The Westchester County Child Fatality Review Team (CFRT) recently reviewed the death of two school-aged children who died from asthma. Both were known asthmatic children, however neither child had been seen by their doctor since the start of the COVID-19 pandemic.
While, neither child had COVID-19, both died during the pandemic and it was determined that both deaths were preventable.
Westchester County Health Commissioner Dr. Sherlita Amler said: “Sadly this is a reminder that the casualties of COVID-19 are more than just the victims of the virus. Parents, please learn from these two tragic deaths that the virus cannot prevent you from taking your child to the doctor. You must –must- stay on top of your child’s health regardless of the pandemic.”
In light of these fatalities, the CFRT takes this opportunity to share with parents and caregivers information and recommendations on asthma management and safety. Asthma can be very tricky, because while a child may appear perfectly well, their asthma might not be under control. Asthma remains one of the most common reasons for children to be hospitalized, and most of the time this can be prevented.
- The most important step to assuring your child’s asthma is under good control is routine scheduled visits with either your pediatrician or an asthma specialist (pulmonologist or allergist), at least twice a year, even if your child is completely well.
- Wear a mask, stay six feet apart, and don’t be afraid to go to the doctor.
- If your child has been prescribed asthma medication, it is to be taken every day, 7 days a week, without fail. Medication supply and expiration dates should be routinely checked to ensure your child does not run low or out of medication.
- If your child is having chronic cough, missing school, has to go to the emergency department or is hospitalized they may need a CHANGE IN THEIR ASTHMA THERAPY. Asthma needs change over time, and there are many medication options to suit a particular child’s condition, so be sure and follow up with your child’s doctor.
- All children, particularly those with asthma, should get their flu shot.
- Meet with your asthma doctor on a regular basis, go over your child’s “Asthma Action Plan”, be certain you are clear on which inhalers are meant to be given every day for prevention of asthma, and which to take when symptoms occur.
- Avoid exposing your child to cigarette smoke, having a parent or other household member smoke can be a trigger for an asthmatic child.
- Asthma has been considered a risk factor for severe disease in children and adults who become infected with SARS-CoV2 (Covid-19). While we are only about six months into this pandemic, and data is still incomplete, there is increasing evidence that if a patient's asthma is under good control, it reduces their risk for severe COVID disease.
- There is good evidence that controller inhalers decrease the severity of Covid-19 respiratory disease in people with asthma of all ages.
Dr Amler reminds parents that the key message is that “children with asthma need to receive their medication every day and follow up with their medical providers regularly even during the COVID pandemic. Also, during an acute exacerbation of asthma don’t be afraid to take your child to the doctor or hospital if needed. We all want to prevent unnecessary asthma related deaths. ”
The CFRT reviews the circumstances that have led up to the death of any child that is unexplained, unexpected or suspicious in an effort to prevent future fatalities. The CFRT, coordinated through the Westchester Institute for Human Development, brings together the resources of a multidisciplinary team of professionals including the Medical Examiner, the Department of Social Services, the District Attorney, the Department of Health, the New York State Office of Children and Family Services, Victim Assistance Services, a child abuse pediatrician, members of law enforcement, including the New York State Police and local police departments. The CFRT wishes to thank Allen J. Dozor, MD, FCCP, FAAP, Section Chief, Pediatric Pulmonology, Allergy, Immunology & Sleep Medicine, Boston Children's Health Physicians, Associate Physician-in-Chief, Maria Fareri Children's Hospital at Westchester Medical Center for his expert input on this topic.