The Tarrant County Public Health Department reports an increase of 17.5% of cases for adults and children. Denton County Public Health Department has reported 318 positive flu cases and 35 hospitalizations as of Dec. 27, 2025. While the state has not reported any pediatric deaths, there have been eight in the United States. 

 Cook Children’s pediatricians are sharing what parents should know when it comes to the flu and other respiratory illnesses.  

Signs and Symptoms 

Flu, RSV and COVID-19 are caused by different viruses, but all are upper respiratory illnesses that share similar symptoms such as: 

• Fever
• Cough
• Fatigue
• Sore throat
• Runny or stuffy nose
• Muscle pain and body aches
• Headache
• Vomiting and diarrhea
• Loss of appetite, taste, or smell
• Shortness of breath 

Managing Symptoms 

If your child is sick, call your pediatrician first. They can help you decide whether to take your child to the doctor's office, urgent care, or the emergency room. For many children, viral illnesses like the flu, RSV, and COVID-19 can be managed at home with supportive care. Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and discomfort. Avoid ibuprofen in infants younger than 6 months. 

Maintaining hydration is crucial. Please encourage your child to drink fluids and consider giving them electrolyte drinks or popsicles. Saline nasal drops and cool-mist humidifiers can help alleviate congestion. 

A fever is defined as a temperature of 100.4 or above. A temperature above 100.4 in babies less than 2 months old is a medical emergency and needs to be evaluated in the emergency room. Any fever lasting longer than four to five days, or one that continues to climb and does not break with fever reducers, should be evaluated by a physician. 

When to Seek Medical Attention 

While most cases can be managed at home, it's essential to recognize the signs of respiratory distress or dehydration, which require immediate medical attention. 

Signs of respiratory distress: 

• Increased number of breaths per minute
• Increased heart rate
• Bluish color around the mouth, on the lips, or on the fingernails
• Pale or grayish skin
• Grunting sound during exhale
• Nose flaring
• The chest appears to sink in with each breath
• Head bobbing when breathing in
• Change in alertness  

Signs of dehydration: 

• Urine output is significantly below the child’s normal (at least once every 8 hours)
• Not producing tears when crying and the eyes appear sunken
• In infants, the soft spot on top of their heads looks sunken
• Dried mucus membranes (lining within the nostrils, mouth, throat)
• Sleepy and unresponsive  

If your child exhibits any of these signs, seek immediate care at an urgent care facility or the emergency department. Reserving visits to urgent care or the emergency department for truly urgent needs helps ensure timely care for those who need it most, reduces waiting times for everyone, conserves resources, and limits your child’s exposure to other viruses. 

Prevention is key 

Kara Starnes, D.O., medical director of Urgent Care at Cook Children’s, encourages parents to practice prevention. Dr. Starnes says one key way to prevent the flu is vaccination.

“The flu vaccine provides the best chance at preventing the more serious complications of the flu,” said Dr. Starnes. “While a flu vaccine may not always completely prevent the flu, it typically makes the illness much less severe and of a shorter duration. It is not too late to get a flu shot, even if you or your child has had the flu.”

• Keep your children at home and away from public areas if they are not feeling well
• Wash your hands
• Cover your nose and mouth when sneezing and coughing
• Avoid touching your nose, mouth and eyes
• Avoid close contact with people who are sick
• Get a flu vaccine for you and your child 

Five years later, we reflect on all that has occurred and changed since March 4, 2020. We asked Cook Children’s employees to reflect on their experiences during the COVID-19 lockdown and how they experienced growth, loss, and change.

El martes, Cook Children's Medical Center en Fort Worth atendió 572 pacientes en el departamento de emergencia. En los siete Centros de Cuidado de Urgencia hubo 842 pacientes. Entre el 10 de noviembre y 16 de noviembre Cook Children's Medical Center en Prosper evaluaron a 113 pacientes por Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) y 29 resultaron positivos.

Cook Children's Medical Center en Prosper también ha notado un gran volumen de pacientes en la sala de emergencia. La mayoría de los pacientes admitidos ha sido debido a VRS, influenza o neumonía.

El aumento de las visitas al hospital se debe a una fuerte propagación del VRS y neumonía ambulante (mycoplasma pneumoniae) en Dallas-Fort Worth.

Cada año por estas fechas, los casos de VRS aumentan más rápidamente de lo habitual este año, dijo El Director Médico de Servicios de Emergencia, Dr. Taylor Louden.

"Hemos visto a más de 1,100 pacientes en los últimos dos días a través de la sala de emergencias, y ha sido es muy difícil para nosotros manejar este volumen de una sola vez", dijo Louden.

De los 972 pacientes examinados en Cook Children's Medical Center entre el 10 y el 16 de noviembre, el 39% de los niños tenían VRS o neumonía ambulante. De ellos, 224 dieron positivo para el VRS y 99 resultaron positivos para neumonía.

¿Qué es el VRS y cuando debo de ir a la sala de emergencia?

El VSR generalmente afecta más a niños menores de dos años y puede causar una acumulación de moco y congestión que dificulta la respiración de los niños. Los padres deben tomar precauciones para limitar la propagación del virus. Quédese en casa si están enfermos. La vacuna contra el VRS está disponible para mujeres embarazadas, bebes, y personas mayores.

Si su hijo está enfermo, los padres y cuidadores pueden ayudar a reducir el estrés en el sistema de servicios de emergencia sabiendo cuándo llevar a su hija a la sala de emergencia y cuándo programar una cita. Limitar el tráfico de la sala de emergencias a verdaderas emergencias ayuda a evitar que el sistema se sobrecargué.

Si su hijo está enfermo, pero no tiene problemas agudos, consulte con su pediatra. Si es posible, programe una cita con unos de los Centros de Cuidado de Urgencia en lugar de visitar la sala de emergencias.

El tratamiento para el VSR es monitoreando y tratando los síntomas. No hay cura para el virus. Muchas enfermedades respiratorias virales se pueden tratar en casa con descanso, hidratación y electrolitos. Para la congestión, los padres y cuidadores pueden usar solución salina nasal para diluir la mucosidad y succionarla con una pera.

¿Qué es neumonía ambulante?

Desde el verano casos de neumonía ambulante han estado alto, dijo Louden. Entre el 10 y el 16 de noviembre, 99 niños resultaron positivos para la enfermedad. A comparación del año pasado, durante la misma temporada, Cook Children's reportó menos de 10 de casos de neumonía ambulante entre agosto y diciembre.

La neumonía ambulante suele afectar a los niños en edad escolar. Algunos de los síntomas incluyen: fiebre leve, fatiga y tos. La mayoría de los casos de neumonía atípica se pueden tratar con antibióticos, pero si su hijo tiene neumonía y ha tenido fiebre durante más de cinco días y/o dificultad para respirar, busque atención de emergencia.

La neumonía, el VRS, la gripe y el COVID-19 pueden tener síntomas similares. La gripe y el COVID-19 también pueden incluir dolor de garganta, dolores de cabeza, dolores corporales, escalofríos y cambios/pérdida del gusto y el olfato. Los padres no deben acudir a atención de urgencia ni al departamento de emergencias para hacerse una prueba de RSV, gripe o COVID. Su pediatra puede realizar pruebas para todos estos.

En muchos casos, los médicos pueden evaluar y tratar a un paciente mediante una cita de salud virtual. Descargue la aplicación MyCookChildrens para programar una cita virtual de salud/telemedicina aquí.

¿Cuándo acudir la sala de emergencia?

•  La temperatura mayor de 100.4F o 38°C en bebes menores de dos meses, es una emergencia médica.
•  Si su hijo tiene fiebre por más de tres días, comuníquese con su pediatra o el centro de cuidado de urgencia.
• Preocupación por deshidratación.  En bebes deshidratados habrá menos pañales mojados o falta de lágrimas. La fontanela hundida puede ser un signo de deshidratación.   
• Su hijo está respirando inusualmente rápido y se puede ver la piel entre las costillas.
• Su hijo requiere más su inhalador de rescate o los síntomas de asma empeoran

Síntomas

Síntomas de Virus Respiratorio Sincitial (RSV, por sus siglas en ingles) en bebes menores de 6 meses:

• Irritabilidad
• Letargo
• Apetito reducido
•  Episodios en donde dejan de respirar
•  Fiebre

Síntomas en bebes y niños mayores de 6 meses:

• Mocos
• Congestión
• Apetito reducido
• Tos
• Estornudos
• Fiebre
• A veces sibilancias

¿Cómo prevenir?

•  Nunca es tarde para vacunarse. Llame a su pediatra para obtener la vacuna contra el COVID-19 y la influenza.
• Adopte buenas prácticas de higiene como cubrirse al toser y estornudar.
•  Lavarse o desinfectarse las manos a menudo.
•  Limpiar las superficies que se tocan con frecuencia.
•  Si usted o su hijo se sienten mal, quédense en casa para prevenir la propagación de enfermedad. Tome tiempo para descansar y manténganse hidratado.

COVID-19 Heroes and Memorial Day was created to officially recognize the front-line workers whose steadfast commitment kept Texans safe during the COVID-19 pandemic and remember the nearly 95,000 Texans who lost their lives to the disease. Other Texas hospitals also commemorated the day.

At Cook Children's Medical Center - Prosper, employees gathered to receive a blessing and honor those we lost in a moment of silence led by chaplain Amanda Payne Lindsay, M. Div. There was also an opportunity to spend time in a reflective prayer activity and grab a pin to support this day. At Cook Children's Medical Center - Fort Worth, employees similarly gathered to receive a blessing and recognize the day in a moment of silence led by Jennifer Hayes, MDiv, BCC, Director of Spiritual Care at Cook Children’s. There was also a display for employees to participate in by sharing who they are both honoring and remembering today. 

Of the more than 800 patients tested for RSV last week at Cook Children’s, more than 200 (29%) were positive. Four percent of those tested for COVID-19 were positive. The Emergency Department (ED) at Cook Children’s in Fort Worth is treating more than 500 patients a day. An additional 800 patients a day are seeking treatment at one of Cook Children’s seven Urgent Care Centers (UCCs). The influx is leading to over-crowded waiting rooms and long wait times across the board.

These numbers are expected to climb as we move closer to peak respiratory illness season, typically December through January.

Parents and caregivers can help reduce the stress on the system by knowing when to call your child’s physician and when to seek emergency care. Doctors say following these guidelines can reduce traffic to EDs and UCCs, reduce wait times for patients and reduce your child’s exposure to viruses.

Many viral respiratory illnesses can be treated at home with rest and lots of hydration. If you are concerned, call your pediatrician first if your child is experiencing mild symptoms without difficulty breathing or dehydration, or for illness-related symptoms (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

In many cases, physicians can assess and treat a patient via a virtual health appointment. Not only is this a convenient option that saves time, but it keeps you and your child out of a waiting room where they could pick up another virus on top of the one they already have.

Download the MyCookChildrens app to schedule a virtual health/telemedicine appointment here.

Parents should not go to Urgent Care or the Emergency Department for an RSV, flu or COVID test. Your pediatrician can test for all of these.

When to Seek Immediate Care:

●      Any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency. If your child has a fever for more than three days, contact your pediatrician or visit an urgent care center. 

●      Concerns for dehydration. In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.

●      Your child is breathing faster than usual or you can see the skin between the ribs being sucked in.

●      If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.

Signs and Symptoms

Symptoms of RSV in infants younger than 6 months may include:

●     Irritability

●     Poor feeding

●     Lethargy

●     Episodes where they stop breathing

●     Fever

Infants and children over 6 months may experience:

●     Runny nose

●     Loss of appetite

●     Cough

●     Sneezing

●     Fever

●     Sometimes wheezing

Flu and COVID-19 share similar symptoms as RSV and may also include sore throat, headaches, body aches, chills and change/loss of taste and smell.

Practice Prevention

When it comes to respiratory illnesses, prevention is always the best medicine, especially as we approach the holidays and the many indoor gatherings they bring. Vaccines can help reduce the spread and severity of illness and prevent hospitalization. It’s not too late to get your child’s flu shot or COVID vaccine. Call your pediatrician to make an appointment.

Remind your children to practice healthy habits such as washing their hands and coughing into a tissue or their elbow. If you or your child feels sick, stay home to prevent spreading illness, take time to rest and stay hydrated with lots of fluids.

As COVID-19 cases rise at Cook Children's, the Food and Drug Administration has approved an updated COVID vaccine.

The Centers for Disease Control and Prevention recommends that anyone 6 months and older should get the new shot to protect against serious illness.

COVID cases at Cook Children’s Medical Center have been steadily increasing since early July. From the week of Sept. 17 through Sept. 23, the positivity rate is 10% or 69 positive cases out of 679 patients tested.

The new vaccines from Pfizer and Moderna are matched to protect against the most common COVID variants circulating now. Please contact your pediatrician's office to schedule an appointment.

The fall and winter months are a common time for respiratory illnesses to spread in our community; in addition to COVID-19, there is typically a rise in flu and RSV cases.

Schedule you and your child’s flu shot as soon as possible to help prevent severe illness and spread of the flu.

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. It is the leading cause of hospitalization for infants, who are much more susceptible to the disease.

This year, infants will have a better chance of protection if they receive the new monoclonal antibody injection for the prevention of severe RSV, which has been shown to reduce the risk of hospitalization and health care visits in infants. This one-time injection was recently approved by the FDA and recommended by the CDC. The treatment will be available at Cook Children's pediatrician offices soon.

Laura Romano, D.O., a hospitalist at Cook Children’s Medical Center, answers some of the top questions from parents regarding these respiratory illnesses, treatment and prevention.

COVID

What are COVID cases like right now? Why should my child get the new COVID vaccine?

Positive COVID cases at Cook Children’s Medical Center have been steadily climbing since the end of June and early July. Across the country, there are higher rates of COVID hospitalizations in both adults and pediatrics. Your child should get a yearly COVID vaccination because we know that this will protect them. People who are vaccinated against COVID have a significantly decreased risk of hospitalization, ICU admission, and death.

What are the symptoms of most COVID cases right now?

Symptoms are mainly upper respiratory symptoms (cough, nasal congestion, sore throat). It’s also causing fevers, muscle aches, and fatigue. And yes, these symptoms are very similar to the flu! 

Should my children and I be wearing face masks? 

You should consider wearing a mask if you, your child, or anyone in your home is at high risk for severe COVID-19 infection. This includes people who are 65 years and older and people with certain medical conditions such as heart conditions, lung disease, diabetes, sickle cell, or a neurologic condition.

During flu, RSV, and COVID-19 seasons, it is very reasonable to wear a mask whenever you are in crowded indoor spaces. This includes pediatric office and emergency room waiting rooms!

My child is involved in many in-person activities this fall. What can we do to protect against COVID?

• Consider wearing a mask
• Get the latest vaccine
• Stay home if you are sick

My child’s classmate tested positive for COVID. What should I do?

• If your child is having symptoms, test immediately. If the initial test is negative, repeat in 48 hours if your child is still symptomatic.
• If your child does not have symptoms, wait five days and take another test.

If my child received a COVID vaccine more than six months ago, should they get the new vaccine?

Yes, they should! The CDC recommends that anyone 6 months and older who is two months out from their last COVID vaccine get the new vaccine.

Will it protect my child against the latest variant?

Yes, the newest vaccine was designed for the currently circulating variants so it should help protect your child.

FLU

What are flu cases like now? When is flu season?

Flu cases are currently low at Cook Children’s. Flu season typically begins in the late fall and stretches into the winter. However, last year we saw unprecedented numbers of influenza very early in the season.

Why should my child get a flu shot?

 Flu vaccines help protect against severe cases of the flu. If your child gets the flu vaccine, they may still get the flu, but they will have more mild symptoms and should not need to be hospitalized with a severe infection.

When will flu shots become available?

Flu shots are currently available at many Cook Children’s pediatrician offices. Check with your pediatrician’s office. Many local pharmacies have them as well.

RSV monoclonal antibody shot

What age groups can get the RSV monoclonal antibody injection?

Infants under 8 months during their first respiratory season and children who are at high risk up to 24 months of age. Talk to your pediatrician about your child’s risk, especially if they have a history of prematurity, heart disease, or chronic lung disease.

What should parents consider with this antibody treatment?

Our babies and infants are the most vulnerable population during cold and flu season so this will give them some protection and lower the chances of having a severe infection.

RSV can cause symptoms ranging from a runny nose to respiratory failure, requiring an ICU admission. It usually causes mild, cold-like symptoms, but it can be serious, especially for infants.

RSV causes bronchiolitis, which can be very serious and sometimes fatal in babies. The new antibody treatment has been shown to reduce the risk of hospitalization by nearly 80%, according to the CDC.

When will the new antibody be available?

The new antibody treatment will be available soon. For newborns, it may be given in the nursery prior to your infants discharge after birth. For older infants, families should reach out to their pediatrician about availability.

Will my child show symptoms once they receive the antibody shot?

Your child may still get symptoms of RSV after receiving the treatment but they are expected to be less severe.

Your doctor will monitor for any signs of a reaction during the infusion and after with your assistance.

How long is it effective?

Since this is an antibody and not a vaccine, it is designed to provide a temporary boost in immunity only. It will provide short-term protection lasting about 5 months which should cover the 2023-2024 RSV season.

If my child previously had RSV, do they have antibodies?

Yes, but the antibodies your body’s immune system makes to RSV last only two to three months. It is very possible for a child to get RSV multiple times in one respiratory season.

Related stories:

• Fighting RSV: Physicians Say New Antibody Shot Could be Game Changer 
• CDC Recommends RSV Shot for Infants. Infectious Disease Doctor Shares What Parents Need to Know 
• Curious About Health and Safety Requirements at Day Care? We Have Answers
  
   

Cook Children’s Medical Center has completed its new infectious diseases critical care unit (CCU), meeting the need for a clinical facility dedicated to the treatment of patients with contagious illnesses.

The expansion ensures children with highly infectious diseases will be treated in the safest environment possible. The unit’s design and technology allow for the treatment of the sickest patients while also protecting Cook Children’s staff and the community from the spread of illness.

While the need for the unit first appeared on Cook Children’s radar several years ago when Ebola made its way to U.S. shores, the COVID-19 pandemic shined a light on its importance once again.

“COVID-19 overwhelmed us and we had a hospital full of kids with COVID during the Omicron surge,” said Marc Mazade, M.D., medical director of infection control and prevention at Cook Children’s. “But we only saw a modest number of kids with COVID-19 who really needed care in the pediatric intensive care unit (PICU), and most of them graduated out of the PICU pretty quickly in comparison to the much sicker adolescents with severe lung manifestations that we saw with the first two waves of COVID. We have to be prepared to deal with whatever comes and this new unit will help us to do that.”

