When we typically think of infectious disease, we think about protecting our most vulnerable – usually the very young, the very old, and those with serious chronic disease. As Coronavirus (COVID-19) begins to spread more rapidly in the United States, we are going to have to start making tough choices about social distancing and keeping the ones we love safe.
So far, the overwhelming majority of death and serious illness is in our older and elderly patients. Infants and children are spared with no or mild disease. Theories on the reason behind this center around the fact that children share other Coronaviruses (not COVID-19) commonly with each other and may have some resistance to disease. Additionally, children may have a more robust immune system than adults. The runny nose from September to May in our daycare kids has a benefit we never imagined.
Below is a graph regarding early information on infection and death due to COVID-19
So what do we do with this information? First, I take a breath as a pediatric provider, reassured that my children and my patients are very unlikely to have significant disease. Then, I look at those around me in my office and within my family and think about how I can protect them.
It is clear that our family members over 50 (and especially over 70) are at the greatest risk. Those with chronic diseases are at even more risk. These are our parents, grandparents, aunts and uncles, neighbors, co-workers, and community members.
If your family member lives in an assisted living home or nursing home or if you work in one of those facilities, it is critical that you think about your own exposure and any signs of illness before visiting/going to work. This is not the time to “push through” an illness to make it to work. As the Coronavirus becomes more widespread think about face-timing and phone calls in place of visits. Perhaps send care packages with pictures and fun things to pass the time. Encourage your family member not to go out to large public gatherings (religious services, sporting events, concerts, etc. . . ) or shopping. Unfortunately, these may be the very things that many older people may value as ways to remain connected – frequent support through other means will be important.
If you have a family member or neighbor who falls into a high-risk group who lives alone, consider helping them socially distance. Go buy their groceries for them. Pick up their prescriptions. Consider rescheduling their non-essential appointments. Again, encourage them not to go to large public gatherings for the short-term. Encourage them to change travel plans (flights, cruises) until the virus is more contained.
If you live with a family member who is at risk – be honest with yourself. If you are sick stay away. Wipe down surfaces frequently, pay attention to the things we all touch – doorknobs, faucets, etc. . . , wash hands thoroughly, cough in your elbow. Make sure your kids are doing the same. Maybe think about how you would quarantine a sick individual in your house to try and prevent exposure to those at risk.
We are all going to be likely asked to change our plans for the good of others – schools closed, trips canceled. While this may be a disruption for many and maybe even cause financial hardship, it could be potentially life-saving for those at the greatest risk.
This is the time to come together as a community and protect the most vulnerable.
Karen Halle, MD
FAAP Westwood-Mansfield Pediatric Associates