‘COVID Isn’t the Worst Thing That’s Out There’

Gail Schonfeld, MD, FAAP

June 5, 2020

I recently saw a 1-½ year old whose mother had reported seeing blood in the diaper twice in six weeks. Her mother feared coming into the office because she was pregnant and afraid of catching COVID-19.  

Their family is from New York City and, like so many other New Yorkers, was self-quarantining in the Hamptons. I explained via a telehealth appointment why I needed to take a urine sample and do a careful exam in the office. I told her everything I would do to keep her child safe and finally persuaded her. 

During the first visit we obtained a bagged urine sample, which did still have a trace amount of blood. The father brought in the child for the next visit, and the mother joined by FaceTime. At that visit a large mass was palpated in the abdomen. As it turns out, there was a cancer in her kidney, called a Wilm’s tumor.

I coordinated with the family’s usual pediatrician and she made an appointment with a specialist for the next day. The cancer was diagnosed and the tumor removed the day after that.

The child’s mother is very grateful that the mass was caught and agreed to share her story to help convince other parents not to hesitate to bring their children into the office when necessary.  

This family is part of the huge exodus out of New York City during this pandemic. So many families have relocated to The Hamptons that my small practice has had a hard time keeping up with demand. In addition, other practices in the area have decreased their weekend hours, so my practice has had to increase our after-hours availability to accommodate the newborns and urgent visits for illness and injury.

I’ve spent a lot of time reorganizing the practice to handle the pandemic surge. We obtained additional space in the building to set up a separate suite for routine checkups, and we’ve expanded our hours.

Of course we have closed our waiting room, maximized disinfecting the rooms, use appropriate PPE and limit the number of patients and parents in the office at once. We have limited the well checks to the morning, see the sick children in the afternoon, and have used telehealth when it is safe and appropriate to do so.

We’re prioritizing well child checkups for children age 2 and younger so vaccines can continue. Another challenge we’ve faced is the fact that up to 75% of our patients each day are new patients. 

I’m very focused on keeping my community, myself and my staff safe through all this. Because on top of all this, I am seeing many patients, including newborns and young infants, with COVID-19.  

But while the fear of COVID-19 is real and necessary, as my story about the little girl with the Wilm’s tumor illustrates, COVID isn’t the worst thing that’s out there. 

A parent shouldn’t be afraid of going to the doctor. There are ways to deliver the care patients need and still be safe.

Send in your COVID-19 pandemic story, and we may share it here and on our social media channels. https://bit.ly/2XVvJIu

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author

Gail Schonfeld, MD, FAAP

Gail Schonfeld, MD, FAAP, is a primary-care pediatrician at East End Pediatrics in East Hampton, N.Y. She serves on the executive committee of the AAP’s Section on Administration and Practice Management and on the Payor Advisory and Advocacy Committee.