The overall expansion for the preparedness of current and future pandemics includes the new six-bed infectious diseases CCU and a 24-hour solutions center with dedicated incident command space. In addition, a new 32-bed medical-surgical unit was added to expand Cook Children’s ability to meet the hospitalization needs of the growing communities it serves.

“I work for a system that pursues whatever is needed to improve a child’s health or save a child’s life,” said Mary Suzanne Whitworth, M.D., medical director of infectious diseases at Cook Children’s. “This new infectious diseases CCU is that next great opportunity and we are all thrilled to be a part of it.”

The pandemic showed us all how important it is to feel close to your family members, even if you can't be in the same room. In September 2020, a Cook Children's dad went viral for dancing in the parking lot during his son's cancer treatments. Due to the COVID-19 restrictions at the time, only one parent or caregiver could attend appointments with patients. 

These new infectious disease critical care units will make seeing family much easier with Virtual Connect – think FaceTime but for hospital rooms. Doctors and clinicians will also be able to visit with patients through Virtual Connect.

This will allow all “dancing dads” to connect with their child if they can't physically be at the Cook Children's Medical Center.

Family-Centered Safety

Since the start of the pandemic, much has been learned about how to maintain safety for staff and guests and expertly care for infectious disease patients now and in the future.

These best practices and protocols are standard design in the infectious diseases units, which feature specialized air ventilation systems, dedicated areas to put on and take off personal protective equipment (PPE), and technology that allows clinicians to closely monitor a patient without having to be directly at the bedside and other heightened protection measures to contain disease spread.

“These units will be used in an effort to place potentially contagious patients in one area,” Dr. Whitworth said. “The goal is to have everybody in one unit with every employee in that specific unit dedicated to being experts in proper PPE donning and doffing, patient and visitor flow and all of the aspects of interrupting the spread of an infectious disease.”

Maintaining a family-centered and supported environment also influenced the design of the new infectious diseases CCU. The decision to limit visitors to Cook Children’s Medical Center during the pandemic was a difficult one for everyone. While Cook Children’s patients have always been allowed at least one family member at their bedside during the outbreak, the spread of the virus demanded that administrators take steps to protect employees and vulnerable patients by restricting the visitation of others within the family unit.

“Segregating families is not who we are as an organization,” said Stan Davis, chief operating officer at Cook Children’s Medical Center. “We promote that when a child is sick and in our hospital, they need family at their bedside to help with treatment and healing. This unit allows our staff to feel comfortable that they’re in the right environment and have the right precautions to be comfortable treating patients, and it allows our community to understand that in addition to having the best nurses, therapists and support folks in the world, we have the right environment to keep families together.”

Each of the new infectious diseases CCU rooms will have a private bathroom, an accommodation not available in the previous critical care space used for contagious patients. This allows parents to stay in the room with their child as long as they would like and reduces the in and out traffic of a parent who may have the same illness as the child due to exposure. Dedicated entrances and exits to these units for staff and visitors will help protect the general hospital environment.

“It’s our responsibility to re-too in order to deal with situations and illnesses such as the re-emergence of SARS which resulted in lots of health care worker deaths in Canada, for COVID-19 variants already circulating, for Middle East respiratory syndrome (MERS), for avian flu, for new and old world hemorrhagic fever viruses, or for bioterrorism-related infections like anthrax,” Dr. Mazade said. “We’re excited to have the facility to do that better than ever.”

To open up space for the infectious diseases CCU, the Cook Children’s simulation lab was relocated. The simulation lab is an educational space where staff practice using new technologies, innovations and research. Last year, Cook Children’s was the first freestanding children’s hospital in the world to receive full accreditation through the Society for Simulation in Healthcare. The relocated lab allows for the future expansion and growth of this program.

System-Wide Solutions

The design of the new 24-hour solutions center was inspired by lessons learned about system-wide coordination and cooperation throughout the pandemic. Members of all 14 of Cook Children’s Health Care System’s entities worked together in the medical center’s incident command center to coordinate a consistent response to COVID-19 across the entire organization. This consolidation and cooperation allowed Cook Children’s to be nimble, flexible and quick to the ever-changing environment.

The new solutions center will operate year-round under the same premise of consolidation, coordination and consistency. It will be a one-stop shop for staff and guests of any one of Cook Children’s entities to report or request assistance with a facility or operations issue.

“The solutions center will be a single touch point for staff, patients and families, in terms of who they contact for assistance with an operations issue at one of our facilities,” Davis said. “The consolidation that will occur is that there will be a joint information system—a communication hub, if you will—that everyone in the system uses, and the issue will be triaged and assigned from there. It’s similar to what you see with a technology help desk.”

Inside the solutions center is a dedicated incident command center equipped with meeting space that accommodates proper social distancing protocols and communication technology that supports real-time global health updates for rapid, informed decision-making. This is a much-needed upgrade from the classroom that doubled as an incident command center during the height of the pandemic.

“We’ve learned with COVID-19 that hospitals can become overwhelmed rapidly,” Dr. Mazade said. “Planning for staff shortages, getting supplies, developing protocols, and getting our teams the most up-to-date information ASAP while combating misinformation is vital to everyone in the organization, to our community partners, and to our community. We need an up-to-date, world-class incident command station built for that.”

Cook Children’s Health Foundation’s Protecting your Tomorrows campaign helped make the expansion and improvements possible. Thanks to the generosity of donors, Cook Children’s is more equipped than ever before to care for children during a pandemic or outbreak of any infectious disease. For more ways to support our patients, staff and families, visit cookchildrenspromise.org. If you’d like to join the Protecting Your Tomorrows fundraising effort, contact Cook Children’s Health Foundation at 682-885-4105.

As you can imagine, this has led to frustration for those seeking care. Our exhausted staff has heard an abundance of complaints and mean comments that are discouraging when they are working so hard to serve our patients and families. Unfortunately, they are outmatched by the demand.

Here’s what we know:

1. The vast majority of patients in our UCCs and ED have upper respiratory infections like colds.
2.  Most COVID-19 tests are coming back negative.
3.  All of our pediatrician offices offer COVID testing and it’s safe to wait one to two days for COVID testing if you plan to keep your child at home.
4. If your pediatrician does not have available appointments for your child’s cold symptoms, there are at-home COVID-19 tests available in stores currently.
5. Minor concerns like sore throat, cough, low-grade fever, diarrhea and other stomach problems are issues your pediatrician can help with.
6. The ED should only be used for severe symptoms and injuries.
7. The UCC should be used for moderate symptoms and injuries.

Media partners: If you are interested in telling this story, please contact Public Relations Manager Kim Brown at Kim.Brown3@cookchildrens.org or at 682-885-1080, 817-266-3728

For information about some common questions we hear, take a look at these articles:

• My Child's Fever Isn't Going Away. Should I Be Worried? (checkupnewsroom.com)
• Fever, Headaches and Stomach Pain. When Should You Be Concerned? (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)
• 5 Reasons Why Your Child's Coughing Is A Good Thing (checkupnewsroom.com)
• Let's Learn About Fevers (checkupnewsroom.com)
• How Much Sickness Is Too Much? (checkupnewsroom.com)

For the second year in a row, Cook Children’s Emergency Department and Urgent Care Centers are seeing a big influx of parents bringing in children who have been exposed to COVID-19 but show no symptoms. This is causing long wait times at all locations and putting unnecessary strain on the health care system.

On Monday, Aug. 29, our Emergency Department (ED) staff saw 614 patients, which is equivalent to a patient checking in every 2 minutes for 24 hours straight. That’s nearly double the number of patients we typically see in the ED. Our seven Urgent Care Centers (UCC) saw 873 patients, which is also much more than usual.

“We are seeing patient volumes equivalent to our worst winters, and it’s taking a toll on our staff,” said Kara Starnes, D.O., medical director of Cook Children’s Urgent Care. “We need everyone’s help by staying home if you only need a COVID test or if your child has mild symptoms.”

Currently, 23% of COVID tests at Cook Children’s UCCs are coming back positive. In addition to COVID, Dr. Starnes says they are seeing a lot of colds.

“If your child tests positive for COVID at home, you can trust the test. You don’t need to have a health care provider confirm the results,” Dr. Starnes said. “If a COVID test comes back negative, it’s safe to monitor minor symptoms at home and re-test in 48 hours.”

Parents and caregivers are encouraged to reach out to their primary care physicians if their child is not feeling well.

Cook Children’s experienced a very similar situation in August 2021, likely triggered by kids going back to school.

Please avoid the emergency room and UCCS for COVID-19 testing. If your child has been exposed to COVID-19, please use an at-home test or schedule an appointment with a testing location such as a pharmacy.

“If your child needs emergency care treatment, our Emergency Department is here for you. That’s why we’re here,” said Natalie Carpenter, director of Emergency Services at Cook Children's. “But please don’t come to the emergency department for a simple COVID test.”

The ED should only be used for COVID-19 symptoms such as:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

If you are going to the ED, please limit the number of people you bring with you (if possible).

Where do you go when your child needs to be seen by a doctor?

Here’s a guide:

• Go to the emergency room if your child has trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. 
   
• Call your health care provider if your child has ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns. The pediatrician’s office can help you decide what steps to take. 
   
• If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Free COVID Tests Still Available to be Delivered to Your Home

Every home in the U.S. is eligible to order three rounds of at-home COVID-19 test kits from the government. You can easily sign up at covid.gov/tests and have the tests delivered to your home. The last day to order tests is Friday, Sept. 2.

For detailed information about what to do if your child tests positive or negative, download the PDFs attached to this article. 

As people gather and travel during the summer months, the COVID positivity rate continues to rise. The seven-day average positivity rate reported at Cook Children’s Health Care System is 21% as of Tuesday.

Many Cook Children’s primary care offices are offering COVID vaccines. Patient families can check MyChart for online scheduling options or call their pediatrician’s offices.

In June, the Centers for Disease Control and Prevention and the Food and Drug Administration cleared the way for children 6 months to 5 years old to get the COVID-19 vaccine.

Our health care providers and pediatricians at Cook Children’s strongly recommend that parents get their children vaccinated. Vaccines are the best way to prevent serious illness in people of all ages, including children.

The COVID positivity rate has slowly increased at Cook Children's.  

Rolling seven-day average positivity rate at Cook Children’s:

• May 5 - 3.5%
• May 16 - 3.3%
• June 5 - 8.4%
• June 20 - 10.6%
• July 6 - 21.6%
• July 11 - 24.5%

On July 6, there was one COVID patient in the ICU and two others in non-ICU beds at Cook Children's.

On Wednesday, Tarrant County Public Health moved the community spread level to High after 774 new COVID cases were reported in the county. 

Positive cases and hospitalizations are increasing across Texas, according to Texas Health and Human Services.

The biggest thing the community can do to help is to take precautions against COVID-19, including masking indoors, hand washing, social distancing and getting the COVID-19 vaccine and booster if eligible.

Not only will this help prevent COVID-19, but it may also prevent multisystem inflammatory syndrome in children (MIS-C), which has continued to affect kids throughout the pandemic.

It’s also important to avoid Cook Children’s urgent cares and emergency department for simple COVID-19 testing. These locations should be used for severe COVID-19 symptoms such as:

• Difficulty breathing
• Difficulty staying hydrated
•  High fever for more than four days

If you need a COVID-19 test for your child, please call your pediatrician’s office to schedule an appointment. At-home tests and community testing locations are also great options when available. Tarrant County’s website is a great resource for finding testing locations.

RELATED:

COVID Vaccine Authorized for Young Children (checkupnewsroom.com)

Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Distribution of the Pfizer-BioNTech and Moderna COVID vaccines for the youngest age group will begin this week. The CDC's Advisory Committee on Immunization Practices’ (ACIP) recommended that all children 6 months through 5 years of age should receive a COVID-19 vaccine.

This expands eligibility for vaccination to nearly 20 million additional children and means that all children ages 6 months and older are now eligible for vaccination, the CDC said.  

Parents may be wondering if they should get their children vaccinated. Vaccines are the best way to prevent serious illness in people of all ages, including children.

The COVID positivity rate has slowly increased at Cook Children's.  

The rolling seven-day average positivity rate:

• June 20: 10.6%
• June 5: 8.4%
• May 5: 3.5%

Based on available data, our health care providers and pediatricians at Cook Children’s strongly recommend that parents get children vaccinated as soon as they are eligible.

Moderna's vaccine, for children 6 months through 5 years old, is two shots spaced one month apart.

The Pfizer-BioNTech vaccine, for children 6 months through 4 years old, is three shots over the course of 11 weeks.

The vaccines are being distributed and will be available at thousands of pediatric practices, pharmacies, Federally Qualified Health Centers, local health departments, clinics and other locations, the CDC said.

Cook Children’s is currently working on its plan to distribute vaccines to pediatrician offices and will announce details regarding scheduling soon.

Laura Romano, D.O., a hospitalist at Cook Children’s Medical Center, has two children, an almost 4-year-old daughter and a 20-month-old son.

“My son was exposed and tested positive when he was 10 months old. We were very fortunate because I had received my COVID vaccine when he was 8 weeks old so he had plenty of antibodies and protection from me and my immune system,” Dr. Romano said. “We escaped his illness with two days of congestion and one day of fussiness. I, unfortunately, know that not all families have been as lucky.”

“These are some of our most vulnerable patients, and being able to provide them protection against COVID will be a huge relief to so many parents, including me!” Dr. Romano said. Here are her answers to some frequently asked questions:

Why should my child get the COVID vaccine?

It is extremely important to get everyone who is eligible vaccinated.

Vaccinating against COVID is what will continue to allow everyone to return to a more normal life. 

People who are fully vaccinated are significantly less likely to spread COVID-19 because of their smaller viral load, which means a lower risk of transmission to others. That’s one of the main reasons why I’m so excited to get my children vaccinated against COVID. My father is a type-1 diabetic with rheumatoid arthritis who is immunocompromised due to his medications, and I always worry about accidentally spreading COVID to him.

Additionally, someone who is vaccinated against COVID, even if they are exposed and test positive for COVID, is at a significantly decreased risk for complications such as ICU admissions, the need for life support and death.

Here at Cook Children’s between Dec. 19, 2021 and Jan. 15, 2022, there were more than 14,800 children who tested positive for COVID at their pediatrician’s office, a Cook Children’s Urgent Care, or at the medical center. Out of 321 patients who required hospitalization, only 18 were vaccinated against COVID. Out of the 37 patients admitted to the PICU with COVID, only two were fully vaccinated. This data strongly suggests that the vaccine is effective at preventing hospitalizations and at preventing ICU admissions.

COVID vaccines also help prevent MIS-C, multisystem inflammatory syndrome in children. MIS-C is a potentially very serious complication that we see four to six weeks after a COVID infection or exposure. Out of a large cohort of 21 million vaccinated young adults, only 21 children developed MIS-C after COVID vaccination. This tells us that not only can a COVID vaccine prevent severe illness from an acute infection, but it can also prevent some of the more serious complications following COVID exposure.

COVID vaccinations also prevent long-haul symptoms such as daily headaches and persistent fatigue. Although not common, we do see COVID long-haul symptoms in a pediatric population. Patients who are fully vaccinated against COVID are 50% less likely to develop long-haul symptoms.

COVID vaccines do not affect a woman’s fertility. The American College of OB/GYN, the Society of Reproductive Endocrinology, and the Society for Maternal Fetal Medicine have recommended COVID vaccination for all women whether they are pregnant, or trying to become pregnant, or breastfeeding.

On a more practical aspect, a fully vaccinated person will also have different quarantine requirements after exposure or testing positive for COVID. As someone who lived through a 10-day quarantine, I would not recommend or want to repeat it. A fully vaccinated person can have shorter quarantine periods.

How do we know it’s safe for children 5 and under? 

Despite the name “Operation Warp Speed,” the process to investigate and certify the vaccine did not cut any corners. Throughout the vaccine development process, researchers had to follow the same procedures and regulations as if they were developing a new medicine for headaches or blood pressure.

In addition, both the Pfizer and Moderna studies have increased their sample sizes throughout the process to make sure that side effects or reactions are not being missed. Participants in the study were closely monitored.

Should parents get their children vaccinated, even if their child recently had COVID?

Children should be vaccinated even if they already had COVID. Some studies have suggested a second or a third infection can be associated with more severe disease. More severe disease could mean hospitalization, ICU admission and even death.

Some infectious disease experts recommend waiting three months after COVID infection before being vaccinated so that the vaccine has the maximum effect.

Why should my child be vaccinated if they have already had COVID?

I hear a lot of parents, neighbors and friends say that they tested positive for COVID and only had mild flu-like symptoms. However, this is not always the case. While I’m happy that your first case was mild, please know that your second infection may not be the same.

What if I live in an area with a low number of cases? 

If you live in an area with a low number of cases, please still get your vaccine. With the global nature of our world, you will have plenty of opportunities to come into contact with people who come from areas with high number of cases.

COVID vaccines can also be extremely important if you want to travel. Some countries or cruises require you and your child to be fully vaccinated before travel.

Do I have to vaccinate my baby on schedule if I am breastfeeding him/her?

After a breastfeeding mother is vaccinated against COVID-19, antibodies pass through her breast milk to her baby. Various studies have found that the 87 – 95% of babies were given immunity through their mother’s breast milk against COVID-19. If it’s been more than six months since the mother received her COVID vaccine or booster, she should consider vaccinating her baby at this time.

How soon after the vaccine will my child build immunity?

Immunity will begin after the first shot! Immunity and protection have been demonstrated in Pfizer recipients within 12 – 14 days after the first dose, but this will be very short-lived. Immunity will be more permanent two weeks after the second dose.

Are the side effects of the vaccine different for children?

The main side effects are very similar to adults. There will most likely be injection site tenderness and some muscle aches. There can be redness and swelling along the injection site. Most people report fatigue and malaise that should be resolved within 48 hours.

A very concerning side effect that we saw in young men was myocarditis. However, only saw four cases in every 1 million vaccines in children 5 – 11 years old.

How do I know if my child is eligible for the vaccine?

Children over 6 months old are now eligible for the vaccine!

There are only a few very strict contraindications to receiving the COVID vaccine. The two absolute contraindications are having a severe allergic or anaphylactic reaction to a prior COVID vaccine or a known allergy to a component in the COVID vaccine.

If you have any questions about children with known clotting disorders, heart problems, or prior neurologic processes such as Guillain-Barre Syndrome, please talk to your primary care provider. The CDC recommends that these patients can receive a COVID vaccine with proper precautions.

RELATED: 

How to Help Young Children Cope with Vaccine Anxiety (checkupnewsroom.com)

7 Reasons Why This Doctor Mom’s Kids Will Be First in Line for the COVID Vaccine (checkupnewsroom.com)

Vaccines are the best way to prevent serious illness in people of all ages, including children. Based on available data, our health care providers and pediatricians at Cook Children’s strongly recommend that parents get children vaccinated and booster shots as soon as they are eligible. Children ages 5 to 11 will now be eligible for the extra dose at least five months after their second shot.

