Dear Colleagues, Friends, and Beyond,
This is one of those times that it is not a cliché to say that we are living in unprecedented times. The global emergence of COVID-19 has certainly displayed the weaknesses in our nation’s public health and health care systems, and it’s affecting every level of our society. Just about no aspect of our country is left untouched.
At the same time, it’s also showing us what is possible as a collective whole. Clinicians, allied health staff, health systems, state and local governments, early childhood, and so many, many more are all banding together to prepare, protect, and parry the expected increase in cases from coast to coast. This is not just practical — it’s a form of deep regard for the safety and ongoing existence of our fellow human beings. To see this playing out in community after community is so inspiring that I wrote a column about it: https://bit.ly/39YgK3t
Please know that your Chapter knows how hard you’re working to be prepared; whether you’re in front-line ambulatory settings, inpatient units, specialty care, public health, or the many other allied fields that touch children’s health, I know all too well how much time and effort is being expended. Untold long days, weekends, and nights are going into extraordinary planning. It’s appreciated.
Your hard-working Executive Director, Kia Kjensrud, has compiled (and is updating) a list of resources related to COVID-19 that may be helpful, at https://www.wiaap.org/wisconsin-immunization-program-covid-19-update/.
While children appear to not be as hard-hit as adults by COVID-19, they are still at risk from this pandemic. As child health professionals, it behooves us to remain ready and willing to ensure that children’s needs are still being met adequately in the short-term, and that conditions to allow them to flourish occur in the longer-term. As such:
- Children will still need health care, including immunizations, evaluation of illness and injury, hospitalizations, and care for chronic conditions — all the issues that continue to occur, despite a pandemic. While some delays in non-essential care may occur in order to afford the pandemic response, ensuring that children’s access to health care is not wholly pushed aside will benefit from your voices, locally and beyond;
- Children will need to be cared for, particularly as their parents may need to continue to work. While flexibility is being offered in child care standards and the like, we should ensure that children are not being given poor (or even dangerous) care in the name of expediency. Children still deserve experienced care from those who understand their needs. Work to speak up for prompt-but-child-protecting solutions to this concern;
- Additionally, many families rely on school and early childhood education programs to provide a fair amount of their children’s nutritional needs. Endeavor to help families learn where they can access food during this difficult time. Many schools are continuing to make food available for pick-up, thanks to flexibility allowed by the USDA. If those provisions have not been implemented, ask why — until you get meaningful change;
- Many of you are already assisting with the many questions and concerns from individuals, businesses, agencies, and beyond. Pediatrics often sits at the intersection of clinical medicine and public health, and this is no exception. Our friends in public health and infection control are being overwhelmed with queries, so where you can help provide informal guidance, it will be calming and a contribution to your community;
- Science communication becomes even more important in this kind of situation. We know how to do this — we routinely explain complex medical conditions to not only parents, but to children over a wide variety of ages. Take the opportunity to broaden this role: speak with media and others to ensure that high-quality information is being shared throughout our state;
- On that note, families may struggle to know how to explain to their children what is happening, why regular events are not occurring, why they can’t meet all their friends at the mall…and to adequately shield them from their own anxiety and worry. We are trusted voices that help guide families throughout these challenges, and should continue to do so;
- Essential personnel are not just front-line health care workers. As you all know, it take many others to back up the work that we do, from laboratory technicians to supply manufacturers to janitors and well beyond. Public safety and public health personnel are also working hard, and they will also have child care and other needs. Speak up in discussions for what they need as well, including health insurance, paid sick leave, and more;
- Take steps to be a voice speaking out for our marginalized and least well-resourced neighbors. Many families do not have backup child care for when schools and early childhood centers close, are not afforded paid sick leave, and may be out of work or facing deep pay cuts due to their place of employment partially or completely closing. These family issues all are pediatric issues as well. Speak up for policy solutions, community approaches, and informal assistance alike for addressing these needs.
Thinking longer-term, these may be the first steps to thinking about how to solve our ongoing societal challenges through well-designed policy solutions. As we eventually move towards this situation resolving, consider how to advance conversations about how this highlights the structural weaknesses in our existing system through an equity lens;
- Finally, be on guard for racism and discrimination around this pandemic. Long-since rife on an implicit level, and smoldering (and occasionally flaring) into the realm of explicit as tensions rise. COVID-19 cares not a whit for your race, ethnicity, religion, gender, sexual orientation, immigration status, or political affiliation. The AAP nationally has long since spoken on this subject, and it’s never more important than it is at times of national stress like this.
I hope these ideas and conceptual frames give you some ways to think about the broader picture of children’s health in this unique time in the world. Your Chapter continues to remain dedicated to the health of all children in the Badger State, and we can only do so alongside our fantastic members, partners, and colleagues throughout Wisconsin.
AMERICAN ACADEMY OF PEDIATRICS, Wisconsin Chapter
Dipesh Navsaria, MPH, MSLIS, MD, FAAP, President