What are medical protocols in a post-pandemic world?

What are medical protocols in a post-pandemic world? | Image credit: © sofiko14 – © sofiko14 – Stock.adobe.com.

In early April, everyone at our clinic here in Nashua, New Hampshire, received an email saying, “Effective immediately, masks are optional.” This was met with cheers and everyone removed their masks. We had tears in our eyes and commented how happy it was to see a smile on his face after three years of wearing a mask the entire time he was on duty.

CDC ends COVID-19 ‘public health emergency’ on 20th May 11, 2023, along with many policies related to the pandemic. Who will continue to wear masks, how many children and adolescents will continue to receive the boosters needed for the COVID-19 vaccine, and how often healthcare workers will recommend testing for COVID-19 In terms of that, I don’t know yet how this will play out.

easily look back

On January 31, 2020, U.S. Secretary of Health and Human Services Alex Azar declared novel coronavirus disease (2019 coronavirus disease) a public health emergency, urging all returning from the Wuhan area of ​​China to He ordered US citizens to quarantine for two weeks. On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a global pandemic.

We all remember what happened after that. Many people were hospitalized, intensive care units were overcrowded, and too many patients died (table).

Our response to the pandemic has been heroic. Rapid diagnostic tests were rapidly distributed, personal protective equipment (PPE) was secured, and a vaccine was developed in record time.

Over the past three years, pediatricians have done their best to help patients and parents survive the pandemic. We wore masks to protect ourselves and our patients from this terrible disease, and we fervently tried to get vaccinated, hoping that the pandemic would end soon. Unlike the 1918 influenza pandemic, which lasted for two years, the COVID-19 pandemic is finally abating after three long years. We are all curious about the impact of unmasking and the relaxation of COVID-19 measures by the CDC.

Now that it’s officially unmasked, I’ve made a few observations. First, it took me some time to get used to the “unmasked” experience again. Before I knew it, I would impulsively reach for the missing mask. Chronic redness on the bridge of the nose due to wearing a mask every day is gradually disappearing. It was so nice to see the faces of the patients (and their parents) again. I used hearing aids, but during the pandemic, my voice was muffled by the mask and I couldn’t rely on lip reading, so it was difficult to hear the answers to my questions. Now, patients and parents rarely have to repeat themselves.

After that office email, quite a few staff continued to wear masks. When asked, most said the medical office was a high-risk environment and that wearing a mask prevented most respiratory infections over the past three years. There are many patients in our clinic who continue to wear masks. Interestingly, one of her staff members who completed vaccinations and boosters contracted COVID-19 just two days after removing the mask. Is this a coincidence, or a result of masking being an option?

While we all wish to return to our pre-pandemic “normal” pediatric practice, the reality is that COVID-19 has changed pediatric practice forever. increase. Post-pandemic pediatrics will need to be very careful about protecting office staff from COVID-19 and other respiratory infections, many of which are likely to be highly virulent (during flu season). I just got over a strep throat epidemic right now here in New South Wales (Hampshire). It is clear that wearing a mask is prudent when caring for children with acute respiratory illness, and is something most health care providers and staff expect to continue for the long term. And we will never run out of her PPE again.

Fortunately, pediatric patients usually did not develop severe symptoms when infected with COVID-19. Of course, that is not the case with children’s parents and grandparents, and too many families have experienced pandemic-related deaths. A recent study found that exposure of young children to seasonal coronavirus infections other than 2019-nCoV leads to activation of T-cells that either prevent or milden most infections. have been suggested to provide sufficient protection against2

Moreover, despite the support of the American Academy of Pediatrics (AAP) and the CDC, after the FDA approved the vaccine for use in children, many children were not vaccinated against COVID-19 and eventually died. can now be vaccinated from an early age. as 6 months. According to the CDC, as of March 1, 2023, 68% of children ages 12 to 17 have received at least one dose of the COVID-19 vaccine, compared with 5 to 11 years old. Children are 39%, only 12%. Children from 6 months to 4 years old (shape).3 This vaccine reluctance is undoubtedly related to the perception by many parents that COVID-19 vaccines have been rushed to market and not tested as thoroughly as the routine vaccines their children receive. do not have.

After the COVID-19 public health emergency, the government will no longer distribute free COVID-19 test kits, and antiviral drugs may require insurance approval. With the acceptance of virtual visits by patients and providers, we hope that insurance companies will continue to pay for these visits at prices comparable to in-office visits. Just wait and see.

reference:

1. Provisional deaths from COVID-19: Focus on 0-18 year olds. CDC. April 12, 2023. Updated 04/19/2023. Accessed 19 April 2023. https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-on-Ages-0-18-Yea/nr4s-juj3

2. Humbert M, Olofsson A, Wullimann D, et al. Functional SARS-CoV-2 cross-reactive CD4+ T cells established in early childhood decline with age. Proc Natl Acad Sci US A. 2023;120(12):e2220320120. Doi: 10.1073/pnas.2220320120

3. American Academy of Pediatrics. Trends in children and COVID-19 vaccination. March 1, 2023. Accessed 19 April 2023. https://downloads.aap.org/AAP/PDF/Child%20Vaccinations%20Report%20US%20Cumulative%20and%20 Weekly%203.1.2023.pdf

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