Katrina Cordts, PhD, assistant professor and pediatric psychologist, UNMC/Nebraska Medicine
How important is it to have a routine for your children?
“It is even more important . . . but also in terms of their mental and physical health and well-being”
How about a routine for the parents?
“Especially so for parents . . . that’s especially true for children”
How trying is this time right now?
“I think it’s difficult . . . the better off we will be long term”
Any advice for parents of children?
“So we are talking a lot about routines . . . even if it’s not scheduled down to the minute”
What advice do you have as this continues on?
“Continue to have open and honest conversations . . . it’s going to be really important”
How important is Telehealth right now?
“It’s hugely important it allows us . . . how to cope with some of the challenges that they’re facing”
What are the challenges parents are facing right now?
“Naturally families are still trying to do things like limit technology . . . when all the learning is being sent to them via online platforms”
At what point should people seek help?
“If you’re noticing that you’re having just these overwhelming feelings . . . that would be a good time to get help from a professional.
Kate Fiandt, Ph.D. Colleg of Nursing professor, University of Nebraska Medical Center
I have a loved one at home sick with COVID 19, what is your best advice on taking care of a sick loved one?
Well you know they’ve got the COVID19 and so obviously the main things are to keep them comfortable, symptom management, so just like any other type of viral illness, fluids keeping them comfortable, pain management, because a lot of people are very achy. The other thing that people worry about is fever, and so certainly managing the fever. We really are getting away from using ibuprofene for fever, and so we are talking about mostly using Tylenol. And so the two things that I recommend is that you be really careful about how much Tylenol you give, especially if somebody happens to have a compromised liver, liver disease, they can’t have Tylenol so you really have to talk to your primary care about what they’d recommend, but watching the dosing of Tylenol, no more than two regular strength Tylenols every six hours. The other thing I like to remind people is you don’t have to treat every fever. A fever under certainly under 101 I would never treat, remember it’s a natural immune response to just let is go rather than worry about it, the fever is the bodies effort to fight the virus. I worry about the caregivers, caregivers worry, so you need to be really thoughtful about who the primary caregivers are keeping the patient as isolated as possible from children, and certainly from anybody at risk, somebody who has chronic lung disease, somebody who is older, and so the person who is doing most of the care should be the person who is at least risk. So those are the things I would start with. The thing I would worry about when to call when to go to the ER is definitely respiratory distress, so that when they are having shortness of breath, having trouble breathing, that’s what we really worry about, the fever the body aches and pains are part of the virus, the respiratory distress is when it becomes a serious illness.
Pete Iwen, Director, Nebraska Public Health Lab
Where do we stand today on testing?
0:04 – 0:25
“Well we are better today than we were yesterday . . . we hope that we can at least test the people that are at high risk and need to be tested?”
Any advice for people living in western Nebraska on getting tested?
0:30 – 0:54
“They need to work with their health care provider, their health care provider can decide whether they need the COVID19 test based on symptoms based on who they were exposed to, their health care provider will work the health care coalition in that district and work then with the public health lab to determine if the test is warranted or not.”
Are we getting close to testing everybody?
0:58 – 1:15
“Are we getting close to testing everybody? I would say at this moment until the commercial companies develop assays that are approved by the FDA for real time, quick time testing, I would say we are still weeks to months away from doing that.”
Lauren Edwards, M.D. adult psychiatrist, University of Nebraska Medical Center and Nebraska Medicine
Every day I hear something about coronavirus. I’m a little scared. Is this normal?
“Absolutely it’s normal to be a little alarmed ... to weather this crisis successfully.”
Why are people panicking about coronavirus?
“So anxiety thrives on uncertainty…that you’re feeling.”
I’ve heard the term panic shopping? Why are people panic shopping? Am I justified for stocking up on supplies?
“I think people are panic shopping because they don’t know…what you should be stocking up on.”
If I have to quarantine myself, what can I do to stay healthy mentally?
“A lot of people are facing the prospect of quarantining … entering in the picture as well.”
Justin Weeks, Ph.D., a clinical psychologist with Nebraska Medicine
How can I keep all of what’s happening in perspective?
