Episode 193 – The COVID-19 virus has caused a lot of change, anxiety and uncertainty for parents and educators in the last week. In this episode, we talk to Dr. Dina Kulik, pediatric emergency medicine doctor at SickKids and founder of KidCrew about the reality of the virus, the real importance of social distancing and how to maintain our sanities at home to as we keep updated with the development of the virus.
Resources:
- Dr. Dina’s Website
- KidCrew Website
- Dr. Dina’s Instagram, Facebook, LinkedIn
KULIK:
The reason why people are talking so much is because of social distancing meaning trying to stay away from others you’ve been, if you seem healthy, is really to prevent the spread amongst people that don’t even know that they have [the virus] and that needs to be talked about more.
SPREEUWENBERG:
Hi, I’m Ron Spreeuwenberg co-founder and CEO of HiMama. Welcome to our podcast about all things early childhood education.
SPREEUWENBERG:
Dr Dina, welcome to The Preschool Podcast.
KULIK:
Thanks for having me.
SPREEUWENBERG:
We’re delighted to have you today. Dr Dina. Everyone we have on the show today, Dr. Dina Kulik, she is a pediatrician and pediatric emergency medicine doctor. She’s also the founder of Kidcrew Medical. Obviously there’s lots happening now and news coming out about a coronavirus COVID-19 and as childcare providers, as parents, as families, we’re all concerned about children’s health. And so we’re going to talk to dr Dina today about children’s health and in particular questions related to COVID-19. Dr. Dina, let’s just start off quickly learning about you and who you are.
KULIK:
So, I’m a pediatrician and I’m a pediatrician who specialized in emergency medicine. So I’m a pediatric emergency medicine doctor and I practice in Toronto. I have a practice called KidCrew Medical that we see as a one-stop for kiddos. So we have everything for kids under one roof from primary care to specialties to allied health to after hours. And I’m a mom of four young sons. My kids are two of five, seven and nine.
SPREEUWENBERG:
Oh, fun. Okay. So you’ve got your hands full at home. Let’s start off with the basics. How are we referring to this? And you know, some, sometimes it’s referred to as Corona or COVID-19, you know, is there a preference? What’s more accurate in terms of how we’re referencing to, to this thing?
KULIK:
So Corona Virus is a generic name or category of a type of virus. There’s many different Corona Viruses out there. And so before it had a formal name, it was called Corona Virus and it is still a Corona Virus, but it’s just one of many. So then they named it formerly COVID, an acronym and added 19 to it because the first cases were found in 2019.
SPREEUWENBERG:
Got it. Okay. And, the big question that we’re hearing a lot of in the early child education community is how to talk to young children about this. Cause obviously it’s something that’s a little difficult to understand as a child. Any thoughts on that?
KULIK:
For sure. I mean the biggest thing is to find out what your kids know, what are they concerned about and what do they have questions about? Because you can’t really presume that you know what your child knows – what your child was exposed to might be different than their friend or your neighbor or other children, right? What they, what they can access in terms of media and social media is buried, you know, and what we see is varied. What more served on social media and media in varied. So, it’s important to find out what your kids know and what they want to know and maybe pose it to them. What do they want to care about as opposed to just sitting them down and saying, well, here’s the deal. You know, there is its own, that’s et cetera. They should also be very age appropriate.
The way you speak to a two year old. The way I would talk to my toddler about this is going to be very different than how I discussed this with my mind, your world. And of course what they know and understand and have the ability to really comprehend is very different. So you want to find out what they want to know, what do they know and what fears they have. And, and I wouldn’t guess what that is because some kid might think they could die from that or their family might die from it and other kids may not have even heard of it. So finding out what their, what they’re up to, what’s in their brains is a good starting point. Yep.
SPREEUWENBERG:
Good point. Let’s kinda revert to adults in terms of information cause as we all know, there’s so much information about – out there about this. And it’s a constant barrage of information and sometimes there’s fake information. So, is there any information out there that you’re aware of, or untrue or inaccurate things that you’d like to set the record straight on or you think are worth addressing?
