Parents:

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Dear Parents:

Please be advised that we are now requiring that all patients over the age of 2 years and the accompanying parent must have some type of face covering upon coming into the office. It can be any type of mask, scarf or bandana. Unfortunately, we do not have masks available to give out. 

Additionally, we are having to reinforce the policy that only one parent/guardian can accompany the child to the office. If more than one parent comes to the office, we will have to ask that one parent waits in their vehicle.

Dear Parents and Families

Since our lives do not seem to be improving quickly and we are all being confused by conflicting information from all sources, I thought it might be helpful to all of you if I simplify some of the currently known information on the COVID illness and management efforts. I realize that this information may be lengthy and detail oriented, but I feel it is important that you fully understand the efforts being made to protect your families.

First of all, as it relates to children, the SARS-corona virus seems to manifest itself mildly in most cases. Although children can contract and transmit the disease as easily as adults, many of them have no symptoms at all or have unique findings not seen in adults. Some children have developed odd rashes on their feet and toes before they have obvious disease. Children also seem to have a tendency to develop gastrointestinal symptoms such as nausea, vomiting, diarrhea and abdominal pain as well common symptoms such as sore throats and headaches. Except in special cases involving children with pre-existent chronic conditions, children rarely develop the lung complications which adults can develop, and which requires them to receive oxygen therapy and ventilator support.

Obviously, as we eventually find ways to treat those who become ill using effective therapies or prevent infection in the first place using vaccinations, it becomes obvious that the need to monitor children closely when they become ill is critically important. Unfortunately, possible medications and vaccines must first be trialed and tested in adults, followed by careful clinical studies in children to ensure that they are both safe and effective. As you might realize, treatments for this illness in children will not be available anytime soon. I do however, plan to participate in clinical trials that we feel are safe and yet offer our patients the opportunity to receive therapies earlier than usual. I caution you not to run out and obtain various medications as they are discussed in the media until we are sure they are truly effective, since they may also have untoward and unpredictable side effects. As new treatment options become available, I will keep all of you informed.

When we consider testing for COVID, we can compare testing methods that we currently use for other diseases such as influenza and Lyme disease. There are a variety of testing approaches for illnesses by which test for the presence of the germ or virus itself or test for a patient’s response to an infection after they have developed it. To test for the actual illness, tests can employ a method which either looks for a protein specific to the germ or look for the specific genetic makeup of the disease. These tests can be very sensitive and specific and can detect the presence of disease even before we have symptoms, or our body responds to it by making antibodies. These tests can provide results within hours when available. Testing for our body’s response to an infection can be tested for by looking at specific antibody responses. These “serologic” tests can tell us if we have had a recent infection or a prior infection which we have recovered from. These tests do however have potential shortcomings with regards to their sensitivity and specificity (accuracy) and can be negative if we test for it too early in the illness. Using both of these tests together, however, can offer us the advantage of picking up early disease and allowing us to determine our response to the infection. Although these tests are not routinely available for COVID at this time at doctor’s offices, we anticipate their availability within the next couple of months.

Finally, we will eventually be dealing with the availability of an effective vaccine, which will provide us with a means of avoiding the disease to begin with and to limit the spread of it, especially to those who are vulnerable to life-threatening complications. Currently there are a number of vaccine trials underway which are using either antigens or proteins from the virus itself or using genetic vaccines which provide “instructions” to our immune cells to make antibodies against the virus. Not only will it be necessary to assess the effectiveness and safety of these various vaccines, but we will need to determine how “durable” or lasting the protective effect of a particular vaccine is. 

Again, the use of these vaccines in children will follow studies in adults as well as eventual trials in children of various ages. Hopefully our office will be able to participate in some of these trials which we believe can offer the greatest potential benefit, while being as safe as possible.

I hope that this has been helpful to you and please let me know if I can answer any related questions. Please stay healthy and safe and know that we are all here to assist you with caring for your families.

Sincerely, 

Dr. Dracker