Presentation for Greenwich Public Schools PTA Council Public Forum 1/29/2021, focusing on 1) COVID19 Vaccination for Children, 2) PE & Sports Clearance for COVID19+ Students, 3) Mental Health Challenges for Children During The Pandemic

1. 
COVID19 Updates Related to Children
3 HotTopics
Katherine Noble (”Dr. Katy”) | January 29, 2021

2. Today’s Outline
 COVID19 Vaccination for Children –
 where things stand now
 PE & Sports Clearance for COVID19+
Students –
 new guidance
 Mental Health Considerations for
Children –
 Depression/anxiety & what to
watch for, constructive ideas to
keep your child and family
moving forward positively

3. COVID19Vaccination for Children

4. The latest information on COVID19
vaccinations for children:
AAP infectious
diseases experts
participated in a
virtual town
hall and offered
important insight

5. Enrollment in clinical trials
for children 12-17 have begun

6. COVID19 vaccinations for children
MAY be available this summer

7. Ensuring Vaccine Safety:
what is the process?
 Clinical trials –
pharmaceutical
industry, FDA
 Post-licensure safety
studies – CDC
 Other organizations
weigh in – including
AAP, ACIP, AAFP

9. CDC

11. COVID19Vaccination for Children
 We cannot “bridge” all data
from adults to children – but
it helps
 Enrolling children in clinical
trials will be a necessary part
of the process

12. COVID19Vaccination for Children
 Vaccines can affect the immune
system differently in children
 We need more time to study
COVID19 vaccination in children
before we can determine its
safety and efficacy in this
population
 Once approved in older
children, we can begin to
evaluate it in younger children

13. Will I support COVID19Vaccination for Children?
• In theory … YES
• I believe that vaccines protect
children
• I believe in the organizations
that study and approve
vaccines in this country
• I believe reducing disease
burden in children will be vital
in fighting the pandemic and
protecting more vulnerable
populations

14. 
COVID19 in Children Is Like …

15. Should the COVID19Vaccine
Be Mandatory in School?

16. Clearance for Return to Sports
after COVID19 infection

17. COVID19 & Myocarditis
 Current data suggest
a very small
proportion of
children with
COVID19 infection
can go on to develop
a serious condition
called myocarditis
(heart muscle
inflammation)
 Symptoms can include:
 chest pain
 shortness of breath
 palpitations
 syncope (loss of consciousness)

18. The Risk of Myocarditis IsVery Low
and is an area of ongoing research & discussion
 Fortunately, most children
are either asymptomatic or
minimally symptomatic with
COVID19 infection –
 this is also what I have
observed in my own
practice since the
pandemic began

19. New Guidelines & Guidance
 Among experts and
academic institutions, there
is a general consensus that
risk of cardiac complications
increases with more
significant symptoms of
infection
 There are recent AAP
guidelines, as well as
guidance from various
academic medical centers

20. FromThe AAP
 The AAP released its latest guidance
(12/7/2020)
 Your pediatrician will provide specific
guidance
 The school will provide additional
requirements

21. Post-COVID19 Clearance May Include
(depending on symptoms & age):
 Office visit with your
pediatrician at the
appropriate time
 10-14 days symptom free
 +/- EKG
 +/- Cardiology consult
 Additional testing may be
recommended, particularly
if there were any cardiac
symptoms
 Severe infection will always
warrant the oversight and
care of a pediatric
cardiologist
 Once cleared, the child must
start a graduated return to
activity over a 7-day period

22. Progressive Return to Activity

23. What Should I Do If My Child Already Had COVID19
& Plays Sports
Connect with your pediatrician
Consider setting up a formal visit if your child had significant
symptoms

24. Pediatric health care providers have
your child’s best health interests at heart!
As recommendations regarding COVID19 change,
your pediatrician will continue to provide
new guidance.

