It’s winter, the season of the never-ending cough. Every year, my kids get some kind of phlegmy hack that peaks after a few days and then gets... mostly better, except at night, when the hackathon reasserts itself. Eventually I get tired of this and head to the paediatrician.
My kids love the doctor. If they aren’t getting shots, they’re delighted to pay a visit, chat with the nice receptionist, get a lollipop, and most importantly, play with the many exciting toys that the office keeps in a small play area. My four-year-old especially loves the play kitchen, with all its many pots and pans and wooden cartons of milk and germs.
Yes, the space is filled with germs — all the germs of all the children who have passed through the paediatrician's office that day.
When the US Girl Scouts put out a pre-holiday reminder to parents that their daughters don't owe anyone a hug, even at the holidays, it was taken as a sign of the (dismal) times. 'At a time when issues of sexual harassment and consent are in the news,' began the CNN story on the piece.
Until now, I’ve mostly managed to put this out of my mind with a sort of Jedi mind trick: La la la, you can’t get sick from the doctor’s office, because the doctor somehow provides a force field of good health around the toys in the waiting room.
Turns out this is not true, say the doctors themselves. The American Academy of Pediatrics issued a policy statement last October titled Infection Prevention and Control in Pediatric Ambulatory Settings — basically, guidelines on how doctor’s offices can reduce the transmission of contagious diseases.
A lot of the paper focuses on handwashing and general cleaning of equipment, but the authors also note that toys, especially plush ones, “have been implicated in the transmission of some pathogens”. It actually notes that spending any time at all in a waiting room is not great for reducing contagion:
Waiting rooms and reception areas offer the opportunity for child-to-child interaction with concomitant child-to-child transmission of infectious agents. Waiting rooms are similar to child care settings, where contamination of the environment and transmission of infectious agents occur at an increased rate compared with the home setting.
In other words, if you thought daycare was a petri dish, wait till you spend a little time with 15 other sick kids waiting their turn with the doc.
The authors offer myriad suggestions for making the reception area less of a virus minefield, among them trying to reduce wait times and crowding, “batching” well visits and sick visits, and suggesting to parents that they bring their own toys and books from home. This goes double for vulnerable children such as those with cystic fibrosis.
Perri Klass, a paediatrician writing for The New York Times, interviewed one of the study’s authors, who suggested asking questions about infection control when choosing a paediatrician, and when making a sick visit, telling the person making the appointment your child’s symptoms. If they have something really contagious, such as chicken pox or measles, the doctor may have a different protocol for examining them. (Both Klass and the authors stress that getting your kids fully vaccinated is the best defence against communicable diseases.)
And Klass points out that you don’t have to wait in the waiting room — you can sit in your car or walk around the block until they’re ready to see your kid. But if you are stuck for a minute or two, have a good toy in your bag to keep Junior distracted. I may even start bringing my own pots and pans from home.