Novel Coronavirus Information

September 12th, 2021:

  • Masks

    • We know that all of our families have the wellbeing of their children at the heart of  their decision making process. We believe that universal masking in schools is both best for our individual children and for the community as a whole. We see teaching and helping a child to wear a mask as both an act of self compassion and of being a compassionate community member. 

    • Children's Hospital Colorado has some great resources to review on masking in schools

    • While we all look forward to the day when kids will no longer need masks, there may actually be some non-COVID benefits to wearing them.

    • We have been impressed with the capacity of so many of our young children and patients to not only wear a mask but to also understand the part they are playing in their community.

    • There are only rare circumstances that we can write a medical exemption letter for a child. These include children who could not remove a mask on their own if needed and children with severe forms of autism. We know that there are some children 2 and over who have a very difficult time keeping a mask on. If we can be helpful with a letter of support to the school that outlines the difficulty they may have, you can set up a telemedicine appointment to discuss that with one of our providers. This would not be an exemption letter but would rather help the teachers understand why a child may have a difficult time keeping a mask on 100% of the time. 

  • Testing

    • We continue to primarily rely on Children’s Hospital Colorado for testing. They are currently only offering drive up tests at their main campus in Aurora. They utilize the PCR (most sensitive and accurate) test and have reliable turnaround time of 24 hours or less.

    • If  Children's Hospital is not a viable option for you, we have some limited capacity to send PCR tests to Labcorp or Quest (turn around times are more variable ~2-5 days) OR you can find free testing sites here.

    • We have rapid antigen tests for COVID at HIP. These are useful in a limited number of circumstances. They are not sensitive enough to clear a child for return to school. A negative rapid test requires a PCR test to confirm the negative result. If a rapid test is positive, COVID is presumed and 10 days of isolation is required. 

    • For testing, contact us to discuss options with our triage team.

    • Children’s Hospital offers saliva testing for children 4-18 years-old who are symptomatic.

  • Vaccine

    • The best studies on the vaccine for pregnant people and breastfeeding moms indicate that it is safer to be vaccinated than to be unvaccinated both for the mother and the newborn. Well summarized answers to FAQ's 

    • We recently received approval to administer COVID vaccines at HIP. We will have clinic times set up in the coming weeks to administer the Pfizer/Biontech vaccine to adolescents 12 and up. This is currently the only vaccine with Emergency Use Authorization for children down to 12 years old. When the Moderna vaccine is authorized for emergency use, that will be an option at HIP as well.

    • As a practice, we have followed closely the data on the mRNA vaccines and their use in children. We strongly recommend that eligible children be immunized against SARS-CoV 2 (the virus that causes COVID-19).

    • Vaccines are available at Children's Hospital Colorado. Those with a MyChart account can self schedule there. Adults without an account can sign up here

  • Office visits

    • We continue to take rigorous precautions to keep everyone safe for in-office visits. We continue to see well families in the office in the morning and early afternoon. Rooms are wiped down thoroughly between visits. We are prescreening all of our visits and any potentially contagious patients are being seen outside. We now have a carport at the rear of the building where we can conduct those car visits when there is inclement weather.    

    • Well visits are taking place in person and we have availability. You can now self-schedule for some of the available time slots via MyChart or call to set up your next appointment. 

    • We continue to recommend the American Academy of Pediatrics well visit schedule which includes visits at 2-5 days old, 2 weeks, 2, 4, 6, 9, 12, 15, 18 months, 2, 2.5, 3 years old and then yearly visits from age 3-18, years old.  

 

April 12th, 2021:

Anyone 16 or older (adults included) can schedule an appointment for the Pfizer/BioNtech COVID vaccine at Children's Hospital Colorado

Updates from Children's Hospital Colorado

Most children with COVID-19 continue to have mild to moderate cases. Children’s Hospital Colorado has treated children with the inflammatory illness MIS-C which is believed to be triggered by the novel coronavirus. This remains a rare but serious complication. More information from Children's Colorado

  • Testing

    • We continue to primarily rely on Children’s Hospital Colorado for testing. They utilize the PCR (most sensitive and accurate) test, have ample availability for drive up testing and have reliable turnaround time of 24 hours or less. 

    • For testing, contact us to set up a telemedicine appointment to discuss your situation or to be seen in person if needed. 

    • Children’s Hospital offers saliva testing for children 4-18 years-old who are symptomatic

  • Vaccine

    • We are grateful to have our providers and many of our clinical staff fully immunized with the Pfizer/BioNtech vaccine

    • The Pfizer/BioNtech vaccine has been authorized for emergency use down to the age of 16. Anyone over 16 (including adults) can receive the Pfizer/BioNtech vaccine at Children's Colorado. Those with a MyChart account can self schedule there. Adults without an account can sign up here

    • Vaccine trials for 12-15 year olds have looked promising and we expect vaccines to be available for that age group in the coming months. 

