Transcription:

Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole, and what a great and important podcast we have today, as we're talking about the Omicron variant, and our kids, what we really need to know as parents. And we're talking with Dr. Neela Sethi. She's a Pediatrician on staff at Henry Mayo Newhall Hospital and Valencia Pediatric Associates.

Dr. Sethi, thank you so much for joining us again. You are just always such a wealth of information and a really great guest. As we're talking about Omicron, and we're also talking about the other things going on right now. Have you seen an uptick in RSV and other respiratory illnesses right now, just kind of in general?

Neela Sethi, MD (Guest): Yes. The short answer is yes. And the long answer is yes. I will say I haven't seen flu take off. I've had some sporadic cases of flu, but I have had so much RSV and obviously so much COVID-19 in the last eight weeks or so.

Host: So, we're going to talk about this coinfection and how to tell the difference. But before we do that, tell us a little bit about Omicron and what we know now. Are we seeing more kids with this? Cause the original COVID-19, you know, was mostly elderly. So, tell us a little bit about this variant.

Dr. Sethi: Yeah, this variant, the Omicron variant seems to be affecting kids just in general, more. Now we don't exactly know if it's because our kids our just in school now and they're back to their activities, and so they have the chance to spread it more. But we're definitely seeing an uptick in pediatric cases, definitely seeing an uptick in pediatric hospitalizations, just in general.

I probably see about 25 sick kids a day and I'm averaging probably 50 to 75% positive rates for my testing, just with COVID-19 in the past, I would say four weeks or so.

Host: Wow.

Dr. Sethi: Yes.

Host: That's really quite a statistic. So, I'd like you to tell us, you're a pediatrician, for parents and our kids have always come down with stuff. But how are we telling the difference now, between flu, which you said you haven't seen a huge uptick, in RSV and Omicron. Can you give us some similarities and some differences?

Dr. Sethi: Sure. I mean, I think what I've been telling parents in general right now is if your child has a respiratory infection, you have to get swabbed because that is the only way for us to really and truly know, especially when they're babies, because they can't talk, they can't tell us how they feel. They can't tell us whether they have a headache or body aches. They can't tell us if they have chest congestion. They just don't feel well. So, when you're dealing with two and under, you should get swabbed right away. And really everyone should get swabbed, but it's a lot more difficult to tell two an under because they're not as verbal.

What I've been seeing in my personal practice is that COVID is presenting as sore throat, fatigue and body aches to start and fevers generally some low grade, some even higher. And then it progresses into a cold where they get, you know, runny nose, cough, congestion. Very similar to flu in that you just feel really crummy for the first couple of days and you can't really describe it. And we call that myalgias where your body just feels achy and tired.

RSV generally presents as cough congestion, pretty much right away. Patients will say, I picked my baby up from daycare and they had a runny nose, and then that night they started coughing. Generally, kind of wet wheezy cough is more associated with RSV than it is COVID. But again, it can be very difficult to tell and swabbing is the best way to know that.

I have been seeing a lot more upper respiratory sort of infections with COVID, more like snotty nose, runny nose, post-nasal drip and RSV tends to be more lower respiratory, which is like in the lungs, wheezy coughy, sort of like a wet wheezy cough. And again, that's not a hundred percent, but that's just sort of a generalized rule of thumb to distinguish the difference.

Host: Wasn't original COVID-19 was very lower respiratory, kind of moved up the lungs as they used to say, but now the Omicron not quite as much, right?

Dr. Sethi: Well, what I've read is that there's something about this spike protein, that's not landing in the lungs as well, but it's landing in the nasal cavity really well. And you know, these variants are smart, right? They know, okay, these guys have been vaccinated. I'm seeing a lot of antibodies for X, Y, and Z. Let me mutate into a different form where I can attack a different part of the body. These viruses will do anything they can to survive. So, what we're seeing is that it's a lot more contagious, but it's landing more in the nose and people are presenting with a lot more sinus symptoms, earaches, and just sort of upper, sort of airway congestion.

And they are getting a cough, but it's not because of tight sort of cough that people were describing with Delta and the previous infection. It's more like a tickle in the throat that's making them cough versus people saying, gosh, I feel like there's an elephant sitting on my chest. A lot less of those symptoms with Omicron.

Host: So, then based on everything we're talking about, can you talk to us about the co-infection aspect of all these respiratory viruses kind of happening at once? What do you tell parents about keeping our kids safe from these things? I mean, it seems there's almost no way to totally keep them safe, but with both of these viruses happening at the same time and possibly flu as well, what are you pediatricians telling us?

Dr. Sethi: Well, what we're telling parents is funny enough, we are still blessed that we live in a world where proper hand washing works. Like isn't that fantastic, that soap and warm water gets rid of carrier states under fingernails and on hands. And what we know is most of the time, we're touching our face or kids are touching their nose or picking their nose or picking their ears or picking their mouth and getting infections that way.

So, first and foremost is hand, proper hand washing techniques, teach your child how to regularly use antibacterial soap and how to properly wash them. How to properly wash their hands, pardon me. That's first and foremost. Second is mask wearing. Now I know that's a topic that people don't really want to discuss, but the fact of the matter is a proper surgical mask or medical grade mask does help.

Why is that? If the virus has a block to get into that nasal cavity and it lands on the mask, you're less likely to get sick. It's just another thing for the virus to have to get through in order to make it to your mouth. So, as best as you can train your child on a surgical mask or a medical grade mask, it's not as hard as we think. We've been at this almost two years. And let me tell you, I see a ton of kids with properly fitting masks that do just fine and can wear them all through the day. The third, and I probably think the most important aspect of this whole situation; and we've talked about this before, is food and vitamins. And we downplay that so much in pediatrics and it's such a huge impact on how people heal their bodies.

