have any great answers on that yet, but I’m hopeful. Our numbers in Nebraska have leveled off, have started to go down, so that’s a good sign that we’ll be able to loosen things up a little bit in the fall.

There’s certainly lots of talk that we might have a second wave of COVID in the late fall/early winter, so I think everyone’s trying to prepare for that possibility. But hopefully. Homeschooling is tough and there’s a reason I’m not a teacher.

Staying safe at pools and playgrounds

Dr. Yaghmour: As this weather, hopefully, will get nicer and we see more sunlight at least, the pools. I know that there’s a big uptick in people asking for home pools. What about public pools?

Dr. St. Germain: Chlorine kills COVID pretty darn well. It does not live in the swimming pool. Now I think the hard part is, as we were talking about saliva, is that when you’re in the pool, there’s water and there’s drool and there’s snot and there’s spit and there’s all kinds of things that I don’t want to think about in the pool. But in the pool is probably fine.

I think the important part is making sure that you maintain the distance outside of the pool, making sure that they’re sanitizing those chairs frequently, and those sorts of things. And limiting the number of people, just so you don’t have exposure to those respiratory secretions.

Dr. Yaghmour: And the biggest thing for me with the pools — when you’re in the pool, even though the water may not have it — if you’re not, if you’re within less than 6 feet from somebody and they sneeze or turn around and spit and play, you’re going to have a higher likelihood of getting it that way than through the water obviously. So in the pools, you’ve got to still maintain. There has to still be a maximum amount of people that they’re going to allow. And it looks like they’re going to have to do it by appointment, so not just going to be able to open it up. They’re just going to have to keep the numbers to a certain amount where it’s safe to still social distance while in the pool.

The same kind of holds on the playgrounds, too. I think they’re going to have to keep those at certain levels, they’re just not going to be able to open it up to everyone. There’s going to have to be somebody policing how many people. Just like when I go to Home Depot — they police how many people are going into Home Depot at one time. So think they’re going to have to do that with playgrounds.

They are safe, you’re not necessarily going to get it from touching as much, unless you have somebody touching their nose and touching it, you just have to be careful in those instances. And make sure that — I wouldn’t go to a playground that’s packed, by any means. I would be very cautious to enter those types.

Planning for summer camp

Dr. St. Germain: I don’t think — we talked a little bit about summer camps. And for those, I’d ask the same types of questions that you’re asking daycares, which is, “How are you limiting the number of kids? How are you making sure that everyone is trying to keep 6 feet apart? How are you making sure that they’re washing hands, and that you’re screening for any illness and not letting any sick kids in there?”

Dr. Yaghmour: I think it’s going to be hard necessarily to find it. Because I think a lot of people are going to limit those. I know that my kids are signed up for some and I haven’t gotten word back if they’re even going to be running them. So I would venture to say you should be calling those camps and make sure that they’re still going to be going on

Dr. St. Germain: And have a backup plan, for sure.

Dr. Yaghmour: Exactly, exactly.

Dr. St. Germain: Well, this was a good talk.

Dr. Yaghmour: Yeah, I thought it went really well. I’m by no means, like I said, an expert at this COVID stuff. I keep trying to learn and read more and more about it. And I hope that our audience got a lot out of this, because I sure learned a lot from you Mel, so I appreciate your input.

Dr. St. Germain: Yeah, it was good talking to you. And just remember that we are always here and if you have any questions, if you’ve got a specific situation, call your doctor. We are more than happy to answer those questions for you.

Dr. Yaghmour: And we look forward to seeing you at our clinics. And thank you so much for listening and once again, I’m Dr. Yaghmour at Children’s Physicians at Creighton.

Dr. St. Germain: I’m Dr. St. Germain out at West Village Point. Thanks for listening!

For the latest info about COVID-19, visit childrensomaha.org. Thank you for listening to Just Kids Health.

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