  • Office visits

    • We continue to take rigorous precautions to keep everyone safe for in-office visits. We continue to see well families in the office in the morning and early afternoon. Rooms are wiped down thoroughly between visits. We are prescreening all of our visits and any potentially contagious patients are being seen outside. We now have a carport at the rear of the building where we can conduct those car visits when there is inclement weather.    

    • Well visits are taking place in person and we have availability. You can now self-schedule for some of the available time slots via MyChart or call to set up your next appointment. 

    • We continue to recommend the American Academy of Pediatrics well visit schedule which includes visits at 2-5 days old, 2 weeks, 2, 4, 6, 9, 12, 15, 18 months, 2, 2.5, 3 years old and then yearly visits from age 3-18, years old.  

November 12th: Audio update (Flu, COVID and wellness recommendations)

 

We are still primarily utilizing Children's Hospital Colorado with their drive up testing locations. A hospital or lab based PCR test from a nasal swab is the most sensitive test at this point and that is what we recommend. 

If you think your child may need a test, send us a MyChart Message or call our office to speak with a member of the triage team. Testing is generally recommended for children with cough, fever, chills or shortness of breath lasting more than 24 hours or any congestion, runny nose, sore throat, body aches, headache, fatigue, nausea or vomiting lasting more than 48 hours. 

   

October 12th: COVID-19 and School/Daycare

We are monitoring the changing recommendations from the Colorado Department of Public Health and Environment. If your child has symptoms that may be COVID-19 related or has had an exposure at school or daycare, contact us and our triage team can begin to answer your questions. In many cases we will suggest a telemedicine appointment for evaluation with one of the providers. In other cases, an in-person appointment will be necessary. 

 

September 27th: Audio Update. Listen to our latest audio update with information on the flu vaccine and COVID-19, including thoughts on testing and recent studies.

June 30: 

How do we plan our life for the next few months?

Our family is having the same conversation that many of you are having right now. How do we decide who we can see, when we can travel, what should we do about school, what about grandparents….? (more)

Pediatric Inflammatory Multi-system Syndrome (PIMS): Helpful information from the AAP

May 7:

Testing for those with symptoms: For kids and parents with symptoms of fever, dry cough, body aches, loss of sense of smell. We can start with a telehealth or in person visit and then arrange for a nasal swab test. Currently we are recommending drive up testing with Children's Hospital Colorado which requires a referral from us and has a 24 hour or less turn around time. 

Antibody testing: in most cases this is not for patients with active symptoms. This requires a blood sample and currenly we are referring kids (over 10 only) to National Jewish Hospital. We expect a reliable, rapid test for these antibodies to be available in our office in the coming months, but it is not available at this point.  Antibody testing (IgG and IgM serology) is to determine who has already been exposed to the SARS-2 virus (COVID-19) in the past. 

 

April 21: HIP is gradually expanding our capacity for well visits while maintaining all the precautions we have put in place. We look forward to connecting with many of you soon! Check out the new information below and our latest audio update here


Cultivating Wellness (new page)


Your HIP team is here to support you...

Know that your team at Highlands Integrative Pediatrics is adapting to these unprecedented times and continually reshaping the services we provide with key goals in mind

  • Keeping you and your family safe

  • Providing up-to-date corona virus recommendations, support and evaluations when needed

  • Addressing non-coronavirus illness and mental and bevavioral health concerns

  • Delivering the vital preventative and general health and wellness support that you have come to expect from us

  • Staying connected with you and your family to support wellness in these trying times

Here's how...

  • Only well children and well parent/gaurdians are being seen in our main exam rooms and come through the main entrance of the building

  • We are asking that one parent bring just the child who is due for a visit when possible

  • Well visits are taking place in the morning and early afternoon. In addition to our own ongoing assessment of the situation, we are following the current guidelines from the American Academy of Pediatrics, Children's Hospital Colorado and the State of Colorado

  • Families with illness concerns including fever, congestion, cough, body aches, sore throat etc who need in person visits are being seen in the later afternoon in our tent exam room (in the parking lot) or in our studio which has a separate entrance at the rear of the building.

  • Telemedicine: We now offer virtual visits for Highlands Integrative Pediatrics families! These visits are with one of the providers and are  covered by insurance in the same way that in office visits are. In some cases, copays may be waived by your insurance plan

                                   
    • lactation consultations, virtual sick visits (for some illness presentations), behavioral consults, COVID19 support

    • To schedule call or text (720) 583-4470 or send us a message in MyChart

 

Reliable Online Resources

 

If your child has a cough and fever:

  • Call our triage line or send a message on MyChart to speak with our nurses and physicians on call.
  • As long as there are no breathing problems or symptoms concerning for an ear infection (ear tugging, difficulty sleeping, increased fussiness), we may advise you to stay at home and start with a telemedicine appointment. The recommendations around testing are evolving. If you think your child may need to be tested, give us a call and we can give you the up-to-date recommendations.  If your child or any family member develops cough, congestion with or without fever, we recommend that you self-quarantine for 10 days from the start of your symptoms.
  • If you are unsure whether your child is having breathing concerns or other symptoms that require evaluation, please send a MyChart message or call our triage team.
  • If your child or a family member has a medical condition that may put them at more risk from a respiratory illness (asthma, cystic fibrosis, diabetes, heart conditions, immunocompromised) and your child has a fever and cough, contact our triage line for advise.

