Sandy pediatrician says viral illnesses down, but mental health concerns upApr 12, 2021 10:53AM ● By Heather Lawrence
The pediatrics team at Alta View Clinic in Sandy hasn’t seen many flu or RSV cases this year, but their mental health services have long waitlists. (Heather Lawrence/City Journals)
By Heather Lawrence | [email protected]
Something interesting happened to pediatric flu and RSV cases this past winter: they practically disappeared. It’s a welcome break from COVID-19 worries, but Dr. Lisa Palmieri at Alta View Pediatrics in Sandy said there’s more to the story than that.
Palmieri said two things on her mind are that being healthy doesn’t mean never getting sick, and measures to prevent spreading COVID-19 have increased anxiety and isolation.
“We’ve had virtually no viral illness at all this year. There’s been no flu and no RSV in my practice. Zero,” Palmieri said.
In a typical winter season, Palmieri said she’d see two to three patients per day with either the flu or RSV. If the season were particularly bad, she’d also be admitting two to three of those patients to the hospital per week.
“It makes sense rationally that the decreased numbers are due to the COVID-19 precautions we’ve taken. It’s not just in Utah; it’s across the world. So hand washing, social distancing and keeping your kids home when they’re sick are likely what’s kept the numbers lower,” Palmieri said.
That’s especially great for those who are vulnerable to illness. But the majority of the population actually needs to get sick to stay healthy.
“The real question is this: is it advisable to keep our kids from getting viruses on this scale? Your immune system works by being exposed to illness, then you build up immunity by fighting things off. Your immune system needs something to do, otherwise it gets ‘bored,’” Palmieri said.
So getting sick once in a while isn’t all bad. “You don’t want to go into your adult years never having built up antibodies,” she said.
Palmieri suggests a lesson from our pandemic year is the understanding that our actions have consequences on others’ health, and then acting accordingly.
“Maybe we’ll be less cavalier about exposing those around us to illness. If your sick child goes to school, maybe all the kids there are OK and can handle the exposure.
“But what about those kids who are going home to a vulnerable family member—they expose a preemie or grandparent to illness. What is your duty to your community? Maybe we’ll be more cautious,” Palmieri said.
Palmieri said she’s decided to continue wearing masks for “sick visits” (as opposed to child wellness visits). But she acknowledges the lower rates present moral and ethical questions. “In the history of man we wouldn’t have guessed we could prevent disease at this level.”
One thing clinicians wondered about from the onset of the pandemic was mental health. Palmieri said that’s proved to be a valid concern.
“I’m particularly seeing mental health issues that start in the middle school population, and they accelerate from there. This age group is peer-driven. The isolation and the lack of contact with others creates problems,” Palmieri said.
Palmieri said the kids who stayed home for school did a good job protecting themselves and others, but their social lives are drastically limited. “I have kids at my practice who haven’t seen anyone [socially] in a year,” she said.
Anxiety, depression and suicidal ideation are all things she’s seeing in patients right now. Instead of admitting patients for RSV, she’s admitting them to inpatient psychiatric hospitals.
Some students learning from home have seen mental health issues intensified or brought to light.
“Screen learning has increased rates of identifying ADHD. Kids who were functional in the school setting just can’t sit still and do screen learning at home,” Palmieri said.
Palmieri said school can be a big anxiety producer for kids even outside of a pandemic. Going back to in-person learning and getting their screens taken away could increase that anxiety.
“They’ll have to confront something—socializing—that they’ve been able to hide from for months. The transition has just begun, and the outcomes are unknown,” Palmieri said.
Palmieri suggests taking manageable steps to transition kids back into socializing. “Encourage them to put down the screens and get together with others. Go outdoors, and get them back into the idea that they can have a life outside. They need to do things that have a social component,” Palmieri said.
Palmieri loves hearing that people are getting vaccinated. “We have an ethical and moral responsibility to protect the vulnerable people in the community,” she said.
While families wait for a vaccine that’s approved for younger kids, Palmieri encourages them to do the things that will keep them healthy, both physically and mentally.
“There are waitlists everywhere for mental health—access is a big problem. So don’t wait until it’s a crisis before you seek help,” Palmieri said, and she doesn’t just mean kids.
“I’ve seen more postpartum depression this past year than in other years, especially in new parents. There’s just a general level of exhaustion among parents,” Palmieri said.
If you have a hard time getting mental health services, she suggests resources like school psychologists and Employee Assistance Programs.
In a crisis, the University of Utah has a mobile crisis outreach team that responds to mental health challenges in person. They can be reached at 1-800-273-TALK (8255). It’s a free and confidential service available 24/7. These visits include help with kids who are a danger to themselves or are having an acute mental health crisis.