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Dr. Sandra Pimentel, Chief of Child and Adolescent Psychology, discussing how to talk to kids about COVID-19.

How can parents talk about what's happening as a result of COVID-19 with kids of all ages? Montefiore's Chief of Child and Adolescent Psychology, Dr. Sandra Pimentel, discusses how to help kids understand COVID-19 using techniques to encourage talking about their feelings resulting from the life changes and uncertainty they're experiencing because of the pandemic, and how parents can model coping methods to help kids make more sense of their world.

Transcript

We get asked a lot about how to talk to kids about COVID-19. And by this point, parents have had at least some discussion regarding COVID-19 and its effects with their kids. Early on, there were major transitions for families moving into remote learning, staying at home, and trying to explain the reasons for staying at home, and things like that. And at this point, in our experience, kids may be asking questions about the end of the school year, when is this going to be over? What's gonna happen this summer? And there's still a lot of uncertainty. And so part of what we wanna talk about is how do we talk to kids about COVID-19 now in terms of where we are today? The answer is, in part, it depends. It depends on the age of the child, their developmental level. Parents, you know your kids best. Are they more, someone who's more verbal and likes to talk about things? Are they more likely to express things via something creative or artistic? Are you better off talking to them while you're doing some shared activity? So the way to talk to kids about COVID-19 depends on the age and developmental level and the style of your child. Unsurprisingly, the best way to talk to kids about COVID-19 or any topic for that matter, is to listen. And we wanna listen out for, what are they thinking? What are they worrying about? What are they expressing? Asking them directly? Sometimes parents are scared to ask about feelings and certainly encourage asking directly about what they're thinking, or how they're feeling about a certain situation. What do they have on their mind about how things are going now, or the future, summer? What are they worrying about most? What do they think about when they're going to bed at night? Another strategy is to ask about, what are their friends thinking? What are their friends saying about all of this? And the experience that's happening with COVID-19. That's another strategy for sometimes getting kids to talk about things, either they may agree with their friends on, or disagree with their friends on. Another strategy in terms of talking to kids is expressing an observation. I noticed that you seemed pretty upset when this happened, or I noticed that you were sad, or I noticed that you stopped talking to this particular friend. So expressing an observation as an entry point for discussion and conversation. And parents, you all are likely more fixers, you wanna fix a situation. And with COVID-19, one of the things that we are learning, we are all collectively learning is to tolerate a lot of uncertainty. And we can't fix a lot of the uncertainty that's out there and what's happening. So part of the best first strategy is to validate the feeling. Uncertainty can be scary, it's scary for adults, it's scary for kids. So a starting point in talking to kids is validating their feelings. So if they feel scared, if they feel angry, if they feel frustrated about not seeing their friends. Validating that that stinks. It's hard to feel lonely. It's hard to feel disconnected from your friends. And validating that feeling is a great starting point. You don't have to fix it, just validate the feeling itself. The other strategy also simple and straightforward is to normalize the feeling. We're all feeling angry, frustrated, confused, sad, disconnected. So sharing and normalizing that experience for kids and telling them yeah, it makes sense, we're all feeling a lot of that at different times. And