Office visits

  • Our staff will be wearing masks, in order to protect you and your family.
  • We are using your car as the waiting room. Call us when you arrive for your appointment
  • We suggest bringing as few family members as possible to the office
  • We are able to do strep swabs, flu tests and some exams from your car, to avoid unnecessary exposure in the office. If your child needs to be seen in the office, we will ta

 

How to keep your family, and our community, healthy:

  • Minimize any close contact with people outside of your household at this time. Social distancing is important to help prevent the rapid spread of COVID. 
  • Stay home when you can, and support those in your community who can’t 
  • This is a great time to get your family outside! Walk, hike, jog, bike ride, play in the park… just try to keep about 6 ft from you and other people if possible :)
  • The obvious things: Wash your hands frequently with soap and water. Avoid crowded spaces as much as possible. Wipe down common surfaces with regular household cleaning products (doorknobs, cell phone, counter tops, the steering wheel, etc).
  • Remember to breathe. Inhale deeply so your belly rises for 4 counts, hold for 7 counts, exhale slowly for 8 counts. Repeat. Teach this to everyone you know. 
  • Put gratitude front and center. Appreciate the small things. Stay in joy. Stay as relaxed as possible. 
  • Take care of your community. Support each other. Get creative in doing so. When able, help elderly neighbors and family members who are most at risk.  Support small business when able.
  • Be kind. To everyone. Especially those who are working in service industries including (but of course not limited to) grocery stores, pharmacies, and mail delivery. Let's support each other through this.  
  • Practice being more in control of your feelings. This website is a fun way for kids (and parents) to explore that concept:  http://imaginaction.stanford.edu


We are here if you need us. Lots of love from your HIP healthcare team.

Instagram: @hipediatrics

Facebook: Highlands Integrative Pediatrics

 

Update 3/22/20: Audio update for HIP families and Poetry Respite (link)
 

Update 3/19/20: Ibuprofen and Elderberry

  • Ibuprofen:
    • Experts were worried that ibuprofen might make COVID-19 illness worse, so they recommended avoiding it until further research was done.
    • There is very little research overall on COVID-19, since it's such a new virus, so this is all very confusing for everyone.
    • The experts did some research. As of 3/18/20, Ibuprofen seems ok with COVID-19, but just to be on the safe side (since everything is so new and evolving), start with Tylenol first to treat fever (unless you have liver disease).
    • If you are on Ibuprofen (or other  NSAIDs, Non-Steroidal Anti Inflammatories) for other medical reasons, it's ok to keep taking them.
  • Elderberry:
    • Probably best to avoid elderberry for now.
    • Elderberry (Sambucus nigra) can be effective in preventing Influenza, but may worsen the COVID-19 infection. If you are science minded, or want the mechanism of action, a full explanation is below.
      • Sambucus nigra (Elderberry): There is preclinical evidence that elderberry inhibits replication and viral attachment of Human coronavirus NL63 (HCoV-NL63), different than COVID-19, but a member of the coronavirus family.
      • Sambucus appears most effective in the prevention or early stage of corona virus infections. Of note, Sambucus significantly increases inflammatory cytokines, including IL-B1 so should be discontinued with symptoms of infection (or positive test). An evidence-based systematic review of elderberry conducted by the Natural Standard Research Collaboration concluded that there is level B evidence to support the use of elderberry for influenza which may or may not be applicable to COVID-19 prevention. Typical dosing of 2:1 elderberry extract is 10mL -60mL daily for adults and 5mL-30mL daily for children.
      • To Avoid: Given the integral role of inflammatory cytokines (namely IL-1B and IL-18) in the pathogenicity of COVID-19, as well as the impossibility of predicting which individuals are susceptible to the “cytokine storm”, technically called secondary hemophagocytic lymphohistiocytosis, or sHLH, it appears to be prudent to avoid high and regular use of immunostimulatory agents which increase these cytokines. Again, in the absence of human clinical data, caution is warranted with elderberry, an immune activating agent, due to preclinical evidence of increased IL-1B and/or IL-18 production in infected immune cells.

 

 

 

Contact Us

Please do not submit any Protected Health Information (PHI) through this contact form. All health and immunization forms requests must be submitted through MyChart patient portal, faxed, or dropped off at the clinic. We will not open or download any attachments sent through email in order to protect your child's privacy.