'Child Vaccinations Plummet 63 Percent, a New Hurdle for N.Y.C. Schools' diff viewer (1/2)

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Child Vaccinations Plummet 63 Percent, a New Hurdle for N.Y.C. Schools	Child Vaccinations Plummet 63 Percent, a New Hurdle for N.Y.C. Schools
2020-06-01 18:18:33 UTC	2020-06-01 18:50:29 UTC (32 minutes later)
Reopening schools, pre-K and day care centers safely this fall was always going to be a crucial part of resuming normal life in New York City, and a herculean challenge for the nation’s largest school system.	Reopening schools, pre-K and day care centers safely this fall was always going to be a crucial part of resuming normal life in New York City, and a herculean challenge for the nation’s largest school system.
On Wednesday, Mayor Bill de Blasio raised alarms about an unexpected new hurdle: plummeting rates of childhood vaccinations as anxious parents have kept their children home — and away from doctors’ offices.	On Wednesday, Mayor Bill de Blasio raised alarms about an unexpected new hurdle: plummeting rates of childhood vaccinations as anxious parents have kept their children home — and away from doctors’ offices.
During the height of the pandemic, from March 23 to May 9, the number of vaccine doses administered to children dropped 63 percent compared with the same time last year, and by 91 percent for children older than 2, according to the city health department.	During the height of the pandemic, from March 23 to May 9, the number of vaccine doses administered to children dropped 63 percent compared with the same time last year, and by 91 percent for children older than 2, according to the city health department.
The city is tentatively planning to reopen its 1,800 public schools in September, along with hundreds of day care sites. But children will not be able to start school and relieve their parents of home schooling and child care duties without shots to protect them against illnesses like measles and chickenpox.	The city is tentatively planning to reopen its 1,800 public schools in September, along with hundreds of day care sites. But children will not be able to start school and relieve their parents of home schooling and child care duties without shots to protect them against illnesses like measles and chickenpox.
In a typical year, about 98 percent of the city’s public school students are fully vaccinated.	In a typical year, about 98 percent of the city’s public school students are fully vaccinated.
“The pieces unfortunately start to fit together in a way that should cause parents real concern,” Mr. de Blasio said in his daily news briefing. Unvaccinated children, he said, could be “at greater threat of contracting a disease that could then put them at a greater threat of contracting Covid.”	“The pieces unfortunately start to fit together in a way that should cause parents real concern,” Mr. de Blasio said in his daily news briefing. Unvaccinated children, he said, could be “at greater threat of contracting a disease that could then put them at a greater threat of contracting Covid.”
That is especially urgent now, since New York is seeing a rare but alarming trend of children falling ill with what is being called pediatric multisystem inflammatory syndrome, which appears to be related to the coronavirus and can cause serious illness.	That is especially urgent now, since New York is seeing a rare but alarming trend of children falling ill with what is being called pediatric multisystem inflammatory syndrome, which appears to be related to the coronavirus and can cause serious illness.
But pediatricians said they were much more concerned about spikes in preventable diseases that can be much more dangerous for children than the coronavirus.	But pediatricians said they were much more concerned about spikes in preventable diseases that can be much more dangerous for children than the coronavirus.
“We really don’t want to have collateral damage of outbreaks of deadly diseases because we are afraid of Covid-19,” said Dr. Sean T. O’Leary, a pediatric infectious disease specialist in Colorado.	“We really don’t want to have collateral damage of outbreaks of deadly diseases because we are afraid of Covid-19,” said Dr. Sean T. O’Leary, a pediatric infectious disease specialist in Colorado.
The city saw last year just how dangerous low vaccination rates can be, when a spike in measles cases concentrated in Hasidic Jewish neighborhoods prompted a public health scramble to tamp down the extremely infectious yet preventable disease.	The city saw last year just how dangerous low vaccination rates can be, when a spike in measles cases concentrated in Hasidic Jewish neighborhoods prompted a public health scramble to tamp down the extremely infectious yet preventable disease.
“The worst thing that could happen would be to have a measles epidemic after this,” said Dr. Michel Cohen, who oversees dozens of Tribeca Pediatrics offices in New York City. Once measles starts to spread, Dr. Cohen said, “it’s very hard to curtail.” Tribeca Pediatrics saw a 40 percent decrease in vaccines administered between late March and mid-May compared with the same period last year.	“The worst thing that could happen would be to have a measles epidemic after this,” said Dr. Michel Cohen, who oversees dozens of Tribeca Pediatrics offices in New York City. Once measles starts to spread, Dr. Cohen said, “it’s very hard to curtail.” Tribeca Pediatrics saw a 40 percent decrease in vaccines administered between late March and mid-May compared with the same period last year.
