Increased demand for COVID-19 testing swamps NC pediatricians

Getty Images photo by Drazen Zigic

The Goldsboro Pediatrics medical team sees a steady stream of patients from 8 a.m. to 5 a.m. or 6 p.m., their appointment schedules swelled by parents wanting COVID-19 testing for their children.

Slots for the 8:00am to 9:00am walk-in hours are usually filled by 8:30am, said Dr. Teague Horton, a partner in the practice.

Some children exposed to COVID-19 at school must be quarantined. They must test negative for COVID-19 to shorten their quarantine from 10 days to seven days if they have no symptoms.

“The poor parents say, ‘Help me so I can get my kid back to school,'” Horton said in a recent interview.

dr. Teague Horton

In addition, schools exclude students who show symptoms of COVID-19 infection, such as fever, headache, congestion or a runny nose. Many symptoms are identical to other common illnesses, leading parents to seek tests to find out if their children have COVID-19.

“Any child who is in school or daycare, or develops an illness — anything with a fever, cough, runny nose, diarrhea — needs to have proof it’s not COVID to return to school or daycare,” said Dr. Ed Pickens, a UNC Health pediatrician who works in Durham. “We do a lot of testing of children so they can be released so they can go back to school. It is not easy to predict who is positive. Most diseases have the same symptoms as COVID.”

dr. Ed Pickens

Schools opened this year amid a spate of COVID-19 infections caused by the highly contagious Delta strain. The State Department of Health and Human Services reported COVID-19 clusters at more than 250 schools and childcare locations on Tuesday. DHHS defines a “cluster” in a daycare or school as a minimum of five confirmed cases with positive test results within a 14-day period, with a plausible relationship between the cases.

Earlier this month, the State Department of Health and Human Services noted the dramatic increase in childhood COVID-19 cases. “Our cases are highest for children 17 and under,” Secretary of State Mandy Cohen said at a news conference on Sept. 9.

The eight-year-old daughter of Goldsboro resident Ashley Jones came home from school a few weeks ago and told her grandmother that one of her classmates had COVID. Jones said she had never heard from the school, but a few days later her daughter started coughing and ran a 103.6-degree fever.

Jones was able to get her daughter an appointment at Goldsboro Pediatrics the next day for a COVID-19 test, which was positive.

This was after her daughter’s routine checkup was shifted from August to December.

“COVID has flooded the office,” she said. “You can’t even get regular health appointments.”

COVID added an extra layer of stress to all the emotions that come with a new school year.

“I was nervous to send her back this year,” Jones said. She sent her daughter to school with hand sanitizer and reminders to keep her mask on. “To send her there and have her come home with COVID is very, very nerve-wracking.”

dr. Christoph Diasio

dr. Christoph Diasio, president of the NC Pediatric Society, called COVID “a sneaky virus” because its early symptoms are so similar to common illnesses.

Diasio said the Sandhill Pediatrics offices where he practices, like the offices of other pediatricians, are juggling increased demand, nursing staff shortages and the need to separate patients who may have COVID-19 from others. All this at a time when doctors are adjusting to new routines with the recent move to Medicaid managed care.

“We’re actually busier than ever and everything is more difficult because of COVID,” Diasio said. “It’s higher patient volume, less supply and administrative complexity.”

Gov. Roy Cooper signed an Executive Order Friday that gives parents more time to schedule medical appointments needed for school, acknowledging the increased demand for pediatric practices.

“One of our top priorities as we continue to fight the COVID-19 pandemic is keeping children in classrooms, and offering extended periods of time to complete these important health activities will help achieve that goal,” Cohen said in a press release. in which the implementing decree was announced.

Usually, welfare checks and proof of immunization are required for children entering public school for the first time within the first 30 days. Under the new order, parents have until November 30 to show proof of an upcoming appointment.

While COVID-19 testing is a major reason for the rush at pediatric offices, the state also saw spikes just as school began in croup and RSV, or respiratory syncytial virus, illnesses typically seen in colder months.

“The seasonal patterns for many of these infections are far off right now,” says Pickens, the UNC physician.

There were few cases of flu and RSV last winter, he said, possibly because the school was online and people were wearing masks. “We don’t know what the coming winter will look like,” Pickens said.

The Centers for Disease Control and Prevention recommends masks in schools for students and adults. A CDC study published this week found that schools that opened without mask requirements were 3.5 times more likely to have COVID-19 outbreaks than schools that required masks.

“We have a very difficult situation at the moment and we are trying to find the best way,” said Diasio. “It’s all about ‘How do we keep kids in school.’” Vaccinate as many children as possible. Keep wearing masks.”

Getting more kids vaccinated “is something that would really help,” he said.

People 12 years and older are eligible for the Pfizer vaccine. On Tuesday, Pfizer and BioNTech submitted data to the FDA as a step toward seeking emergency use approval so that children ages 5-11 can take the shots.

Increased COVID-19 cases in children can have devastating ripple effects as they can spread the virus to vulnerable family members.

That’s what happened to Jones’ family in Goldsboro. She contracted the virus for a second time, even though she had been vaccinated, as did her elderly parents who share a house with her and her daughter.

All have recovered except Jones’ mother, who spent a week in the hospital.

“It’s damaged her lungs so much that she’s still dependent on oxygen,” Jones said. Her mother seems to be getting better, then there is a setback.

“We believe in God that she will come home.”

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