In recent months, SARS2-CoV-2, a new form of a class of viruses referred to as Coronavirus has caused an illness known as COVID-19. COVID-19 has made headlines around the world and its presence in the US is escalating rapidly. The Centers for Disease Control (CDC) is providing updates daily. We are all feeling the changes in our daily routines as a result of COVID-19. Because of its spread, on March 11th the World Health Organization designated COVID-19 a pandemic. According to the CDC, “pandemic refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.” In response, the Boards of Directors of the Child Neurology Foundation and Child Neurology Society are issuing this joint statement to offer guidance to families and physicians during this difficult time.

To work together to stop the spread of COVID-19, there are some basic steps that you and your family can take. COVID-19 is spread through person-to-person contact so the more we can limit close contact in large groups, the better. It’s also absolutely vital to practice good hand hygiene (wash hands for at least 20 seconds and do your very best not to touch your face!). It is also important to stay home if you’re experiencing symptoms of COVID-19. The main symptoms of COVID-19 are fever, cough, and breathing difficulty (shortness of breath). For the general public, the CDC has released an excellent set of easy-to-follow guidelines for how to help stop the spread of COVID-19. They’ve also released a COVID-19 fact sheet that includes symptoms, and simple precautions that you can take in your day-to-day life.

For the child neurology community, where children and families may need to spend time in clinics and hospitals, or may experience lowered immunity, we’d like to provide some additional guidance for how to proceed during a time when COVID-19 has reached pandemic status. The CDC has created an additional COVID-19 guidelines page specifically for people at higher risk. Some additional recommendations include:

• Being extra cautious about attending large gatherings. The more you can minimize contact with folks who could be infectious, the better.
• Practicing social distancing by keeping six feet away from people when possible.
• Washing and disinfecting areas in your house frequently.
• Stocking up on a small supply of over-the-counter medications. In case you do happen to fall ill, it might be helpful to have basic cold and flu medications on hand to help keep you comfortable.
• Talking to your child’s healthcare provider. Ask them if your child’s condition or medication might put them at higher risk in the event of COVID-19 infection.
• If you feel your child or you have been exposed to COVID-19, calling your primary care provider first to know what to do.
• If you are sick and must go out, wearing a mask and avoiding contact with other families whose children might have compromised immune systems.
• Letting friends and family members know about the added risk of COVID-19 infection to your family so that they take extra precautions if visiting your home.
• Limiting visitors to your home when possible.
• If you have worries about your child’s medications, contacting your healthcare provider to make an appropriate plan.
• Asking if your healthcare provider offers a telehealth option if an in-person visit is not essential, or call them to see if your concerns can be addressed over the telephone.
• As this situation evolves, so do options for telehealth. Check in with your physician or medical institution if you’re interested in telehealth options, as many are making special concessions at this time.
• Using sanitizer or washing your hands before and after the medical appointment. Be assured, your healthcare provider is doing the same, often in the hallway, as they enter and exit your room.
• When possible, avoiding people who have symptoms of COVID-19.

Some of you may be worried about the impacts that contracting COVID-19 could have on your child.

Currently, the FDA is not reporting any new medication shortages as a result of COVID-19. In their official statement, they have said, “The FDA continues to take steps to monitor the supply chain. The Drug Shortage Staff within the FDA’s Center for Drug Evaluation and Research (CDER) has asked manufacturers to evaluate their entire supply chain, including active pharmaceutical ingredients, finished dose forms, and any components that may be impacted in any area of the supply chain due to the COVID-19 outbreak.” You can find the most up-to-date information on the FDA’s Drug Shortages Page.

In terms of other impacts on the child neurology community:

For those with epilepsy, the guidance from Epilepsy Foundation is excellent (also available in Spanish).

“Physicians in Italy have reported no significant changes in seizure activity in children with epilepsy. Most children who contract COVID-19 appear to exhibit only mild symptoms. However, if your child is taking a medication such as steroids that can lower their immune system response, there could be an increased risk for more significant symptoms. In addition, children with lung disease, such as asthma, may also be at higher risk. Therefore, it is important to practice preventative precautions. We hope that this information will help to reduce some of the fears that families in our community may be experiencing”, says Dr. Scott Pomeroy, President of CNF’s Board of Directors, and Chair of the Department of Neurology and Neurologist-in-Chief of Boston Children’s Hospital.

CNS President, and Director of Epilepsy and Clinical Neurophysiology at Boston Children’s Hospital and William G. Lennox Chair and Professor of Neurology at Harvard Medical School, Dr. Phillip Pearl echoes this statement:

“While children seem to show milder symptoms when exposed to COVID-19, it’s still important for them to practice social distancing and vigilant hand-washing measures, when possible. This is especially true if they have weakened immune systems, or regularly come into contact with children with weakened immune systems. Physicians are doing everything that they can to accommodate remote appointments when possible. If this is something you’re interested in, we recommend that you check in with your healthcare provider to ask about options in your area”.

If you have any concerns, or think that your child may have contracted COVID-19, we encourage you to reach out to your child’s primary care provider first.

We’d also like to take this opportunity to thank our front-line healthcare professionals, and say, “We see you”. We would be remiss if we didn’t draw attention to the hard work that healthcare professionals do every day. In times of high alert, healthcare professionals are at increased risk of falling ill themselves, not only because of increased exposure, but also due to added stress, long hours, and a potential lack of self-care. If you are a physician, nurse, or other allied healthcare professional reading this, we hope that you’ll be able to take the time to rest up when you can, drink water, take a walk in the sunshine, watch an episode of your favorite show, or otherwise give yourself a chance to rest and recover. Thank you for your hard work, and for supporting our community’s health every single day.

Let us be clear, we understand that an outbreak like this can be scary for families in our community. We hear you, and we are here to support you through this. If you and your family are feeling extra stress during this time, please reach out to CNF’s Family and Support Empowerment Program. You are not alone, and we are here to walk with you every step of the way.

On behalf of the staff and Boards for Directors of both the CNF and CNS, may you, your families, and everyone in your community stay safe and healthy during this time.

For media inquiries, please contact the Child Neurology Foundation by email at [email protected] or by phone at 612-928-6325.