September 2020 Newsletter
Practice News & COVID Testing Update
Michael Miller MD joins the medical staff at Bambini this week.  Another male doc in the office!  Dr. Miller graduated from the Stevens Institute of Technology in Hoboken, NJ in 1998.

After completing medical school at Rutgers four years later, he spent a year at Beth Israel as a resident in Internal Medicine before heading back to Rutgers to complete his pediatrics residency.

In addition, he went on to a fellowship in pediatric infectious disease at Yale University from 2007 through 2010. (click here)
Bambini remains one of the only practices in the region to offer Sophia antigen testing.  We offer this test to parents and close family members as well for $75.

Some ask:  what is the difference between antigen testing and PCR?  Antigen testing is an FDA-approved nasal swab that yields results in 15 minutes.  We have done hundreds of these over the summer.  We actually just had our first positive -- on a patient that had been at summer camp out of state.  When the rate of COVID in a region is very high, antigen testing could miss an occasional case (false negative).  

PCR is currently considered the "gold standard."  This is a deep nasopharyngeal swab that is sent to Labcorp or Bioreference (Quest has not supplied us with test kits).  When COVID hit the southern states in early July, it took up to two weeks to get a result.  They have since shortened their turnaround time to 48 hours.
A few parents have already been asking when we will be giving flu shots this fall.  We do not yet have dates.  We wait until we have stock of both commercial (HMO) as well as NY DOH (VFC) vaccines.  

Perhaps as a silver lining of the social distancing / face mask mandate / etc, we have seen almost no Coxsackie virus, strep, roseola, fifth disease, etc. this spring and summer.  Kind of nice.  If that trend continues, it could be an extraordinarily light flu season!  
Our summer student volunteer program was such a success that we are continuing on with it this fall!  Learn what it is like to work in a busy pediatric practice - here in the era of ramped-up infection control.

Students will serve primarily as "concierge" - prepping exam rooms between patients and chaperoning families from the waiting room to their assigned spot with additional experiences as circumstances permit.

For more details, please click here.
The 21st Century Cures Act, passed in 2016, requires patients be provided access to all the health information in their electronic medical records without charge by their physicians beginning November 2, 2020.

Up to this point, Bambini has made most of the medical record available in our portal.  By the end of next month, we will be including progress notes, nurses notes, and other documents in patient portals for ready access.
Back to School Concerns
It appears that children with asthma will not be permitted to use a nebulizer at school this time around.

Nebulizers, at least theoretically, can aerosolize respiratory tract secretions.  Instead, children will need to use a metered dose inhaler + spacer.  
While wearing face masks here in the COVID pandemic has been quite a contentious mandate, there is agreement that medical exemptions are necessary and appropriate. Yet, there is little guidance for us on how to approach a request for an exemption.

Making the situation even more complicated is that it appears there will be variation among school districts and perhaps even teachers on how this mandate will play out in classrooms.  Some may provide mask breaks on the hour.  In other classrooms where there is adequate spacing and ventilation, masks might not be required during instruction.

We certainly understand that children with cerebral palsy, autism, severe anxiety, and related conditions may not tolerate a mask at school.  We encourage parents to first see how things shake out during the first few days back on this matter and share their concerns with the school before requesting a note.  
The New York State Department of Health recently recognized that, due to the COVID-19 lockdown this spring, many children fell behind on their vaccines -- especially those affected by the end of the religious exemption last summer.

Nevertheless, they are giving these children all of 14 days from the start of school to get every overdue shot on board.  This is regardless of whether they will be in the classroom, doing remote learning, or a hybrid program.  Click here for details.  
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