COVID-19 | Mount Sinai Today

How to Talk to Your Child About COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

Discussing difficult topics with children can be uncomfortable and this pandemic is no exception. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares information parents and guardians can use as they care for children during the time of COVID-19.

Should I let my children watch the news?

If you want to give age-appropriate information to your kids, I recommend reading articles from reputable sources—either to them or with them—and then talking about the information. You may want to stick with resources that do not show images as it can be hard for children—and adults—to get images out of their minds.

We don’t want our children to see difficult images that we cannot control. For that reason, I would recommend turning off the news completely in front of younger children. In fact, older children and teenagers don’t really need those images either. Ideally, you should set aside time to watch the news to when you are alone or with other adults. This will also help manage your own stress because you will be limiting the amount of time you spend taking in this information.

I would discourage people of all ages from watching the news too much. Having the news on 24/7 heightens stress in the household and sends the message that you’re scared to turn the news off because you’re afraid you’ll miss something.

How do I help my child understand why they cannot see their friends and loved ones?

It can be hard for children to be unable to visit friends and loved ones, like grandparents, who they might be accustomed to seeing regularly. Try to empathize with your child and help them come up with proactive ways to connect with grandparents or other loved ones whom they cannot see.

This is the time to take advantage of social media and digital devices to empower your child to forge a connection with someone when they are not in the same room. Help turn sadness into productive action by encouraging your child to write letters, send notes, call, and video chat. These are beautiful ways to connect and show children that there is something they can do to help a person they love feel better.

If your child doesn’t have someone to connect with, there are organizations that can help you reach out, write letters, and draw pictures for elderly and vulnerable people who are currently isolated.

Should I tell my child if a loved one is seriously ill?

No matter how old your child is, it’s important to be honest and give your child the information needed. How you explain the situation depends on the child’s age.

For younger children, if a close family member is ill and you know how that illness is progressing, you can tell your child that the person tested positive for COVID-19. Explain the care that person is receiving and that you need to support them from afar.

If the person is very ill and you do not know what the outcome will be, it’s okay to express that to your child. Explain that the person is receiving great care and that you will keep in touch to see how things are going. You do not want to tell your child that everything is fine and then, all of a sudden, the person’s condition deteriorates.

On the other hand, if the person is asymptomatic and has tested positive, you don’t necessarily need to tell your children.

What if I or my partner becomes ill?

If you or your partner are sick, you need to tell your child what is going on. Explain that COVID-19 is very contagious. Explain that, in order to keep their body healthy and their parent’s body healthy, you will need to be separated for 14 days. You can make a calendar as a visual reminder of how long you will be apart. This can work well for the whole family as even adults can benefit from being able to check off each day of quarantine as it passes.

When you explain anything to children, be sure to check in first. See what they know already and then you can see where to begin with the explanation.

Dr. Pressman is the host of parenting podcast Raising Good Humans. Recently, she and Mariel Benjamin, LCSW, from The Mount Sinai Parenting Center, answered questions from health care providers and staff on the front lines to help support their parenting curing COVID-19. Additionally, The Mount Sinai Parenting Center maintains a COVID-19 resources page for parents, caregivers, and health care workers.

Managing Your Child’s Anxiety Caused By COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The COVID-19 pandemic is incredibly stressful for adults and can be puzzling and frightening for children. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares advice for parents and guardians on how to manage your child’s anxiety as we navigate the uncertain times of COVID-19.

Are there steps I should take to help my child’s mental health?

This is a very confusing time for adults and kids. Typically, when kids are going through a new experience it is one that we, the adults, have been through. We’ve worked through it, we’ve grown up, and we’ve come out the other side. In this case, none of us have ever been through this and so our kids can’t look to us for that safe secure feeling. We don’t have a road map.

Be honest with your kids. Tell them that you know this is a new experience for all of us. Tell them that you understand if it feels scary or if they are worried. Remind them that you are right there with them.

How should I respond to my child’s anxiety?