This news comes after the first booster (third dose) of the Pfizer-BioNTech vaccine was approved for children ages 12 to 17.

We asked Nicholas Rister, M.D., of the Cook Children's Infectious Disease team to answer some of the top questions that parents and caregivers might have.

Why should my child get the COVID vaccine booster? 

Children are at risk to get sick from COVID-19 disease, requiring hospitalization, and in rare cases, dying from the infection.  More commonly they will get a mild infection and recover quickly, but vaccination can prevent more severe disease from developing. This is especially true for children with underlying risk factors including obesity, chronic lung disease including asthma, seizure disorders, and immunodeficiency.

How do we know it’s safe for children 5 to 11?  

A pediatric drug trial involving 140 children aged 5 – 11 years was submitted to the FDA showing high efficacy and safety.  Additionally, blood samples showed similar antibody development compared to data in older children and young adults. A large increase in antibodies that specifically target COVID-19 were observed in patients after a third dose of the vaccine, regardless of whether they had previously had COVID disease.

How long until the booster will be available for children 5 to 11?

With formal FDA approval, all children ages 5 to 11 can be offered a Pfizer vaccine. However, be sure to check with your vaccination site if they currently have the Pfizer vaccine available for these children.

If my child recently had COVID, how long should we wait to get the booster vaccine?  

There has been little in the way of formal recommendations regarding when to get booster vaccination following COVID infection. This is largely because there is tremendous variability in different individual’s infection and how robust their antibody response is. It is generally thought that after COVID infection, there is a period of 3 to 6 months during which repeat infection, especially severe infection, is unlikely. However, there is no reason that you or your child needs to wait to get the booster. Whether a booster is given immediately after recovering from the illness or a few months later, the antibody response has been excellent.

What should parents do if they have more questions?

Talk to your pediatrician. They have your child’s medical history and are the best source of information for this topic. They have the latest information available and want to help you make an informed decision.

If your child is eligible for the COVID-19 vaccine, please contact your local pediatrician's office to schedule an appointment.

Parents may be wondering if they should get their children vaccinated. Vaccines are the best way to prevent serious illness in people of all ages, including children. 

Based on available data, our health care providers and pediatricians at Cook Children’s strongly recommend that parents get children vaccinated as soon as they are eligible.

“It is important to keep our children safe now and in the future," said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. "This is one way to safely protect your children AND protect people who they might expose from catching SARS-CoV-2."

We asked Dr. Whitworth to answer some of the big questions and shed a little light on the subject.

Why should my child get the COVID vaccine? 

Children are at risk to get sick from COVID-19 disease, requiring hospitalization, and in rare cases, dying from the infection.  More commonly they will get a mild infection and recover quickly. But while they are contagious they can spread this to others such as vulnerable grandparents.

How do we know it’s safe for children 5 and under?  

The children who participated in the vaccine research had no serious adverse events and we know that the FDA is extremely cautious and will review the data quite carefully before approving this.

Should parents get their children vaccinated, even if their child recently had COVID?  

Yes. Those who have been infected with this virus can get infected again. This second infection may be the same, milder, or more severe – and they are able to transmit SARS-CoV-2 to those who are more vulnerable.

What about if I live in an area with a low number of cases?  

SARS-CoV-2 will not be eradicated.  We will have this infection with us for years to come, just like influenza.  Low numbers now are something to enjoy, but we will all be exposed at some point in the future. 

What should parents do if they have more questions?

Talk to your pediatrician. They have your child’s medical history and are the best source of information for this topic. They have the latest information available and want to help you make an informed decision. 

If your child is eligible for the COVID-19 vaccine, please contact your local pediatrician's office to schedule an appointment.

RELATED: BioNTech Asks the Food and Drug Administration to Authorize COVID-19 Vaccine for Children Under 5

A variety of brands on the market offer the convenience of testing for COVID-19 at home. These kits can be purchased at retail stores or online as an alternative to seeking out a testing site or busy healthcare provider for a COVID-19 test.

Alice Phillips, M.D., a Cook Children’s pediatrician, explains what parents need to know about the reliability, timing and results of the at-home COVID-19 testing options approved by the U.S. Food & Drug Administration (FDA).

First, if your child is running a fever: KEEP HIM OR HER HOME.

“Any illness with fever is likely contagious, and we don’t want to spread strep, flu or even colds,” Dr. Phillips said. “If your child feels great but with mild symptoms, at-home tests provide parents with the ability to quickly screen their kids.”

As a reminder, Dr. Phillips listed some common COVID-19 symptoms: cough, congestion, sore throat, fever, diarrhea, and potentially loss of smell or taste. However, not everyone infected with the SARS-CoV-2 virus shows symptoms.

At-home rapid antigen tests look for the presence of proteins from the surface of the virus, she explained. These tests have reported ability to accurately detect disease in the 65-85% range in patients with symptoms, Dr. Phillips said. That falls to the 35-40% range if asymptomatic.

“Timing of the test is critical,” she said. “Sometimes testing too early in the illness could result in a false negative. This is why the kits include two tests.”

The U.S. Centers for Disease Control and Prevention (CDC) considers testing a critically important tool to help reduce the spread the disease. Those who have symptoms or exposure to someone with COVID-19 should be tested regardless of whether they’re vaccinated, according to the CDC. 

Type and price of at-home kits vary. Some tests require a nasal swab, while others require a saliva specimen. Antigen tests deliver results within about 15 minutes, while the more sensitive PCR test takes at least 24 hours.

The CDC website provides these tips:

• Check the expiration date. Don’t use if past-date or if the kit’s components appear damaged.
• Read the manufacturer’s instructions completely before opening the test devices.
• Clean the tabletop or surface where the test will take place. Wash your hands with soap.
• Follow the directions step by step. Otherwise, incorrect results can occur.

Dr. Phillips gives some guidance for what happens next.

The result is positive. “Believe it! I am sorry, but your child has COVID. No repeat test is needed. The good news is most kids have mild cases. Call your pediatrician for questions or perhaps set up a telemedicine visit to discuss treatment options and for your doctor to lay an eye on your kiddo in a safe way for all.”

The result is negative. Using the second test in the kit, repeat the test in 24-36 hours to confirm the finding. In the meantime “if your child has symptoms highly suspicious for COVID or fever, keep them home to help protect your community.”

The CDC points out that the results of at-home tests might come back inconclusive or invalid due to user error or a malfunction in the device. If that happens, the CDC recommends contacting the test manufacturer for assistance.

Accuracy depends in part on the quality of the nasal/saliva sample. Whether a child undergoes the test at a clinic or at home, the process of obtaining a specimen can be… interesting, in the words of Dr. Phillips.

“Have you ever wrestled an angry Tyrannosaurus Rex? This would be what it is like to push a swab up the nose of a 3-year-old with fever and cough.

“And then there is the teenager. Tired, grumpy and does not really want to go to school anyway. You eagerly describe to them that you are going to place a swab in their nose and rotate for 15 seconds on each side. Hmmm. Not a happy customer,” she described.

A positive result on an at-home COVID-19 test should be reported to the state or local health department. This helps officials to keep accurate information on transmission rates in the community. Click here to report for Tarrant County: COVID-19 (tarrantcounty.com

It’s not uncommon for kids to be nervous about needles. So the experts at Cook Children’s offer some advice to provide reassurance and support throughout the vaccination process. Honest conversation, creating a comfort plan, and distraction techniques can help put children at ease. Reinforcing a positive mindset helps too: You can do this!

“If you go in with the high expectation that your child can handle this and our staff is going to take good care of your child and make it as comfortable as possible, the kids will rise to the occasion,” said Kim Mangham, M.D. at Cook Children’s Pediatrics Keller Parkway.

The U.S. Centers for Disease Control and Prevention (CDC) on Nov. 2 approved a lower-dose Pfizer-BioNTech vaccine for ages 5-11. Children ages 12 and up were already eligible for immunization against the virus that causes the illness known as COVID-19.

Dr. Mangham said some of her younger patients have been eager for their turn at vaccination. “Some of them are so excited about being protected,” she said.

Clinical coordinator Trish Skelly, LVN estimates she has given hundreds of COVID-19 shots to 12-year-olds and teens through Cook Children’s during the pandemic. It’s a two-shot vaccine, so Skelly gets the chance to follow up when the patients return three weeks later for the second round.

“Usually, I ask how they did after the first one, and they say it was a lot better than they expected,” she said. “They’re handling it much better than the adults with the side effects.”

To help alleviate fears about the shot, Skelly wears her fun nurse’s scrubs and relies on an assortment of aids including stickers, suckers and a topical spray that feels like ice on the skin, relieving the needle’s sting. Most of her patients opt for the nicknamed “Elsa spray” or “magic spray” before the injection. Skelly also answers any questions that come up.

“I explain everything I’m doing when I’m doing it so that there’s no surprises. Most of them don’t even feel it. It’s actually an easier shot than the flu vaccine,” she said.

As coordinator of the Comfort Menu program at Cook Children’s, Whitney Brosey works to educate medical personnel about techniques that can make children feel less leery about going to the doctor. And Brosey promotes the strategies that caregivers can follow – at every point from scheduling the vaccine appointment, to the shot itself, to the 15-minute monitoring period afterward -- for a happier end result. Let’s take a closer look at each stage.

Get Ready, Get Set

Parents should start by informing themselves about the vaccine, Brosey recommended. Next, try to schedule an appointment time that doesn’t interfere with sleep, meals or extracurricular routine so that the child isn’t hungry/cranky and coping poorly.

“If you have to wake them up from a nap or if they have to miss one of their activities, there's going to be added disappointment,” she said. “As much as possible, don't disrupt their normal schedules, so that they don't have added stressors.”

When is the best time to give your child advance notice of a vaccine? It depends, Brosey said, on the child’s personality. Some kids might worry excessively if they know multiple days ahead of the appointment. Brosey informed her 8- and 6-year-old daughters the night before their recent flu shots.

“It’s important to tell kids what is happening to their body. Surprises are fun, but not when it comes to things at the doctor” in order to build trust in medical experiences, she said. “I want to make sure that my kids feel like it's OK to feel nervous or it's OK to be a little bit scared, but to have time to process those feelings so that then there's also time to come up with a plan to help it not be so scary.”

Don’t wait to break the news until you arrive at the doctor's office or vaccination clinic, she said.

More pointers beforehand… Explain in simple words that vaccines help keep our bodies from getting sick. Friendly resources include “Daniel Goes to the Doctor” for younger kid and an animated video from the American Academy of Pediatrics. Allow your child to make appropriate choices, such as whether to bring along a special blankie or stuffed animal from home.

“One of my daughters had dance class after her flu shot, so she wanted to get it on her right leg because she does all of her turns on her left leg,” Brosey said. “That was the control piece for her. She felt empowered.”

And Go

Once at the clinic, parents should talk with the medical staff about the preferred approach for their child’s vaccine. Find out if cold spray or other options are available for comfort. Parents might want to call ahead if the child has developmental delays or sensory needs, Brosey said. Be your child’s advocate.

“Sometimes parents feel like they're being a difficult parent by saying what works, or they think that they're inconveniencing someone, and that is not the case,” she said. “We trust that they know their child best. We want you to communicate with us and have a conversation with us about your child. If you want to hold and hug your child while they're getting their vaccine, then you communicate that with the medical team.”

Distraction is key, according to everyone interviewed for this article. Distract your child by playing a game like I Spy. Sing a song or listen to music. Recite the ABCs backwards. Prompt your child to talk about a favorite memory. Brosey calls this therapeutic conversation.

To keep the child from feeling overwhelmed, only one parent should speak to the child at a time, she said. Reinforce the message of the child’s main job – to hold still. Recognize it’s OK if they cry. If possible, don’t bring siblings who aren’t getting vaccinated, because total attention belongs on the child receiving the shot.

TLC after the Shot

Brosey recommends coloring books or games to pass the time during the 15-minute observation period after the COVID-19 vaccination. Follow up your child: Do you feel like that went well? Or what could we have done differently? Give a treat or some extra one-on-one time later at home.

“It’s so important to help your child return back to baseline after they've gotten nervous or scared. It's almost like the next step in distraction,” she said. “And so I may say, ‘Hey, we can run by the donut shop!’”

Also, let your child know they might experience soreness or other side effects the next day. Brosey said it’s important for the child to report to you if they don’t feel well.

Although CDC approval of the pediatric COVID-19 vaccine is new, kids usually have some familiarity with getting immunized against other illnesses. Brosey said parents should use age-appropriate vocabulary and detail to help explain the purpose of vaccines. The bottom line is to work out a comfort plan, collaborate with the medical team, and stay positive.

“When it comes to coping or how children perceive shots, they're not too big at 11 to be scared,” she said. “We care about our kids' emotional safety. We don't want to have a traumatic experience. We want them to feel safe and we want them to feel heard and seen and acknowledged, and all of that can be done.”

Many parents say they’re anxious about getting their children vaccinated against COVID-19. We decided to ask several Cook Children’s physicians what they think about all of the recent vaccination news regarding children. Here are their responses:

How do you feel (or what do you think) about the recent news of a Pfizer vaccine potentially being available to children 5+ in early November?

Excited. This opens up a preventative treatment for kids in this age group. The sooner this is evaluated and approved, the more illness we can prevent. Especially going into the holidays. – Nicholas Rister, M.D., pediatric infectious diseases physician at Cook Children’s

This is great news. The vaccines are very important to get ahead of this pandemic. – Ana Rios, M.D., pediatric infectious diseases physician at Cook Children’s

I cannot tell you how excited I was to hear Pfizer asking for emergency use authorization (EUA)! I cannot wait to begin vaccinating our younger and more vulnerable patients. Vaccinating as many people as possible is the only way to end the spread of this disease and restore some degree of normalcy to our lives. I’m hoping that families who are planning on traveling for the holidays or seeing extended family for the first time in months will consider vaccinating their children to protect their families while traveling and to protect at-risk older relatives. I know that my 5-year-old niece will be getting her vaccine as soon as it’s available. I know my own two children (3 years and 1 year) will have to wait a few more months but they will be first in line as soon as it’s approved for their age group! - Laura Romano, D.O., hospitalist at Cook Children’s

We want to make sure that we are moving forward in the safest way possible but having protection for children would be great before holiday gatherings begin. – Justin Smith, M.D., pediatrician at Cook Children’s Pediatrics Trophy Club

Excited and very much full of anticipation as both a pediatrician for my patients and as a mom for my littles who are 5 and 7. – Bianka Soria-Olmos, D.O., pediatrician at Cook Children’s Pediatrics Haslet

I am looking forward to being able to provide my patients who are 5-11 years of age the same protection that my older patients have been getting for the last several months. It is so important that we extend the protection of this vaccine to this age group so that they can stay in school and not spread the disease in the community to those more vulnerable among them and around them.

– Jason Terk, M.D., pediatrician at Cook Children’s Pediatrics Keller Parkway

Are you concerned about how long it’s taking for the COVID vaccine to be approved for kids 5+?

No, in the contrary. I think that the evaluation of safety and efficacy of vaccines in children take longer and this means that they are taking the time to analyze the data and evaluate for potential signals of concerns. – Ana Rios, M.D.

While we always want to have treatments available for children as soon as possible, it’s important they be rigorously evaluated. Especially with concerns for some rare side effects that skewed to younger age groups like myocarditis, it was important that the vaccine application have adequate data from children and not extrapolate only from adults. – Nicholas Rister, M.D.

I am not concerned about the length of time, if anything I am comforted by the process. I’ve heard from a lot of families in the hospital that one of the reasons they have decided not to vaccinate their children is that this is such a new vaccine and the process has been rushed. They are concerned since it was called “Operation Warp Speed” that corners have been cut. It’s nice to be able to reassure them that both Pfizer and Moderna increased their study length and their study size to make sure that this vaccine was safe and effective! While the mom in me wishes it would have happened three months ago, the scientist and the pediatrician in me appreciates the process and the time that it has to take. - Laura Romano, D.O.

I would want things to be done in the safest way possible. If that means taking some more time to get information and thoroughly review it, I am fine with that. – Justin Smith, M.D.

No concerns given my hopes are that people gain perspective of how the data was gathered and analyzed to ensure efficacy, safety and other measures considered when vaccine trials are conducted. – Bianka Soria-Olmos, D.O.

No. It is so important to make sure that we understand how the vaccine works in younger children. Younger children are not little adults and the physiology is unique. Making sure that the vaccine is safe and effective in this population is something that must be appropriately studied. The clinical trials show that the Pfizer vaccine works very well in 5-11 year olds and is associated with the same common side effects that are seen in older eligible teens and adults.

– Jason Terk, M.D.

What should parents consider when deciding whether or not to get the COVID vaccine for their children?

Parents should consider that COVID can affect children more than what we originally thought. COVID is here to stay, and it’s better to get vaccinated against it than to get the viral disease. – Ana Rios, M.D.

Assuming the vaccine is approved, the major consideration should be where and when to get vaccinated! As with adults, the risk for these vaccines is likely to be extremely low while the benefits are relatively high. Of course, children that have risk factors (chronic disease, obesity, asthma) should expect even more benefit from vaccination, but the general population should plan to get it as well. There are so many people who are at risk of severe disease and death from COVID that the benefit we get form widespread vaccination isn’t just about our children or ourselves, it’s about many people who we can prevent from getting sick without ever even knowing them. – Nicholas Rister, M.D.

Parents need to be aware that, although COVID has been mild for most kids, that is not always the case. Severe COVID and MIS-C continue to be a problem in children but these can be eliminated with an effective vaccine. – Justin Smith, M.D.

Parents should continue to have conversations with their child's doctor. Each child's particular situation is better discussed between and parent and pediatrician that knows the child. Because although the vast majority of children will have mild disease the recent surge has shown that children can get severely ill from COVID-19 and even deaths have occurred. The recent surge has shown that besides underlying health conditions being unvaccinated is a risk factor for severe illness. – Bianka Soria-Olmos, D.O.

Parents need to know that while most children who have gotten sick with COVID-19 have had a fairly mild illness, many have gotten more seriously ill and have required hospitalization. At the very least, illness in children has required that they isolate and that their household contacts quarantine for even longer. This has deprived them of their ability to go to school and to return to normalcy. – Jason Terk, M.D.

Parents need to consider the risks of being infected with COVID versus the risks and benefits of the vaccine. COVID, despite what some of our families still believe, is not simply a bad flu. COVID can be just as serious in our children as it can be in adults. Children’s hospitals, including Cook Children’s here in Fort Worth, have unfortunately had children pass away from COVID. Some of these children could have been vaccinated but parents decided to wait. Others were too young to be vaccinated. I’ve heard some parents say that it’s “only 500” or so children that have died. “Only” and “children who have died” are two phrases that do not belong together. Any child that dies from a preventable illness, which COVID now is, is a tragedy. And I’m sure that the parents and families of the “only 500” children if given the opportunity would have vaccinated their children. 

