While most Nebraska families remain hunkered down at home to avoid the coronavirus, pediatricians say there’s one place parents still should be taking their children.
Doctors who specialize in caring for kids say they’re concerned that their young patients are missing out on needed vaccinations and timely well checks, as well as sick visits and checkups for chronic conditions.
The American Academy of Pediatrics, in fact, has received reports from pediatricians across the country indicating that roughly 70% to 80% of children are not visiting their doctors right now, said Laura Polak, executive director of the group’s Nebraska chapter.
The national organization plans to launch a campaign this week to encourage parents to bring their children in for needed shots, checkups and other care, under the hashtag #CallYourPediatrician. The Nebraska chapter will join the call.
A key message will be that pediatricians’ offices, like other clinics and hospitals, have established practices to keep kids, parents and providers safe from the virus so families can feel comfortable coming back in for needed care and checkups.
Also high on doctors’ lists of needed interventions are the behavioral health screenings that now are an important part of well checks for older children. With school out and restrictions limiting youths’ access to friends and other coping mechanisms, health care providers are seeing more anxiety and depression among their patients.
“We’ve worked through all the kinks in the system so we can bring (children) in with minimal to no risk of transmission,” said Dr. Phil Boucher of the Lincoln Pediatric Group in Lincoln.
Many practices now require masks for patients, parents and staff. They also have designated separate locations for sick kids and healthy ones or have separated the two by designating different hours or building entrances. Waiting rooms are sitting empty, with providers often calling patients in one by one from their cars and ushering them directly into exam rooms. Many also made a quick pivot to providing telehealth options for patients whose concerns can be handled remotely.
“There’s less interaction than you’d have at a grocery store,” Boucher said.
But some care can happen only in person. Babies need vaccinations and well checks at regular intervals in order to ward off vaccine-preventable illnesses and catch developmental delays or concerns.
The federal Centers for Disease Control and Prevention posted guidance in late March emphasizing the importance of keeping kids, particularly those under age 2, up to date on routine well care and immunizations.
But a study posted last week by the CDC indicated a substantial decline in ordering of vaccines by physicians in nine large health systems following the COVID-19 emergency declaration, a sign that fewer kids were getting their shots.
Data from the Nebraska Department of Health and Human Services shows that childhood vaccinations also are down in Nebraska. From January through Friday, immunizations — not counting influenza shots — were down nearly 9.7% for children under 2; 30.3% for kids ages 2 to 7; and 35.5% for those 7 to 17, compared with the same period last year.
Boucher said providers in his practice gave 26% fewer vaccinations in April than they did in the same month last year.
Dr. Melissa St. Germain, a pediatrician at Children’s Physicians’ West Village Pointe clinic in Omaha, said well visits for kids under a year old were down 20% in April from April 2018 across the system. They were down 50% for kids 1 to 4 years old and 60% for those 5 to 18 years of age.
Vaccinations for pertussis, or whooping cough, were down 20% in April compared with the same month last year. Measles shots were down 40% over the same time frame.
That’s a concern, said St. Germain, president-elect of Nebraska chapter of the pediatricians group, because outbreaks of those two highly infectious diseases could occur if the number of vaccine-protected kids drops too low.
While Nebraska hasn’t seen measles outbreaks like those reported last winter in places such as New York, Michigan and Oregon, the state sees cases of whooping cough every year. It’s an illness that hits babies particularly hard.
Another concern is a recent decision by the Nebraska School Activities Association temporarily lifting the requirement that high school students get physicals each year to be eligible for athletics. Only incoming freshmen will need them in order to meet insurance requirements.
Polak said the pediatricians group still recommends that kids get those physicals, particularly if they have a health condition such as asthma.
St. Germain noted that doctors check for a host of other concerns during such visits, including behavioral health issues and substance abuse. “Those sorts of screenings are really important,” she said.
Boucher said it can be difficult for parents to distinguish between normal teen angst and more serious problems. And teens may not be willing to communicate such things to their parents.
Checkups also give pediatricians a chance to check for signs of mental or physical abuse at a time when families are under added stress and kids aren’t under regular observation by teachers and other school staff.
“If we can talk with them,” Boucher said, “we can uncover a lot more serious stuff that’s going on.”