The good news: few kids get seriously ill with COVID-19. The bad news: the pandemic is indirectly threatening critical support for children, specifically access to care and life-saving vaccines.
Recently, Italian authorities reported in The Lancet a series of distressing pediatric cases of delayed access to care in March 2020, during the height of their COVID-19 surge.
For these children, late care resulted in more severe disease, complications and a high mortality rate. The common thread in these cases is that families were afraid to seek care for their kids due to fear of COVID-19 infection.
A survey of U.S. primary care practices, undertaken last month by the Larry A. Green Center, showed that the primary care practice, children’s most basic access point for health care, is under severe stress. Adults and children alike are not receiving needed preventive care and patient visits have decreased dramatically.
Like many small businesses nationwide, primary care is fighting to stay solvent: nearly half of the 2,602 practices responding to the survey were unsure whether they could stay in business over the next month.
With families staying away from their doctors, recent reports show a dramatic decrease in childhood vaccine administration in March and April. This should raise alarm in Colorado, which regrettably sets the bar for one of the worst-in-the-country MMR (measles, mumps and rubella) vaccination rates for kindergartners.
Any further deterioration of kids’ vaccine coverage will further heighten the likelihood of outbreaks of life-threatening, vaccine-preventable diseases.
So, how can we keep kids healthy in the COVID-19 era?
First, we must maintain access to care with financial support for our state’s primary care infrastructure. Gov. Jared Polis and other Colorado elected officials must fight to ensure that primary care practices have immediate access to federal and state small business relief and health care rescue dollars.
As many practices have quickly pivoted toward telehealth, both commercial health insurance and government payors, like Medicare and Medicaid, must also quickly adapt to reimburse for both acute and preventive telehealth visits.
Second, when they reconvene this month, state lawmakers should expeditiously pass Senate Bill 163, which would balance improving our state’s child vaccination rates with respecting parental choice.
Third, the Colorado Department of Public Health and Environment should partner with primary care to help children whose vaccinations have been delayed get caught up.
Many primary care practices have turned to innovative approaches to deliver care, including “drive-through” vaccinations in their parking lots.
Finally, we must reassure families that health care facilities are safe places to go for care. Parents’ fears of COVID-19 are understandable, as we have all been deluged by stories of health care systems stretched beyond their capacity.
Fortunately, in Colorado we have made smart decisions, collectively and individually, to slow community spread, such that high-quality hospital-based and primary care has been maintained. Comprehensive patient and employee screening programs are in place at health facilities to protect patients and staff.
Please don’t delay necessary health visits for yourself or your children – our health care system in Colorado will be ready to care for you and keep your family safe.
David Brumbaugh, MD, is the Associate Chief Medical Officer, Children’s Hospital Colorado. Michael DiStefano, MD, is the Chief Medical Officer, Children’s Hospital Colorado, Colorado Springs.