KULIK:
I think it’s confusing who is getting COVID and what that looks like. People, many people don’t recognize that the vast majority of people who get infected with COVID don’t have any symptoms at all. Or they have very, very mild symptoms. So you and I might have that it is possible. I think it’s likely that there are people in your life that have been infected previously or infected currently and that’s a scary thing because if we have a lot of people that are in the community, which again is likely at this point, at least in Canada and probably around the world, all of the world, if there are people in your life that have COVID and they don’t have symptoms and you’re still hanging out with them, they could pass it onto you. You may have symptoms or you may not. You can pass it on to the next person and they may pass it on to the next person and all ten, fifteen, twenty, however many people that we see every day and less for practicing social distancing as we should.
We could ask it on and on and on without even knowing that perspective and the danger of that may not be for me or you as healthy young people, but it can be devastating and cause very significant illness or even death and someone who is either unlucky there. There are lots of people that were young and healthy that got very sick or die from this illness around the world or people that are older, have a weakened immune system or have complications from health concerns that could again get sick and die from that. So the reason why people are talking so much for those social distancing – meaning trying to stay away from others, even if you seem healthy – is really to prevent the spread amongst people that don’t even know that they have it and that needs to be talked about more. I think a lot of people think, well people are telling us, researchers and scientists and doctors are telling us that most people are staying healthy, that most kids in particular are staying healthy, particularly kids younger than 10.
By and large, these kids are showing no symptoms for only very mild viral symptoms like cough or cold or runny noses. Then you wouldn’t assume was something, you know, scary like this big scary Corona Virus people are talking about. If it’s not so serious and most people are staying healthy, why does it matter? Why do we need to isolate? Why is school not in session? Why do I eat, avoid going to parties? And it’s this reason that not everyone shows symptoms. Very rarely do we show symptoms, but we have the capacity to pass it on to one 10 hundreds or thousands of people. And those people, one, ten, thousands of people there and there and there. Like you know, if you picture like, you know, the, the main part of a tree and then the bigger branches and the smaller branches and the smaller branches, there was a potential to make this into this huge problem. Like we’ve seen in many countries in the world where, you know, in, in weeks there were no cases and then hundreds of thousands of cases and many deaths like in Italy and Korea and Iran and China. So, that’s why the most important part is to stay away from other people right now, even if it’s tempting to be with people that seem healthy.
SPREEUWENBERG:
And so is that one of the reasons why governments are acting so aggressively on restrictions in, in countries and States and provinces, do you think?
KULIK:
Absolutely. So the first step was to prevent COVID from coming into Canada in a big way. And many people feel that we were too slow to do so in fact near the borders are still open to two Americans, for example. And there’s plenty of COVID and you know, States and elsewhere and many people feel that if we close the border sooner and, as well to The United States, we would have less imported COVID, if you will. But as long as people are moving around, you’re going to see an emergence of more what we call community spread. So first the cases and still have the job, majority of cases to date are from people that went elsewhere that brought COVID back with them. So they went to Italy, factored in Italy, came back to Canada and then, you know, got sick here. That was step 1 and that we could have stopped a long time ago. But we were slow with that and people didn’t take that seriously. Governments did not take that seriously both in the United States and Canada and elsewhere. But now what we’re having is not just international spread, spread regardless of travel, but now we’re starting to see a lot more community spread. And this is when true epidemics and connects and that happens when you don’t have to be elsewhere to get it. You can get it from your neighbor or your teacher or your doctor or your friend.
SPREEUWENBERG:
And you talked a little bit about symptoms and lack thereof in particular with children. Is there a medical explanation as to why symptoms seem to be less severe in children? And is that true?
KULIK:
It is true that kids in particular, less than 10 years of age, are by and large not getting very sick. They might have very mild symptoms like cough, cold, you know, Corona Virus – COVID, I should say, COVID-19, is a corona virus as we mentioned at the outset. And most coronaviruses are benign colds, that you would see any day, every year, all year round. There’s just a tape of math. And for some reason, some magical reason, which is very unlike most typical viruses, kids and also pregnant women seem to not be getting as sick as quickly. And the death rate, the mortality rate seems to be quite a bit lower in these populations. And this is unlike many other viruses. So if you think about influenza, as an example. Influenza still has much greater numbers. Prevalence is higher and Canada, the U.S. and probably everywhere. Though, then we don’t know exactly, which to be honest, cause we’re not testing everyone for Influenze or a COVID or we’re only testing a certain group of people that are getting sick with it.
