Page 73 - Demo

LITTLE LEGENDS 71
PBy Nerine Zoio.
harmacists and pharmacy assistants are encountering parents concerned or outrightly anxious about the
prospect of having their kids back in the outside world and at school during COVID-19, especially those with primary immunodeficiency (PID).
This parental fear is exacerbated by new rules that forbid parents to enter
the school except for emergencies and staggered drop-off, break and pick-up times, in the interests of social distancing.
Regardless of such fears, the general feeling is that it’s not to the child’s benefit to be prevented from attending school indefinitely – until a vaccine is available
– when the evidence shows that only a small number of patients with known PID have been diagnosed with COVID-19 and no evidence that children with PID, or those without PID, are at increased risk of severe COVID-19 infection.
Professor Greg Murray, Director of Swinburne University’s Centre for Mental Health in Melbourne, says pharmacists and pharmacy assistants can help parents manage their anxiety through acknowledging that their fears are a natural part of a person’s response to threat and uncertainty.
Most people are under stress, which results in stress responses such
as anxiety and lowered mood, and sometimes disturbed sleep, Professor Murray tells Retail Pharmacy Assistants.
“Those are just signs that people
are noticing a problem,” he said. “The next step in the equation is what do
you do about it, which we call coping. And most of us cope. So, it’s entirely understandable for people to be anxious about their kids returning to school, but most people will find their way through the anxiety.”
With a little “gentle conversation”,
he says, pharmacists and pharmacy assistants could get a customer who is a “worrier” to identify as one.
“It’s legitimate to ask someone who’s anxious whether they’re prone to worry more than others, struggle when there’s a lot of new stuff going on, and predict the worst, which helps them
to self-identify as a bit of a worrier,” Professor Murray said.
“This can be reassuring to customers because it reminds them of all the times they’ve overreacted to situations by panicking.”
Professor Murray says this brings to mind one of his favourite Mark Twain quotes: ‘I’ve been through some terrible things in my life, some of which actually happened’.
“My take-home point is just because there’s some anxiety doesn’t mean there’s a problem,” he said.
He adds that worrying about their children is a sign of good parents, which pharmacists and pharmacy assistants can also allude to in attempting to settle anxious parents.
Underscoring the lack of a significant threat is the NSW government’s report on its investigation of 15 schools where COVID-19 cases were identified in March. Only two cases of probable secondary infection were found among 735 students who were close contacts of known cases (0.2 per cent).
This is in line with international studies that agree that rarely do children infect other children or adults.
Associate Professor Richard Loh, Clinical Immunology/Allergy Specialist and Co-Chair of the National Allergy Strategy, says the recommendation to send children to school is based on the fact that children are far less likely than adults to contract SARS-CoV-2 infection, the risk of severe COVID-19 is very low in children, very low rates of community transmission are taking place, and
the evidence suggests that most immunosuppressed children are not
at a significantly higher risk of severe COVID-19 than their age-matched peers,
“There’s good evidence that children don’t spread SARS-CoV-2 like adults, child-to-child transmission is rare, and it’s very unusual for asymptomatic children to spread COVID-19,” he said.
The risk of secondary school students contracting COVID-19 is slightly higher than for primary school children and rises slightly in older teenagers.
However, Associate Professor
Loh says this slight increase in risk
is not sufficient to make different recommendations regarding returning to school for these two groups.
The decision to send vulnerable
children, including those with PID, is complex, considering that the type and degree of immunocompromise varies widely between children with PID,
he says.
Therefore, pharmacists and pharmacy
assistants would do well to recommend that a child’s parents seek advice from their child’s clinical immunologist if they have specific questions, Associate Professor Loh suggests.
Authorities also advise parents
to have children with coughs, colds, fever, loss of smell and other symptoms checked.
Associate Professor Loh says the greatest risk for school outbreaks comes from adults, so it’s very important that parents comply with restrictions to minimise contact they have with other parents, teachers and students in the school environment.
On the nutrition front, Accredited Practising Dietitian Geraldine Georgeou says she’s been asked what can be done to help children, especially those with PID, fare better at school and in the world at large as COVID-19 restrictions ease, with pharmacies coming up against the same question.
“The thing to keep in mind is that immune health is multifactorial, which means support has to be multifactorial, too,” she said. “One aspect to this is good nutrition, particularly for children who have pre-existing health conditions or who are underweight and aim for a healthy weight. This includes two fruits and five vegetables a day; protein;
low glycaemic index carbs; good fats; adequate zinc from meat, shellfish, legumes like chickpeas, lentils,
seeds, dairy and eggs; wholegrains; and antioxidants from green,
leafy vegetables.
Ms Georgeou emphasises that a healthy body weight “makes a big difference in supporting immune health, as does ”eating a good source of iron and avoiding an iron deficiency”.
“And parents shouldn’t let their kids walk off without breakfast,” she said. “I know that not all kids are breakfast eaters, so in those cases, nourishing drinks fortified with nutrients are the way to go.”
She highlights that there are many different products on the market, in the form of a drink, that are designed to provide catch-up growth for kids.
“The thing to keep in mind
is that immune health
is multifactorial, which
means support has to be
multifactorial, too.”
RETAIL PHARMACY ASSISTANTS • JUL 2020