Other pediatricians said vaccinations are particularly crucial for young children who have not yet had their first round of immunizations.	Other pediatricians said vaccinations are particularly crucial for young children who have not yet had their first round of immunizations.
“If you don’t stay vigilant, you are looking at whooping cough coming back, more cases of preventable infections,” said Dr. Jason Perlman, a pediatrician and infectious disease specialist who practices in Park Slope and Crown Heights, Brooklyn.	“If you don’t stay vigilant, you are looking at whooping cough coming back, more cases of preventable infections,” said Dr. Jason Perlman, a pediatrician and infectious disease specialist who practices in Park Slope and Crown Heights, Brooklyn.
A recent change in state law unrelated to the coronavirus now requires public school families to prove that they are up-to-date with immunizations within 14 days of the first day of school. The city is preparing to implement that practice this fall.	A recent change in state law unrelated to the coronavirus now requires public school families to prove that they are up-to-date with immunizations within 14 days of the first day of school. The city is preparing to implement that practice this fall.
Because children require different vaccinations and boosters at different ages, students in kindergarten through high school have separate requirements from toddlers enrolling in licensed day care centers. But the city requires proof of at least some immunizations for children of all ages in all of the centers and schools it oversees.	Because children require different vaccinations and boosters at different ages, students in kindergarten through high school have separate requirements from toddlers enrolling in licensed day care centers. But the city requires proof of at least some immunizations for children of all ages in all of the centers and schools it oversees.
Vaccination rates have fallen dramatically across the country because of the closures of many practices, as well as fears of taking healthy children to doctors’ offices during the pandemic, though the American Academy of Pediatrics has recommended that parents continue “well visits” that include vaccinations.	Vaccination rates have fallen dramatically across the country because of the closures of many practices, as well as fears of taking healthy children to doctors’ offices during the pandemic, though the American Academy of Pediatrics has recommended that parents continue “well visits” that include vaccinations.
In a survey in April, PCC, a pediatric electronic health records company, found that vaccine doses had fallen between 40 and 73 percent for a range of preventable illnesses.	In a survey in April, PCC, a pediatric electronic health records company, found that vaccine doses had fallen between 40 and 73 percent for a range of preventable illnesses.
Dr. O’Leary said that doctors across the country are just beginning to see families come back to their offices for well visits and shots — and not a moment too soon.	Dr. O’Leary said that doctors across the country are just beginning to see families come back to their offices for well visits and shots — and not a moment too soon.
“Most states are still planning on enforcing vaccination requirements for schools,” he said. “It would be better to get them now than to wait for August. If school does start up in August and September, you may have trouble getting into your pediatrician’s office.”	“Most states are still planning on enforcing vaccination requirements for schools,” he said. “It would be better to get them now than to wait for August. If school does start up in August and September, you may have trouble getting into your pediatrician’s office.”
Dr. Perlman, who has kept his practice open for both well and sick visits, said he ensured that his office is as safe as possible for his staff and families.	Dr. Perlman, who has kept his practice open for both well and sick visits, said he ensured that his office is as safe as possible for his staff and families.
~~Updated ~~May~~ ~~28,~~ 2020~~	Updated June 1, 2020
	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.	More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.	Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.	Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
“We don’t want people being scared of us, we are here for them,” he said.	“We don’t want people being scared of us, we are here for them,” he said.
But with many doctors’ offices closed, some New York parents say they have been struggling to schedule vaccinations for months.	But with many doctors’ offices closed, some New York parents say they have been struggling to schedule vaccinations for months.
Lindsey Reynolds had a standing appointment for her 16-month-old daughter to receive vaccinations in early April and was planning to bring her child in despite the pandemic.	Lindsey Reynolds had a standing appointment for her 16-month-old daughter to receive vaccinations in early April and was planning to bring her child in despite the pandemic.
Then she got an email notifying her that her appointment had been canceled, and Ms. Reynolds spent the next few weeks trying to reschedule the visit before finally getting her daughter vaccinated.	Then she got an email notifying her that her appointment had been canceled, and Ms. Reynolds spent the next few weeks trying to reschedule the visit before finally getting her daughter vaccinated.