“In terms of putting it into perspective…take things one step at a time.”
What can be done to prevent an increase of alcohol and drug use?
“One thing people do as a response to stress…use it as a means to cope.”
Ryan Edwards, M.D., psychiatrist at the University of Nebraska Medical Center and Nebraska Medicine talks about what parents can do in these difficult times.
What are some signs your child may be struggling with fear over coronavirus?
“It’s important to keep … get professional help.
What do parents need to keep in mind when it comes to media consumption?
“It’s important to keep in mind that children … filter the information but answer as they come up in real time.”
What are some things we can say to reassure our children?
“One of the things that I would say to help reassure your children … were doing everything we can to keep our family safe.”
What can I do with my kids if we’re all at home to keep mind off the situation?
“With any natural disaster … will be critical.”
Children can act out during times of stress. What advice can you give parents to reduce the stress around them?
“Children will manifest stress in a variety of different ways … That can be a very, very powerful intervention if it’s structured and done every day.”
Matt Beacom, M.D., an assistant professor and family medicine physician in the University of Nebraska Medical Center College of Public Health. He also is a farm safety expert.
What are the signs and symptoms of COVID-19 or coronavirus and what should I do if I have it?
“The signs and symptoms of COVID-19 . . . and cough medications.”
Those who live in rural areas are known for hard work and can-do attitude. What is your advice when it comes to coronavirus?
“In growing up in a rural environment myself … now is not the time to do that.”
How should our interactions change in the rural environment?
“The interactions significantly need to change … and now is not a time to be social.”
What do I need to know about wiping down surfaces? How long does coronavirus live on surfaces?
We don’t really know … therefore it is prudent to wipe them down appropriately.”
When should someone seek medical attention?
“The greatest thing to seek … start moving toward the hospital and calling ahead to let them know you’re coming.”
Jeffrey P. Gold, M.D., chancellor of the University of Nebraska Medical Center.
What are some of the top rural concerns regarding the coronavirus?
Audio (mp3) | 25 seconds
“I would put at the top of the list accurate information sharing – ability to communicate in a timely fashion with up-to-date information to physicians, nurses, pharmacists and others regarding training, regarding precautions, regarding appropriate use of protective equipment – think masks, gowns, caps and things along that nature.”
What are some of the top rural concerns regarding the coronavirus?
Audio (mp3) | 30 seconds
“Equipment and supplies -- do our critical access hospitals and small community hospitals have an adequate amount of that? I can tell you I the large cities we are struggling with that. While we do have a reasonable amount of that material on hand, it’s certainly not infinite and if this continues to grow, as it has along the coasts to rural America, those supplies are going to be particularly limited in our rural and particularly critical access hospitals.”
What are some of the top rural concerns regarding the coronavirus?
Audio (mp3) | 31 seconds
“If individuals show up with the signs and symptoms of COVID-19 or coronavirus disease, what capabilities will our rural hospitals have to make that diagnosis, to provide timely testing and access and then get those specimens into the hands of a laboratory that’s got the capacity to make a determination in a timely fashion. Hospitals and health systems in rural America need to be watching very carefully.”
Do you see surge capacity for rural hospitals being an issue?
Audio (mp3) | 1:08 seconds
“I think it’s very much unknown at this time. If you look at other parts of the world, think Italy or certainly in China, and any other parts, we have seen outbreaks in those communities that in both the rural and the urban communities. You know we see a concentration of that in the large urban communities in America now and certainly other parts of the world and that’s because of the density of the population and the way the virus spreads by droplet transmission. But as people travel across the country from urban to rural communities back and forth, you know, think about people that are part of our supply chain, people who work for our railroads, people who work for trucking industries, farmers and ranchers who have to bring things back and forth to different markets. That’s when the interaction between individuals who have either been exposed actually even be ill and not know it themselves can occur and then unknowingly they would bring that back to their rural community.”
Do you feel rural hospitals are prepared to handle these cases?