So the real numbers around the world are impossible to know. But in terms of who’s getting tested, influenza virus, has and probably will continue to be a much more prevalent illness in Canada and the U.S. and has a higher mortality rate in North America as it stands right now. And, when we look at the mortality rate of COVID, the mortality rate is much higher amongst older people, and that’s true of influenza too. But influenza tends to hit hard and cause more and more mortality in young people and pregnant people and the elderly and people with chronic health concerns. Whereas with COVID, it tends to be the latter two groups or their people, particularly people older than 70 or 80 and people with chronic health conditions hand. And pregnant women and the younger children tend to be maybe getting it as much as the older people that are coming to us much less frequently.
SPREEUWENBERG:
And so knowing this, you know, how can parents really tell the difference if their kids just have a cold or maybe they have the flu or maybe they have COVID-19.
KULIK:
They will not be able to tell the difference – that’s the reality. And that’s why we have to distance ourselves because we will not have the ability, we didn’t have it then and we don’t now have the ability to test everyone for COVID.Our resources are already tight. And so what health professionals are doing now is testing people that are highest risk. So, those that are exposed to people that have weakened immune systems, those with chronic health concerns, those that are exposed to people that do have these issues in their homes. But by and large, they’re not going to be able to test the vast majority of people that have presumed COVID or suspected COVID and some of these people will have COVID and some will have influenza and some will have other viruses that we see all year round. But you will not find out, most likely if you have a runny nose or if your child does if you have COVID. And so all we can do is prevent being around other people. You can control that. That’s all we can really control with you.
SPREEUWENBERG:
Hmm. Yeah. This, this point that you keep talking about in terms of the limited, limited symptoms in particular with children, does definitely seem like something that should be getting more air time because I think a lot of people just sort of think, you know, if I’m really not feeling well, like I feel like I have the proper flu, then you know, maybe I have this, but you know, you could have it, like you said, without even really knowing it in some cases.
KULIK:
In the vast majority of cases, and you’re right, this is not getting enough air time. And I think as ministries and the prime minister and the presidents and people of power that have a strong voice here, we just see that people don’t understand why they should start moving around. But I think most people don’t understand why they have to start moving around, especially when the talking heads are saying, don’t worry, most people are staying healthy so people are so partying and you know, going to Blue Mountain as they were this weekend and you know, many, many places are still open or were open over the weekend that people don’t understand why it’s important to stay away. You know, it’s just a cold. There’s no big deal. They’re not really thinking about, they don’t really understand why it’s a public health concern. Like I think most people, if you ask them, they don’t really understand what happened in Italy.
You know, why? Why did it get so crazy? Why are they on lockdown? Why are they not actually their house? You ask the average that actually I think if you ask 99.9% of Canadians why Italy is on lockdown, why they’re not allowed to leave legally at their homes, they will not have any idea what the answer is. And the answer is that if we keep hanging out with other people in, you know, quote unquote big groups or even small groups, but the reality is with any people outside of your, you know, particularly family even we’re talking about extended family. My children, I have four children, and we’ve been off to school. Of course my kids are exposed to me and my husband of course and each other. They haven’t seen their grandparents. We’ve been FaceTiming. We haven’t seen friends. We’ve FaceTimed, we call them. But my kids haven’t seen other kids. This is really important. I can’t drive this home enough. We will see this last thing for much longer like this could be months longer. We are at risk of being on house arrest like we’ve seen other countries in the world. That is a legit concern if we don’t stop moving our bodies towards other people’s bodies. This is a real fact.
SPREEUWENBERG:
Hmm. It’s weird. It’s like one of those things where, you know, again, there’s so much information out there yet. One of the most important pieces of information is I’m not front and center, which is, you know, one of the reasons why we do this podcast. So I’m glad we are.
So, one of the questions we’re hearing as well is it, you know, we talked a little bit about mortality rates and how it impacts different ages of the population with different risk factors. Is there a risk of that changing? You know, I’ve heard the word “mutation” like can COVID-19 mutate into something else and you know, it, that changes.
