Experts address virus during Nemours virtual town hall

Professionals ranging from infectious disease doctors, to pediatric hospitalists, to psychologists, came together virtually to answer questions and address concerns of how the nuances of coronavirus can impact families and communities differently, particularly children, in a town hall Friday.

Hosted by Nemours, the town hall gathered a group of professionals who discussed the different impact that the pandemic can have depending on a variety of factors.

Roger Harrison, a clinical psychologist, discusses keeping calm during the pandemic during a livestreamed town hall Friday. The panel, composede of different medical professionals, was hosted by Nemours. Submitted photo

Of coronavirus cases in the world right now, the U.S. has the largest population of cases. About 2% of those are children, said Salwa Sulieman, an infectious disease physician.

“In Italy, in China, in other countries, only about 2% of all the cases that we’re seeing are in children,” she said. “So, that is good for us but it doesn’t take away the fact that it’s still happening.”

Looking at the cases documented from February to April, research found that COVID-19 is predominantly affecting the adult population, said Chalanda Jones, pediatric hospitalist.

For the children who have high-risk or underlying health issues, however, COVID-19 is likely to manifest with secondary or severe symptoms, “although it’s still a very low population,” she said.

Those risk factors associated with pediatric patients affected by COVID-19 include children with sickle cell disease, HIV, chronic lung disease like asthma, immunosuppression, children receiving chemotherapy or heart disease, she said.

“We have also noted, as we’ve done studies here in the United States and we’re getting more and more data, is that we know that there are high risk populations as it relates to race and ethnicity. So, particularly the African American population, Latino Hispanic population, Asian and Native American population have been hit hard by COVID-19,” she added.

The discussion comes on the heels of an inflammatory illness, thought to be linked to COVID-19, that is impacting children, including those in Delaware.

The inflammatory illness, pediatric multisystem inflammatory syndrome, mimics other diseases like Kawasaki or toxic shock syndrome. Symptoms include abdominal pain, diarrhea, nausea, vomiting, rash and lethargy. Some children may test positive for COVID-19, others may not, but they will have antibodies present that suggest exposure to the coronavirus, Meg Frizzola, head of the intensive care unit.

While data is still being collected, Dr. Frizzola said that “there seems to be a higher likelihood” in children with obesity, diabetes, epilepsy and those with developmental disabilities.

When it comes to mask wearing for children, Dr. Sulieman said that children 2 and under don’t have to wear a mask, but three and up should.

In her comments, Dr. Jones also discussed if there’s an inability to social distance, like families living in multigenerational homes, or those working closely with coworkers. Making sure to wear a mask and wash hands is important, she said.

“I know in some households where there are multi generational or people of different ages there that people have actually sectioned themselves off into certain parts of the home so if you have an older person in your home, maybe they may spend more time in their bedroom as opposed to being in a social area like the living room or the kitchen where others may be,” she said.

However, there are other stressors at play during the pandemic, including how the virus’s impact applies to race.

One question came from an African American woman with a 16-year-old son, who expressed fear about her son wearing a mask.

“I certainly understand the concern that you’re expressing and that concern is the fact that people may take your son as wearing a mask as being something that’s hostile, and give them an opportunity to act violently or discriminate towards your son as opposed to others who may be wearing masks and don’t get that same sort of reaction,” Dr. Jones said.

She suggested picking masks with sports insignia or school insignia on it.

“Something that, at first glance, someone may take a look at and feel that it looks a little bit more gentle as opposed to not,” she said. “Those are some of the realities that we live in, I certainly would try to look for that type of material when I’m getting a mask for him. But it’s very important that he protect himself against this illness.”

She added that COVID-19 is affecting the African American community disproportionately to others. And while the teen getting sick is a concern, he could also be asymptomatic and pass the virus to others in the family.

“As African Americans, I think we’re always balancing between protecting ourselves in society versus our own health benefits but in this case, you certainly need to try to do all that you can to make sure that he is wearing a mask in public and protected,” she added. Dr. Roger Harrison, a clinical psychologist, discussed how to remain calm in a time of uncertainty, as well as “minority stress,” a term which examines “the additional burden of your minority identity status.”

An example of that minority stress, he said, is the question regarding the mother worried about her 16-year-old teenager wearing a mask.

“So, the kind of thing that you might not have to think about, for example, if you are a white family, like being in the suburbs of one of our communities here, you might never think twice about putting a mask on your adolescent son and sending them out in the community, but that is not a luxury that a parent who’s raising an African American or perhaps a Latino or a Native American child has,” he said.

When it comes to identifying concerning signs in a child or teenager who might be experiencing depression or anxiety, Dr. Harrison said parents should “attend to the NEWS” — Nutrition, Exercise, Water, Sleep.

Diana Rash-Ellis, social worker for patient and family services, noted that activities that once were typical — work, school, the grocery store — may now stoke fear and anxiety. During the pandemic, too, people may be experiencing pay cuts, furloughs or may be fearful of going to work for numerous reasons.

“A lot of individuals don’t feel that they have those support systems as they did before because they’re isolated,” she said. “They don’t have those financial securities they did because of their jobs either no longer being in existence or their jobs have changed.”
But, she said, resources are out there.

“One thing that I just want to say is that you’re not alone; this will pass eventually,” she said. “There are great resources and supports out there. You just have to reach out to anyone, everyone, all individuals to try and help and get those resources.”

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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