COVID-19 Germs Experiment for Kids! March 17, 2020 by Kylie Karley As schools are closing and some parents are working from home more than they regularly do, you may find your family spending more time together than before. Here’s a fun experiment to do with your kids to explain the importance of washing our hands amid the Coronavirus pandemic. What you’ll need: Pepper (which acts as the germs) Bowl of water (which acts as surface of our skin on our hands) Soap Step 1: Shake pepper on top of the water. Give it a good coat! These are the germs that are on the surface of our skin. Step 2: Have your child stick one fingertip directly into the bowl of water with pepper or “germs” on it. You’ll see the germs stick all over your hand when you don’t wash your hands! Step 3: Rub a clean fingertip in soap. Make sure it is coated well. Step 4: Stick the finger with the soap on it into the “germy” water and watch the germs spread out across the water! This is because the soap breaks down the virus!
Guidance on COVID-19 for Pediatric Kidney Disease Patients March 13, 2020 by Kylie Karley We know there are a myriad of questions surrounding COVID-19 and pediatric kidney disease during this unpredictable and unprecedented time. The follow list of FAQs were put together on March 12, 2020, in consultation with various NephCure Specialists who focus specifically on pediatric nephrology, to help you and your child maneuver through this pandemic in the safest possible way. As always, please consult with your nephrologist for specific guidance for your child. Should parents pull their immunocompromised children from school? Monitor the information from the CDC on COVID-19, as well as your local hospital’s website. These are your best sources of up-to-date information given the changing situation and variation in different locations. Doctors are currently most concerned about transplant recipients, dialysis patients, and children receiving moderate to high doses of immunosuppression, though we don’t know really know much about the increase in risk just yet. The situation is changing rapidly, and many schools are already closing. If your child’s school is currently open, you can generally send your child to school. If your child has recently undergone a transplant and is on high-dose immunosuppressants, he/she should probably stay home for now. As always, speak with your child’s nephrologist for specific instructions. They are an excellent source of information if you have ongoing questions. This situation is changing day-to-day, and this guidance may quickly become outdated. A good general rule is to follow the advice from the CDC that’s been issued for the elderly. Also check your local government’s website for information that may be more specific to your region. Should patients stop taking their immunosuppressants? You should never stop your child’s immunosuppressant medications unless you speak with your child’s nephrologist. Stopping medications can lead to rejection of a transplant or relapse of Nephrotic Syndrome. There may be rare situations where the immunosuppressive medications can be reduced or stopped, however please consult with your nephrologist first. How can patients who must go to a hospital or other center for treatment (like dialysis, plasmapheresis, etc.) protect themselves from exposure? Practice the general recommendations to limit spread: Handwashing, limit face touching, limit touching public surfaces (like handrails), stay away from other people as much as possible, etc. Pediatric-only centers will be better, if possible. Minimize sitting in waiting rooms and time spent in hospitals as much as possible. Clinics and dialysis centers have most likely developed plans to deal with the spread of COVID-19, including enhanced screening, separating patients into risk groups, etc. Routine medical center visits are probably safer than urgent care or emergency room visits. When should parents call their child’s doctor? In general, you should call for the same issues that would typically prompt you to call your nephrologist. COVID-19 may cause pneumonia and heart problems so call immediately if your child develops respiratory symptoms beyond a mild cough. It is best to call your doctor first, but you may need to take your child to urgent care or the emergency room if the symptoms develop rapidly and are concerning. Symptoms of COVID-19 infections are similar to those of a lower respiratory infection. Use the following guidance to determine whether or not your child needs medical care: Respiratory symptoms beyond a mild cough: difficulty breathing, rapid or deep breathing, or a severe cough Shortness of breath from continued coughing Refusing liquids with decreased urine frequency Crying without ability to be consoled Fever that is not responsive to fever reducing medications Behavior that is not normal for your child Bringing your child to an ER or urgent care “to get tested” or for minor symptoms is currently not recommended since many sites are not offering testing and there is a risk of exposure to COVID-19 and other serious infections. These recommendations are and will remain fluid. For the most up-to-date information, reference your local hospital’s website, your local government’s website, and guidelines from the CDC for high risk populations and children. These guidelines were generated on March 12, 2020, in consultation with: Larry Greenbaum, MD, PhD, Emory University Sangeeta Hingorani, MD, MPH, Seattle Children’s Hospital Elaine Kamil, MD, Cedars Sinai Medical Center Frederick Kaskel, MD, PhD, FASN, Children’s Hospital at Montefiore Kenneth Lieberman, MD, Hackensack University Medical Center Joshua J. Zaritsky, MD, PhD, AI duPont Hospital for Children
Special update on Coronavirus (COVID-19) for kidney disease patients March 10, 2020 by Lauren Eva NephCure is closely monitoring the situation with the Coronavirus (COVID-19) as it continues to develop worldwide. The World Health Organization (WHO) has declared a Public Health Emergency of International Concern over the global outbreak of the coronavirus, and on January 30th, Health and Human Services Secretary Alex Azar II declared it a Public Health Emergency in the United States. According to the most recent information from the United States Centers for Disease Control and Prevention (CDC), the majority of people who are exposed to the coronavirus will experience mild symptoms, and the likelihood for most people to develop serious illness after exposure is thought to be low. However, older individuals (approximately age 65 and older) and individuals of all ages with underlying health conditions (like kidney disease) or compromised immune systems seem to be at higher risk of developing serious COVID-19 illness. If you are taking medications like prednisone (steroids), cyclophosphamide (Cytoxan), cyclosporine (Neoral), mycophenolate (MMF, Cellcept, Myfortic), prograf (Tacrolimus), rituxan (Rituximab), or any other immunosuppressant drug, your immune system is likely compromised. Prevention is key. We urge you and your immediate family members to take the following precautions now to prevent or delay the spread of the coronavirus and limit your personal risk of exposure to it. Wash your hands frequently. Regularly and thoroughly wash your hands with soap and water for at least 20 seconds, especially after using the restroom, blowing your nose, coughing, or sneezing, or having been in a public place. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Why? The virus can be transferred in bodily fluids, including saliva and stool. Washing your hands with soap and water or using alcohol-based hand sanitizer kills viruses that may be on your hands. Avoid touching your eyes, nose and mouth. Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick. Keep space between yourself and others. Maintain at least 3 feet of distance between yourself and anyone who is coughing or sneezing. Why? When someone coughs or sneezes, they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease. Practice respiratory hygiene. Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately. Why? Droplets spread virus. By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu and COVID-19. Clean and disinfect your home. Practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones) using a regular household cleaning spray or wipe. Why? Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. Cleaning and disinfection is a best practice measure for prevention of COVID-19 and other viral respiratory illnesses in households and community settings. Avoid crowds as much as possible, cruise travel, and any non-essential air travel. Why? Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick. During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed. This information has been collected from the CDC and the WHO and has been reviewed by NephCure’s Board Medical Directors. In addition, you may want to contact your healthcare provider to ask about obtaining extra necessary prescription or over-the-counter medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time. If you have additional questions related to you or your loved one’s health, please contact your primary healthcare provider or nephrologist and follow their guidance. If you would like to be connected to a NephCure Specialist in your kidney disease, please refer to our list of experts here. If there are no specialists in your area, many of these doctors will provide a health consultation via phone. NephCure will continue to monitor world and US-based health guidance, and if new information becomes available that pertains to our rare and chronic kidney disease community, we will provide an updated statement. Additional information can be found directly from the World Health Organization or the Centers for Disease Control and Prevention: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 https://www.cdc.gov/coronavirus/2019-nCoV/summary.html