Audio (mp3) | 42 seconds
“What’s going to happen in the rural communities actually is on a somewhat different scale. If one or two nurses or one or two physicians were to have to be quarantined or become ill in a large urban medical center, they could be covered for relatively easily. But if one of two critical physicians or nurses, pharmacists, etc., in a small critical access hospital were to become ill, that could be an impact of a totally different proportion. So we have to watch very carefully, stay tightly connected to what’s going on in the rural hospitals and attempt to try to prevent exceeding the capacity of what those hospitals may need to deliver.”
Broadband and telehealth have been a big issue for rural communities. Can these play a role in addressing coronavirus?
Audio (mp3) | 49 seconds
“We believe they can, they should and they will. Certainly the ability to deliver telehealth services which is what exactly what we want to do. So if there are individuals who have a fever of a cough or is somewhat short of breath, and they’re not sure what to do, in a rural or an urban setting, the best thing to do is make a phone call rather than get in the car and head off to your local emergency room or health professions office. But telehealth also is going to play a role in screening, it’s going to play a role in how we manage critically important supplies and equipment, and it’s also going to be a way of supporting families because people are going to have all kinds of very important questions – should I go to work, shouldn’t I go to work, etcetera, and telehealth can help do that.”
Jeff Harrison, M.D., professor and chair, UNMC department of family medicine
How do I know I have COVID-19 with other viruses like the cold and flu still circulating?
“That’s one of the big challenges that we have right now as health care providers and the entire industry is being able to separate out which those are. The problem is there are so many symptoms that overlap among COVID-19, influenza and the common cold, they all have a cough, which becomes a very nonspecific sign to help health care professionals and the public delineate those things. So COVID-19, and influenza tend to have a fever a fever of 101 or greater, which should raise concerns. The other common cold viruses don’t tend to have a fever. So if you are not febrile that’s a reason for a little bit of reassurance. Shortness of breath tends to go specifically with COVID, much less so with influenza and again the other common cold viruses that we see. Probably the most specific finding is actual exposure to someone who’s got the illness, so if a close personal contact, family member, someone you’ve spent extended time with, is diagnosed with COVID and you develop fever, cough, shortness of breath, you’ve probably got COVID. One of our big challenges right now is we just don’t have enough testing supplies, it’s a much more complex test than many of the things that we do otherwise, so if you’ve had exposure and you have symptoms of fever, cough and shortness of breath, the assumption is that you have the illness and really should self-quarantine. Unless you become extremely short of breath you develop any confusion, you have any trouble breathing any chest pain at that point we would want you to come in and seek medical care. But call your medical provider ahead of time, we are still trying to mitigate the number of people who would be exposed by anyone who potentially have the illness.”
What viruses are currently still circulating in the population other than COVID-19?
“We are still seeing a lot of influenza A, which we’ve all gotten a little bit complacent with, it’s a number going down each week, I believe there were still 16,000 cases still last week. We’ve had almost a quarter million cases of influenza in this flu season so it is still quite prevalent and it probably has more overlap with the COVID-19 than the other common respiratory illnesses. But they are still out there, rhinovirus is out there, non-COVID coronaviruses are out there, metapneumovirus virus, RSV are still all out in the communities. Most healthy adults tolerate those just fine. It’s that nuisance common cold that we’re all used to. The most important thing to remember most of those will not cause a fever they will not cause confusion they will not cause shortness of breath. They will give you the runny nose, the sneezing the ear plugging, so that becomes another delineation so when you have those symptoms you can actually pretty comfortably be thinking yeah this is probably just a common cold. We don’t tend to see that with the COVD or the influenza.”
What illnesses are still circulating among kids?
“We are still seeing more influenza b among the kids, the good news is as spring comes we are seeing less RSV we are still seeing a lot of the typical rhinovirus. One of the few good things we that we can say about COVID-19, children and infants tend to be relatively spared and tend to do much better than the adults and older folks.”
Should people take their temperature every day?
“Daily temperature monitoring is a good, so the folks that we are asking to monitor closely, I’m a contact of a contact who may have had exposure, twice daily temperature monitoring is actually a good way to monitor because you may develop fever before you develop other symptoms and at that point we want you contacting your doctor.”