COVID infection causes many severe complications such as blood clots, myocarditis, pneumonia, and acute respiratory failure. We are seeing children be affected with daily fatigue and headaches as long haul symptoms. We still see multisystem inflammatory syndrome in children (MIS-C), which is always serious and can be fatal itself. These are all things that can be prevented with the vaccine. 

The vaccine will also protect against subsequent infection. Some families and parents believe that if they have previously been infected with COVID, they cannot get ill again. Studies are now showing that protection from COVID only lasts about 6 to 8 months. After that, these patients are at risk for a second, more severe infection. 

Yes, there are risks to the vaccine. Many people experience injection site pain, muscle and joint aches, fatigue, and maybe fever/chills. Yes, there can be more serious side effects such as myocarditis. But these risks are extremely rare (less than 1 in 20,000 people experience myocarditis following a COVID vaccination) when compared to the actual infection itself (almost 1 in 40 experience myocarditis with an actual COVID infection). 

The vaccination also does not affect fertility and it does not cause miscarriages. 

We have administered almost 3 billion doses of the vaccine to the 6 billion people in the world. Half of the world’s population is now at least partially vaccinated against COVID and we are not seeing any serious sustained side effects. 

The vaccine is safe. The vaccine is effective. It protects against a life-threatening and fatal illness. The benefits of the vaccine far outweigh the risks associated with the vaccine and the risks associated with the actual virus. - Laura Romano, D.O.

For those of you with young children, do you plan to get your child vaccinated against COVID? Why?

My children are 3 years old and 1 year old. They will be first in line to get vaccinated once they are eligible! I’m doing this for their own protection since I treat COVID patients on almost a daily basis. I’m doing this for their protection since they are both in daycare. I’m also doing this to protect my father and their grandfather. My father is a Type 1 diabetic with rheumatoid arthritis and I’m always terrified of accidentally spreading COVID to my father when he visits his grandchildren. My children being vaccinated will give me so much peace of mind. - Laura Romano, D.O.

I plan to review the data gathered and released just like I have for every other vaccine in past. As a physician scientist, I will evaluate the data objectively and make recommendations based on this data. This will afford me a good basis for helping me make the decision for my own children. As long as the data shows good efficacy, high safety (minimal risk of adverse side effects) then I will vaccinate my children. Although the official data has not yet been released so far from what I have heard from my expert colleagues the data is promising. – Bianka Soria-Olmos, D.O.

I’m still waiting on the official data and FDA panel’s recommendation but expect that it will be favorable. – Justin Smith, M.D.

I don’t have children but I do recommend my friends and relatives to get their children vaccinated since the benefits outweigh the risks. – Ana Rios, M.D.

With COVID-19 cases decreasing, should children still wear masks to school?

I think that that physical measures such as wearing masks to school should continue in the meantime since we still have many cases in the community and a lot of people that are not vaccinated, children and adults, especially in Texas. – Ana Rios, M.D.

We are happy to see cases decreasing but there is still a lot of COVID out there. As long as total cases remain high, there is still a significant benefit from wearing the masks at school. As we get into lower and lower case counts, this will likely change but it remains unclear exactly how long. – Nicholas Rister, M.D.

Yes, although it is very promising that cases are decreasing, community spread remains high and at this point mitigation policies are the only way to bridge the gap of time between now and an EUA for COVID-19 vaccine for school aged children which will hopefully create a continued decline in disease burden and safer schools. – Bianka Soria-Olmos, D.O.

Yes. We know that masking substantially reduces risk of transmission and subsequent illness in schools. We encourage all of our patients to maintain masking whether or not they are vaccinated. – Jason Terk, M.D.

Yes, children should absolutely continue to wear masks to schools! This will continue to help decrease the number of cases not only of COVID but of RSV and influenza. 

I also tell my patients that I got my initial vaccination series when I was 6 weeks postpartum. I was exclusively breastfeeding my infant son and was so happy to be able to pass some antibodies to him to offer him some protection. He unfortunately tested positive for COVID in August of this year. While it was an extremely terrifying time for our family, he luckily managed to escape with 3-days of nasal congestion and one day of fussiness. I tell my patients and their families that the only reason we were not in the hospital with severe respiratory distress was because of the antibodies he received from me, from my vaccine. My vaccine not only protected me but protected my son as well. I tell my families that I would have gotten the vaccine even while pregnant because I knew that it would not harm me or my baby and that it would protect both of us. - Laura Romano, D.O.

Anything else you’d like to add?

Being a pediatrician mom has been such roller coaster, especially this last year and half. It has made living life in a pandemic a bit more complicated than most may think and have experienced. Knowing the "worst case scenario" while parenting during a pandemic makes me want to keep my kids in a "bubble" which of course is impossible and has proved to be nothing less than nerve-racking. It however has allowed me to counsel families with the assurance that I would not recommend anything for their children that I would not do for my own. – Bianka Soria-Olmos, D.O.

Let’s imagine a scenario that no parent wants to think about.

Let’s say your child starts acting weird over the past few weeks. She seems tired. She’s sleeping more, and laying around all the time.

She starts to drink more water. It sure does seem like a lot of water – way more than on a hot day outside. She’s starting to pee more often. She’s waking up at night to refill her cup over and over.

She’s starting to lose weight. She’s complaining her vision is blurry. She started to vomit yesterday, and cries today that her stomach hurts. She’s acting exhausted.

You take her to the pediatrician, who checks her blood sugar. The number is so high, the monitor cannot read it. It only says “over 500”.

You rush her to the ER, where you get the diagnosis: diabetic ketoacidosis. Your child is a new diabetic, and you had no idea until this moment. DKA is life-threatening and requires ICU care, the ER physician says.

“The problem is…we don’t have any PICU beds available currently. The unit is completely full.”

In the spirit of our ongoing efforts to be real and transparent with you about the status of children with COVID in Tarrant and surrounding counties, allow me to share with you what my colleagues have shared with me. I asked them, “Are the high numbers of COVID patients in our hospital affecting your other patients?”

The following quotes are nearly word-for-word (though I took to liberty to make a few large medical terms more understandable, and keep patient details anonymous):

Dr. Scott Perry, Neurology: “I’ve got plenty. Several surgeries canceled. Surgeries that could potentially stop seizures in children where their condition is life-threatening. Several workups canceled while we wait for more room. Trying to manage people at home throughout the night so they don’t need the emergency room. I am so exhausted from this, from dealing with the pandemic and the risk of losing highly trained people as a result. The list goes on…”

Dr. Samson Cantu, Gastroenterology: “From the GI standpoint, we have had to second guess our decision to proceed with planning for gastrostomy tube (feeding tube) placement in our failure-to-thrive patients. All new feeding tube placements require hospital admission for 48 to 72 hours. Given the scarcity of inpatient beds, we are very limited in having a scheduled admission, despite a feeding tube being a true life-line for several patients.”

Dr. Charles Saadeh, ENT: “With airway surgery, we have to take into account worst-case-scenario hospital resources that necessitate PICU bed availability. I have had two patients so far that have had a delay in care. Cook has been so very diligent about accommodating patients that need to go when they are delayed, but it’s definitely a case-by-case discussion with each family. We wouldn’t be offering supraglottoplasty (a complicated surgery that allows children with airways disorders to breathe easier) if things weren’t relatively urgent to begin with, so this is certainly a difficult position for us.”

Dr. Teena Thomas, Endocrinology: “More than once last week, when I received a transport call for a new onset, I was not always sure that I would be able to admit a new onset in DKA to the PICU because of the lack of bed availability. On my last day of call, we had to divert a very young new onset to another hospital… I have never not been able to admit a new onset here. I checked on the child the next day and the hospital they went to did not actually have PICU availability either (they had to some shuffling to get the kid to the PICU). Last week, my diabetic patients also had to spend a lot more time in the ER because of lack of bed availability in the PICU or the endocrine floor.”

Dr. Michelle Marcincuk, ENT: “I had an entire day of surgeries cancel because there were no beds to admit the patients to post-op. These were kids with trachs, airway obstruction, swallowing dysfunction. I had a child with a mass on the face that needs a biopsy. Had a little one with a draining fistula on the neck. All had to be postponed. Two kids were hoping to get their trachs out. But had to cancel.”

(Imagine the day finally comes when your child gets the breathing tube taken out of their neck…and your day is yet again postponed, and sometimes for a YEAR. Keep reading.)

MM: “Since the hospital has been full, I can’t say whether we will get to do their surgery the next time they are scheduled. It’s just a complete guess as to whether or not there will be a bed available for them on the day we reschedule. And since we don’t decannulate (breathing tube taken out) kids in the winter, if we don’t get them done soon, they may miss their window of opportunity to get decannulated this year and may have to wait a whole year more for their next chance. That’s a whole additional year with a trach due to COVID. None of my patients have COVID. But their health is being affected by the COVID surge. 

The health of these kids is suffering because of this pandemic. Even though they themselves don’t have it. And their parents have done everything possible to keep them healthy. The parents have taken days off work preparing for this surgery. When the surgery is cancelled, they have to take even more days off for the new surgery date, putting their jobs at risk due to absences. And some patients drive 5-6 hours here for surgery, only to arrive and be told that they can’t have the surgery and have to drive back home because the hospital is full. Then you think of the wasted time the surgeon experiences when this happens. Basically, it’s a day that they can’t see patients because of the last minute, unexpected cancellations. We have a huge list of kids waiting to be seen in clinic, but most of the time these cases are cancelled last minute and it’s too late for new patients to be booked into clinic. So both the surgery patients and the new patient for clinic who are waiting for appointments are affected.”

Dr. John Honeycutt, Neurosurgery: “It is frustrating from several different levels. However, we are ONLY delaying non urgent or elective surgeries. Cases for brain tumors or other surgeries where delay could cause harm we are still full steam. But it is very frustrating to families that have planned, taken off work, mentally prepared and then have to delay. It’s extremely hard for them. Nobody’s outright angry or screaming, all seem to understand, which is so cool. We see all this in media about people screaming and yelling about selfish things, but they miss the vast majority of people that are just trying to get by in life and care for their community and others. They are frustrated, but make the sacrifice for the better of others. That is missed and it is refreshing to see that personally.

As a team, we are so used to being full steam, so for us to transition to a lull is a bit of a challenge (easier for younger docs, harder for me). But we understand too. We see the ICU, ER and hospitalists and nursing staff overworked and stressed. Sad to see.

Finally, our service line has not had our neuro PICU for a year and a half since it is now the COVID unit, and last week we lost our neurosciences floor to be the second COVID floor unit. So we are scrambling hard, being extra sure our patients get what they need since they are now scattered throughout the hospital. Exhausting for our team.

We are fine, just adapting to the new norm which I pray is short lived.

Dr Karthik Srinivasan, Pediatric Hospitalist: “As pediatric hospitalists, we care for children who require hospitalization. I recently took care of a cute infant who was not admitted for COVID and improved within a day. I was excited to discharge him home, as was his mother. We had a pleasant conversation, and the mother was very thankful. She seemed to trust Cook Children’s and all our staff. As I was leaving, I mentioned that her son was too young for the vaccine but wanted to know if family members had received it. “No. No. We’re not going to talk about that” was what I got, and the tone and mood took a 180. There was an awkward silence. The family was out the door within the next 20 minutes. 

As of about two months ago, we were fortunate to have ZERO COVID positive patients admitted to our service. Now, we are up to about 40% of our service as a whole. About 75% of these children are admitted directly because of COVID, not just incidentally being positive. This is very different than in months past.

Clearly, the delta variant has been a game changer that is much more easily transmitted. We recently set our service’s all-time record for the number of hospitalized children we are taking care of, which can be directly attributed to COVID. We started last year utilizing one floor as the typical “COVID unit.” This grew to two floors, and most recently we have started filling up a third floor, anticipating even more as I write this. 

We are seeing children in all age groups being admitted due to COVID. Although we are noting that obesity is a risk factor, we are admitting some children without any apparent predisposing factors. More recently, about 3-4% of older teenagers who are testing positive in the Cook Children’s system are being hospitalized. Beyond infancy, our highest rate of hospitalization and many of our sicker patients are older teenagers, the vast majority who are vaccine eligible but have not received the vaccine.

On a typical call shift, it is not unusual to be called on at least a couple of children who are admitted for COVID and are appearing sicker. And it is a process to see them. For staff member safety and our own protection, there is extensive protective equipment required to see them, and this needs to be worn anew upon entering and completely removed upon exiting the room. Additionally, for some of these sicker children, multiple specialists may be involved in their care, leading to several phone calls. This is all while the Emergency Department anxiously is paging for several additional patients needing to be admitted. Admittedly, in these times, it can be near impossible to return their calls in a timely manner.

As we are stretched thin, the medical care we provide may not be as efficient as you are accustomed to. We need your patience, understanding we are all in this together. If your child gets sick and needs to be hospitalized, we are here for you and your child. But the best weapons we have against this is preventing the illness in the first place. Go back to the basics that have been preached by Cook Children’s physicians for quite some time now. Mask up, socially distance, and get your vaccine if eligible. Even if your child cannot get the vaccine, have family members and friends get it if eligible. Please trust us on this as you do with the care of your child. To be clear, virtually all the physicians at Cook Children’s were vaccinated well before the word mandate was even thrown around. We preach what virtually every major physician organization has advocated for and what we have practiced ourselves. Do it for yourself. Do it for your child. Do it for your neighbors. Do it for us.

We strive to keep our “Promise” to you and your children, but we need your help.

Dr. Christine Ellis, Pediatric Hospitalist: “Page comes through as I barely walk through the doors of the hospital that another one of my patients is in respiratory distress. Seconds later, I hear the “Med Alert” overhead- of course, it’s my patient I was just paged about from the COVID unit. I skip making my morning coffee and checkout from the evening physician and run upstairs to the COVID unit.

I throw down my bag, quickly place on my PPE and walk into the crowded room to see my teenage patient breathing over 60 breaths a minute and oxygen saturations decreasing despite maximum support on a non-rebreather face mask. PICU team arrives shortly and my patient is whisked away to our pediatric ICU for higher level of care. I try to comfort the mother quickly as they start to roll to the elevator for transfer.

I take off my n95 mask, make my coffee and get the rest of my checkout from last night’s physician that stayed late to talk to me. I finally slump into my chair to start rounding on all my other children for the day and all the emotions flood over me. 

SADNESS for the patient and family as they go through this difficult time with a very sick patient.

FEAR for my patient’s respiratory status as I am afraid that he is on a long road that will require possible Bi-Pap or even intubation.

FRUSTRATION sinks in as this patient, like many of my other patients, was eligible for the COVID-19 vaccine and is not currently vaccinated. This child likely would not have these severe complications if he was vaccinated. They were completely healthy except for obesity (which significantly increases chances for complications as well). All of this could of been prevented.

As the day goes on, I go between our now two full non-ICU COVID units and see patient after patient similar to my first child of the day. Some children too young for the vaccine but when I talk to their parents, no one in the house is vaccinated either. I continue to march room to room. EXHAUSTION hits me. My face hurts from my n95 mask but I sign up as the COVID physician the next day.

As I drive home to my family I try to find HOPE. Hope that tomorrow will be a better day. Hope that tomorrow another sweet child does not go to the ICU for a now preventable disease. Hope that our community continues to step up and get vaccinated and wear their masks appropriately. Hope that vaccines are available for our younger children soon so my patients and my own children at home can be more protected.

❤️ Dr. Ellis

Dr. Laura Romano, Pediatric Hospitalist: “Our hospitals are full. Our ICUs are full. Due to the surge from the delta variant, we do not have any beds. This means that patients at outside hospitals or clinics who need specialized care cannot be transferred to our facilities. This means that there are children who have to wait longer for necessary and sometimes life-saving treatment.

I've seen a lot of people say that wearing a mask or getting vaccinated is a "personal choice" or "my body my choice." Your choice to not wear a mask and to not get vaccinated is putting our children and our patients in jeopardy. The time for personal responsibility is over. It has already failed our children and that failing has led to unprecedented COVID spread in a few weeks since schools have returned without mask mandates and without vaccine mandates. This spread will continue unchecked and we won’t have the beds or the space to help our patients. It's simple math at this time.

I've seen people posting that health care professionals need prayers because we are tired and overwhelmed. Yes, we are exhausted. We are tired. We are running on empty and are experiencing burn out that we have never felt before. Yes, we appreciate your thoughts and prayers. But what we need more is for YOU to get vaccinated.

The time for talk is over. You need to get vaccinated. You have to get vaccinated. It is the only way to end this.

If you don't care about your own health and wellbeing, please care about your children's health. Please care about my patients' health. Please care about your nieces and nephews. Please care about your neighbor's children. They need your help. We desperately need your help. 

And if that's too much to ask, if it's too much to ask you to care about a child, then wear a mask. It's literally the least that you can at this point.

The time for talk is over. We need action. We need it now. I know how some of you will react to seeing this: another COVID post. Some of you will say that this is a joke and a political hoax. Some of you will say that this is baseless fear mongering by the mainstream media to make you afraid of what will amount to a slight cold or a flu. Please know that none of those statements are true.

This is virus that spreads easily. This is a virus that is now causing severe and life threatening disease in children. Please, please, please listen to medical professionals who are quite literally begging you to get vaccinated. 

If you don’t want the vaccine for yourself, please get it for your kids, your nieces and nephews, your friends’ kids, or even for the children in your neighborhood since a lot of us don’t have the option to vaccinate our kids against a deadly and fatal virus. 

If you have any questions about the vaccine, please reach out to me or your family doctor. We would love to talk to you about it! You have entrusted your children to us throughout the entire lives. We need you to put your trust and faith in us again. Please get your vaccine. 

And if getting vaccinated is too much to consider, then please just wear a mask. Please. Children are literally dying from this and we have the ability to stop it.

Dr. Bianka Soria-Olmos, Pediatrician at Cook Children's Pediatrics Haslet:

"Se sabe que la variante delta es altamente transmisible, desafortunadamente ha causado que los casos de COVID pediátricos aumenten significativamente recientemente. Esto, a su vez, ha provocado un aumento de las hospitalizaciones por COVID en nuestro propio hospital.Ha habido varias partes diferentes del hospital que se han convertido en unidades dedicadas al tratamiento de niños con COVID-19.Esto significa que a medida que más niños requieren atención para su enfermedad COVID-19, hay menos camas disponibles y personal para cuidar a otros niños que pueden requerir pasar la noche en el hospital por una condición médica no relacionada con COVID-19. El aumento actual está provocando retrasos en los procedimientos que no son de emergencia o electivos, dado que algunos de esos niños requieren habitualmente de hospitalización, seguimiento posoperatorio o recuperación.

