Updates for the community from Shelly Voet, MD

May 25, 2020

I hope this letter finds you, your practice staff, and your families well.  I wanted to give you a brief update on my work this month with Jeff Anderson MD, the Community Practice Advisory Council, and Physician Outreach at CCHMC. 

As you know, May was a month of transition in our region, as restrictions on in person health care began to be lifted.  Most of us have carefully expanded in person care and are actively recalling our patients due for well visits and immunizations while maintaining safety guidelines.  Our CPAC group has worked with Physician Outreach at CCHMC to compile in one place for you the many helpful resources produced locally and nationally to support pediatric providers re-connecting with families.  If you have not had a chance to look recently, take a look at the resources under the Practice Resources tab: https://cincinnatichildrens.foleon.com/microsite/coronavirus-covid-19/home/

We have also added important clinical information regarding the newer manifestations of the disease in children, including information regarding the Multisystem Inflammatory Syndrome in Children.  Dr. Brad Sobolewski’s blog with review of information to date can be found on the site above.

We also recognize that re-opening our communities safely depends on access to testing.  I am happy to report directly from Dr. Jeff Simmons that testing pediatric patients at CCHMC has gone smoothly.  CCHMC is following CDC guidance on symptoms of COVID-19 when considering testing (see below).  While CCHMC is also testing a limited number of specific asymptomatic patients, the number of tests which are positive on asymptomatic patients is very low (less than 1%).  However, Dr. Simmons reports that pediatric patients with some consistent symptoms have higher rates of positivity (6-7%).  According to Dr. Simmons, “We believe we are all in a learning mode to better understand the pediatric nature of COVID-19, so do encourage primary care providers to consider testing more than they might routinely consider for viral illness in order to learn more about the disease and help track, trace, and isolate positive people in our community to limit spread.”

CDC lists pediatric symptoms as fever, cough, nasal congestion or rhinorrhea, sore throat, shortness of breath, diarrhea, nausea or vomiting, fatigue, headache, myalgia, or poor feeding or poor appetite. CDC lists adult symptoms as cough, difficulty breathing or shortness of breath, fever, chills, muscle pain, sore throat, or new loss of sense of taste or smell. 

In addition, CCHMC is testing specific asymptomatic ambulatory patients as follows:

·         Pre-Surgical/Pre-Anesthesia procedures

·         CBDI pre-admission for chemotherapy or BMT

·         Select Ambulatory pre-procedure high risk Aerosol Generating Procedures

·         Neonates with a COVID-19 positive mother (@ 24 and 48 hours)”

We were also grateful in May to have the chance to learn and connect with CCHMC faculty while we maintained social distancing.  In May, the first ever virtual Coffee with Colleagues was held with Dr. Kalyani Marathe from Dermatology.  Later in the month, we offered a live ENT update hosted by our East Region physician Jillian Schaffeld MD.  ENT faculty also provided four additional Practice Support Tools on topics we requested.   You can access those here

We will be providing more live updates from surgical specialists later this summer and will be discussing how to continue to offer some virtual events in the future.

As we move forward, we realize changes are not happening as rapidly but we are still learning about this pandemic. We recognize that there is still a need to provide a central location for resources, and regular communication about changes for pediatric providers.  We have elected to move to a weekly email summary (Tuesdays) and website updates as algorithms change.  A new feature to the Tuesday update will be Health Collaborative data from our region on COVID-19.

Thanks for all that you do for the children and families in our region,

Shelly F. Voet MD

Pediatric Associates PSC
Cincinnati Children’s Executive Community Physician Leader