Give your child permission to talk about what they are feeling and worrying about. Acknowledge their anxiety even if it has nothing to do with COVID-19 or is only slightly related to the pandemic. For instance, children may feel stress because they miss their friends or aren’t allowed to celebrate an event like a graduation or birthday. Try not to diminish their feelings or say ‘we have bigger things to worry about than your birthday party.’ Instead, tell them that you know it’s really hard. Let them know that you are aware that this is a big change. Assure them that you can figure out how to have celebratory experiences, even if they are not quite how you originally planned them.

This is a very challenging time for everyone. You can explain to children that they are being asked to be health superheroes. Through the practice of social distancing and by washing their hands thoroughly, they are keeping themselves safe and helping to protect others who are more vulnerable. This is a wonderful, empowering message that does not scare children.

Is it important that I keep my child’s routines going?

Although it can be hard to keep routines going during a time that has very few routines, kids and adults thrive on knowing what to expect each day. So, try to set up a flexible routine for the coming weeks or months.

I encourage writing out a plan for your children. If they are younger, you can draw a picture of the routine of the day or use photos from magazines to help them understand what to expect. Ask older children to come up with what they think is a good daytime routine. You want to make sure they are comfortable with the schedule, but you also want to get certain boxes checked about what needs to happen each day. Make sure that it includes something healthy for their bodies, something healthy for their brain, something healthy for their relationships, and so forth.

It’s also important to let children have some enjoyment. Allow them to be happy about getting out of some obligations they had prior to practicing social distancing. Your kids might be a little bit happy about spending more time at home with their parents. Let them know that it’s okay to have mixed feelings.

Also, allow yourself to embrace the new normal and accept that there may not be a completely perfect routine and predictable day-to-day experience. Children need to know what to expect, but they’re also very flexible if you explain clearly that there may come a time when the unexpected will arise. Children can take in new information and, if you are consistent, they will understand that you are there for them. Finally, if you are having any concerns about you or your child’s health and wellbeing, be sure to reach out to your health care provider for guidance and support.

Parenting During COVID-19

Updated on Jun 30, 2022 | COVID-19, Mental Health, Your Health

Trying to be the best parent possible is a challenge even in the best of times. It is even more complex during this pandemic. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares information parents and guardians can use as they care for their children during the time of COVID-19.

How can I be a good parent at this time?

If you are worried you aren’t being the best parent possible, you should know that this is not the time to focus on trying to be the perfect parent. In fact, there’s never a right time because it simply isn’t possible. Besides, it’s important for kids to see that human beings are not perfect. That gives them permission to be imperfect too.

In addition, if you’re stressed and not taking care of yourself, that’s not good for anyone. As they say, you need to put your oxygen mask on first so you can take care of your little ones. In other words, it is important to alleviate some of your anxiety so that you can take the best possible care of your kids.

The news has me feeling tremendously anxious. How can I manage this?

We are in an unprecedented time. Feeling out of control or uncertain can lead to anxiety. Everyone is feeling this way now; you are not imaging your lack of control. It is important to realize that there is no way to get this 100 percent right. No matter how much time you spend reading articles and watching the news to try to make sense of what is going on, you won’t be able to.

The best thing you can do for yourself—and for your children—is to accept this and learn to tolerate the feeling of uncertainty. Focus on the things you can control, the problems you can solve. For instance, you can control washing your hands and teaching your children to wash their hands. You can control staying inside your home and maintaining social distance when you’re outside the home.

Do you have any tips to help me stop feeling so worried?

It is perfectly normal to worry right now. This pandemic is making all of us feel threatened. But remember, worrying about things you cannot do anything about will keep you from being able to take care of your family.

Try to find ways to release the underlying emotions, through activities such as meditation or gratitude practices. These approaches will get your nervous system into a state that allows you to alleviate some anxiety and think clearly. `Additionally, it can help to make anxiety a bit of a friend. Welcome that friend, and acknowledge that this is somebody who you’re going to be hanging out with for a while and you might as well get to know each other a little bit. Sometimes you are going to want your anxiety around, and other times you’re going to say you’d like to be left alone. One way to express this anxiety is by assigning different levels of stress a particular color, or a number from one to ten. This gives you a tangible way to acknowledge your anxiety level.

My child had a tantrum and I overreacted. How can I make things right?

