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Opinion: The Novel Coronavirus and its Impact on Children

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There are growing fears that COVID-19 is now linked to a syndrome in children who may be vulnerable to the virus and can become infected with minor irritants such as a rash, to more serious health issues such as cardiac arrest.

It’s called Multi-System Inflammatory Syndrome in Children (MIS-C).

According to HealthyChildren.org, the Center for Disease Control and Prevention identified a correlation between COVID-19 and MIS-C as up to half did not test positive for the virus. Doctors and scientists around the world are working to understand the syndrome and how best to treat it.

Parents should be aware that most children are not affected by the coronavirus, and reports of children who become seriously ill are rare and unusual cases. Presently, the best thing parents can do to protect their child is to call their pediatrician if they have any concerns about their child’s health.

Some of the symptoms to look for in MIS-C are: a fever lasting more than 24 hours; abdominal pain, diarrhea or vomiting; rash or changes in skin color; trouble breathing; and mental confusion or excessively sleepy. MIS-C affects older children, median age 9 to 11.

Dr. Omoniyi Omotoso, Lifelong Pediatrics clinical lead in Richmond, Calif. noted that there have been cases in Europe, and this past month, case reports in New York City of MIS-C during the ongoing COVID-19 pandemic. “MIS-C is a severe inflammatory process that overwhelms the child’s body leading to shock and often affecting the heart and other organs,” said Omotoso.

“Fortunately, with the strict adherence to the Shelter-in-Place policy in the Bay Area, we have flattened the curve at present and seen few cases of symptomatic pediatric (COVID-19) cases. And not surprisingly, MIS-C has been rare thus far with one confirmed case per California Public Health Dept.”

“Parents should seek medical attention if their child has these red flags such as persistent fever lasting four to five days, breathing difficulty, or rashes associated with swelling of hands and/or feet.”

MIS-C has been compared to another rare childhood condition called Kawasaki disease because it shares some of the same symptoms. Kawasaki disease is the leading cause of acquired heart disease in infants and young children under the age of five.

The condition causes inflammation in the blood vessels, and the symptoms can be severe. In addition to several days of fever, children with Kawasaki disease may develop symptoms such as rash, swollen neck glands, swollen hands and feet, and red eyes, lips and tongue.

Kawasaki disease is not contagious. It does not spread among family members or children in child care centers. The disease occurs more frequently in children of Asian or Pacific Island ancestry.  However, it can affect people in all racial and ethnic groups.

While MIS-C may sound frightening, the American Academy of Pediatrics reminds parents that the condition is still very rare. It is important, however, to call your pediatrician with any questions or concerns about your child. Always contact your pediatrician’s office for checkups, vaccines, or if your child is sick.

Children are presenting with MIS-C four to six weeks after peak COVID-19 infection rates. So, doctors say the best thing you can do for your family is to continue following recommendations about social distancing, masks, and hygiene, to avoid contracting COVID-19 in the first place.

Clifford L. Williams

Clifford L. Williams

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ESSAY: Technology and Medicine, a Primary Care Point of View 

The COVID-19 pandemic, for example, restricted millions of people to their homes, which required reliance on the internet for communication and information.  Personal internet searches became essential to understanding information about COVID, human physiology, symptoms, and keeping up with vaccine updates.  However, this increase in independent online research resulted in people accessing more misinformation circulating on the internet. This posed a challenge for medical providers trying to treat patients according to research-based guidelines.  With so much information within reach, it was difficult for providers to help their patients distinguish between legitimate evidence-based sources and opinion, speculation, and fabrication.    

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Dr. Adia Scrubb Photo provided by California Black Media..
Dr. Adia Scrubb Photo provided by California Black Media..

Dr. Adia Scrubb
Special to California Black Media Partners

Technology has enhanced communication between medical professionals and patients; improved patient care management; and eased access to care and information, benefiting both patients and medical clinicians.

However, despite the ease and many conveniences these patient care improvements have ushered in, adequate patient care still includes physician supervision, examinations, and interaction, which present challenges for keeping up with demands on the healthcare system and accurate patient education.

Technology has made more educational resources available at our fingertips, and it has created independence for those who want to know more about their bodies.