it's okay to feel those kinds of feelings. It's okay to feel sad and confused. It's good for us even to feel anxious. And so what can we do with those feelings? Sometimes we just have to feel the feelings and know that they will pass. And one of the strategies that parents can use in terms of helping their kids cope with some of these feelings is to model their own coping strategies. So you may not be able to fix the uncertainty that comes with the COVID-19. We can't fix necessarily what's gonna happen this summer, or know what's going to happen in the fall with school. But what we can do is have a discussion with kids about how to cope with those feelings. And parents can model that coping. So how do you cope with your feeling? How do you cope with stress? Parents often worry about showing their own feelings to their kids. And it's okay within reason to show your feelings, to show that you're stressed, to show that you need space or to walk away. And to tell kids, I'm feeling really stressed out, so I'm gonna do some deep breathing. Or I'm really anxious and upset about something that happened at work, I'm gonna take a break, I'm gonna call a friend. So giving voice to what you already do as a parent, but saying it on purpose so that you're modeling it for your kids. Even just talking about, when I get upset or when I get anxious, my stomach gets grumbling, or I get nauseous, and just connecting the dots for your kids in terms of how to talk about feelings. Again, these are all part of general emotional health and trying to talk about feelings. But especially now during COVID-19 and everything that's going on, it's probably even more important that parents are talking about these types of things with kids. And I said before we wanna sometimes get rid of those feelings. And sometimes we just have to sit with them. We have to tolerate them, and know that they're gonna get better, you might feel better in a little bit. And we have to sit with those feelings in order for that to happen. Another important sort of coping strategy that parents can rely on is social support. So what does that mean? So who's on your team? Who helps you cope? Who do you call when you feel stressed out and wanna talk about something? Who do you call when you need a laugh? Who do you call or who do you text, or who do you write a letter to, who's on your team? And modeling that for kids, teaching kids to identify, well, when you feel upset, or down, or isolated, because of everything that's going on with COVID, who do you call? Who do you text? Who do you wanna write a letter to? Who do you wanna color with, or color for, and send this coloring project to? And so encouraging and teaching kids to develop social supports is another way. These are all in the spirit of helping kids discuss their feelings, and discuss their feelings specifically with respect to COVID-19. The point about having discussions with kids is not only just listening and trying to help them and trying to make sense of their world, it's also about controlling the information you want them to have. There's a lot of information out there. And in part, whether with younger kids or with older kids, it's important to teach kids to be consumers of information, and good information. So as a parent, I would say, definitely try to limit the amount of news and information that comes in via the news into your household, I know that can be hard. It's exceptionally important for smaller kids and younger kids that they don't have as much access to the news. Try to limit your own access to social media, and just reminders of things that are happening with COVID-19. And definitely try to teach kids to manage their own intake. And these discussions may be different whether a child is younger, you may have more control about the information coming in, the middle school age kids to teenagers. And an understanding that there's a lot of information, so discussions around how to be a good consumer of that information. And that's another strategy for these types of discussions with kids.

