Pediatric Infectious Disease and the COVID-19 Response

April 2, 2020 by

By Debbie-Ann Shirley, MBBS, MPH, Clinical Director, Pediatric Infectious Diseases & Director, UVA COVID clinic

Q: Tell me about your work in pediatric infectious disease.
A: As pediatric infectious disease specialists, our division provides a wide range of clinical services to children here locally in Charlottesville, as well as across the commonwealth and beyond. One of the most important of these is to provide consultative services spanning a variety of infections, including the rare and serious. Our division works within the Children’s Hospital to provide interdisciplinary care in both inpatient and outpatient settings. We have developed several specialized programs for children, including for those with immunocompromising conditions. We also work closely with the medical center’s antibiotic stewardship program and hospital epidemiology/ infection prevention and control program to help meet the specific needs of our pediatric populations and help monitor for the emergence of infectious disease outbreaks.

Q: Tell me specifically about your work with the Coronavirus.
A: I actually have a small role working within a much larger team of courageous and dedicated colleagues to develop our preparedness plans and respond to the novel 2019 coronavirus (COVID-19) outbreak. We are working to address areas specifically related to pregnant women, pediatric patients and health care workers in anticipation of the onset of community transmission.

Q: Is there a task force?
A: Since early January, officials all across UVA have been busily working in task forces to ensure that both the University, Student Health and the medical center are as prepared as possible, working closely with the Virginia Department of Health. Procedures have been put in place to appropriately isolate patients with either confirmed or suspected infection in order to prevent the spread to other patients and staff. Management plans have been developed to help support the care of patients requiring hospital level care. There is a specific task force working to the Women’s and Children’s Hospital

Q: Do you work on this each day?
A: This is a continual effort, and many team members are working tirelessly night and day behind the scene to monitor the situation. Discussions occur daily, virtual meetings to relay information are very frequent throughout the day now and plans are updated as soon as we learn more or new guidance comes out. Everyone should make an effort to stay as up to date as possible each day, as our knowledge continues to evolve quickly.

Q: How do you handle how quickly things change?
A: It’s challenging! I feel like COVID is always on my mind. I have been doing my best to listen to the news, read publications, follow forums and stay in communication with colleagues. I check the CDC website on a regular basis too. I am really impressed with how much has been published within the medical literature on this virus over the past 3 months already. It is important for the global medicine community to share as much knowledge as we can to limit spread and help care for patients.

Q: How are you getting news/updates out?
A: Our Hospital Epidemiology and Emergency Management teams have worked with colleagues across UVA Medical Center to develop a response plan. Our service line leadership has also created a management plan for the special populations we serve in the Women’s and Children’s Hospital to help protect our team members and our patients as well as quickly identify any patients that may have COVID-19. This plan is being continuously updated, and I have been directing people to this great resource. Children fortunately seem to have a milder disease course, but are suspected to contribute to ongoing transmission. We still have to be prepared to take care of children though, especially those who may be at higher risk of complications, such as those who are immunocompromised or those with underlying comorbidities.

Q: What have you learned from this process?
A: I was still a trainee during the 2009 H1N1 epidemic, so this is my first experience as a faculty member preparing for a respiratory viral outbreak of this magnitude and severity. I am learning about how much team collaboration is involved and how essential clear and regular communication is needed, especially as plans changes rapidly.

Q: is there a contact, website, etc. if someone wants to learn more?
A: Here are three helpful websites that all providers should be routinely checking for updates.

  1. The CDC’s COVID-19 website for national updates
  2. The VDH’s COVID-19 website for statewide updates
  3. The UVA Health COVID-19 resource page for UVA specific updates

Q: What’s the one thing you’d like people to know about your work/this virus/etc.?
A: It is hard not to feel anxious about what we see going on in the world around us, so it helps to keep focused on factual information and appropriately use the tools of personal protective equipment, physical distance and hand hygiene while avoiding contact with our eyes/ nose/ mouth areas to keep us safe. It is hard not to feel frustrated that guidance may change rapidly as we learn more and try to respond as quickly as possible to changes, so draw on that fortitude and resilience that we all have within us to care for our patients and ourselves as best as we can. We may all be asked to help in different ways over the upcoming months, but we will get through this if we all can play our part by working together!

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