March 17, 2020:
By this time, you’ve surely heard about the current coronavirus (COVID-19) outbreak and how it is affecting our community and the world at large.
To help give some guidance to our families, we here, at Metropolitan Pediatrics, have put together this notice AND will be making some temporary changes in our practice of pediatric care in the office. This notice is intended to detail why COVID-19 is concerning, how COVID-19 impacts children, resources you can use to learn more, PLUS policy changes we are temporarily implementing at Metropolitan Pediatrics to help prevent the spread of COVID-19 and keep your family healthy.
Please read this entire message.
Coronaviruses are a frequent cause of the common cold. We’ve all had coronaviruses before. However, COVID-19 is a brand new strain—which means that we don’t have immunity against it. The result is that COVID-19 can spread much more easily than many other common illnesses. In fact, some experts estimate that 40-70% of the world population will have had COVID-19 over the next 12 months.
Luckily, for most people—especially those who are young and healthy—COVID-19 causes either mild or even no symptoms. Unfortunately, this also contributes to how easily it spreads—people can spread it without knowing they are sick. Older adults, especially those with heart disease, lung disease, and other chronic illnesses are at the highest risk of severe complications from this virus.
So, while most individuals’ level of concern should be minimal, the public health & institutional level of concern is very high. This is exactly why governments, companies, schools, and other institutions are enacting fairly drastic measures to combat spread of COVID-19.

Current data shows that children are doing very well when infected with COVID-19—having either mild or no symptoms. Very few children worldwide have been hospitalized, and as of the time of this post's publishing, there are no known child deaths from COVID-19. However, children appear to be getting infected with COVID-19 at the same rate as adults. Because of this, children may spread COVID-19 to their grandparents and other adults in the community who may be at higher risk of severe complications.

As the COVID-19 community situation evolves, you can stay up to date on CDC information here, and Maryland’s COVID-19 information here.


Because children and adults can easily spread COVID-19 infections without knowing it, our role as pediatricians in this outbreak is to: 

1.     Keep your family healthy, and

2.     Help prevent unnecessary spread of COVID-19 throughout our community


Here, at Metropolitan Pediatrics, we want to make sure that anyone with exposure to COVID-19 is properly diagnosed and cared for, while also minimizing the likelihood of spread to other patients and their families.


In order to help fulfill these goals, we are making the following temporary changes in how we manage appointments and care for your family:

1.     Check-upsWe will only be providing Well Child Checks (WCC) for children Newborn-18 months, 4 year olds and 11 year olds.  All other WCCs will be rescheduled for future dates when risks of infection have been effectively reduced.  We will reschedule ALL WCCs to the morning hours and reserve the afternoon hours for sick visits. We hope this will reduce the risk of sick patients spreading ANYTHING to WELL children.

2.     Remote Care and Sick VisitsALL illness concerns of any kind will be addressed by our triage team and providers initially and either be given an in-office appointment (for acute but apparently non-infectious issues) or we will schedule a telemedicine visit with a provider to address the concern; should the provider and you agree that a face-to-face, in-office appointment be required, your child's appointment will be scheduled for later that day. Some issues likely to be treated remotely via telehealth and can be scheduled without expectation of an in-office appointment are:


  • Pinkeye (conjunctivitis)

  • Longstanding issues (i.e., abdominal pain for several weeks, constipation, chronic headaches)

  • Low intensity mental health issues like: ADHD management, mild depression (without suicidal ideation), certain behavioral consultations

  • Vomiting and/or diarrhea without signs of dehydration

  • Certain Rashes

  • Mild Asthma

  • Other issues on a case-by-case basis


3.     Minimizing mild respiratory infection appointments –  While it is most likely that your child simply has a common cold, we cannot definitively know that your child does not have COVID-19. Unfortunately, COVID-19 testing is scarce and must currently be reserved for those who have the highest likelihood of exposure. If your child has cold symptoms and does not meet the criteria below, please STAY HOME.


Though it is impossible to provide an exhaustive list of medical concerns, please call our office if your child has:

  • Fever and Cough AND either exposure to a person known to have COVID-19 or if your child has fever, cough, and has personally traveled to an area with a large number of COVID-19 cases. Please call and we can discuss next steps to take.

  • Fever >103 for >24 hours

  • Fever >101 for >3 days

  • Fever in any infant under 2 months

  • Significant Pain of an acute nature (ear, abdominal/testicular, throat, etc)

  • Respiratory Distress (Moderate to Severe Asthma or suspected Pneumonia)

  • Lethargy that is unresponsive to Tylenol or Ibuprofen (for children over 6 months)

  • Your child has any underlying significant chronic medical condition

*** Please remember that the definition of Fever is a temperature of 100.4 or higher


  • Fever >100.4 and your child is under 2 months old

  • Respiratory distress

  • Signs of dehydration like poor urine output (i.e., not making wet diapers)

  • Lethargy that isn’t improved with Acetaminophen (or Ibuprofen if child is over 6 months of age)



First and foremost, please know that we are here for you and just as available as always to guide you in caring for your family.


To help prevent spread of COVID-19 in your family and your community, you can:

  • avoiding close contact with people who are sick

  • avoiding touching your eyes, nose and mouth

  • staying home when you are sick (but STAY HOME IN GENERAL!)

  • covering your cough or sneeze with a tissue or clothing

  • cleaning and disinfecting frequently touched objects and surfaces

  • washing your hands often with soap and water for at least 20 seconds

  • remember to get your Flu Vaccine yearly; we are still providing Flu vaccine to those not immunized with this year's vaccine

We at Metropolitan Pediatrics know that this current situation has many people on edge. We take comfort in knowing that the vast majority of people in our community will handle this just fine—especially our kids. But we do take seriously our role in helping protect those who are most at risk, and we hope that you’ll join us in this cause.

Practicing compassionate, evidence-based, quality-assured pediatric medicine in caring for your children and families is our most critical mission and this COVID-19 outbreak will not change this goal.