The COVID-19 pandemic, for example, restricted millions of people to their homes, which required reliance on the internet for communication and information.  Personal internet searches became essential to understanding information about COVID, human physiology, symptoms, and keeping up with vaccine updates.  However, this increase in independent online research resulted in people accessing more misinformation circulating on the internet. This posed a challenge for medical providers trying to treat patients according to research-based guidelines.  With so much information within reach, it was difficult for providers to help their patients distinguish between legitimate evidence-based sources and opinion, speculation, and fabrication.

Nowadays, patients continuously arm themselves with medical information and challenge clinicians with the research they gather from internet sources to advocate for themselves and their care.  This often leaves medical professionals with the complex task of navigating challenging discussions, pointing patients to validated and verified medical information, and following evidence-based medical guidelines for treatment.

Reviewing information before an appointment can certainly make an office visit much more productive, but it is essential to acknowledge the possible bias and limitations of internet searches.  Consideration of the author, source, and date of the information may help determine its validity.

Furthermore, simply asking medical professionals for their preferred patient information resources will direct patients to safe and validated information that is in line with standards of care practices.  This can help patients better understand the recommendations from their doctors and streamline their internet searches.

Access to individual online medical record information, such as blood tests, MRI reports, and office visit notes, has been a significant expansion of technology in medicine. This digitization of medical information enables and positions patients to take a leading role in managing their care.  What used to be multiple sheets of paper in a large file folder is now a click away at any time.  Despite these benefits, instant access can be overwhelming for both patients and medical providers, especially since patients, in many instances, can receive their test results online before the physician has had the opportunity to review them.

Patients may review the office visit notes or their lab results out of context or misinterpret information, which can lead to anxiety, confusion, and fear.  Clinicians are put in a difficult position when they are not able to suddenly break away from their scheduled office visits to reassure an unscheduled patient about their results and next steps.

Medical providers have tools to assist with identifying sensitive results that need urgent review, and efforts are made to notify anxious patients as soon as possible.  However, a patient can be proactive in scheduling a follow-up visit ahead of time to review results with their provider specifically.  This can help patients avoid the stress of suddenly trying to get a hold of their doctor when dealing with unclear or concerning results.  Normal test results often don’t require explanation, but allowing several days for your provider to work through hundreds of test results before sending messages requesting clarification will help medical professionals prioritize their responses to test results based on medical urgency.

Technological improvements such as online messaging and video/telephone appointments have made access to care much easier both for patients and clinicians.  Telephone and video visits have been especially beneficial for patients who are elderly, disabled, or do not have access to transportation.  However, the increase — and ease of — access has created much higher demand for physician time both during and outside of the office visit.  Test results, patient messages, insurance forms, emails, and medication requests are all pouring in while providers conduct their daily scheduled appointments.  Thus, very little time is left in the day for a clinician to respond to every email, fill out every form, and review every lab result when they are responsible for 1,800 or more patients.

This situation, unfortunately, creates a perceived delay in response in a culture where an instant response is expected from messaging and phone calls.  But the reality is that the medical provider is constantly playing catch up to thousands of inquiries due to the around-the-clock online access patients now have.

Patients can make the most of their experience and their physician’s time by taking the time to learn their physician’s communication preferences.  Despite the multiple modalities of access (telephone, email, video, in-person), a medical provider will have a preferred method of communication with their patients.  Some may ask their patients to make an appointment to explain a complex topic, instead of responding to multiple messages. Others may prefer to communicate via phone call if they have to deliver bad news.

There will likely be more medical providers who prefer to communicate only through email or video appointments as remote work becomes more common. If a patient’s communication preferences align with their physician’s preferences, it will create a stronger patient-doctor relationship and foster more effective and impactful communication.

The expansion of technology in medicine has fostered better collaboration, communication, and education between patients and their medical professionals.  Combining electronic resources with rapport, mutual respect, and trust for providers will help patients navigate this new landscape of healthcare.

About the Author   

Dr. Adia Scrubb, MD, MPP, is a Board-Certified Family Medicine Physician currently practicing in Solano County. 