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Dr. Charles Esenwa,  Montefiore’s Medical Director at the Comprehensive Center for Stroke Care, discussing strokes and COVID-19.

Why are some COVID-19 patients having strokes? Montefiore’s Medical Director at the Comprehensive Center for Stroke Care, Dr. Charles Esenwa, explains why some COVID-19 patients experience strokes, who is most at risk and what causes these COVID-19-associated strokes.

Transcript

- What we've noticed in COVID-19 is that there's about a 1% risk of patients suffering a stroke while they're infected with COVID-19. And before we talk about the specifics, I think it's really important to define what a stroke is. In order to do that, I have a model of a brain here, and as you can see, the model has all of these folds, and each one of these is responsible for doing something. So for example, this part of the brain and this fold specifically here controls movement of one side of the body. This fold, for example, controls speech or language. Now, if a blood vessel that supplies this part of the brain is blocked off, and that part of the brain is not receiving blood, that's exactly what a stroke is, and that is the definition of a stroke. Now, in COVID-19, we've noticed that the patients who we're treating and who are coming in with strokes tend to be younger. And what I mean by that is, the typical age for a stroke is anywhere in the 60s and 70s, but we've encountered a lot of patients who come in in their 40s and more so in their 50s. The other difference is that COVID-associated stroke or patients with COVID-associated stroke are less likely to have what we call traditional risk factors. And what I mean by that are the typical risk factors that we think of, like hypertension or high blood pressure, smoking, diabetes, high cholesterol. Patients with COVID-associated stroke are younger, and they're less likely to have these traditional risk factors. Now, the good news is that, as I said earlier, stroke seems to affect a very, very small percent of people with COVID-19, and that's less than 1%. But we are still working on trying to decipher why it is that COVID affects the younger and also more healthy individuals. What we're starting to come to, however, is that, with COVID-19 infection and with the pneumonia that people suffer, they also have a heightened inflammatory state in their body. And what I mean by inflammatory state is that the body is trying to fight off the virus. And in doing that, all of the chemicals and things in the blood that help in that fight can make people more likely to develop clots. And when people develop clots in their blood, those clots can lodge themselves and block off critical arteries that supply the brain, hence, leading to a stroke. If somebody with COVID-19 starts to experience symptoms of a stroke, the most important thing to do is to call 911 immediately. During the COVID-19 surge, we actually measured how many patients with stroke came to the hospital, and it was about a 50% drop in the number of patients that we were able to treat for their stroke. This is an important thing to talk about, because we don't want people staying at home with stroke symptoms. And if they were to come to the hospital, we could potentially treat them and limit any long-term disability that they would otherwise have from their stroke. Now, here at the Montefiore Comprehensive Center for Stroke Care, the first comprehensive stroke center from Northern Manhattan to Albany, and one of only 200 such centers nationwide, we treat mild strokes, all the way out to the most severe strokes, but we only have about 4 1/2 hours to do that. And we know that the quicker people come to the hospital, the less likely they will have long-term disability from stroke. And that's true, no matter if they have COVID-19 or not. The quicker we can treat, the better people will do in the long run. Early on, ahead of the COVID-19 surge, we implemented measures to prevent COVID-19 infection in people coming into the hospital for emergencies, like stroke. Those measures have remained in place today, including COVID-free zones for treatment.

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4:42

COVID-19 Symptoms

People with COVID‑19 have had a wide range of symptoms reported, from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Individuals experiencing these symptoms or combination of symptoms may have COVID‑19:

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Cover Coughs

Cough

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Shortness of Breath

Shortness of breath or difficulty breathing


Or at least two of the symptoms below:

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Fever

Fever

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Chills

Chills

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Repeated shaking with chills

Repeated shaking with chills

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Muscle Pain

Muscle pain

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Headache

Headache

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Sore Throat

Sore throat

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New loss of taste or smell

New loss of taste or smell

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Diarrhea

Diarrhea


This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning to you.

Care doesn’t stop

To ensure the safety of all our patients, we’ve implemented rigorous COVID-SAFE Care protocols, tailored to each setting.

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Covid-safe Care

Your Gratitude Keeps Us Going

The current outpouring of appreciation for New York's healthcare workers has been truly humbling. Our community's grace and optimism in the face of hardship inspires us every day. To all those who have cheered and honored our heroes, and to the many who are giving to support our COVID-19 efforts, Montefiore-Einstein would like to thank you. To those who would like to show their support, here's how.

How does COVID-19 spread?

The virus is thought to spread by people in close contact (approximately within 6 feet) through respiratory droplets when an infected person coughs or sneezes. It is also possible to contract the virus by touching an infected surface or item and then touching the nose, eyes or mouth. The virus may be able to live on a surface for a prolonged period of time.

Protect Yourself
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Wash Hands
Wash hands frequently with soap
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Avoid Touching eyes and mouth
Avoid touching eyes, nose, mouth
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Seek Care
Seek care if you develop a fever, cough or shortness of breath
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Avoid Close Contact
Avoid close contact with people who are sick
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Distance
Maintain social distance of at least 6 feet
Protect Others
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Stay Home
Stay home if you’re unwell
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Cover coughs and sneezes
Cover coughs and sneezes
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Clean and disinfect surfaces
Clean and disinfect surfaces
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Mask
Use a face covering when leaving the home for essentials
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Distance
Maintain social distance of at least 6 feet

Trusted Information Resources

Centers for Disease Control and Prevention

The leading national public health institute of the United States
 

NY.gov

For the latest COVID-19 guidelines and information from New York State 

World Health Organization

UN agency responsible for international public health