Show some compassion for yourself. Forgive the hard moments where you overreact with your kids, have an outburst, or breakdown. And forgive your kids if they have an outburst or a breakdown. I’m not suggesting you do away with your boundaries or expectations for yourself or your children. But labeling those emotions, showing empathy and compassion, and then moving on is going to be a lot more helpful than expecting everything to go right all the time. This is a different kind of crisis. It’s going to be a marathon not a sprint. You need to brace yourself for a long haul.

This is a challenging time for all of us and there are certainly going to be parts of it that are unimaginably difficult. But when we have moments that are painful, we grow emotionally. And we come out the other side better able to adapt to difficult situations. Think of this challenge as an opportunity for you and your family to grow and adapt. Have the compassion to remember that this may not feel like a positive challenge, but it is necessary for growth.

How to Stock Up and Eat Well While Social Distancing

Updated on Jun 30, 2022 | COVID-19, Diet and Nutrition, Your Health

As multiple states issue shelter in place and stay at home orders to combat COVID-19, people across America are required to stock up on food for extended periods of time. Families want to remain food secure while making sure their kids eat nutritious meals.

Clinical Nutrition and Wellness Manager Kelly Hogan, MS, RD, CDN, and Clinical Nutrition Coordinator Rebecca Fernandez, MA, RD, LD, CDN, CDE, provide advice on stocking up and eating well as we do our best to stay home to ‘flatten the curve.’

What should people focus on when food shopping?

Rebecca Fernandez: Try to get things you can use long term like staples for the pantry. These are items that will not be expiring quickly like grains and oats which you can buy in large amounts. Also, consider getting shelf stable milk—which does not require refrigeration—and, unopened, is good for up to six months. Take advantage of the frozen goods like frozen vegetables and fruits that you can stick in the freezer.

Kelly Hogan: Going in the store with a list is important. You don’t want to forget anything and have to make extra trips. Having some go-to recipes that you can batch cook to have leftovers is helpful.

What should people avoid when shopping?

Ms. Hogan: Try not to feel like you have to buy a crazy amount of things at once. The grocery stores are not closing. They’re well stocked and will continue to receive shipments of food. Do try to limit your exposure to health advice online or through social media, as it often comes from those who are not health or medical professionals. For example, advice telling you to avoid or eat certain foods because they may impact immunity has been largely inaccurate and misleading. Focus on shopping for a variety of foods you know you enjoy and will use, including fruits, vegetables, whole grains, legumes, lean proteins and a few of your favorite treats.

What are some healthy snacks for kids?

Ms. Fernandez: There are gummy fruit snacks that are made with less sugar, less preservatives, and are flavored with real fruit juice. I encourage getting kids involved in making snacks whether it’s popping popcorn and adding toppings, such as a dash of maple syrup or Parmesan cheese, or making trail mix using nuts, pretzels, mini M&Ms, and chocolate chips.With these snacks, they’re getting the flavors they love (sweet and/or salty) but in a healthier more nutritious way.

Should we add any new vitamins to our diets during this time?

Ms. Hogan: Most healthy people do not need to take extra vitamin supplements, but this should always be discussed with their dietitian or doctor. I am always wary of herbal supplements, however, especially ones that claim to benefit immune health. These are not regulated by the U.S. Food and Drug Administration and may have adverse effects and/or interact with medications. Instead, focus on other things that can help with immunity such as eating healthy food, getting adequate sleep, and managing stress.

Sample Shopping List

Pantry foods

Pastas
Rice
Oats
Dry cereals (low sugar)
Unsalted/low salt crackers
Unsalted nuts
Beans/lentils
Tomato sauce
Granola bars
Dried fruits (apples, raisins, cranberries, mango, apricots)
Cooking oils

Foods that can be frozen

Meats (chicken, turkey, fish)
Vegetables (broccoli, green beans, peppers)
Fruits

How the Loss of Smell and Taste Relates to COVID-19

Updated on Jun 30, 2022 | COVID-19, Ear Nose Throat, Your Health

Cough and fever—followed by potentially life threatening pneumonia—have been the most talked about symptoms of COVID-19. However, as we learn more about the illness, it appears that the initial symptoms can often be associated with the upper respiratory tract or the nose, mouth, throat. In particular, otolaryngologists in South Korea, China, and Italy have noted that a decrease in the sense of smell and taste—medically known as anosmia and dysgeusia respectively—often precedes the other symptoms of COVID-19. Patrick Colley, MD, rhinologist and skull base surgeon within the Division of Rhinology and Skull Base Surgery at New York Eye and Ear Infirmary of Mount Sinai, answers frequently asked questions about this discovery.

