School’s Out For….Spring?

This week’s guest columnists are Drs. Mark Carreras and Jacob Sellers, Family Practice residents at the University Hospital and Clinics here in Lafayette.

When I was a kid, the last day of class would end with a final bell, and we’d blast Alice Cooper’s “School’s Out For Summer.”  We were free, thrilled we’d “survived” another year, as if we’d reached high ground just ahead of a tsunami. With schools closed probably for the rest of the year, many kids celebrated pretty early.

For parents this is NOT a fun, exciting time (their lyrics: “Well I tried to make it Sunday, but I got so damn depressed”).  School’s definitely not out yet for summer, and while parents are used to kids’ summers off, this is very different.  There’s no more family vacation, with many household budgets taking a hit and vacation spots closed. Working parents must find babysitting and activities for their kids way before they were ready.  And there’s school work still to be done. At home.

Unless you’re a professional educator, schooling and teaching are tough. Who remembers what they learned in history, much less technical subjects like trigonometry?  While schools are transitioning to on-line teaching and assignments, parents must do their share to keep their kids from falling behind.  More on this below.

Doctoring must be done at home too. Offices and clinics have shortened hours, and visits are more time-consuming.  Many practices have parents wait in their cars, and staff call them when it’s their turn to come in.  Emergency Departments are COVID war zones, with really sick and contagious patients; not places you want to be with your child.

This blog’s a place to go for advice if your kid is sick.  If you’re reading this in the Advocate, note the blog address below.  Stock up on ibuprofen, tylenol, and benadryl. Make sure asthma medicine is refilled, as COVID can make trouble for wheezers. And don’t panic. Many kids are still getting cold and fever viruses, and parents worry it’s COVID.  Rest assured that in most kids, COVID is benign, and soon gotten over.  Only go to the ER if kids are short of breath, too sleepy to drink enough, or vomiting continually.

As a new parent, one of the most shocking realizations for me has been the power of the screen.  My 2 year-old is typically unreserved, energetic, and sociable. All at once.  He’ll hold a conversation with you while leaping from couch to chair.  However, a flip of the television switch turns him into an expressionless, drooling zombie.  I wouldn’t be surprised if he started moaning “..brains….brains….”

Limiting screen time may be the biggest challenge for parents during this extended school break, or school-at-home-for-the-rest-of-the-year.  But this battle is worth fighting, as increased screen time is linked with worse childhood obesity, depression, poor diet and constipation, and worse sleep.  In other words, an overall tanking of quality of life.  As Dean Wormer said in the movie Animal House, “Fat, drunk, and stupid is no way to go through life, son.”

One recipe for success during this COVID outbreak is maintaining a routine.  Filling kids’ days, making them adhere to school work and stay off the computer/phone/tablet/TV sounds tortuous.  However, mapping out a daily schedule can actually save time and make things easier.  Start with wake-up time, three meals, snacks, and bedtime. Then insert school work, indoor play time, outdoor playtime, chores, and family activity. There can be some fluidity in that schedule, but keep in mind that kids are happier and better behaved when kept to a routine. The wake-up, mealtimes, and lights-out should be reasonably enforced.

One daily activity that can’t be discounted is reading.  Study after study shows that reading with children improves brain development, social-emotional skills, language, and of course literacy.  Your schedule should absolutely include reading to your child, or them reading independently.  When they read on their own, make time to discuss with them what they’ve read.  One of the best opportunities to read to your child is bed-time. This should ALWAYS be part of the nightly ritual.

How you manage this challenging time will make a difference about how your children grow up.  Do you want them to be successful and happy?  Kids thrive on structure and reading.  Reinforcing these makes the difference between your kid being strong and independent, or being a screen-addicted zombie, depending on others for…..their brains!

Don’t Touch Your Face?

When we visited my 89 year-old mother-in-law last week, we met on the patio. Staying on the swings far from her chair, we couldn’t pass her the COVID virus if we were carriers.  My wife brought her own bottle of wine.  Later Nana went into the kitchen to refill her glass, and through the window we saw her pick up my wife’s bottle, examining the label, while we both slapped our foreheads: “Nana, go wash your hands!”

Staying safe from the COVID-19 virus, aka Coronavirus, is like playing “invisible force field,” where any surface (counters, door knobs, wine bottles) is potentially contaminated, and you need to wash your hands before you touch your face or food.  That’s how COVID, or any cold/flu virus, gets into your system.  You inhale it when someone coughs or sneezes near you, or you put it in your mouth, nose, or eyes with your fingers.

The good news is that so far, COVID doesn’t seem bad for children.  They get a cough, runny nose, and maybe fever, but many fewer kids are hospitalized for breathing trouble than adults. Like any other cold and fever virus, kids get by with ibuprofen or Tylenol for fever and pain, and plenty of fluids.

The bad news, and the main reason why schools and daycares close, is that kids spread infection around.  They cough and sneeze without covering their mouths, letting fly with virus-laden droplets.  They wipe their nose and mouths with their hands, and smear infectious drool onto every thing they touch.  Kids shed virus into the environment worse than adults, because they’re, well, gross.  So we close schools so kids don’t pass the virus from family to family, sending it into households with vulnerable family members- the elderly, cancer patients, or those with certain medical conditions.

Some kids get seriously sick from COVID.  The Chinese experienced some pediatric hospitalizations, with some critically ill. Kids with asthma might get it worse, or kids with heart conditions, or infants.  If your child has a potentially dangerous condition, be extra vigilant about who they contact, where they go, and what they touch.  And don’t touch your face!  More on that below.

Three weeks ago my wife and I were on vacation.  We weren’t in China or Italy; we were in the snowy woods of Quebec, away from crowds, cross-country skiing.  However, we flew home through Newark airport, part of New York City’s transportation network, with lots of international travelers milling about.  In the Customs line a kid next to us kept sneezing without covering his mouth, his parents oblivious. Great.

We haven’t gotten sick, so the little turkey apparently hasn’t given us COVID, but it’s  now revealing itself in Acadiana.  As you keep hearing, the best defense against catching the virus is good hygiene. Cough and sneeze into your elbow to avoid spreading the virus.  Don’t get close to anyone since they might be shedding it.  Wash hands frequently, in case you’ve inadvertently touched a contaminated surface. And don’t touch your face?

As we mentioned above, the virus gets into you through your mouth, eyes, and nose.  You can pick up the virus from a doorknob, a handshake, a handrail, and then when you touch your face, you pass it into those portals.  It’s remarkable how many times people touch their faces- on average several times per hour.  After all, faces are sensitive, and need scratching.  Noses need picking, thumbs need licking..

Telling people to stop touching their faces is like telling them to lose weight or stop smoking.  Eating badly, smoking, and rubbing your nose are all near-impossible habits to break.  Hence the draconian steps of closing schools, restaurants, and anywhere else people mingle. The virus spreads too easily, and people pick it up too easily as well.  And try teaching kids not to touch their faces!

That’s also why we’re advised to wash hands so much.  When we do touch our faces, we’re safer with clean hands.  Frequent hand-washing is easy for me, washing them over forty times per day at work anyway, before and after touching each patient.  But not everyone has that habit.

The CDC has warned that wearing a face mask doesn’t really stop the spread of infectious droplets. But maybe wearing the mask will keep you from getting your fingers into your mouth, nose, or eyes.  Maybe people should wear mittens instead.  And definitely, for the next few months, stay away from Nana.