25. 
Mental Health

26. With the pandemic…
 Increased rates of depression & anxiety
 New onset eating disorders
 School avoidance
 Substance abuse
 Increased suicide rate

28. FeelingAnxious versus
Having an Anxiety Disorder
 Feeling anxious or worried is a normal
part of human existence
 Before a test
 Before a race
 Watching a scary event unfold – in real
life or on the news
 Anxiety disorders develop when these
worries are so persistent or extreme
that they cause distress and disability
in everyday life

30. Signs of Anxiety Disorder: Watch For
 Avoidance: not going to school, not
participating
 “Somatic symptoms”: headaches,
belly aches
 Sleeping difficulties
 Needing excessive amounts of
reassurance
 Trouble concentrating & poor
school performance

31. Signs of Anxiety Disorder
 Eating problems: too much,
too little
 Explosive or oppositional
behavior

32. Treatment
 Anxiety disorders in
children generally
carry a good
prognosis
 Psychotherapy
 Medication
 if therapy & other
measures have not
been effective

33. Developing your own tools
 Understand anxiety: “anxiety
breeds anxiety”
 You can stop the cycle by
accepting your worries and not
fighting them
 Take a moment for a “reality
check”  is this really
something I need to worry
about???
 Relaxation, meditation, exercise

35. Depression

36. 
Depression can come on suddenly…

37. 
Or rather quietly, insidiously …

38. Shame is part of the problem

40. Signs and Symptoms
 Depressed mood or irritability
 Less interest or pleasure in doing
things
 Change in appetite or weight
 Difficulty sleeping
 Psychomotor agitation or
retardation – feeling sped up or
slowed down

41. More Serious Signs and Symptoms
 Fatigue or loss of energy
 Feeling worthless or guilty
 Difficulty concentrating
 Difficulty making decisions
 Thoughts of death or suicide –
repetitively
 Psychosis (delusions, hallucinations)

42. Worrisome associated conditions
 Increased risk of eating disorders (anorexia, bulimia)

43. Worrisome associated conditions
 Substance use (drugs, alcohol… )

44. Suicide

45. Good common-sense recommendations
For Anyone Struggling with Anxiety or Depression
 Eat healthy foods
 Get regular exercise
 Get outside for fresh air

46. Good commonsense recommendations
for Anyone Struggling with Anxiety or Depression
 Get proper sleep!

47. StartThe Conversation withYour Kids
Establishing Common Ground
“I’m frustrated
by these pandemic restrictions….
aren’t you, too?”

48. Normal emotions for children
during COVID19
• Feeling cut off from friends
• Feeling let down
(graduations, proms, sports
seasons, special events or
vacations cancelled or
postponed)
• Feeling annoyed by daily
restrictions, including
masks

49. 
Do’s & Dont’s forYour Kids….

50. Don’t let your frustrations lead you
to make bad choices
 Don’t smoke, vape, or
experiment with drugs
 Don’t spend time on
electronic media in
ways that can be
harmful to you
(violent games,
connecting with
strangers, etc.)

51. 
Cell phones:
a tool that can get out of hand

53. Night-time Cell Phone Use:
A Slippery Slope

54. Keep an open dialogue with your child

55. Connect
JOYS, SORROWS, FRUSTRATIONS

56. Be open to getting help
 Expose the problem & talk
to someone you trust
 Encourage or seek
professional help
 Therapist
 School psychologist
 Psychiatrist

57. Suggestions
• Establish new and fun routines
with your family – make dinner
together, bake together, movie or
game night
• No video games, TV or cell phone
use during school hours – whether
you are learning remotely or in
school
• Use technology to connect with
those you care about and avoid
excessive electronic media that
isolates you

58. Suggestions
• Remain open in talking
• Take on projects to help your
family or others in the community

59. Other Ideas….
• Spend time with friends
outdoors
• Stay active: run, jog,
hike
• Read a new book
• Research new hobbies
or skills to learn

60. A little humor with your kids
can go a long way

61. My favorite GIF on Garbage Day