Pediatricians along Colorado’s Front Range are getting creative to try to provide needed care to kids whose parents are understandably afraid to take them outside.
Public health experts have raised concerns about a resurgence of diseases like measles both in the United States and overseas if children miss their scheduled vaccinations. Others are worried that developmental delays will go unnoticed, and doctors will lose the opportunity to ask about socioeconomic struggles and other problems that can strain families.
Dr. Beth Ballard, a pediatrician at The Youth Clinic, said she’s encouraging parents to bring kids in for their shots, which can prevent diseases that are least as dangerous to children as COVID-19.
“The last thing we want to do is come out of this and have an outbreak of measles,” she said.
The Youth Clinic designated one of its four locations in Larimer County for kids with respiratory symptoms, with two others handling routine needs, Ballard said. They’ve also required families concerned about respiratory symptoms to check in ahead of their visits, answer screening questions in their cars, and wear surgical masks before they’re let in the door. There’s one exception, for children younger than 2, who could be in danger if masks trap carbon dioxide they exhaled and they rebreathe it, she said.
Some Kaiser Permanente clinics are taking the same approach, treating only sick or well children, while others have designated areas and hours for kids with respiratory symptoms, said Dr. Hector deLeon, assistant regional director of pediatrics at Kaiser Permanente Colorado.
Kaiser is using a “virtual first” model for things like check-ups on older kids, behavioral health care and medication follow-ups, deLeon said. That’s not an option, though, when kids need their shots, or for babies, who need close monitoring for lack of growth and other problems, he said.
“We’re still encouraging our members and our parents to bring them in, especially the younger children,” he said.
Ballard said The Youth Clinic also is using telemedicine when possible, and is offering some mixed visits. For example, an infant might need to come in to be weighed and measured, but the doctor and parent could reduce face-to-face time by discussing any concerns about feeding and sleeping over the phone, she said.
“A lot of well care is just talking,” she said.
Whitney Gustin Connor, executive director of Kids First Health Care, said their clinics also are encouraging parents to consider telemedicine, but some things have to be done in person. Kids First operates the Brighton High School student clinic, which reopened Monday. They see kids who need routine care, like vaccinations and physicals for fall sports, in the morning, with appointments for those with respiratory symptoms in the afternoon, she said.
Normally, the clinic only serves Brighton High students, but they’re opening appointments to anyone under 21 in the community, Connor said. They will be open three days a week, to coincide with the times when the school distributes take-home meals. She said she isn’t sure how much demand to expect, though the number of appointments is below normal at the other clinics Kids First operates.
“Things are a little bit quieter,” she said.
Ballard said The Youth Clinic also is seeing fewer patients, but she’s not sure how much is due to fear of COVID-19, and how much comes from kids not exposing each other to so many viruses in school and at play.
“There’s just a lot fewer sick kids out there,” she said.
The Kaiser clinics also are seeing fewer kids than usual, but have a fairly high volume of minor injuries, presumably from kids finding active ways to entertain themselves in isolation, deLeon said. There’s also some of the usual problems, like asthma exacerbations, as well as some less expected illnesses, like mononucleosis, which spreads through saliva.
“Illnesses find a way,” he said.