Return-to-school requirements for children being evaluated for COVID-19 infection or exposure to someone with COVID-19 may differ from your utilization of testing in your practice. Below are some clinical pearls that will help your pediatric patients and their families better navigate the return-to-school process after an illness or exposure.

Many individuals in Spokane County are still unsure of how to get vaccinated—this includes both adults and adolescents age 12 and older If your practice is not currently offering COVID-19 vaccine, please share the sites below with individuals inquiring about vaccination.

COVID-19 disrupted both in-person learning and routine well-child visits for many children during the last year. We all want our kids to be back in school safely, and that means getting caught up on vaccines that were missed during the past year. The Centers for Disease Control and Prevention’s (CDC) public sector vaccine ordering data show a 14% drop in childhood vaccines for the period of the 2020-2021 school year compared to the 2018-2019 school year, and measles vaccine is down by more than 20%. Catch-up vaccination will require efforts from healthcare systems, healthcare providers, schools, state and local governments, and families.

COVID-19 cases and outbreaks continue to pop up in childcare, daycare, and preschool facilities. As a friendly reminder, all COVID-19 cases within Spokane County should be reported to Spokane Regional Health District (SRHD) as soon as possible and all COVID-19 positives and close contacts should be advised to isolate or quarantine at home as appropriate.

Hepatitis C (HCV) continues to be a problem in Spokane County and around the country. Nationally, HCV is a growing problem with ties to the opioid epidemic. Spokane Regional Health District (SRHD) is currently offering case management for patients who may struggle to complete HCV treatment for many reasons, including active addiction. Case management consists of meeting with patients to provide support before and during HCV treatment, with periodic follow-ups after treatment is completed, coordination of appointments, and contact with providers as necessary. It is important to provide treatment to any patient identified as HCV positive who agrees to completing the course of treatment.

Summer is upon us, and with it increased outdoor water recreation, exposures to wildlife, BBQs and picnics. Every year, beginning in the spring, we see a rise in enteric pathogenic infections such as Salmonellosis (nontyphoidal Salmonella). To date for 2021, Spokane County has had 14 confirmed cases of Salmonella reported to Spokane Regional Health District. From 2014 to 2018, Spokane County had an average of 39.8 cases per 100,000 of Salmonella per year, with a mean of 40 cases.

In spring 2021, there was a typhoid fever outbreak in Spokane County, with seven people developing typhoid fever between March 24 and April 21 (five confirmed, two probable). Prior to this cluster, a total of two confirmed cases of typhoid fever were reported in Spokane County over the past five years. The seven recent cases had no known exposure to a diagnosed typhoid fever case or recent international travel. Contact tracing and whole genome sequencing confirmed an epidemiological link between the seven cases and connected them to a cluster of cases in Hawaii. Two of the seven cases were hospitalized.

Across Washington state and the country, there have been outbreaks of COVID-19 in many settings. Some of the most difficult outbreaks to control and manage are those in congregate settings. Washington state and Spokane County have had their share of these outbreaks to manage. In Spokane County, the Spokane Regional Health District (SRHD) epidemiology team has managed outbreaks in homeless shelters, family shelters, drug treatment centers, behavioral health facilities, county correctional facilities, supported living facilities and group homes.

SARS-CoV-2, like other coronaviruses, mutates and produces variant strains as it spreads to susceptible hosts. The longer we go with suboptimal vaccination coverage and insufficient herd immunity in Washington state, the United States, and the rest of the world, the more opportunity for variants of concern to spread, and potentially, for different variants of concern to emerge.

It is no secret that healthcare workers all over the world have been significantly affected by the SARS CoV-2 pandemic, in both caring for COVID-19 patients and being patients themselves. According to the World Health Organization (WHO), healthcare workers account for 1 in 7 reported COVID-19 cases globally.