KULIK:
Yeah, that’s a possibility. So viruses are smart creatures and the reason why viruses and bacteria still exist and they have existed way before humans existed and animals existed is because they’re smart and they realize how to stay alive. The way for a virus to stay alive is to find a host. It’s found a bat. And then from a bat they can now have the host of the han hand. It will continue to stay alive because that’s just mandates like a h ans mandates. And so if we have, let’s say, a vaccine or medicine that would kill it off, which people are so excited that there’s this media stuff about vaccines happening. Even if the vaccine was created tomorrow, vaccines are tested for months, sometimes years before they’re given to humans. So instead of relying on a vaccine to save us and save our communities, again, social distancing and where it’s at, but viruses and bacteria will learn how to change if the environment makes it so that they can’t live.
So that’s why, for example, influenza, there’s many, many strains. It keeps on changing. The reason why a flu shot may work one year and not the next year. The reason why we put multiple strings of influenza work in a single year of vaccine is because every year it’s a little bit different. It changes itself just a little bit because if we have a vaccine for it and it kills off all strains of influenza, then influenza would be gone. So the virus is like okay, I need to change myself just a little bit so that I can keep on living and thriving. And that is a risk of all viruses. And that’s a big rescuer. If we realize how to control this particular COVID-19 virus, that isn’t a thing. It’s not going to come back in six months or a year or a mutate quickly. And none of that is predictable.
So this could be wearing a tad every year or every six months, you know, like influenza, we have every year, year by year for the last, you know, generations and Quentin keeps on coming back. You know, SARS was there once, MURs was there once, but you know, 10, 15 years ago, we didn’t really have the SARS and MURS and the COVIDs. So, things are changing and these viruses are getting smarter and finding big hosts. And with more travels and more movements of people, the viruses have an ability to propagate much more quickly and a much more worldly way.
SPREEUWENBERG:
Yeah, totally. And that’s, you know, that’s something that’s certainly different in 2020 versus the past. And so as we’re practicing social distancing, which clearly is super duper duper important, we’re faced with some new challenges, which, you know, for you maybe, being at home all day with your four children every day, as with some others, you know, what are some tips to those parents and families out there that are home with the kiddos all day and aren’t used to that and are also, aren’t able to go out and do the things you do otherwise. Like, go out to the restaurant or go out to, you know, we like to go to the science center with our little guy and we can’t do that. Any thoughts on that?
KULIK:
Yeah, it sucks. Know being home with your kids. It’s hard for parents, but it’s really hard for these kids. Right? Kids are used to routine and things like routine. They’re not as flexible as most adults are. As many adults, you know, probably aren’t that flexible either. But people like to do what they like to do in the way they like to do it. And many families, many parents are exhausted by Sunday evening. Just having had the weekend, but that’s it. So now we’re going to add on, you know, two or three, maybe more, probably more weeks of that where again, we’re trying to maximize the social distancing and that’s why school is our trade school is out so that people are not spreading it, you know, within a school and then outside of the school, et cetera. That’s exactly social distancing is why schools are closed. A lot of people don’t understand why that, that is the reason why.
KULIK:
So routine, I would say it’s the most important thing. We all like routine. So you know, some people have, you know, little laid out agenda in we’re going to wake up at seven 30 and we’re going to brush our teeth or I’m going to get dressed and we’re going to do some kind of exercise, whether that’s like yoga or running around the backyard, whatnot. But if your kids can, you actually can know that this hour I’m going to do this sort of thing and then an hour from them or they did this sort of thing. We’re gonna have lunch at this time and a quiet some of this time to get them into the routine within a couple of days don’t fall into that routine. And that makes way, you know, a lot of parents are very worried about, you know, March break or Christmas break or summer break every year.
But most people find that you know, weekend things are starting to become routinized. So Christmas break the first week tends to be a little more chaotic and then it’s a little bit easier because you kind of know what to expect every day and your kids to March break just the week just sort of chaotic all the time, only gets used to what’s happening. But the s mer break and then a week or two of your kids are pretty much anticipating what the day is going to look like and you as well. So that’s where we have to get into here where the sort of predictable what’s happening. I think getting outside every day is paramount for your mental health, for your physical health and for their kids as well. And for inside cooped up all the time. We’re all going to go crazy. Truly. Like it just, it’s so not good for us.
