This article appeared on Michigan Health Blog. Read the full story here.
As primary care clinics begin to ramp up usual operations, C.S. Mott Children’s Hospital’s director of general pediatrics discusses safety and the importance of staying up-to-date on well visits and vaccines.
Since the coronavirus has kept families home, children may have been unable to have important primary care appointments, resulting in them falling behind on their vaccine schedule.
But as COVID-19 cases begin to decrease in Michigan, primary care clinics are beginning to ramp up operations. For parents, that means it’s time to get little ones back in for their check-ups.
Some still may feel a little unsettled by the idea of making an appointment for an in-person visit, but here, director of general pediatrics, Kelly Orringer, M.D., addresses questions around safety and how appointments will be prioritized, so you know what to expect at your next appointment.
Reopening safely
The state of Michigan recommends wearing masks for entry into enclosed public spaces. The Center for Disease Control also recommends mask use for clinical encounters.
“In accordance with these recommendations, anyone entering a clinic will be screened when they enter the building, as well as the day before their appointment,” Orringer says. “If anyone in the family is feeling sick, we’ll try to reschedule the well visit and if we can’t, we’ll try to have a non-ill family member bring the child in.” All clinic staff will be required to wear masks, as well as all visitors age two and older.
In the waiting room, special floor markings will guide people on where to stand for checking in or out. To keep the waiting room at a lower capacity, patients at many clinics will also have an option to check-in electronically.
Additional measures to allow for more social distancing include being proactive in separating children with symptoms of illness and those who appear well. Children who need a regular wellness visit will have appointments in the morning while children with a fever or other symptoms of illness will have appointments in the later afternoon.
To assure even greater clinical safety, children who are suspected to have COVID-19 are seen in a separate clinic where they can be evaluated.
Although health services are separated in this way, it’s still important to allow enough time between appointments to thoroughly sanitize exam rooms to reduce risk of illness transmission.
“For the past few weeks, we’ve only been seeing patients every 30 minutes. This reduced schedule means fewer people in the waiting room at a time and more time for disinfecting surfaces,” Orringer says. Other common areas, like restrooms, will be sanitized often, particularly frequently touched surfaces like doorknobs and railings.
Currently, all consolidated clinics are expected to reopen and increase capacity over the next six weeks.
Making an appointment
As clinics begin to expand services, patients may feel ready to make an appointment with their child’s primary care provider, with the following types of appointments being prioritized:
- Well-visits for children two-years-old or younger
- Any child needing a wellness visit in addition to immunizations
- For any parent with an urgent concern about their child’s growth, development or behavior
“Since the pandemic, our clinics’ virtual health care capacity has significantly expanded. Virtual visits help us practice social distancing, but can also be beneficial for a variety of conditions by allowing patients to receive their care from anywhere,” Orringer says. A virtual visit can be requested through the patient portal or pediatrician’s office.
Conditions that may be well-suited for virtual care include:
- Rashes
- Diarrhea
- Cough
- Feeding problems
- Constipation
- Sleep issues
- Other behavioral issues
If an in-person appointment is preferred, clinics are expected to open to anyone who needs a wellness visit without immunizations by mid-June.
“A message through the patient portal will be sent to parents of children overdue for a wellness check with immunizations in the upcoming weeks,” she adds.
Prioritizing immunizations
COVID-19 has painted a frightening picture of what a world without a vaccine looks like. It’s important to fight preventable, infectious diseases by receiving vaccines that already exist and doing so on-time.
“Vaccines are most effective if given on a recommended schedule. You can miss the window of greatest protection possible if there’s a significant delay in when you receive a certain vaccine,” Orringer says. “There should be urgency around this issue and that’s why we want to see these children as soon as possible.”
According to a recent study from the Centers for Disease Control and Prevention, fewer than half of infants 5 months or younger in Michigan are up to date on vaccines: an alarming side effect of the COVID-19 pandemic.
Getting vaccinated not only protects from potentially deadly diseases, but also helps protect immunocompromised individuals around you that may not be able to get vaccinated, Orringer says.
“Like the commitment to staying inside and social distancing when in public spaces, there’s an obligation to do our part in keeping community members safe by receiving vaccinations,” Orringer says. “The stakes are too high to do otherwise.”