Como pediatras y especialistas en pediatría estamos acostumbrados a atender a TODOS los niños de inmediato en el momento en que necesitan intervenciones o tratamiento, lamentablemente nos estamos dando cuenta de que esto puede no ser posible y no podemos evitar sentir una avalancha de emociones: frustración, tristeza, temor. Nosotros también somos humanos y lo que nuestros ojos ven todos los días crea una montaña rusa de sentimientos que tememos que nadie más pueda entender.Sin embargo, tenemos la esperanza de que si compartimos solo un pequeño vistazo de lo que nuestros ojos ven y presencian todos los días, esa bondad y abnegación ganarán y que nuestra comunidad hará lo correcto.Le pedimos a usted (nuestra comunidad) en este momento que considere que sus decisiones y acciones de la vida diaria pueden afectar y afectarán la trayectoria de esta situación.Le pedimos que nos ayude haciendo lo siguiente: vacunen a TODOS los adultos y adolescentes elegibles en su hogar contra el COVID-19 y se use cubreboca cuando estén fuera de su hogar. Estas simples acciones de bondad no solo lo protegen a usted y a sus seres queridos, sino que también pueden comenzar a aplanar la curva de infección de COVID que necesitamos en este momento para ayudarnos a cumplir nuestra promesa a todos los niños del norte de Texas y nuestra comunidad."

Dr. Diane Arnaout, Pediatrician at Cook Children's Pediatrics Forest Park: 

The actions we all take in our daily lives will make a difference for these hardworking doctors, our amazing and exhausted hospital staff, and most importantly, the kids.

Don’t send your kids to school sick. If in doubt, get a test. Move the parties, get-togethers, and playdates outdoors – fall is coming, and it’ll be beautiful out.

With winter approaching, I worry about our already-strained hospital system. COVID is already putting us under pressure – and the flu will bring new challenges for us all. Please get your family vaccinated against the flu now. Kids need to be in masks in school – last year’s nonexistent flu season can attest to how well they work.

We are counting on our community to do what’s right. Please help us help your kids

I ask you to put yourself in the place of the parents of one of these children, who desperately need urgent or critical care, and who may not be able to get it because of the number of patients in our hospital.

There are 41 patients currently in Cook Children’s with COVID. 63 beds and four units that are using vital resources of staff, oxygen, ventilation, life support.

Cook Children’s will always strive to accommodate all of our community’s needs. But I beg to you ask yourself: what can I do to help?

• Send your child to school in a mask. Ask them to keep it on at all times unless outside or eating.
• All children in school over age 2 should be masking indoors. School districts should strive for universal masking right now.
• Quarantine all children who come in contact with a COVID+ child if unmasked and for longer than 15 minutes indoors.
• Get your kiddo the COVID vaccine if they’re over age 12. It’s safe and it’s effective.
• Please keep your sick children home from school.
• Postpone indoor gatherings for now- it’s not going to be forever. Just for now.
• Move the party outside.
• Open windows when you have people over.
• Limit the number of people who can attend sporting or theatrical events at schools so there can be spacing between families.
• Mask up and put at least six feet of distance between you and other people in meetings.

This won’t last forever, but Cook Children’s needs your help to be able to always have a bed available for your child should you ever need one.

As the medical director of our Infectious Diseases department, Dr. Mary “Susi” Whitworth has told us, “we never want to get to the point where we cannot prevent a preventable death.”

They shared how Cook Children’s is currently being impacted by a surge in COVID-19 cases and hospitalizations.

Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases, Corwin Warmink, M.D., medical director of Emergency Services, Kara Starnes, D.O., medical director of Urgent Care Services, and Bianka Soria-Olmos, D.O., pediatrician at Cook Children’s Pediatrics Haslet have all worked tirelessly to ensure our patients and families are receiving the best care throughout the pandemic.

During the news conference, the experts addressed what they are seeing in our urgent care locations, emergency department, and Cook Children’s system as a whole.

“We need compassion from the community and this is an illness affecting our children,” Dr. Starnes said. “We are hitting crisis mode and we can’t do it without your help.”

Cook Children's Urgent Care facilities are being stretched thin. Over the weekend, Cook Children’s was forced to close its Hurst location due to a lack of staff members and high demand for services.

"This is the first time we’ve had to take such measures. We closed in an effort to consolidate staff and safely take care of our patients,” Dr. Starnes explained.

On Monday, the six remaining urgent care locations saw 1,400 children. This is twice the number of patients the urgent care centers typically see.

Dr. Starnes stressed that if you believe your child has been exposed to COVID-19, it is best to find a local testing site in the community or use an at-home testing kit. You can find a list of local COVID-19 testing locations here. 

Cook Children’s Emergency Department (ED) is experiencing patient volumes not seen since the H1N1 pandemic in 2009. On Monday, the ED saw 601 patients with patients arriving every 2.5 minutes.

“We are breaking records we don’t like to break,” Dr. Warmink said. “I have been at Cook Children’s for 18 years and this is the worst it’s ever been.”

We encourage all families to come to the emergency room for emergencies but ask that they do not come for a simple COVID-19 test. This pulls resources away from critically ill and injured patients and takes up already limited bed space. Along with COVID-19, we are still seeing RSV cases but thankfully, they appear to be on a downswing.

“The adults in the room need to step up and do the right thing,” Dr. Warmink said. “If you send your kid to school without a mask, it’s not if they are going to get sick, it’s when.”

Dr. Warmink advises all parents, “Ask yourself if this can wait” before bringing their child into the emergency department.

Most children have mild illness with COVID-19, but that is not the case for everyone. Throughout the course of the pandemic, Cook Children's has hospitalized 1,129 children with COVID-19, with 241 of those admitted to the Intensive Care Unit (ICU). Throughout the pandemic, seven children with COVID-19 have died. Two died this past week. They were a 4 year old and a 15 year old. 

"We are seeing more severe illness than we have seen at any point during the pandemic. The January surge was nothing compared to what we’re seeing now,” Dr. Whitworth said.

As a result, on Monday, Cook Children’s opened up a third COVID-19 unit for the first time since the start of the pandemic. This unit has nine beds – and within the first 24 hours of being open, was completely full.

With Labor Day weekend ahead of us, Dr. Whitworth encourages everyone to be safe, mask up, and socially distance, as we cannot handle another influx at this time.

“Every child that has the virus inside of them has the potential to spread it to someone else, and they don’t mean to,” Dr. Whitworth said. “Much of what we are seeing is 100% preventable, children have to wear a mask.”

Cook Children's also set a record for COVID-19 hospitalizations on Wednesday with 35 patients. This is the highest number of COVID-19 patients hospitalized at the medical center at any point in the pandemic. The COVID-19 ICU was also filled. 

What can the community do to help?

All four experts we heard from on Wednesday have a few simple pleas:

1. Get vaccinated and get your child vaccinated as soon as possible.
2. Please have your children wear a mask to school.
3. Wash your hands frequently.
4. Re-think gatherings – if you gather, wear masks, stay socially distant and gather outdoors if possible.

Across the board, Cook Children's is seeing record numbers of families each day who are wanting rapid COVID-19 tests for their children.

"We understand this is a scary time, but want to remind families not to panic if your child was exposed to COVID-19," Dr. Starnes said. "We understand schools have requirements, but we need you to understand we do not want you to panic or rush in to be seen immediately after an exposure. Rushing to our urgent care locations puts a strain on our resources.”

The best thing you can do if your child was exposed is find a local testing-only site in the community or use an at an at-home testing kit.

Cough, fever, runny nose, sore throat, body aches, headache, vomiting and diarrhea are all common symptoms of COVID.

For children over the age of 3 months, these symptoms can typically be managed at home with symptomatic care. Medications such as acetaminophen or ibuprofen can help with fever and pain. You should encourage your child to drink plenty of fluids and it is ok if they do not have much of an appetite.

Parents should seek care for their child over 3 months of age if they have had 5 days or more of fever, difficulty breathing, inability to keep fluids down or stay hydrated (no tears or no urination for 8 hours or longer) or if their child is having pain or fever that is not helped by an appropriate dose of fever reducer/pain reliever.

Patients under 3 months of age who are sick should be seen in person and evaluated.

Also, if there is at least one known positive case at home and others are sick, it can be assumed that all have COVID and everyone needs to isolate at home for 10 days from the start of symptoms.

“We cannot magically create hospital beds at the drop of a hat,” Dr. Whitworth said. “Wear a mask no matter if you’re vaccinated or not, wearing a mask is not an option.”

The rising number of COVID-19 cases in North Texas is due to the delta variant, which is more contagious than other strains of COVID-19, and a significant number of unvaccinated people. With Texas doing away with virtual learning this school year and the COVID-19 vaccine not yet available for those under 12, many parents and children are understandably feeling anxious.

Amanda Jordan, Psy.D., a licensed psychologist at Cook Children’s Alliance, can relate. She has a child starting kindergarten in the fall and is experiencing similar feelings.

“I want parents to understand you can’t take care of others if you don’t take care of yourself first,” Dr. Jordan said. “You have to check in with yourself first to see how you’re feeling because you don’t want your children to pick up on your negative energy.”

As for parents, Dr. Jordan says it is important to engage with other parents, make sure to create and maintain their own schedule, talk with their partner/spouse and seek professional help when necessary.

Dr. Jordan says once parents have worked through their anxiety, it is good to start preparing children for their ‘new normal’ as early as possible. She says it’s important to pose open-ended questions such as, “I wonder what your first day will be like?” or “I wonder who your teacher will be this year?” These types of questions allow your child to open up about how they’re feeling and can lead to other questions or concerns they may have.

Dr. Jordan also stresses the importance of establishing a routine as school beings again because many children have been off of their schedule for more than a year. This routine includes bedtimes, meal times, changing eating habits, etc.

“There has been so much flexibility with virtual learning,” Dr. Jordan said. “Children have been going to bed and waking up later than normal, and could do their work at their own pace.”

She says starting a ‘school year’ routine before school officially starts can help ease some of the anxiety on the parents and children.

Another technique Dr. Jordan recommends to parents is called ‘Name it to tame it.’

“It is important to help children put a name on their feelings,” she said. “As parents, we want to fix things and say things like ‘don’t be scared’ or ‘you’re going to be fine,’ but you must validate their feelings.”

Dr. Jordan says to respond to children by validating their feelings and letting them know you understand how they feel and let them know they always have a safe space to express their feelings.

Along with the anxiety of returning to school, medical professionals at Cook Children’s are also getting questions about children wearing masks in the classrooms. Alice Phillips, M.D., a Cook Children’s pediatrician at Cook Children’s Cityview says she stands behind the recent recommendations from the American Association of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), that all children K-12 should wear masks in classrooms this school year.

“I believe children need to be in school for their social skills, mental health, and other key personal connections,” Dr. Phillips said. “I recognize it’s a hot topic, but for students to stay in school without shutdowns or quarantines, we must do it safely.”

Dr. Phillips says the new delta variant is spreading rapidly in our unvaccinated population. At Cook Children’s we have seen a rise in the number of children testing positive for COVID as well as an increase in the number of children being hospitalized. For this reason, she believes it is even more important to make sure all children have masks on in the classroom, no matter their vaccination status.

“Parents have to begin modeling mask-wearing behavior at home, and support their children if they feel pressured to do otherwise by their peers,” Dr. Phillips said.

To prepare children to wear masks in the classroom, she says it’s important to explain to children the reality of doing ‘hard things,’  for our friends and communities. Equally important is providing encouragement to children when they're doing the right thing.

“I understand that it’s hard to be brave sometimes,” Dr. Phillips said. “The best we can do is encourage, support, and validate children’s feelings and let them know the ‘why’ behind masking and the importance of keeping themselves and others safe.”

Dr. Phillips says her advice to all adults is to get vaccinated and be an example. She advises all adults to wear a mask when they are in the grocery store and other public settings as recommended by the current CDC guidelines, 

“If parents are vaccinated and their children are not, I still advise the entire family to mask up to support the child and protect them,” she said.

If you have any questions about preparing for your children to head back to the classroom or need guidance for masking, contact your child’s pediatrician.

Read more about preparing for the upcoming school year here:

Cook Children's 10-Point Guide for Safely Reopening Schools

Should My Child Wear a Mask to School this Fall? 

The American Academy of Pediatrics is recommending that all children over age 2 wear masks in school this fall. The internet rejoiced, everyone agreed it was a great plan, scientists and politicians shook hands, and no one had anything to say about it.

Ha. Kidding. I promptly picked up some curly fries and wine when I heard about it and laid face-down on my office floor. Not the most sanitary place to do some deep breathing, but whatever.

I hate to joke about serious things like this, but if I don’t, I may cry. The idea of a uniform and agreed-upon plan for halting the spread of a disease that could prevent the deaths of many seems like a pipe dream at this point.

Let’s walk through this and see if I can help you with your decisions this fall.

What did the American Academy of Pediatrics recommend?

• “Everything possible must be done to keep school in-person.” This is because the rates of academic struggle, obesity, and mental health crisis all rose tremendously this past year. Kids need to be in school. We all agree on that.
• They recommend all eligible kids receive the COVID vaccine (12 and up currently)
• Universal masking for anyone in school over age 2 (all students and all staff)
• Flexibility in policy – COVID is an ever-changing scenario and if something isn’t working well, schools need to recognize it and change it
• Attendance of students should be closely watched, and mental health resources for both students and staff should be available
• There should be ongoing federal, state, and local funding to schools to help them with all this.

Why is the AAP recommending all kids wear masks this Fall?

• The AAP is asking all students to wear masks in order to not only protect those that cannot be vaccinated yet, but also the families of these children, and the community as a whole.
• The AAP advocates for children. ALL children. Not just your kid. The wealthy ones. The poor ones. The sick ones. The healthy ones. The physically and mentally challenged. The kid who is being raised by his elderly grandmother and doesn’t have the means or transportation to get that vaccine yet. The kid who doesn’t have enough food at home but gets 2 good meals at school. The child who doesn’t have access to the fancy laptop or functioning internet. The AAP gives us advice based on what will help our community better support and protect our kids.
• Guess what? Last year, we masked in schools. We washed hands more. We asked sick kids to stay home. And schools were then found to not contribute significantly to the spread of COVID-19. (Click here for more information)
• We also noticed a pleasant, NONEXISTENT flu and RSV season as an added side-bonus.
• What happened this summer? We took our masks off, had playdates, saw friends, had parties. And now have plunged into a winter-sized scourge of viral illness. My office has been booked days in advance. The hospital is full. In July. These school strategies work not only in regards to COVID, but all viral illness– both focused studies and my own practice numbers have proven this.

What is the “Delta variant”?

• The COVID virus is mutating (as we expected), and this is the newest and most common version of it in the U.S. right now
• It is crazy, freaking contagious. More so than the original bad boy.
• Verdict’s out on whether it makes you sicker. I suspect it will put a larger burden on hospitals just given the number of unvaccinated people who may be infected.
• Vaccines seem to be working well against it.
• A recent study from the United Kingdom showed that children and adults under 50 were 2.5 times more likely to become infected with Delta.

Why should my vaccinated kid wear a mask?

• Because keeping track of who is vaccinated and who isn’t is a huge burden on schools. And trust me, they have already suffered enough burden.
• Because many kids cannot have the vaccine yet, or haven’t had access to it.
• Because we don’t yet know how well the vaccines work against the new COVID variants and until we are more comfortable with seeing how effective it will be, this is the most low-risk and safe thing we can do.

Will masking harm my kid? Why are all these people saying these awful things about masks?

• Putting a piece of thin cloth on your child’s face does not harm your child.
• I have written one mask exemption this entire year. One. It was for a child with a very rare lung disease. The child’s lungs are anatomically and physiologically very different than a normal child’s and keeping oxygen levels up even without a mask was a struggle for this kiddo.
• The worst I’ve seen is a mild face rash here and there. Otherwise, don’t believe the hype. Masks are not causing TMJ problems, lost social development, increased CO2 levels, increased illness, etc etc. It’s a lot of weak arguments with no evidence and as a pediatrician who saw and examined thousands of children this past year: the kids are fine.

Does masking protect other people? Or me?

• Both.
• Even if your child is the only child wearing a mask in the class, it will protect him. (Click here for more information)
• This all works better if everyone masks.
• If an unmasked sneeze happens nearby, a mask prevents your child from inhaling AS MUCH virus into his airway – and there is brewing evidence that the MORE virus particles you inhale into your body, the more severe the subsequent illness may be.
• I also think it really keeps kids from touching their face, picking their nose, putting fingers in mouth, etc. Our absolute lack of flu and RSV last winter can attest to this.

What if only some kids are wearing masks? Will my kids get bullied?

• I don’t know. I doubt it. We did a whole year where everyone masked and school-aged and young kids were generally pretty cool and flexible about it. Most don’t seem to care either way. The bullies in this scenario often seem to be the adults.

When are the vaccines for the younger kids going to be ready?

• Pfizer’s clinical trial data for children age 5 to 11 is likely coming in September. If approved, shots for kids this age will be available within 1-2 weeks after that.
• Ages 2 to under 5 coming soon after that, in October.
• 6 months to 2 years soon after that.

What about my child under 2 who can’t wear a mask?

• It’s okay. Send them to daycare. Send them to mother’s day out. Do the swim lesson. Get the speech therapy. You need it to work, thrive, survive. COVID seems to be milder in young kids. And while I can never guarantee anything in life 100%, I think the benefits outweigh the risks for kids in this age group.

What if the daycare doesn’t require their staff to be masked? Vaccinated?

• I’m hopeful that daycare centers will strongly encourage their staffs to vaccinate and mask up, but I know that not all will. I think you should ask the questions and expect answers from childcare centers. You can certainly make that a part of your decision-making process when choosing where to place your child.

Do kids really get severely sick with COVID?

• COVID in children is mostly mild. No one debates that. But kids (especially the older kids) contribute to the spread in the community.
• Let’s not forget the times it’s not mild. I’ve seen kids with post-COVID chronic fatigue, long-term smell and taste change or loss, multisystem inflammatory problems, psychosis, and cardiac issues that have kept them out of sports for the year.
• We are still learning about the long-term consequences of COVID infection. There is thought that up to 30% of people who have had COVID will develop long-term medical problems.
• I talked to one of the Cook Children’s Pediatric ICU doctors the other day, Dr. Linda Thompson. I wanted her input about kids with more severe illness as she has seen much more of it than I. She said she’s seen more severe illness in older children compared to the younger ages. She also mentioned “please let everyone know I vaccinated my 14-year-old as soon as I could.”

What do you recommend, Dr. Diane? What will you be doing with your kids?

My kids (6 and 7 years old) will be going to school in-person this fall. They will be wearing masks regardless of what the other children are doing. They can take them off when outside. We will talk about it a lot before it happens, and expectations will be clear.

