COVID-19 Message from Dr. Middleton

In an effort to come alongside you and your family, I want to share some thoughts re: COVID-19 and where we currently are. As you have undoubtedly already appreciated, the situation is changing almost daily (perhaps even faster). I have been a little hesitant to send out anything because it is so dynamic as well as in an effort to not “add to the noise” (we have all received so many emails from everyone from various airlines to our favorite fast-food restaurants).  But for now, I wanted to offer some updates and some thoughts that I hope will be helpful.

What we know

The number of COVID-19 cases in the U.S. has increased significantly and quickly, is continuing to do so, and that pattern is likely to continue in the coming weeks and months. Currently, the risk of your child having COVID-19 – without a known exposure to someone with laboratory-confirmed COVID-19 and without international travel – still seems very low, certainly as compared to influenza and other seasonal respiratory illnesses. However, this is likely to change in the coming weeks and months as more community spread of COVID-19 is anticipated. Much of what is known about the illness itself is based on the experience of other countries as well as other parts of the U.S. that are further along in this new illness. At this point, it does appear that children are far less affected by the illness, remarkably less likely to have severe illness. However, as we focus on reducing community spread, it must be remembered that children are often the primary ones to spread respiratory illnesses, even when and perhaps especially when they do not have a severe illness.

What we don’t know

Part of what makes the current situation difficult is that there is still a lot of unknown, and everyone trying to predict the future (a difficult proposition at best) and then make decisions that will alter it in a better direction. Many of these decisions are difficult for us as individuals (inconvenient, expensive, frustrating) but are being made in the spirit of what is best for the community. The experience of other communities supports the position that extreme measures at the beginning are far more effective than extreme measures later. We will likely know far more in the next 2-4 weeks re: what our community is likely to experience, both in terms of number of illnesses and severity, even though the outbreak will undoubtedly continue far longer.

What we are doing

What are we as an office doing? There are a few ways we are acting differently, and in many ways, we are not doing anything differently. As an office, we are always trying to make sure our office is clean and the risk of exposure to infections is low; we always want to answer your questions re: your child’s health; we always are trying to communicate with you in a variety of ways. We meet as a team every day, and these days those meetings are as you would expect often a discussion of the current situation to make sure that we are all well-informed, on the same page, and doing whatever we can to serve the families of Middleton Pediatrics with excellence. None of that has changed, though we are trying to do even better in all these measures. In terms of things we are doing slightly differently, consistent with CDC and DOH guidelines, we are trying to ask about exposure risks before bringing patients into the office. If you suspect your child could have coronavirus infection, it is recommended that you call our office prior to coming in. Additionally, you can call your local health department (see our webpage for contact information) if you suspect that your child has COVID-19 or has had a definite exposure.

On our webpage, we have put together some helpful links, local hotlines, and trusted sources of information (see Keep checking as this will continue to be updated.

What we need

Issues like this demonstrate in many ways how connected we all are. Similarly, our responses must be done also with an eye towards the greater community, and our “living as a connected community” skills become even more important. These range from not hoarding toilet paper to not ignoring the recommendations of our health authorities. Some oft-stated reminders that are worth restating: wash your hands and encourage/teach your children to do the same; if soap and water are available, use soap and water and don’t worry about scrambling to find hand sanitizer; if you or your child is sick, please avoid going to public places. Two other communal “skills” are worth mentioning, specifically as they relate to pediatrics and children – staying well-informed and staying calm.

Re: staying well-informed – At this point, the amount of information circulating far exceeds the spread of the virus itself, and much of the information is likely inaccurate and/or incomplete. We encourage you to be wise about your sources and to follow their guidance, especially as it relates to limiting our gatherings with large crowds of people. It is imperative that we look to trusted sources (see webpage for a list of trusted sources). The CDC, WHO, local and state health departments, epidemiologists and infectious disease specialists are all working tirelessly on behalf of all of us, and we are grateful for these individuals and organizations. Additionally, our local hospital systems and their clinical staff have been amazing in their efforts of preparedness as they seek to serve our community. We are blessed by their work; many parts of the country and world are not as fortunate.

Re: staying calm – As is already being experienced, this situation has the potential to produce a lot of anxiety and we need to be sensitive to our children in this way. Though it is indeed good news that children seem less susceptible to this illness, they are acutely susceptible to catching our anxiety. They tend to “adopt” our disposition – if we are calm, they will be too; if we are anxious, they likely will be too. Usually talking about it with your children will help alleviate anxiety, not increase it, provided that we allow them to ask questions, share what they are worried about, and provide them with accurate information (and are careful to not let our own anxiety be inadvertently communicated to them). It can also be helpful to tell them that some really smart people, some of the smartest in the world, are working on this to help keep it under control and keep us protected. There are some other resources listed on our webpage, and we will continue to pass along good resources as we find them. Additionally, everyone (governments, schools, healthcare workers, sports leagues, etc.) is doing the best they can to determine how best to handle the unknowns of this situation, and it is in all of our best interest to be understanding as we work together to keep our community healthy.

As the coronavirus clears our calendars and turns down some of our activities, we encourage you to redeem the time as a family. Play some games with your kids; take walks; watch movies; play outside. Those may be the best things we can do for our family’s health during this time!

Thank you for the opportunity and privilege of serving your family.

Michael Middleton