So, you’re having this lockdown like they have in Italy. That terrifies me. It’s not just because I want my freedom and I want to be able to have groceries and I wanna, you know, go see my friends. But to being locked in a house all the time, that is terrifying. That’s really, that’s, that’s creating, making. So you may not be able to go to the science center and you may not be able to go to big crowds and parties and concerts, but even as go up or, you know, take a ball into your backyard if you have a backyard and just kick your ball around with you and your children. Or we’ve been going for hikes in a ravine. So you know, people are spread apart. We almost see no one actually, but just going for simple walk, we call it a hike.
Doing simple things like that. When you’re in nature and moving your body at least an hour a day is really, you know, it’ll make you feel a lot better. And it’s really important for your physical and your mental health and also turn the screen off. So I think a lot of people are spending a lot of hours a day with the screen on and it can, I know why, you know, like a lot of us are still working, right? So you may still have a job to do when you’re working in your teleconferencing and those sorts of things. And we can’t be entertaining our kids all the time. We’re teaching our kids all the time. So a lot of people are relying on screens. Furthermore, a lot of people are now doing work on a screen, like my kids were given quite a bit of homework and just almost exclusively screen when we’re watching screens, I’ll be every day.
It is not good for mental health. It’s not good for your physical health because you’re not moving your body and it tends to lead to a lot more aggressive behavior or violent behavior. Behavioral issues. Like, I think a lot of parents, especially a very young people can attest to the fact that as our kid watches, like even half an hour of a show there are more difficult, you know, it’s harder to get them to do the things we want, like go brush your teeth or go eat your nice meal. So I would, I would limit screens as much as you can knowing that of course a lot of our kids are being rough on screens, but then I wouldn’t also have a two hour break where they’re watching their favorite show more activity as much as you can and less screens and routine. That’s when they three things I would talk about.
SPREEUWENBERG:
Yeah, that resonates with me because I started my toddler’s day today with Lion King one and a half. And my partner said to me, I’m trying to start a routine. So, I hear you. We’re getting on that, on that party line. And, and a lot of what you said, it certainly will resonate with our early charters, educate our listeners in terms of getting outside, getting in nature, getting active in the routine pieces. And just if I can chime in on that to our audience too. Don’t forget everybody, you’re the experts. You’re the early childhood educators and people like me at home. While we love being parents, we’re not experts in early childhood education. So to the extent you can help us, parents at home, to understand what the routines are that you’re doing in your childcare programs to share, ideas for activities that we can do with the children to keep them engaged and keep that development and learning going every day. I think is a really great thing for you to, to help parents in this situation.
KULIK:
100% people are looking for resources. I’m getting very many Instagram messages and ticked off messages of parents looking for something. Like what do I do besides the screen? And very personally, some options out there, many companies have put forward, you know, like websites and code so that they could download books or download programs. Again, as many of it is screen-based. My very favorite thing that someone sent me in the last week was actually it was a childcare educator and this person sends me very simple little cable and all you need is one that die. And if you roll the day and it’s two you do two j ping jacks. If you roll the die, there’s three, you do three pushups or whatnot. And it was just like, you know, one, two, three, four, five, six different activities you do. And it just gets the kids talking about nubers for one. So little kids like my, you know, my two year old for example, it’s like, Oh that’s two one, two like it’s up an account. So it’s educational, but also again, getting you moving but screen free smoothness. So it’s learning and attractive. And if we could find more things like that, then our kids will go less crazy and it’s just better for them in life.
SPREEUWENBERG:
Totally. This has been super informative. Dr Dina, anything that we didn’t get a chance to cover that you wanted to leave with our audience before we wrap up?
KULIK:
I think to hammer home that the most we stay away from other people, the better off we’re going to be and if we’re around other people or even just around our own kids. The best strategy to prevent any virus from spreading were bacteria all year round. Every single year. Cohort or no Koba is not being around sick people not going into work or school. When you’re sick, good hand hygiene, which means washing your hands with soap and water for at least 30 seconds, multiple times per day before you eat. Have to eat, have to using the washroom when you come in from, from the classroom or playing outside many times a day, which we washing our children’s hands, washing her hands and role. Modeling is really key here so our kids are not going to stay away from other people if we’re not staying away from other people.