We will practice wearing them while we watch our screen time to get used to them again on our faces. We will pick the favorite fabrics. If our community numbers drop and my children are able to safely get vaccinated this winter, I can’t wait to tell them to take ‘em off.

But until enough of us get vaccinated, COVID is not going away. And it will likely surge again this winter.

As long as the numbers keep climbing in the community, we have to protect not only the kids, but all of us. Remember those hospital numbers in January? Remember the goal of not over-straining our medical resources? Remember Uncle Pete who had a heart attack and there wasn’t a single hospital bed available for him last winter?

I’ve said it before and I’ll say it again: we are building this boat as we float in it. We don’t know what the future holds for us and we are making the best decisions we can in a situation that no one has yet conquered. Having patience as we gather the data and learn from our successes and mistakes is the beautiful and necessary process of science.

But many people question the safety of a novel immunization for a novel virus, especially parents with young children. Moderna recently announced plans to begin testing its coronavirus vaccine in children between the ages of 12 and 17, while Pfizer and AstraZeneca began their pediatric trials in October.

We were able to talk to Jason Terk, M.D., physician at Cook Children’s Pediatrics Keller Parkway and a nationally known advocate for vaccines, who answered a few questions about the COVID-19 vaccine.

Tell us about the COVID-19 vaccine and why people should feel safe receiving it.

The vaccine is really showing a lot of promise because we've gotten data that shows that the efficacy (that's how well the vaccine works at protecting against COVID-19 disease), is much more effective than what we might've expected. We were hoping to get something around 70% and the two vaccinations that are being considered for emergency use authorization have efficacy of about 95%, which is really fantastic. I think that that bodes well for the potential of these vaccinations to make a real difference for us.

While trials in children are just beginning, should parents go ahead and get the vaccine?

Well, the quantity of vaccinations that we have available is going to be limited initially. The CDC, FDA and the state health departments are all working together to determine what priority groups need to be getting it first. The elderly nursing home population, healthcare workers, and first responders are going to be the first individuals recommended to get the vaccination. Obviously we need to protect the health care workers so that we can continue to do our jobs providing care to our patients. Unless you have some serious underlying health condition that makes you high risk for complications from COVID-19, you will not as a parent be among the first groups of individuals  recommended to get the vaccination. But once we have plenty of supply, I certainly encourage parents to get the vaccination for themselves.

When is the vaccine going to be available for children?

Trials in children are only just beginning. We need to prove that the vaccine is just as effective and just as safe in children because children are not little adults. We also need to make sure that it works as well for them too. I have no reason to expect that it will not be as effective for children. It's going to be important to stay tuned for that. Once the vaccine is available for myself, I'm definitely going to be in line to get it. And I am unreservedly optimistic about its impact for myself and for the rest of us.

What gives you that confidence that it is a safe choice for you to get the vaccine?

In medicine, we're data driven and we have really good data that shows its effectiveness, as well as what the safety profile is with the 30-40,000 individuals who were involved in the Phase 3 trials. Right now, what we've seen from a safety point of view, is that it is producing some side effects that are very similar to other vaccinations out there that are routinely recommended and they're fairly mild for most people. The two vaccinations that are currently under consideration for emergency use authorization require two doses. One of them requires two doses separated by 21 days. The other one requires two doses that are separated by 28 days. It appears that after that second injection, that maybe about half of the individuals have some side effects like achiness and, and maybe sore joints and, and some injection site soreness and things like that, but it doesn't last very long. It's generally gone after a few days. We've had the pandemic going on now for about a year. And we've had these vaccines that are under consideration now for about six months in the clinical trials. People in those clinical trials will be followed for at least 2 years to monitor for any problems. I have no reason to expect that there will be safety concerns.

Will children receive the same vaccine as adults?

Very good question. We won't really know the answer to that until the clinical trials are completed in children. Sometimes kids require lower doses of the same vaccination that we need to get as adults. And sometimes they get the same dose. What you're looking for is to get the desired therapeutic point of protecting against the disease at the lowest dose to minimize side effects. So that's what they'll be working on for kids too.

Should people who have already had COVID-19 get the vaccine?

So the current recommendations coming from the CDC is that prior COVID-19 disease should not be a determining factor about whether you should get the vaccine, because we do not know how long natural disease will give you immunity. It certainly gives you some protection for a period of time, but how long that lasts? We really don't know. Probably because of limited supply, individuals who were shown to definitely have had COVID-19 will probably not be the first ones that will be recommended to get the vaccination. That’s getting kind of ironed out right now and we'll get more specific information on those recommendations in the next several weeks I expect.

Where should people look for more information as they make the decision on getting the vaccine?

I think that it's important to talk about information and how people get information. Unfortunately, there is organized resistance against vaccinations generally, and against efforts to try to vaccinate the population against COVID-19 specifically. Consumers of this information need to know that that those sorts of agenda-driven organizations are working to prevent the end of the pandemic. We really need to be very careful and make sure that the things that we're reading or watching on social media are evidence-based. These vaccinations are going through the same – and even greater – rigorous processes and scrutiny that all the other vaccinations that we have gone through. I have every confidence that this is going to be a game changer for the human population. We all need to get vaccinated and support this challenging effort.

Are you hopeful that a COVID-19 vaccine can help end the pandemic?

Absolutely. This is our way forward to try to get back to normal. It's not going to be an immediate thing, but it's going to be a lot quicker now that we have such effective vaccinations. It will take some time for us to really get back to normal as we know it, but we're getting there.

For more information about vaccines and COVID-19, visit https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.

For the latest on how COVID-19 is impacting kids and Cook Children’s work to protect them, visit the medical center’s newsroom at checkupnewsroom.com.

All patients with exposure to COVID-19, regardless of symptoms, will need to quarantine for 14 days. This is required, regardless of test results, because COVID-19 can develop between two and 14 days after an exposure.

At Cook Children’s Urgent Care, a patient may be required to have two negative COVID-19 tests before their doctor or nurse practitioner will sign a form allowing the child to return to school. This will likely be the case if the child's symptoms are high risk for the virus. 

If a child tests positive for COVID-19, they will need to stay home for 10 days after the onset of their own symptoms. This could mean a quarantine longer than 14 days. 

Cook Children's Health Care System follows guidelines from the Centers for Disease Control and Prevention (CDC).

We also follow the Infectious Disease Society of America which has issued the following COVID-19 guidelines: 

• Intermediate to high clinical suspicion of COVID-19: A COVID-19 test should be repeated in 24 to 48 hours (different samples if indicated)
• Low clinical suspicion: No re-testing

All patients with high-risk symptoms should be tested for COVID-19 before returning to school based on physician or nurse practitioner discretion.

These symptoms include:

• Fever
• Cough
• Shortness of breath
• Body aches
• Loss of taste/smell
• Headache
• Sore throat
• Sustained vomiting or diarrhea (and usually a combination of the these symptoms)

“Our goal is to make sure we limit the spread of COVID-19 as much as we possibly can to keep everyone healthy,” said Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “If the first test gives a false negative result, we could potentially be sending a contagious child back into the classroom. That is why a second test is needed in cases of high suspicion.” 

All patients with low-risk symptoms and NO known exposure to COVID-19 can be tested before returning to school based on physician discretion. Low-risk symptoms include congestion or runny nose, rash or a single episodes of vomiting or diarrhea.

Click here to read more about COVID-19 testing.

Fears regarding COVID-19 have increased the amount of hand sanitizer and other disinfectants in homes, giving children more access to ingest these products. While hand sanitizer is beneficial for killing germs on our hands, it can be toxic if swallowed or misused.

“The biggest concern with hand sanitizer ingestion in kids is alcohol intoxication that can lead to low blood sugar, which can cause coma and seizures,” said Justin Smith, M.D., pediatrician at Cook Children’s Pediatrics Trophy Club. “Less serious symptoms can include nausea and vomiting.” 

Earlier this month, the U.S. Food & Drug Administration (FDA) issued a warning for a voluntary recall from Ashtel Studios due to hand sanitizer that is packaged “in containers resembling a food and drink pouch.” The appearance of the product is similar to applesauce and fruit packets and marketed with popular children’s characters, like PAW Patrol and Barbie. 

“It’s important that we remember that hand sanitizers should be kept out of the reach of small children, especially those under 5 years old. While keeping our children safe from COVID-19 is very important, we don’t want to let our guard down against other risks,” said Dr. Smith. “And please don’t buy sanitizer in containers that could look like food or could otherwise be more attractive to kids.”

As the coronavirus pandemic continues and flu season arrives, parents need to be more careful than ever to store hand sanitizer out of the reach of children. For more information on poison prevention, visit our website.

“We're learning more and more about coronavirus and how it affects the body in general, and particularly how it affects the heart,” said Deborah Schutte, M.D., medical director of Cardiology at Cook Children’s. “We're now learning that the virus can attack the heart much like many other viruses and kids can get what's called myocarditis, which is inflammation or swelling of the heart.”

With increasing research in this area, the American Academy of Pediatrics (AAP) recently released its recommendations for safe return to sports and activity. They suggest all children and adolescents with exposure to COVID-19 rest for a minimum of 14 days, regardless of whether or not they had any symptoms. If a child had mild symptoms (fever, cough or runny nose for less than three days), they should rest for at least 14 days after illness.

“They should talk to their pediatrician and they need to stay out of vigorous activity or sports for 14 days after they're asymptomatic or after exposure,” said Dr. Schutte.

For kids with moderate symptoms (those that last longer than three days), further examination, such as an electrocardiogram (EKG), may be required. The AAP also recommends waiting at least 14 days after the symptoms subside and obtaining clearance from a primary care physician before returning to exercise.

If a child had severe illness due to COVID-19 and/or multisystem inflammatory syndrome in children (MIS-C), restriction from activity is recommended for three to six months.

“It's very important for us to be able to assess the patients before they return to sports,” Dr. Schutte explained. “We know from other viruses that cause myocarditis that patients who decided to participate in sports, and perhaps have had a viral infection in their heart, there can be serious consequences, even death, related to sports activities or vigorous exercise.”

While this may sound scary, Dr. Schutte says parents shouldn’t be afraid to let their kids exercise. She says physical activity is important for children and teens, especially now.

“As a parent of two boy athletes, I totally get that you're potentially scared to send your child back out on the field,” she said. “I think exercise is so important for everybody, but kids in particular. It helps combat the isolation they might be feeling right now from having to either quarantine or be socially distanced all the time. And it can also help with anxiety and depression, in addition to the physical benefits of just maintaining a healthy weight and staying fit.”

She says in most cases, the benefits of getting back out onto the field outweigh the risks. But, she adds, it’s an individual decision for each young athlete and their family.

“Parents need to take into consideration what sport it is because there are sports that are considered high-risk like football and wrestling,” she said. “You can imagine you're face-to-face with your opponents as opposed to something like soccer or volleyball, which are considered medium risk, as opposed to golf where they can safely distance themselves.”

Parents also need to consider who the athlete interacts with and whether there’s a high-risk individual in the home, like an elderly grandparent who may be more susceptible to seriousness illness if exposed to COVID-19.

“Unfortunately, it's not easy. It's a very complex decision that needs to be made within the family,” Dr. Schutte said. “But I certainly would not discourage it.”

First of all, families need to discuss risks and benefits of traveling by car or plane. I understand the desire to see your grandparents at Thanksgiving and Christmas. My own Grandma is in an assisted living center and I have had very little contact with her over the past six months. We don’t want our relatives to spend the holidays alone, but we also don’t want to put them in any unnecessary risk. So, do we stay or do we go?? There is no “correct” answer to that question. We want to cherish time with our relatives, especially the elderly ones, but need to be cautious if visiting older or immunocompromised family members.

If you choose not to travel, having a small intimate family holiday will be a nice change from the normal, sometimes stressful, celebration. You can FaceTime or Zoom other family members and still be engaged at mealtime, present opening, cooking favorite recipes, and even coordinate games together. Technology affords us the opportunity to stay close, even when we’re far away.

Ideas for a socially-distanced holiday:

• Cook a family recipe and host a contest on who nailed it the best: presentation, taste, closeness to “how Grandma makes it.”
• Gingerbread house decorating contest.
• Play games: My family was laughing so hard we couldn’t speak when we played the Heads Up! game on our phones last year. Grandma nearly peed herself laughing when her clue was “monkey” and all adults ran around the kitchen acting like crazy animals at the zoo!
• Make a shared album for photos/ videos and upload pictures daily for the rest of the family to see and enjoy.
• Purchase themed family pajamas and put on a fashion show.
• Holiday light or tree decorating contest.
• Scavenger hunt/treasure map.

If you choose to travel, I recommend smaller groups visiting older or immune compromised family members. This is not the best year for a 50 person family reunion. Stay in the largest home available and spread out. Wear a mask for close contact inside and when cooking. Wash hands more frequently. Weather permitting, eat and socialize outside. Who wouldn’t love making s’mores in a fire pit?!

Ideas for safe traveling during the holidays:

• When driving: many fast food restaurants do not allow customers inside for potty stops, so be mindful to stop at rest stops or gas stations. Wear your mask inside, wash your hands very well, and have hand sanitizer in the car. Pack snacks and drinks and limit unnecessary pit stops.
• If travelling by plane: pick the first flight of the day when the plane is the “cleanest.” Pack plenty of snacks so you don’t need to purchase in the airport; I advise fruit & veggie squeeze packs, trail mix, crackers, cereal bars, practically enough to be a mini meal if needed. Use antibacterial wipes and hand sanitizer often. Keep your mask on the entire time you are in the airport and on the plane.

In this unprecedented year, holidays may look different. Decide on what will work best for your family this season and be safe no matter what you choose.

As of Oct. 12, the number of patients who have tested positive reached 1,657, with four of those patients currently in the hospital.

Pediatric cases of COVID-19 have been climbing along with overall cases in Tarrant County. On Sunday, Tarrant County Public Health reported an ‘uptick’ with 794 new cases.

“I’ve been asked frequently about the number of infected children, as well as the number of infected adults locally and throughout the state. We’ve noticed over the last couple of weeks that we’ve had more positive cases here,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children's. “Part of the reason we have more cases here is because we are doing more testing. If you double the amount of testing you do, you would expect to double your number of positive results. If you more than double your number of positive results, that means there’s more disease in the community.”

Cook Children’s COVID-19 positivity rate was near 2.5% in August. Today, our overall positivity rate is 5.3%. Dr. Whitworth says that rate is in line with statewide and national data for children. She says throughout the pandemic, less than 10% of all COVID-19 cases occurred in children under 15 years old.

“It is disturbing that our percent positivity rate is going up, and we also see that in Tarrant County,” she said. “Tarrant County is hovering around 10% positivity rate, while the state has dropped to around 7%.”

There are a number of reasons why this may be occurring, including people going out more and becoming tired of wearing masks and social distancing. She also says there are some cases at schools, but those haven’t been tremendous numbers.

So what can you do to protect yourself and your family?

• Wash your hands often, for 20 seconds with soap and water, or use hand sanitizer.
• Keep at least six feet away from others.
• Wear a mask.
• When around others, remember being outdoors is safer than indoors.

“As the holidays approach, I have wrestled with how to handle this and I know everyone else is wrestling with it too,” she said. “It’s going to be difficult to not be involved in crowded gatherings, but they’re not going to be very safe this year. Those are some of the things I think we can do.”

She says another important way to protect yourself and your family is to get a flu shot.

“There are decades of safety data with flu shots. They are safe. You can’t get the flu from a flu shot. You might be a little achy afterwards, but that beats having the flu where you might be in bed for a week with high fever and miss work or miss school.”

The Centers for Disease Control and Prevention (CDC) is discouraging trick-or-treating nationwide, calling it a high-risk activity for spreading COVID-19. They’re also dissuading trunk-or-treat events (where treats are distributed from trunks of cars in parking lots), indoor parties and haunted houses.

So why are these Halloween favorites considered high-risk?

“We know outdoor activities are much safer than indoor activities,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children's. “The problem is coming in close contact with people you’re not around regularly, like family members.”

She says masks have been very beneficial in slowing the spread of COVID-19, but warns of a recent rise in cases in Fort Worth and surrounding areas.

“Tarrant County has had an increase in COVID-19 cases over the last couple of weeks, and our positivity rate is hanging around 10% or 11%, which is pretty high,” she said. “The State of Texas is several percentage points below that right now. So now is not a good time to increase face-to-face contact locally.”

As of Oct. 5, 672 people had died of COVID-19 in Tarrant County, and nearly 45,000 others have recovered from the virus. With the current uptick, Dr. Whitworth says maintaining six feet of distance from other people is critically important, regardless of the activity.

“When you talk and exhale, you have droplets come out of your mouth and your nose that you don't see. There are a lot of them and they typically fall within three feet, but not always. You may talk louder or you may cough and they might travel farther. This is why the recommendation is to stay six feet apart” Dr. Whitworth explained. “It is less risky if you're outside because most of those droplets are diffused away and diluted outdoors. Of course, it’s even safer if you can wear a mask.”

In case you’re wondering, she isn’t talking about a Halloween mask. Dr. Whitworth says typical Halloween masks have openings for the mouth and nose, which defeats the purpose of stopping the spread of droplets.

But Halloween doesn’t have to lose all of its magic. Rayne Delgado, program coordinator for the Child Life Zone at Cook Children’s, has suggestions on how to make Halloween fun and safe for children this year.

“There are a lot of things families can do instead of trick-or-treating, like scavenger hunts in the house, family movie night and games.” Rayne said. “Pinterest also has a ton of craft ideas that meet all budgets.”

Here are some specific ideas Rayne shared with us:

Sensory fun

• Make Halloween slime and add googly eyes or critters in it
• Create sensory boxes filled with Halloween candy to find
• Build sensory bins with things like fake spider webbing, dyed-spaghetti noodles, soapy water, black beans, crushed graham crackers, un-popped popcorn, dyed rice, and Halloween trinkets (If age-appropriate)

Cooking activities

• Pumpkin face homemade pizza
• Dessert pizza using Halloween candy
• Carmel apples
• Ice cream cone witches hats
• Mummy hot dogs

Games

• Play Halloween-themed bingo
• Create a family mystery game with a play on Clue.
  • Using different rooms in your house, family members are the characters. Swap weapons for costumes.
  • Try to figure out which family member stole what piece of candy from what room, while wearing which costume. (This can also be done virtually with children and their friends. Switch rooms to each other’s houses.)
• Create an escape room in the house.
  • Start with one envelope that needs to be solved. That leads to another with another puzzle and so on until you find the bucket of trinkets/candy.
• Have a costume contest
  • Find things in the house to play dress up with. Who can be the most creative or silliest?

(We have provided templates in the 'Downloads' section of this article.)

