Q&A: College of Medicine – Phoenix physician talks about pediatrics in a pandemic

Q&A: College of Medicine – Phoenix physician talks about pediatrics in a pandemic

By University of Arizona Health Sciences
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Gary Kirkilas stands in front of the mobile health unit he uses to reach homeless and disadvantaged communities.
Gary Kirkilas stands in front of the mobile health unit he uses to reach homeless and disadvantaged communities.

Gary Kirkilas is sharing some difficult news related to COVID-19 that parents may not even be considering: He expects an increase in child drownings this summer, and he's sounding the alarm to help raise awareness about pool safety.

Kirkilas is a father of three, a pediatrician at Phoenix Children's Hospital and an assistant professor at the College of Medicine – Phoenix.

More children are at home without camps and other summer activities that have been canceled because of the pandemic, he noted, adding that inflatable pool sales have skyrocketed this summer.

"This increased time at home means more exposure to their pool and, thus, more chances to have an accidental drowning," he said. "With home schooling now the norm, parents are taking on the additional role of teacher, which means their attention/supervision is now even more divided."

Kirkilas works with some of the Phoenix community's most vulnerable populations, from homeless families to victims of abuse. He is a spokesman for the American Academy of Pediatrics and is passionate about making sure parents have the information they need to make good health decisions.

"I really enjoy blog writing, media appearances, distilling down complex information so that it could be readily understood and applicable," he said.

Kirkilas recently reflected on what it's like to be a pediatrician during this global health crisis. 

What is changing for children's health during this pandemic?

We're seeing vaccination rates plummeting currently. Orders are down by about 60%. This school year when kids come back, up to 60% of them will not have had their vaccines. Herd immunity is achieved when 90% of a population is vaccinated. So, there's a possibility we could see more outbreaks of measles and diphtheria and things that we didn't have to really deal with or think about in the past. That feels like a tidal wave coming in the fall when schools request updated vaccination records.

In what ways has your clinical work changed during the pandemic?

For my work with Phoenix Children's Hospital, we unfortunately have had to stop using the Mobile Medical Units (40-foot medical RVs complete with two exam rooms, a laboratory and a pharmacy) due to infection control constraints. These mobile medical units are used exclusively to provide free pediatric care to homeless and disadvantaged communities here in Phoenix.

Research tells us that homeless and disadvantaged communities have been hit hardest with COVID-19, which makes it particularly sad that we can't connect with them. We are still offering telehealth visits via Zoom, which works great, assuming your patient has a smartphone or laptop with a data plan. But this isn't a reality for most of our homeless and disadvantaged patients.  

What concerns related to the pandemic are you hearing from parents of your patients?

Because the majority of my patients are homeless or (come from) disadvantaged communities, the parents I speak with have the added worry of finding and keeping a roof over their heads or keeping their job, along with avoiding infection with COVID-19. I can sense a real change in anxiety in the conversations we have since the COVID pandemic took effect. COVID-19 is obviously creating a large socioeconomic impact on everyone, but disadvantaged communities are already dependent on limited public resources.

I would also say this anxiety is present in all parents I speak with regardless of socioeconomic status. There is so much unknown about COVID-19 (that) it leaves parents worrying about what would happen if they or their child should contract the virus.

We're all learning new things because of the virus and the measures we've taken as a society to reduce its spread. As a doctor, what have you learned?

It has been most surprising to learn how many parents are now getting their medical information from social media and other news outlets, which can be both a blessing and a curse. Traditionally, medical information has been dispersed to parents from their pediatrician or family doctor. But now, with social media, parents have a wealth of information – or misinformation – at their fingertips. This trend has been going on for some time now, but I feel COVID has ushered in a new awareness of health media. I've personally learned that I need to be more aware of what is trending in health media circles to be able to combat misinformation and fear-based headlines.

The American Academy of Pediatrics is urging a safe return to school this fall. What is the academy's thinking on this issue?

We know that children learn best when they are physically present in school. School is much more than just a place to learn math, grammar and science. It is where social and emotional development takes place, where physical education, mentoring, individualized education plans and even behavioral counseling takes place. Some students depend on food service in their schools.

The big question is, then, how and when do we safely return students to school? The "how" relies on a couple strategies with the aim of mitigating viral spread: cohorting classes so that there is minimal interaction with other students, social distancing and masking when feasible, and protocols enforced when a student does become sick with COVID. The "when" relies on what the specific community viral spread looks like. For example, in communities where the virus is rapidly spreading, it would be wise to hold off on starting in-person school.

What is one piece of advice you find yourself giving to parents right now that you can share with employees who are parents?

Parents – like myself – are being bombarded by headlines about hospitals surging with patients and multisystem inflammatory syndrome in children, so I try to point them to some factual-based good news. I stress that the ongoing data from the U.S. shows the overwhelming majority of children with COVID-19 do surprisingly well. Many have either no symptoms at all or mild symptoms from which they simply can recover at home. Even when they do show worsening symptoms and require hospitalization, only 2% require admission to intensive care units. Holding on to factual-based information is especially key during these chaotic times.

A version of this story originally appeared on the University of Arizona Health Sciences website.

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