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Archive: Jul 2020

  1. Demystifying “It’s Just a Virus”

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    “I know that you are going to tell me that it’s just a virus, but…” 

    We’ve heard this utterance countless times from parents.  It is usually said (and understandably so) in anticipated frustration that we would not have a prescription that would quickly relieve their child’s symptoms.  Most likely the parent first heard the phrase during a sick visit for a cough or sore throat.  From a healthcare provider standpoint, the primary intention of “it’s just a virus” is to convey that viruses are different from bacteria, and that antibiotics – often perceived as the golden ticket to getting better the fastest – will not help the patient fight the viral infection.  Over time, however, “it’s just a virus” has inadvertently led people to believe that viruses are not as harmful as bacteria.  A pandemic like COVID-19 has been eye-opening for many to learn how serious viral infections can be.  

    How do bacteria and viruses differ?  Why can’t you treat a virus with an antibiotic?  What makes viruses so hard to treat?  Hopefully, the rest of this post will help you to understand these families of germs better.

    Bacteria and viruses do share some qualities.  They are both microorganisms – too small to be seen without a microscope.  They both can cause illnesses in humans that range from mild to moderate to severe.  They both vary in their rate of contagiousness and can be passed by sneezing, coughing, body fluids or in contaminated water or food.  This is where their similarities end.

    Bacteria and viruses are different in size, survival skills, and impact on humans.  Viruses are much smaller than bacteria.  The largest virus is only a fraction of the size of the smallest bacteria.  Bacteria are complex, single-celled organisms.  They live and reproduce on their own.  Viruses, on the other hand, consist of only a protein coat and a center of genetic material – DNA or RNA.  They must attach to a living cell to reproduce.  Without a host, they cannot survive.  Many bacteria are either harmless or, better yet, helpful to humans.  “Good” bacteria help by fighting cancer cells, destroying disease causing microorganisms, providing essential nutrients, or digesting food.  In contrast, most viruses cause disease. 

    In 1928, Alexander Fleming’s discovery of penicillin led to one of the most transformational medical developments in the last 100 years – antibiotics.  Antibiotics provide treatments for such infections as rheumatic fever and tuberculosis, as well as ear, skin, lung, bloodstream and urinary tract infections.  Antibiotics attack bacteria by either killing them or stopping their reproduction.  With repeated exposure, however, bacteria may develop resistance to the antibiotics.  Overuse or misuse of antibiotics (i.e. taking them for viral infections) is a large contributor to bacterial resistance and is considered to be one of the world’s most pressing health threats. 

    Viruses are much harder to treat since they are within the human host cells.  Most antiviral medications slow down the virus but do not kill it.  Antivirals keep the infection under control, or stop the virus from multiplying, while your immune system does the heavy lifting.  The cell walls specific to bacteria that antibiotics destroy do not exist on viruses, making antibiotics ineffective against them. Another big difference between our treatment of bacteria and viruses is the number of medicines available. Whereas at least one antibiotic is available to treat a given bacterial infection, most virus infections do not have a corresponding antiviral treatment.  The best way to treat viral infections is actually to prevent them with vaccines.  We’ve seen the successes with polio, measles, mumps, rubella, and chicken pox.  There’s hope that protection against COVID-19 will be similarly attainable.

    So where does this information leave us?  Especially when we continue to face an unrelenting viral pandemic.  Hopefully it:

    •  gives us an appreciation for the similarities (few & simple) and differences (many & complex) between bacteria and viruses.
    • allows us to be on the same page about our limitations for treating viral infections and reinforces that antibiotics are not the answer.
    • puts us on the same page regarding the origin and intention behind that dreaded phrase.

    Ideally, we can now all agree it’s never “just” a virus.

  2. Staying Healthy in Phase III

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    We are a week into Phase III here in Virginia, and we’ve received many phone calls and questions during visits on how to best navigate the loosened restrictions. In this blog entry we’ll try to tackle the most commonly asked questions. First, we’d like to convey how appreciative we are to this community for all the steps you’ve taken to minimize the impact of COVID-19 in RVA, especially among our children. We sincerely thank you.