In the following video, our team answers the questions they hear most frequently, including how COVID-19 has impacted the program.

Learn more on our website.

Now that schools have opened, who needs COVID-19 testing?

Rapid testing for COVID-19 can be helpful to promote isolation for positive cases, and to prevent prolonged unnecessary isolation for those children exposed to COVID-19 or with questionable symptoms. The symptoms that most likely warrant testing are combinations of the following: fever and headache, vomiting, diarrhea, congestion, loss of taste or smell, cough, muscle soreness, extreme fatigue and shortness of breath. Children with diabetes may see unexplained difficulties with sugar control. Any combination of these symptoms should be taken more seriously if there has been a known contact with a COVID-19 case.

Does a child who has had COVID-19 need a negative test to return to school?

While we have seen some schools and athletic programs requiring a negative test in order to return, this is based on outdated guidance. Testing may remain positive for weeks after symptoms have passed but does not mean that the child remains contagious. The current guidance is that students may return when their symptoms have resolved for 24 hours AND they are 10 days since the start of symptoms. In practicalities, most of these students will be waiting until the 10 days pass. If a child was hospitalized, it is recommend that they wait 20 days from the start of symptoms.

If a child is exposed to COVID-19, can we end their quarantine early with a negative test?

Testing is reasonable if symptoms develop to make a diagnosis, but quarantine should continue for 14 days from the end of the last contact. A negative test should not provide false reassurance as symptoms could continue to develop throughout the 14 day period despite a negative test.

Many parents are concerned about whether their child is at more risk for COVID-19. Which patients are at risk for more severe disease?

Risk factors for severe disease at any age include: cancer; COPD; immunosuppressed state due to organ transplant; obesity (BMI >30); serious heart disease such as heart failure, coronary artery disease, and cardiomyopathies; sickle cell disease; and type II diabetes.

Individuals with the following conditions MAY be at increased risk for severe diseases: asthma; stroke; cystic fibrosis; hypertension; immunocompromised state due blood or bone marrow transplant, steroids, or immunosuppressing medications; neurologic conditions; HIV; liver disease; pregnancy; pulmonary fibrosis; smoking; thalassemia; and type I diabetes.

Children who are medically complex, who have serious genetic, neurologic, metabolic disorders, or congenital heart disease might be at increased risk for severe illness from COVID-19, as well as children with obesity, diabetes, asthma and chronic lung disease, or immunosuppression.

What do you do when a child has a family member who is at risk for severe disease? Does the child’s age matter?

In this situation, distance learning might remain the best option for this family. Because the disease can be contracted at any age, this should not factor into the decision. While child to adult spread may not happen as easily as adult to child, there are studies that show it does occur.

Do children who are planning to do virtual learning need to have their vaccines updated?

According to the Texas Department of State Health Services (TDSHS), vaccine rules are still in effect regardless of whether a student is participating in on-campus or virtual learning.

Read more about Cook Children's recommendations for safely returning to school on our website.

*This post includes information provided by Marc Mazade, M.D., medical director of Infection Control and Prevention at Cook Children’s and Justin Smith, M.D., pediatrician at Cook Children’s Pediatric Trophy Club.

“It’s definitely a much better summer than we’ve seen in recent years,” said Sharon Evans, trauma injury prevention coordinator at Cook Children’s. “In a way, there may be a silver lining with COVID-19 that’s helping prevent many of the tragedies we’re used to seeing this time of the year.”

In June, Cook Children’s admitted eight patients for drowning injuries. Nine were treated in July. While the ideal number of drowning patients would be zero, it is encouraging to see fewer incidents, especially in light of the high volume from recent years.

June of 2015 marked a turning point for Cook Children’s on this issue. That month, emergency room staff saw nearly a child a day for drowning, 28 total. The numbers were so alarming, the hospital launched its first drowning prevention campaign, ‘Lifeguard Your Child.’

“I believe the message is starting to resonate with people,” said Dana Walraven, community health outreach manager for Cook Children’s. “The fact that the numbers are coming down is fantastic, especially with more children home, but we know we have to really continue the message.”

In the past five years, ‘Lifeguard Your Child’ has grown from a grassroots, social media campaign to a multi-pronged program with more than 70 partners across North Texas. So far this year, ‘Lifeguard Your Child’ partners have educated more than 3,500 children on water safety and distributed hundreds of life jackets. In addition, life jacket stations have been constructed for cities such as Cleburne, Alvarado, Weatherford, Grapevine and Flower Mound. These stations provide free life jackets for families to borrow at lakes.

“You’d think that during the pandemic that things just sort of stopped, but they really haven't,” said Walraven. “We’ve been enacting some really smart strategies to help force the numbers down.”

As in years past, hospital admissions data has been a main driver of the ‘Lifeguard Your Child’ campaign. One issue the data continues to point out is the importance of barriers around swimming pools. Out of the 17 cases seen in the past two months, eight occurred either during non-swim time (i.e. a child slipped outside of the home unnoticed) or when a child returned to a pool unsupervised after swim time had ended.

“Tracking the data has helped us understand the biggest threats for children around water,” Walraven said. “The majority of the drowning incidents we see are not during what we consider ‘planned swim time.’ Most are happening either when it's not a planned swim event, or when it's in transition, like packing up and leaving after a day at the pool.”

There is one specific difference this year from summers past, according to Evans. She says we’re seeing less drowning cases from large gatherings.

“We used to see many cases from backyard parties where families would get together, and often a child would slip under the water. There was a false sense of security with so many adults present, but too often there wasn’t a ‘water watcher’ or someone monitoring the water 100%,” Evans explained. “We’re seeing less of this now and I think that has to do with people not getting together as much due to COVID-19.”

Both Evans and Walraven say they’re thankful to see less children being injured around water and hope the trend continues.

“I'm just grateful to our partners for everything they are doing, from offering swim lessons to handing out life jackets,” said Walraven. “We're fortunate to live in an area where everyone is so concerned about the wellbeing of our community, and that's a really cool thing to be part of.”

In a recent essay published on NBC News’ website, Leah explained how face masks and forced social distance once marked her as 'cancer girl.'

“I spent a year of my life in rooms with filtered air, marked by rare trips to the outside world; even a decade later, a warm hug triggers a lingering anxiety in me,” she wrote in the essay. “That experience informs how I practice social distancing today.”

Leah was a 15-year-old athlete in her hometown of Aledo, Texas when she was diagnosed with Acute Myeloid Leukemia (AML). What followed included months of intense chemotherapy and a lot of time isolated on the hematology/oncology unit at Cook Children’s in Fort Worth.

“At the time, I was super angry because I mean, I've been through so much. I lost my dad to leukemia when I was 4 years old,” Leah explained over the phone from her home in Chicago. “I basically had the identical cancer to my father's. Now I’m starting chemotherapy, my hair’s falling out and this is high school, when you’re supposed to be having fun.”

Leah vividly remembers the day she got the news. She had just been rushed to the emergency department (ED) at Cook Children’s following an appointment with her pediatrician. Some unusual symptoms, such as fatigue and extreme bruising, led her doctor to run a blood test. He found her white blood cell counts to be exceptionally high.

In the ED, the attending physician told her “I have no doubt in my mind that you can make it through this, but this is going to be a battle.” Those words stuck with Leah for the next several months as she endured grueling treatments. She couldn’t leave her room without wearing a mask and visitors had to keep a safe distance from her. No touching was allowed.

It was tough, but after her last round of chemotherapy Leah was enrolled for a natural killer cell transplant. It was a clinical trial through St. Jude and it worked. She’s been cancer free ever since.

While being a cancer patient consumed nearly a year of her life, Leah didn’t let it slow her down.

“I didn't want to be held back. I wanted to graduate in my class and ultimately did,” she said.

She went on to attend the University of Texas as an undergrad and became a sports reporter. Today, she is pursuing a Master's of Science in journalism at the Medill School of Journalism at Northwestern University. She says she’s had a lot of time to process what she went through and has learned some things that are helping her get through the current pandemic.

“When I was in the hospital, I scheduled things around watching ‘That 70’s Show’ on TV, reading and doing schoolwork. I needed to keep myself occupied,” Leah said. “I'm basically doing the exact same thing now, just with less restrictions.”

And she says it is much easier to wear a mask now, then it was back then.

“We're in this moment where everybody's wearing a mask and they're cool and stylish, whereas mine were those paper Cook Children's disposable masks,” Leah explained. “There's a difference between wearing a mask when no one else is wearing one, and wearing one when everyone around you is wearing one. It’s a lot easier now.”

Leah hopes sharing her personal story will help others realize there are many out there who have been forced to wear a mask and social distance to protect their own health. And she says it’s something we should all do now in a sort of ‘golden rule’ kind of way.

“I've done it for my own protection. Now, I'm doing it for my own protection and for other people's protection.”

Her advice to all of us, including those fighting cancer now, is to take the precautions advised by doctors and scientists and to be patient.

“Just take everything day by day and see every day what you can do to lift your morale and make you happy,” she said. “If it's watching TV, learning a new craft or doodling in a journal, I don't care what it is, but try to find something that does occupy yourself and makes you happy.”

Since the arrival of COVID-19, a desperate search for a vaccine to fight the pandemic has ensued worldwide. However, despite this present-day example of the importance of vaccination, immunization rates at Cook Children's have dipped.

From March 1 through May 31, 2020, 66,049 children received their vaccines at either a Cook Children's primary care office or a neighborhood clinic. That's compared to 81,984 in those same months in 2019.

While some of the decreases in numbers are due to families staying at home because of the pandemic, pediatricians want parents to know it's essential to get your vaccines, perhaps now more than ever. Data from Scientific American found that during March 2020, vaccination rates dropped to 44.7% in Texas, the second-lowest in the nation behind Washington D.C. (44.4%).

The Centers for Disease Control and Prevention (CDC) reported a 2.5 million decrease in non-influenza vaccines ordered from the federal Vaccines for Children Program between January 6 and April 19 of this year. The CDC adds there was a 250,000 drop in the number of measles vaccines ordered during that time.

"Immunizations are the safest, easiest way to protect your kids from unnecessary and sometimes fatal childhood diseases," said Jason Terk, M.D., a Cook Children's pediatrician in Keller and a national advocate for vaccines. "We all desperately want a vaccine to protect us from COVID-19. But I think it's important to focus on what we do have right now, and that's vaccines for 16 different diseases. These vaccines are tried and true. We have had many years of experience with them, and we know that they are safe."

Doctors stress vaccines to protect not only your child but other kids as well. Immune-suppressed people have a higher risk for the deadlier complications of measles infection, such as encephalitis and pneumonia. Vaccines protect your child and those who may come into contact with them.

Dr. Terk said, "the best course of action is to make sure that all persons in close contact with babies less than 6 months of age are properly vaccinated against measles and avoid situations where larger groups of unvaccinated people are likely to be."

While the overwhelming majority of parents do choose to give their children vaccines, some have decided not to, ignoring leading health care organizations.

"Vaccines are safe and effective," said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children's. "There are decades of sound scientific research to support this. We recommend that all children be vaccinated as recommended by the American Committee on Immunization Practices schedule to help keep them safe."

With so much misinformation online undermining the safety and importance of immunizations, it can be difficult for parents to separate the facts from fiction.

Pediatricians and other health care providers at Cook Children's are concerned about the potential rise in preventable diseases and even more concerned about the risks they pose to babies, kids, teens, and adults.

Alice Phillips, M.D., a Cook Children's pediatrician, welcomes a conversation with her patient families. She said her job is to listen to concerned parents in a respectful way to provide facts and calm their worries.

"I try to answer them with what my experiences as a practitioner have been. I tell them not only what I've seen as a physician and explain all the science supporting immunization, but what I've done as a mom," Dr. Phillips said. "My children are vaccinated. I believe in vaccines. Often, a parent needs kindness, compassion, and assurance that they are making the right decision for their child. I truly want them to know that receiving a vaccine is the right decision for your child."​​

Important Resources

• Immunization Schedule for Your Child
• Calendarios de vacunación
• Common Questions Answered About Immunizations
• Immunization Collaboration of Tarrant County
• Immunization Collaboration of Tarrant County - Schedule of Events

According to Nicholas Rister, M.D., an infectious diseases pediatrician at Cook Children’s, anecdotes of COVID-19 parties are circulating the medical community nationwide. While he says we have not seen any confirmed cases of COVID-19 from such gatherings here in Fort Worth, he wants parents to know that we do not recommend intentionally getting COVID-19 given the uncertain benefits and potentially high-risk for harm.

"Historically, getting exposed to a disease as a protective measure is rarely indicated, but has occurred in the not-too-distant past with chickenpox," Dr. Rister explained. “We don’t recommend chickenpox parties now that we have a vaccine, but immunity was lifelong with those antibodies. With COVID-19, the immunity could be temporary and incomplete, so the benefit is unclear and maybe not what families are wishing for.”

He says even though children typically don’t get as sick as adults, there’s still a severe risk that comes being exposed to the disease.

“Most children do well compared to adults, but some kids do very poorly,” he said. “Some kids need to be intubated and end up in the hospital and could die, so just because most kids do well doesn’t mean your child will.”

And knowing which children will do well is still a mystery. Dr. Rister says we still have a lot to learn about COVID-19 and doctors don’t always know why one child ends up extremely ill while another may have mild symptoms.

“It’s hard say your child is truly safe or completely healthy and when exposed to the virus will turn out fine,” he said. “There’s certain cases where we know your child is going to be at a higher risk, like if your child has cancer, but there’s other children, who as far as we knew were completely healthy, but they got very sick and needed to go into the ICU. There’s almost certainly more to that story, but we couldn’t tell there was any other major illness even with lab work being done, so we wouldn’t expect parents to know either.”

We assume parents who may consider sending their child to a “COVID party” may be trying to take some control of a situation that is truly out of their hands. But Dr. Rister says all of that assumed control will go out the window when their child is admitted to the hospital.

“You’re now at the hospital and things can get out of hand pretty fast,” he said. “Especially with the numbers so high right now, this is probably the worst moment to be engaging in that behavior.”

So bottom line is the risk of intentionally exposing yourself or your child to COVID-19 far outweigh any potential reward and should never be considered.

“What we are noticing is that the number of cases is ballooning over a short period of time,” said Nicholas Rister, M.D., pediatric infectious diseases physician at Cook Children’s Medical Center.

This rapid increase in COVID-19 cases is causing concern among physicians that we will see the virus spread even further, especially with the Fourth of July weekend ahead of us.

“We understood that as we re-opened Texas we would see more cases,” said Dr. Rister. “I think these numbers show that this disease spreads among all people, and that includes children.”

Ninety percent of the positive cases at Cook Children’s have been among symptomatic children. The most common signs parents should be aware of are cough, fever, mild respiratory symptoms, rash and stomach pain. More severe symptoms may require hospitalization and can progress to respiratory failure but thankfully remain uncommon in children.

At this time, the number of infected children needing hospitalization remains low, with six patients currently being treated at Cook Children’s Medical Center. But Dr. Rister says while the majority of children are able to recover on their own, some will need oxygen support and even a ventilator.

“It’s rare for a child to become so ill they need a ventilator because of the virus, but we have seen it and it’s something we want to prevent,” he said.

The ages of COVID-19 patients span from infants to 20 year olds, with no real concentration on one age group over another.

“It’s tough to say where someone gets the virus from, but big events with lots of people are a common way transmission occurs,” Dr. Rister explained. “We have seen children who we believe became infected at youth sporting events and summer camps.”

Dr. Rister says it’s important to limit your child’s exposure to large groups as much as possible, and always try to wear a mask, maintain social distance and wash your hands as much as possible.

“We know it’s hard to say all children should wear a mask, but as much as you can, it’s going to make a difference,” he said. “Every day we hear about COVID numbers on the news, but most families haven’t seen it despite how common it is. I think it’s important to remind people that the boogie man is real, this thing is out there and the precautions you are taking are very important.”

As for the Fourth of July, Dr. Rister hopes families will still find a way to celebrate while taking into consideration the risk for contracting and transmitting COVID-19.

“The question to ask yourself is ‘how many people are you going to be around and how exposed will you be?’. If you can effectively social distance, wear a mask and you’re in a smaller group, then I think those are very reasonable things to think about doing,” Dr. Rister said. “The larger group activities like being around big groups of people at pools, large cookouts, sporting events, large fireworks displays where you are close to other people; those events are what we’re worried about.”

For families trying to decide how many people to invite for Fourth of July gatherings, consider whose most at risk. If you have elderly grandparents or people who are ill, Dr. Rister advises you to be cautious.

“We’re not saying you can’t have a celebration, but we do think you need to have a real honest talk about how you can limit risks.”

As I say in this video – and I truly mean it – coming to see your Cook Children’s Pediatrician is safer, I believe, than going to the grocery store these days.

What can you expect when you come to see us?

Well:

• We ask that you call from your car before you come in. That way, there will be a room fresh, clean and ready for you
• You can complete your check-in paperwork on the MyChart app
• We ask that one guardian accompany one child for the visit
• Parent and child (if age 2 or older) should wear a mask
• You will be greeted and screened by a member of our staff when you arrive. We’ll take your temps and ask a few quick questions.
• Most days, the waiting room will be empty and you will not stop there.
• No more toys or books in the exam rooms
• All staff and providers will be wearing masks
• Super duper hospital-grade clean-down process in each room after each patient.

You know what’s a bummer? I can’t get or give my patented Dr. Diane hugs for awhile. Seriously – it’s so sad. But I await the day those hugs can come back.

Til then, we elbow-bump, my friends.

Stay healthy.

Dr. Diane

“All of these children presented to the hospital with symptoms that resembled a severe case of Kawasaki disease,” said Nicholas Rister, M.D., an infectious diseases physician at Cook Children’s.

Kawasaki disease is an illness that creates inflammation in blood vessels with no proven cause, but is generally thought to follow various infections after they have otherwise resolved. Dr. Rister said the patients with MIS-C arrived at Cook Children’s following exposure to COVID-19 and had symptoms including fever, abdominal pain and outward evidence of inflammation including diffuse rashes, conjunctivitis and swelling. In the more severe cases, evidence of multi-organ dysfunction including respiratory distress, low blood pressures, liver and kidney damage and altered mental status were also seen.

“Of particular concern to us is inflammation of the heart and surrounding major blood vessels which is also seen in Kawasaki’s disease. We have seen this same thing in several of these COVID inflammatory disease patients,” explained Dr. Rister. “Minimizing the degree of inflammation in these children, while providing supportive care for any organ damage, has been a key component of treatment.”

All four patients were tested for COVID-19. Three tests came back negative and one was positive.

“We believe all of these cases are related to COVID-19,” said Dr. Rister. “The three negative results are evidence of how far the infection had progressed, resulting in the inflammatory syndrome.”

Three of the patients have been released from the hospital. One remains in the pediatric intensive care unit.