Are these symptoms common among COVID-19 patients?

Observations from physicians in Germany noted that two out of three patients in that country who were COVID-19 positive experienced a loss of smell and taste. In other countries where a larger number of patients were tested for COVID-19, they noted that 30 percent of patients that tested positive for the virus had loss of smell and taste as the major presenting symptom. This means that somewhere between 30 to 60 percent of patients infected with the illness will experience these symptoms. For this reason, The American Academy of Otolaryngology has recommended—in the absence of other respiratory diseases such as allergic rhinitis, acute sinusitis or chronic rhinosinusitis—that a loss of smell and taste should alert physicians to the possibility of COVID-19 infection and warrant serious consideration for self-isolation and testing.

Is this an early or late symptom of COVID-19 infection?

Based on the data that is currently available from other countries with COVID-19 outbreaks, it appears that the loss of smell and taste associated with this virus is an early sign of infection. This means that many individuals will experience these symptoms prior to showing the signs of fever, cough, or shortness of breath more commonly associated with COVID-19.

How can I tell the difference between a loss of smell due to seasonal allergies and a loss of smell due to COVID-19? What should I do if I have these symptoms?

Patients suffering from allergies can experience decreased senses of smell and taste, but will usually have nasal congestion, a runny nose with predominantly clear liquid, and sneezing. They also frequently note itchy eyes, nose or throat. This is very different from the cough, fever, and shortness of breath that is typically seen in COVID-19 patients.

If you experience sudden loss of smell and taste in the absence of recent head trauma, allergic rhinitis, or sinusitis; observe strict self-isolation protocols and contact your primary care doctor, otolaryngologist, or a COVID-19 hotline to discuss the appropriate next steps of care.

How long will the loss of smell and taste last? Will patients fully regain their senses after recovering from COVID-19?

When associated with a viral upper respiratory tract infection, the senses of smell and taste can be expected to return to normal in three weeks to three months. The time course is dependent on whether the virus damaged any nerves in the nasal cavity.

It is unknown at this time how many patients will recover their sense of smell and taste completely after COVID-19. In other upper respiratory tract infections, the recovery rate is 90 to 95 percent by three months after the infection has resolved. Older patients and patients with underlying medical problems tend to have a lower recovery rate. We are assuming a similar recovery rate for COVID-19, but it is too early to provide any accurate data at this time.

How is the loss of smell and taste associated with COVID-19 treated? How can I be evaluated for a decreased sense of smell or taste?

The primary treatment of loss of smell and taste associated with COVID-19 is to treat the viral infection itself. Proper rest, self-care, and monitoring of symptoms are important for ensuring the best outcomes in patients infected with this virus. The loss of senses is only a symptom of this infection and will often resolve after the infection has resolved.

Individuals experiencing a decreased sense of smell or taste in addition to a cough, fever, or shortness of breath should contact their primary care doctor or a COVID-19 hotline (NY/NJ/CT). If this is the only symptom you are experiencing, schedule an appointment with an ear, nose, and throat specialist. Physicians at Mount Sinai’s Department of Otolaryngology are available for telemedicine consults.

Patrick M. Colley, MD

Assistant Professor, Department of Otolaryngology and Division of Rhinology and Skull Base Surgery, New York Eye and Infirmary of Mount Sinai

Call 212-979-4200 to make an appointment with Dr. Colley

What Causes the Loss of Smell and Taste?

The sense of smell stems from small olfactory nerve fibers that are found in the superior portion of the nose. These nerve fibers connect through small holes in the skull directly to the first cranial nerve inside the brain. Air that flows through the nose deposits smell particles in the superior portion of the nose where these nerves can detect smell.

This is the same mechanism that is used to taste the majority of the foods that you eat. The taste receptors, or taste buds, that are found in the mouth only detect salty, sweet, bitter, sour, and umami flavors. The remaining flavors are detected by air flow from your mouth back into your nose where they come in contact with the same olfactory nerve fibers. These nerve fibers in the nose are actually where you taste garlic, onions, herbs, and many other flavors commonly used while cooking.