Our kids are not going to learn to wash their hands regularly if they see us not washing their hands regularly. So role modeling this behavior and all behaviors that you want to, you know, show your children that you want your kids to do. The more you role model that, the better. So multiple times a day I take my kids to the wash room with me or into the kitchen and say, okay, we’re going to wash your hands. What do we want to think this time? And they all know that we pick us on let’s say happy birthday or wheels on the bus and we’re going to do two or three verses of whatever song they pick, tinkle, tinkle home, I’ll pick your song. It’s all good. We’re looking for 30 seconds and we wash our hands, we’ll wash them. Well, I show them how to wash their nails and in between the fingers and make sure to include their funds.
We make a game out of it so they know really well how to wash their hands now and then also to show them again, modeling this behavior not to touch your face. This is really hard. A lot of adults to touch their face, you know, they’re gorging on their computer or they’re reading a book and their hands or by their mouth, their nose, their faces. And this is again how we spread the virus as a bacteria. So train as much as you can to model that behavior and then our catch would see the same and they’ll, it’ll become a routine for them.
SPREEUWENBERG:
Yeah, that makes a lot of sense. Actually, that reminds me, I have one more, one other question for you. How long does like a virus stick around like on inanimate objects? Like on a door handle?
KULIK:
It’s an excellent question. Yeah, excellent question. We don’t know about what’s covered actually. So every virus is different. Some viruses are Mark already than others. Some don’t live on surfaces for more than a couple of seconds and some somewhere for a couple of days. Cool data. We’re thinking it’s probably up to two to three days. There’s been some studies and you was such a new thing, right? I mean, it’s called the novel coronavirus. So this is a new thing. It didn’t exist before, at least not in h ans, right, which probably in bats and maybe other animals. But as far as human transmission, it’s new. It’s only been four or five months. So we’re learning things all the time. There’s been some studies that show it can last up to three days. A more recent study showed is probably only a couple of hours. It depends on the surface as well. So it’s likely lasting longer on metal surfaces.
So some people are saying, you know, avoid swings at the park, for example, that have metal, you know, handholds or metal parts. You put your bottom line or slice. It might be metal versus plastic. My hope, the virus doesn’t last long. The thing is, is such evolution, there’s such a dynamic process as pandemic. And so we’re learning new things all the time. So as best you can, you know, wash your hands. Well, don’t touch your face. Even if you touch a surface where you come in contact with a person that has COVID, if you wash your hands, wow, can you don’t spend, touch your face and hopefully minimize the spread to you and your family.
SPREEUWENBERG:
Interesting. Okay. And it really just reiterates that it’s important that we’re getting information from experts and reliable sources. I know on himama.com we have created a lot of information and content related to COVID-19. But, Dr Dina, if I’m listening to the podcast and I want to learn more about, COVID-19 from you, I’m assuming you’ve got some content out there as well. Where can I go to get more information?
KULIK:
Sure. Yeah. So I have a website called drdina.ca . It’s been around for six or seven years. I have hundreds of different blog posts from myself and by many health experts. So from chiropractors to physiotherapists, speech therapists, PTEs, all sorts of people providing evidence based information there. And I do have some articles and COVID of course as well. And I’m very active in the media. I’ve been doing lots of media within Canada the last couple of weeks and I put those things on YouTube where I post videos about many different childhood issues, brushing teeth, using poppers to name a few, and I’m very active on social media, pretty much every platform. So I’m asked dr Dina Kulik – D-R-D-I-N-A-K-U-L-I-K you have my Instagram and Facebook and TikTok and YouTube and LinkedIn, kind of all of this and I’m sharing a lot of information day by day, hour by hour sometimes.
I’m hearing a lot that people are having a very difficult time navigating the news. What is real? What is pseudoscience? What are myths? What do I believe? Who are these quote unquote experts that are telling me to go out and party and go, I’m March break and who hang listening to and what if the websites that I’m being taught to use like the world’s health organization or the CDC, what happens if they’re not to date? How does this affect me if I live in Timbuktu versus Toronto? Anyway, I’m trying as much as we can with the information available to update my audience, particularly on Instagram where I’m doing stories a few times a day. So anyway, you can check me out there and I’m happy to answer questions as well.
SPREEUWENBERG:
Wonderful. Thank you so, so much for sharing all your knowledge about this subject that we’re also focused on right now and during this very unique time for us all in challenging time as well. Dr. Dina, thank you for joining us on the preschool podcast today. It’s been wonderful having you as guests.
KULIK:
Thank you very much for having me stay healthy.
SPREEUWENBERG:
Thank you.