In addition to the recent appearance of MIS-C cases, the infectious diseases team at Cook Children’s is also looking closely at increased reports of unexplained fevers in our area.

“We want parents to be aware of these cases as COVID-19 continues to spread in our community,” said Dr. Rister. “Unexplained fevers for several days and evidence of generalized inflammation may be signs of this illness.”

Symptoms of more severe MIS-C cases include severe abdominal pain, shock from low blood pressure, respiratory distress and lethargy. If your child exhibits any of these symptoms, seek emergency medical care immediately.

Less severe symptoms include fever, abdominal pain and rash. Caregivers should call their pediatrician if these symptoms appear, as they overlap with many other common infections and medical conditions. It is important for these children to be fully evaluated.

Doing their best to minimize in-person visits, Cook Children’s Primary Care Physicians and Cook Children’s Urgent Care Physicians are partnering to provide telemedicine visits to help provide the quality pediatric care you expect from Cook Children’s.

A Video Visit allows a patient to have a remote visit with a Cook Children's primary care provider for non-urgent reasons. A patient must have a MyChart account to request a video visit.

• Desktop web browsers
• Mobile devices

Click here for tips on how to prepare for a video vist.  

“Many parents have simple questions that can be answered by a quick conversation with a pediatrician and do not require an in-person visit,” said Justin Smith, M.D., a pediatrician and medical director of Virtual Health for Cook Children’s. “This technology allows our pediatricians to help prevent the spread of COVID-19 while still providing high-level care to our patients.”

Patients can access telemedicine at Cook Children’s via two major pathways.

Both require two steps in preparation for a visit:

1. Patients must have active Cook Children’s MyChart accounts.
2. Patients must have the videoconferencing program Zoom downloaded to their device.

After that, parents can choose to either:

• Request a visit with their regular pediatrician by selecting the “Appointments” tab in MyChart or by calling their pediatrician’s office to set up an appointment. These appointments will be available during regular office times. When the time comes for a visit, patients go back to the appointments tab to complete e-check in and start the video visit. Click here to learn more.
• If your child’s regular pediatrician is not available, then you have the option to request a visit with the next available pediatrician by selecting the “Video Visit Now” tab in MyChart. Urgent Care doctors are available to see these visits from 11 a.m. to 9 p.m. every day. Once selecting the "Video Visit Now" button, patients are put in line for the next available provider.

In addition to telemedicine visits, Cook Children’s pediatricians are actively working to help keep patients safe by direct messaging with patient families and providing phone visits when video is not an option. Messages can include a picture or video and can be sent through the MyChart “Messages” tab.

For more on this, view the following:

• Primary Care Video Visits
• Urgent Care Virtual Visits
• Zoom: https://cookchildrens.org/mychart/Pages/video-visits.aspx
• My Chart: https://cookchildrens.org/mychart

Acknowledge All Feelings

• While children express stress in different ways than adults, they may still have many of the same feelings as adults. Sadness, worry, anger and feelings of loss may be common.
• Before moving to conversations about hope, ways to stay safe, and fun activities to pass the time, it is important to meet children right where they are emotionally.
• Validate your child’s emotions, “It is okay to be feel sad.” And let them know that you have felt that way too “I really miss seeing my friends, too.”
• Encourage expression of emotions in age appropriate ways. For example, art for younger children and journaling for older children.

Honesty is Best

• Even though you are doing your best to keep your child’s life feel as “normal” as possible, children can sense the changes going on around them, and they may have overheard adult conversations and news.
• Children also sense adult worry and anxiety.
• Children fear the unknown, and they often imagine things far worse than reality, so avoiding the discussion of Covid-19 with your children could cause more worry.
• To help your children to feel safe, explain Covid-19 in an honest, yet age appropriate way. See the resources below for age specific help.
• Begin by asking your children what they already know about Covid-19 or what they have heard, and build upon this knowledge. Your goal is to dispel misinformation and fears, not to cause more worry.
• For older children, use specific words children might have heard and ask if they understand the meaning (for example: social distancing, coronavirus, quarantine, pandemic)
• You don’t need to overwhelm children with information or great detail, but be willing to answer their questions openly, simply, and honestly.
• Follow your child’s lead. They will let you know when they have had enough information by asking to play or showing disinterest in the conversation.

Reassure Your Children

• Choose the right time to talk to your children. When you are feeling anxious or worried, this is not the best time. Take time to calm yourself before having important conversations with your children.
• Focus on what you are doing as a family to stay safe (washing hands, staying home, not attending social events, keeping distance from others while playing outside, and maintaining a clean home).
• Discuss how healthcare workers are doing their very best to take care of people who do get sick.
• Explain that most children are staying healthy, and most children have mild symptoms even if they get sick with this virus.

Keep Checking In

• As with any stressful topic, emotions and questions may change and develop over time.
• Revisit the conversation as things change, and be willing to discuss with your children when new questions arise.
• Watch children for signs of stress such as, lack of interest in typical play activities, trouble sleeping, or regression in development and contact your healthcare provider if needed.
• Reassure children that you will always be honest with them.
• Calm your children by explaining this will not last forever.

Routines Help

• Routines and predictability help children to feel safe.
• Keep old routines such as mealtimes and bedtimes.
• Create new routines and allow children to have control and choice in developing these routines.

Age Specific Resources

Preschool:

• Explaining Covid-19:
• Online book explaining social distancing

School Age:

• Printable book explaining Covid-19 (young school age)
• Video explaining Covid-19
• Comic explaining Covid-19

For other questions regarding COVID-19 and children, Cook Children's has developed a resource page with information for parents. 

Written by Cara Bozarth, a child life professional and clinical educator at Cook Children's.

It smells like strawberry Laffy Taffy.

This strategy works like a charm to get a strawberry flavored popsicle stick into a little one’s mouth, but in today’s world of COVID-19, they might have a new use as well.

New data from adults suggest that the anosmia, or the loss of the sense of smell, might be a sign more specific for COVID-19. This could be helpful in the middle of cold and allergy season when everyone seems to have cough and congestion. According to researchers, it's possible that between 30 and 60 percent of COVID-19 patients have a significant loss of smell. This seems to occur both before sypmtoms arise and along with other symptoms. 

While it might be difficult to assess with young children, parents and providers could be able to use loss of smell as an indication that COVID-19 might be more likely.

One important thing to keep in mind is that a lack of smell is likely to be significant if the child does not have nasal congestion, which would otherwise explain the symptom. 

According to the U.S. Centers for Disease Control and Prevention, the most common COVID-19 symptoms include fever, cough and shortness of breath. Some patients also report digestive issues like diarrhea.

Related Articles

• COVID-19 Testing Guidelines: Why Every Patient Won’t Be Tested For COVID-19 At Cook Children’s
• New Visitation Rules at Cook Children's Medical Center in Response to COVID-19
• Don’t rush to the doctor’s office. Here’s what to do if you suspect your child has COVID-19
• What Parents Need to Know About the Coronavirus
• COVID-19 (Coronavirus) Information
• Información sobre el COVID-19 (Coronavirus)
• How to Prepare for the COVID-19 (CDC)

My own kids have been asking questions and have been hearing lots of information about COVID-19. While he was still in school, my 6-year-old told me that his teacher mentioned a child in the Dallas area being sick with COVID-19. He then tearfully told me he was scared because he didn’t want the virus to “get him.”

I saw the fear and worry in his eyes. In that moment, I knew it was important that I proceed with caution, while also helping him to understand an age-appropriate version of what’s happening in the world.

You may also be struggling to find the right words to help explain things to your kids without frightening them or giving them more information than they need.

First and foremost, remember that you as a parent know your child best. You truly know their personality, as well as how they express their own feelings and emotions. Here are some general things you can do to help your child:

• In the words of Mr. Rogers, “look for the helpers.” Assure your children that scientists and medical staff are looking for all the ways they can to keep people safe and healthy.
• Try to maintain your regular routines as much as possible. Children thrive with consistent, predictable routines. They feel safe and cared for when they know what to expect. One of our routines is reading before bed and talking about our day. I make it a priority to keep this routine going.
• Limit kids’ exposure to media as much as possible. News coverage is not meant for little ears. If you think your kids aren’t picking up on things, please think again. Little ears are always listening.
• Monitor and limit your own media consumption. If you are constantly tuned in, you can become overwhelmed and your children will pick up on your fears and anxiety.
• Wash your hands! Wash your hands frequently and have your children do the same. Hands should be scrubbed for a minimum of 20 seconds (sing the happy birthday song twice through)
• Leave your shoes outside. Shoes are covered in germs!
• Routinely clean and disinfect surfaces. Pay special attention to things like door handles, faucets, light switches, counters and remotes. Let your kids help, give them a job and praise them for helping keep your family healthy.
• Prioritize sleep. Young or old, a rested body is important for physical and mental health.
• Try to get some movement every day. Have a living room dance party with your kids. Turn on some Kidz Bop, and don’t be afraid to let your kids see you act silly! Exercise releases feel good chemicals in your brain!
• Exercise your child’s brain, too. By now you may have been sent information from their school on work they can do during the day. But find time for some math, reading or science during the day. This seems repetitive.
• Consult your child’s pediatrician if you are concerned they have signs of illness.

Our amazing Emergency Department Child Life team shared some great online resources you can use with your children. I recommend you view them first before sharing with your kids:

Video for children:

https://www.brainpop.com/health/diseasesinjuriesandconditions/coronavirus/

Resources for caregivers on how to talk to children:

https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx

https://kidshealth.org/en/parents/coronavirus-how-talk-child.html

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/talking-with-children.html

Contracting COVID-19 near your delivery date could impact how you will care for your baby in significant ways.

Here are some tips to help prepare you and your new baby:

• Follow the advice of your doctor. Things are changing rapidly and they will be the best resource for up-to-date information.
• Contact your delivery hospital in advance to understand their policies regarding your partner and other visitors.
• Call your Cook Children’s Pediatrician for a Virtual Prenatal Consultation. You can meet your pediatrician in advance, and they can talk you through the policies we have in place to keep your baby safe and provide you the best possible care.

Find ways to cope with COVID-19 social distancing guidelines

There are more people staying home and you may have lost your usual activities due to the new restrictions. Social distancing doesn’t mean you’re alone.

• Stay in regular contact with family, friends and neighbors by phone, social media or other technology! Even a few minutes of conversation a day is important.
• Take part in healthy activities that relieve stress. Take walks, go outside, read or tell stories. Find ways to cultivate joy and connection.

Reduce the pressures of parenting

You may feel like you have a lot more on your to-do list, especially with kids at home.

• Feel good about what is going well and celebrate the small things! Pat yourself on the back for a decent meal, a funny joke or just quiet moments.
• Build a new routine at home. Remember to include breaks for everyone to take care of themselves with downtime, playtime and exercise.
• Speak up when you need help and offer support when you can.

Reach out for help

Sometimes the pressure can be too much. Reaching out for help is important for you and your family. The following are 24-hour free help lines for different needs.

• For confidential support when you need help with the stresses of parenting, call Child Help:
  • Call or text 1-800-4-A-Child (1-800-422-4453) or live chat at childhelp.org
• For help with teen specific concerns:
  • Call Texas Youth Helpline: 800-989-6884 or text 512-872-5777
• For help with parenting tips, local resources and to learn about family fun:
  • www.helpandhope.org
• For mental health support and crisis care, call iCARE:
  • Call or text iCARE at 817-335-3022
• For access to services through a social service hotline:
  • Dial 2-1-1 or 877-541-7905 or go to 211texas.org

For all other questions/updates on COVID-19, visit cdc.gov.

If you suspect a child is being abused or neglected, please contact the Texas Department of Family and Protective Services (TDFPS) toll free at 1-800-252-5400, 24 hours a day, 7 days a week. You may also file a report using the secure TDFPS website. Reports made through this website take up to 24 hours to process. The Texas Abuse Hotline is 1-800-252-5400.

For more resources:

• The Center for Prevention of Child Abuse and Neglect
• About The Center for Prevention of Child Abuse and Neglect
• Early Detection of Child Abuse and Neglect Training
• Predicting Child Abuse and Neglect
• childhelp.org
• Childhelp National Child Abuse Hotline

About The Center for Prevention of Child Abuse and Neglect

The Center for Prevention of Child Abuse and Neglect is focused on innovative ways to address this important concern in our community.

Through the 2007 Community-wide Children's Health Assessment & Planning Survey, child abuse/maltreatment was identified as one of the top seven health issues affecting the children of North Texas.

Child abuse and neglect includes the issue of child abuse but is also a more all-encompassing term that describes a wide range of behaviors and related risk factors that are unacceptable and must be addressed. These include:

• Sexual abuse
• Physical abuse
• Psychological abuse
• Neglect
• Neglectful supervision
• Medical neglect
• Threat of gang violence
• Bullying
• Cyber bullying
• Related trauma
• Trafficking

Learn more about our program here. 

Here’s what you need to know:

• We are taking every proactive step we can to get ahead of COVID-19 and prevent further spread of the virus.
• We believe it is our social responsibility to embrace these changes to protect the community.
• There is no vaccine or medical therapy for COVID-19. We are being aggressive with our prevention efforts because it is our best bet in combating this virus.

The care you need will still be available, but with a few changes aimed at protecting everyone.

The new guidelines are as follows:

COVID-19 Testing

Currently, Cook Children’s will only perform COVID-19 testing on patients who are admitted for inpatient care. No outpatient settings will perform this testing including primary care, neighborhood clinics, urgent care or specialty clinics.

Urgent Care Centers/Multi-specialties/Primary Care (shared entrances) Changes

A staff member with clinical expertise will be out front in personal protective equipment (PPE) to screen patients for any recent travel to an area with active COVID-19 and to evaluate symptoms. If the screen is positive then the family will be instructed to please return to their vehicle if the patient is stable and does not need immediate attention. The family will be given instructions to call the front desk number for further instruction.

The front-desk staff will answer the call and will offer a virtual visit or if needed families will be directed to a safe entrance for further evaluation.

Visitation Policy for Outpatient Clinics, Neighborhood Clinics and UCC locations

A maximum of one primary caregiver will be allowed per patient, per visit inside Cook Children’s primary care, neighborhood clinics, urgent care and pediatric specialties. Please designate the primary caregiver who will go into the room with your child upon arrival.

Appointments: No walk-in visits will be allowed.

All physicians (specialty, primary care and neighborhood clinics) will follow these appointment rules for at least the next six weeks:

1. Portal-scheduled visits will be temporarily disabled and when telemedicine options become available those will be opened on the portal.
2. If a current appointment is elective and therefore can be rescheduled these will be rescheduled to at least six weeks into the future.
3. If the visit can be carried out via phone or telemedicine this option will be available at provider discretion.
4. If the patient must be seen in person, then standard CDC screening and PPE precautions will be taken to assure safety for patients and staff.

Well-child Checks

All well-child check visits for children more than 18 months of age and who are up to date on vaccines will be canceled until further notice and rescheduled as soon as possible.

Any child who has not had all vaccines recommended to be given up to 18 months of age will continue to be seen for well-child checks until the immunizations are caught up to that age group’s recommendations. (Pre-18 month visits for immunizations are currently judged to be non-elective).

All attempts will be made to schedule well-child checks and sick visits separately. Well-child checks will be scheduled early in the day and sick visits will take place after a lunch break and the opportunity to thoroughly clean the office.

Elective Surgery and Specialty Clinic Visits

Beginning Friday, March 20, Cook Children’s will begin canceling and rescheduling surgical/procedural cases that are deemed to be elective through May 1. These decisions will be made by clinicians on a case by case basis in an effort to reduce person-to-person contact. Time sensitive, emergent and urgent cases will still take place. Parents and guardians will be contacted if their child’s appointment/procedure needs to be rescheduled. If you feel your child’s upcoming procedure or appointment can be postponed at least six weeks, please call your physician’s office. This change is being made in accordance with recommendations by the federal government and the American College of Surgeons.

“Cook Children’s remains dedicated to the care of our patients and our community during this public health emergency,” said Alice Philips, M.D., a member of Cook Children’s Physician Network’s COVID-19 Emergency Preparedness Task Force and a pediatrician in Cityview. “As a health care system, we are taking unprecedented measures to protect our patients, their families, the community, our physicians and staff. We hope people understand any inconvenience this may create and work with us, until this public health crisis is over and we return to a sense of normalcy.”

These changes will be followed for the foreseeable future. As with everything involving COVID-19, this situation is fluid and changing frequently. Please continue to follow Cook Children’s for the latest information.

Related Articles

• COVID-19 Testing Guidelines: Why Every Patient Won’t Be Tested For COVID-19 At Cook Children’s
• New Visitation Rules at Cook Children's Medical Center in Response to COVID-19
• Don’t rush to the doctor’s office. Here’s what to do if you suspect your child has COVID-19
• What Parents Need to Know About the Coronavirus
• COVID-19 (Coronavirus) Information
• Información sobre el COVID-19 (Coronavirus)
• How to Prepare for the COVID-19 (CDC)

The answer is we simply don’t have the ability to test every patient suspected of having the virus. And that’s OK, because our recommendations for taking care of those patients wouldn’t change based on the test results.

Currently, Cook Children’s will only perform COVID-19 testing on patients who are admitted for inpatient care.

“At this time, there is a shortage of testing supplies in both public health laboratories and clinical laboratories. Labs cannot keep up with the demand of testing every patient who has symptoms of COVID-19,” said Morgan Pence, Ph.D., a microbiologist at Cook Children’s. “At this time, Cook Children’s is unable to test every patient suspected of having the virus.”

The number of tests currently available in the U.S. is not enough to test every patient who is suspected of contracting COVID-19, so the medical field has focused on patients most at-risk who need to be tested immediately. In addition to not enough tests, there is a shortage of components of the test kit and a shortage of the sample tubes used to collect patient specimens. Labs cannot keep up with the testing demand of every patient who has symptoms of COVID-19.

In situations where there’s a known exposure and symptoms are consistent with COVID-19, the patient and family should call their primary care doctor and isolate themselves from others until they are no longer showing symptoms and they are well.

“The good news is that children have been the least affected by this virus,” said Alice Phillips, M.D., a Cook Children’s pediatrician at Cook Children’s Cityview. “If you suspect your child has COVID-19, call your doctor. It’s important to limit exposure to others and prevent the spread of the disease.”

As with everything involving COVID-19, this situation is fluid and changing frequently. Please continue to follow Cook Children’s for the latest information.

Related Articles

• New Visitation Rules at Cook Children's Medical Center in Response to COVID-19
• Don’t rush to the doctor’s office. Here’s what to do if you suspect your child has COVID-19
• What Parents Need to Know About the Coronavirus
• COVID-19 (Coronavirus) Information
• Información sobre el COVID-19 (Coronavirus)
• How to Prepare for the COVID-19 (CDC)