The decreased sense of smell and taste that is often seen in upper respiratory tract infections such as COVID-19 can either be due to nasal congestion causing decreased air flow through the nose and obstruction of the nerve fibers. It may also be caused by a viral infection of the nerve fibers themselves, causing them to stop functioning or die.

Mount Sinai Turns Hundreds of Machines for Sleep Apnea into Hospital Ventilators, Shares Instructions Worldwide

Updated on Jun 30, 2022 | COVID-19, Featured, Research

Members of the Mount Sinai team that created the ventilator prototype seen here, included, from left, Drew Copeland, RPSGT; Thomas Tolbert, MD; Brian Mayrsohn, MD; and Hooman Poor, MD.

A team of pulmonologists, anesthesiologists, sleep and critical care specialists, and medical students at the Mount Sinai Health System are reconfiguring hundreds of donated machines that are typically used at home for sleep apnea and deploying them as ventilators to be used for severely ill patients who are hospitalized with COVID-19. Mount Sinai has shared the protocols and instructions with the Greater New York Hospital Association and the American Thoracic Society, as well as with other hospitals that are dealing with a national shortage of invasive ventilators during this pandemic. COVID-19 affects the respiratory system and has greatly increased the number of patients who are entering intensive care units and require assisted breathing.

When Mount Sinai received a shipment of 200 ResMed VPAP ST machines as a donation from Elon Musk, Chief Executive Officer of Tesla, Inc., in late March, a Health System task force was immediately organized to repurpose them. Within several days, the team put together a prototype that was tested in the Simulation HELPS Center at Mount Sinai, a unique laboratory run by the Department of Anesthesia that enables clinicians to simulate human responses to innovative technologies and procedures.

Three important modifications were made by the Mount Sinai team. First, a connection to an endotracheal tube replaced the typical mask that can present a risk of COVID-19 aerosolization; second, alarms that can alert clinicians if there is a problem with air flow were included; and third, the team enabled doctors and respiratory therapists to view and control the machine’s settings from outside the patient’s room, so they do not need to enter the room to make minor adjustments.

These VPAP machines will be used as an option under the current circumstances at Mount Sinai to prevent a shortage of invasive ventilators needed to serve the ongoing surge of patients. They are preferable to splitting invasive ventilators that serve two patients at the same time, a move that many hospitals are concerned they may have to pursue as a last resort.

Among the clinicians leading the effort at Mount Sinai is Charles A. Powell, MD, Janice and Coleman Rabin Professor of Medicine, Chief of the Division of Pulmonary, Critical Care, and Sleep Medicine, and Chief Executive Officer of the Mount Sinai – National Jewish Health Respiratory Institute. Dr. Powell says the machines can be used “in patients who do not require all the power of a regular ventilator, freeing up those conventional devices for the acutely ill.” He adds, “Our objective is to share our protocols widely with our colleagues around the globe facing this crisis. This project is a demonstration of the success of the team science collaborative research infrastructure at Mount Sinai that allowed us to make these innovations quickly.”

Any type of high-performing sleep device that delivers a comparable level of pressure to the ResMed VPAP ST model can work as a repurposed ventilator, according to Drew Copeland, Director of Operations for the Sleep Program at the Mount Sinai Health System. He says, “For many patients, this can save their life. We are not yet at a critical mass for ventilators but we may be getting there. This is a moving target. Hopefully, we can keep pace.”

After the first prototype was developed, Mr. Copeland enlisted a team of medical students from the Icahn School of Medicine at Mount Sinai to write the instructional user manual. They completed it in one day.

The students are now assembling the machines to be used throughout the Health System’s eight hospitals in the event of a shortage of invasive ventilators. Two floors of the medical school’s library have been set up as a staging area for the makeshift assembly line. The goal is to have all of the machines ready to be deployed by the end of this week.

To view the new Mount Sinai protocol, click below

Repurposing bi-level ventilators for use with intubated patients while minimizing risk to health care works during insufficient supply of conventional ventilation for patients with COVID-19

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