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Alameda County

After Years of Working Remotely, Oakland Requires All City Employees to Return to Office by April 7

City Administrator Jestin Johnson recently told city unions that he is ending Oakland’s telecommuting program. The new policy will require employees to come to work at least four days a week. These new regulations go into effect on Feb. 18 for non-union department heads, assistant and deputy directors, managers, and supervisors. All other employees must be back at work by April 7.

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Oakland City Hall. File photo.
Oakland City Hall. File photo.

By Post Staff

The City Oakland is requiring all employees to return to the office, thereby ending the telecommuting policy established during the pandemic that has left some City Hall departments understaffed.

City Administrator Jestin Johnson recently told city unions that he is ending Oakland’s telecommuting program. The new policy will require employees to come to work at least four days a week.

These new regulations go into effect on Feb. 18 for non-union department heads, assistant and deputy directors, managers, and supervisors. All other employees must be back at work by April 7.

The administration may still grant the right to work remotely on a case-by-case basis.

In his memo to city unions, Johnson said former President Joe Biden had declared an end to the pandemic in September 2022, and that since then, “We have collectively moved into newer, safer health conditions.”

Johnson said “multiple departments” already have all their staff back in the office or workplace.

The City’s COVID-era policy, enacted in September 2021, was designed to reduce the spread of the debilitating and potentially fatal virus.

Many cities and companies across the country are now ending their pandemic-related remote work policies. Locally, mayoral candidate Loren Taylor in a press conference made the policy a central issue in his campaign for mayor.

City Hall reopened for in-person meetings two years ago, and the city’s decision to end remote work occurred before Taylor’s press conference.

At an endorsement meeting last Saturday of the John George Democratic Club, mayoral candidate Barbara Lee said she agreed that city workers should return to the job.

At the same time, she said, the city should allow employees time to readjust their lives, which were disrupted by the pandemic, and should recognize individual needs, taking care to maintain staff morale.

The John George club endorsed Lee for Mayor and Charlene Wang for City Council representative for District 2. The club also voted to take no position on the sales tax measure that will be on the April 15 ballot.

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Bay Area

Authorities Warn: There’s a COVID Surge in California

According to data estimates by the Centers for Disease Control and Prevention (CDC), the coronavirus in California’s wastewater has spiked for eight consecutive weeks. Hospitalizations and emergency room visits have also increased since the rise of the new subvariants. Over the last month, Los Angeles County experienced an average of 389 hospital patients per day that tested positive for the coronavirus. The FLiRT subvariants such as KP.3.1.1. Made up over 2% of coronavirus samples nationwide, an increase of more than 7% last month.

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Photo provided by California Black Media.
Photo provided by California Black Media.

By Bo Tefu, California Black Media

California is experiencing a COVID-19 surge this summer, experts warn, as numbers of infections increased for the third month this year.

State public health authorities attribute the summer COVID surge to more infectious subvariants that have emerged as the coronavirus evolves.

Dr. Elizabeth Hudson, regional chief of infectious disease at Kaiser Permanente Southern California, stated that subvariants of COVID-19 called FLiRT increased in recent months, particularly one named KP.3.1.1 that has become the most common strain in the country.

Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco, said that the subvariant KP.3.1.1 seems most adept at transmission.

“The subvariant is the one that people think will continue to take over, not only in the United States, but … around the world,” Chin-Hong said.

According to data estimates by the Centers for Disease Control and Prevention (CDC), the coronavirus in California’s wastewater has spiked for eight consecutive weeks. Hospitalizations and emergency room visits have also increased since the rise of the new subvariants. Over the last month, Los Angeles County experienced an average of 389 hospital patients per day that tested positive for the coronavirus. The FLiRT subvariants such as KP.3.1.1. Made up over 2% of coronavirus samples nationwide, an increase of more than 7% last month.

The majority of the people who tested positive for COVID-19 complained of a sore throat and a heavy cough. Risk factors that can increase the illness include age, underlying health issues, and vaccine dosage.

Health experts stated that the demand for the COVID-19 vaccine has increased in Northern California. However, people are having a hard time getting the vaccine due to the increasing number of cases.

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