So, is your child getting a multivitamin? If not, it's time to start. With Omicron and with COVID we know that vitamin C, vitamin D and zinc help, C, D and zinc. We just know that. It slows down viral replication it, the virus doesn't like these things in your body, it boosts your immune system. So, if you can get your child on a proper dose of multivitamin and give them an extra bit of C, D and zinc, you can literally get this stuff in gummy form.

There is literally no excuse why you can't give your kids this. Now I know dentists don't like gummies, but I will tell you, when we're dealing with Omicron, have them brush their teeth twice because it helps. Food, if you're going to feed your child junk, you are going to decrease their immune system. If you give your child a healthy dose of fruits and vegetables that are filled with antioxidants, what do you think those, you know, those are going to do for your body.

They're going to rev up your immune system. They're going to help your digestive system. They're going to help you sleep better. They're going to just give you the fuel that you need to carry out your day versus if you're giving your kids junk food. So, food, diet, vitamins and then exercise. Keeping your kids active, getting them outside, moving their bodies, getting air to the deepest part of their lungs because they're running and they're jumping and they're climbing, that helps because they're moving all of their bodily fluids out of their lungs, out of their nose. And there's less of a chance for that virus to catch. Kids that are sedentary, kids that have weight issues, they tend to do worse than kids that are in a healthy BMI, and that are active just in general with any virus. And this holds true for COVID as well.

Host: Could you give us any better advice than you just gave us right there? I swear that should be the main leading story on every single solitary news station is the advice you just gave us. Now, you know, while there's so much politicized about this particular, you know, virus that's going around, can you give us an update from the CDC on our boosters for our five plus year olds? And some of the, what we're hearing is that parents have concerns about pediatric myocarditis. Can you clarify that for us Dr. Sethi?

Dr. Sethi: So, the booster is not available for five and up yet. The booster is available for 12 and up if it's been a specific amount of time and I believe it's four months, but you know, the guidelines change all the time. In my practice, we're about at six months. What we tell patients is this, myocarditis is a risk. But we're not finding that people that even suffered from myocarditis or having long-term cardiac effects. And most of the time that is not a concern. What I tell my patients is this, I, when the booster came out and the vaccine came out, my kids were 10 and 12, so it was a perfect time for them to get it.

I have a slew of sub-specialists that I love and adore that I trained with that I called and said, listen, what's the deal with this myocarditis. I have a son, I have a daughter. What would you suggest? And every single one of those pediatric cardiologists said, Dr. Sethi, this is not a concern. What we, what worries us more is we don't know how COVID affects the heart long-term. We know that effects the muscles of the heart, but we don't know how, and we don't know what long-term COVID and long-term effects of COVID, the actual virus are. So, what we do know is what we can control with the dose of the vaccine. We can control, if patients get symptoms after the vaccine, we can get an EKG, we can get an echocardiogram and we can follow them. So we have control. Once they get infected with COVID, we have very minimal control because it's a watchful waiting game. I will tell you, we, not personally, but in our practice we have thousands of vaccinated cases and I've had two cases of myocarditis in older boys that both self-recovered without requiring hospitalization.

Now again, is that a study? No. But it offers me some solace in knowing that we're giving such large volumes to large amounts of kids in a short period of time, and really not seeing large numbers of myocarditis. This is not a conspiracy theory. This is not me getting paid by some government agency. This is just a suburban pediatrician telling you what I see in my practice.

It seems safe. And I will tell you, and this is something that should be, like you said, screamed from the rooftops, kids that are vaccinated and get COVID do better, hands down, they recover better. Their symptoms are more mild. They go back to school sooner. They get less fevers, they get less chills. They get less body aches and they tend not to get reinfected. Kids without the vaccine tend to get sicker. Their symptoms last longer, and they are more likely to get reinfected.

So, that brings up the other issue of mental health in kids, which we've talked about in the past. Mental health impact of COVID. If your child is out of school and then out of sports and then not active and then feeling depressed and then staying home and playing video games all day and then eating junk, what do you think that's going to do for a re-infection rate? It's going to increase it. If you can get your child vaccinated, and if they meet criteria, get boosted, they are less likely to get COVID and get back to school with their friends, in the sports active, playful, happy. More likely to get back to normal and that's how we're going to more quickly get back to normal.

And that is the best service you can do for your child is getting back to normal. Don't you agree? That's what these kids need more than anything. And it's not a vaccine fight and a mask fight. It's let's group together, get our kids safely vaccinated, get our kids safely boosted so we can decrease variants, so that we can get back to school and get back to sports and get back to our normal life.

Host: I'm just going to give you a little applause here, Dr. Sethi, because you just rocked that. I don't even have to ask you any more questions because you just really, and you are an expert and you may say you're just a suburban pediatrician, but you see this every day and you are such a great educator. So parents, I hope you were listening to her. Kids tolerate the masks better than we do. And really, they are definitely little immune strength if we do what they need to do. And just as Dr. Sethi said, vitamin C, vitamin D, zinc, exercise, healthy eating, and we can get them back to school. And gosh, let's get this thing gone. Dr. Sethi, I thank you so much for joining us and putting the information so straight forward out there that it is really very understandable.

Thank you again for your expertise. And for more up-to-date information, we encourage you to check the Henry Mayo website at henrymayo.com and click on the COVID-19 link at the top of the page. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please remember to share this show with your friends and family, on your social channels, because we are learning from the experts at Henry Mayo Newhall Hospital together.

I'm Melanie Cole.