    The Basics

    • Continue to physically distance yourself from non-household members (ideally 6 feet or more).
    • Wash your hands when you return home, and before all snacks and meals – even if you’ve been home all day.
    • Wash with soap and water for at least 20 seconds.
    • If soap and water are not available, use hand sanitizer with at least 60% alcohol.
    • Avoid touching your face and eyes.
    • Wear a mask when in public indoor spaces.
    • Wear a mask at public outdoor spaces when a physical distance of 6 feet from non-household members cannot be maintained.
    • Assume your mask is contaminated. When removing it, pull off from/with the ear loops, then wash your hands afterwards.

    Visiting with Friends/Family

    • Whenever possible, visiting with family and friends should continue to be outside while maintaining physical distance of 6 feet between non-household members.
    • B.Y.O. ______. You name it, try to bring your own chairs, food, drinks, toys/activities, etc.
    • Keep gatherings small, and preferably to people whose symptoms, travel and distancing history you’re well aware of.

    Daycare

    • There is no right or wrong here. Many families are dual-income or single-parent, and may not have the luxury of sitters or nearby family members to help.
    • If you decide, or need, to send your child to daycare, become educated about the daycare policies regarding cold symptoms, fever, temperature screening upon arrival, clearance for return following illness, number of individuals per classroom, cleaning procedures, cohorting classrooms, etc.
    • If your child has any symptoms of illness, exercise caution and keep them home. (NOTE: for non-specific cold/illness symptoms, current recommendations are to consider patients contagious for 10 days from the first day of symptoms)
    • Develop childcare contingency plans in the event your child gets sick.
    • If the daycare does temperature screenings on arrival, do not give your child fever reducers (e.g. Tylenol, ibuprofen) in the morning before drop-off.
    • If your daycare requires a COVID test following an illness, please inform our schedulers when making the sick visit appointment. These visits are to be done in the parking lot, not in the office.

    Eating Out

    • Though Phase III allows for indoor dining, we still encourage and recommend outdoor dining at restaurants. Because most customers will not be wearing masks as they eat and drink, the potential for spread of COVID-19 is greater indoors.
    • Even in outdoor seating areas, ensure tables are 6 feet apart.
    • Bring your mask in the event you need to go inside to use the restroom.

    Pools

    • First and foremost, remember standard water safety precautions:
      • Children should ask before getting in the water & ensure an adult is watching them while in the water.
      • Dr. Mahoney always said, “the most dangerous setting for child safety is when everyone is watching, but nobody is watching.” The pool is a perfect example. The number of people can give you a false sense of security that all parts of the pool are being monitored. But there is so much commotion, sometimes caregivers and lifeguards can become distracted. Remain vigilant in watching your children.
    • Clean hands prior to eating.
    • Remember your masks in the event you or your child need to use the pool restrooms.
    • Inquire with pool managers about cleaning of lounge chairs, ladders, railings, and other frequently touched surfaces.
    • When socializing with other families, try to maintain a distance of 6 feet.

    Traveling and Vacationing

    • Travel by car whenever possible.
    • Bring a picnic blanket for meals on road trip days. You can pack your food/snacks, or do curbside delivery of food then picnic outside.
    • Bring your own groceries, or do curbside grocery pick-up at local grocers such as Walmart, Kroger, etc.
    • Eat as many meals in your vacation home/rental as possible. If you choose to dine out, we recommend outdoor seating as mentioned above.
    • Have masks handy for potty breaks or other times you may need to use indoor public facilities.
    • Consider gas station apps that allow you to do non-contact payment.

    Stay safe RVA! The sacrifices we made for the first 3-4 months made a huge, positive impact on the COVID-19 burden in our community. Hopefully these recommendations help you to safely and appropriately venture out.