The CDC provides helpful information on what to do if you were exposed to the virus. If you've tested positive, isolate immediately, and let your supervisor know.

Click here for a link that contains:

• An Isolation and Exposure Calendar.
• What to do about being exposed.
• What to do after being exposed.
• Continuing precautions.
• Getting tested.

Also, please view this helpful video on what to do if you were exposed to COVID-19.

Masks:

1. Routine wearing of masks is NO LONGER REQUIRED for ALL Cook Children's employees, regardless of COVID-19 vaccination status.  As always, an employee may choose to wear a mask at their discretion.
2.  Annual N-95 mask fit testing remains mandatory per OSHA guidelines.
3.  N-95 masks or other isolation PPE will still be required for caring for a patient with an active COVID-19 infection.

COVID-19 Vaccination:

COVID-19 vaccination is no longer mandatory for current employees or new hires.

COVID-19 Hotline

1. The COVID-19 Hotline will be discontinued.
2. Staff members experiencing illness will refrain from coming into work and will follow their normal department notifications.
3. Return to work procedures through Occupational Health for absences are still required.

We appreciate your adherence to our COVID-19 guidelines, and we believe that our vaccine mandate truly made a difference in the lives of our patients and staff.  Our community's and organization's baseline immunity has evolved over the past three years. With that assurance, we feel comfortable with our new path forward. CMS has ended their mandate for COVID-19 vaccination and for masking, and we will follow their recommendations.

COVID-19 continues to circulate world-wide and throughout the United States. If future COVID-19 variants again cause more widespread infections and severe disease, we will adapt accordingly, and could need to resume masking and/or the vaccine mandate for the protection of our patients, families and employees.

We highly recommend staying up to date with vaccine boosters as they become available, especially for those with health conditions putting them at higher risk for severe COVID-19 disease.  An updated COVID vaccine is expected to be available this fall.  For those at higher risk, please remember that early and prompt treatment with antiviral medications active against COVID-19 can prevent more severe disease, hospitalization and death.

• 7 a.m. - 4 p.m., Sept. 20, Pav 1
• 7 a.m. - 4 p.m., Sept. 22, Family Meeting Center
• 8:30 a.m. - 2 p.m., Sept. 27, ROB 1102 ABC meeting rooms
• 9 a.m. - 2 p.m., Sept. 29, Pav 1
• 10 a.m. - 2 p.m., Oct. 4, 901 7^th Ave., 3^rd floor conference room
• 10 a.m. - 2 p.m., Oct. 6, 901 7^th Ave., 3^rd floor conference room
• A Calmont flu clinic is currently being planned and the time and date will be updated once confirmed.

Whether you receive your flu shot in your department or at one of our flu clinics, you must complete a consent form. To sign the consent form electronically through Lawson, follow these steps:

• Scroll down on the left navigation bar and click on “Employee Self Service”
• Then click “Human Resources”
• Then click “Occ Health Portal”
• Then click on “Forms” at the top of the page and click on “Influenza Vaccine Consent” to complete your form

Please let families know they can receive the flu vaccine for their children by making an appointment to see their pediatrician or, beginning next week, while they are inpatient.

“We play a critical role as providers in keeping our patients up to date on their routine childhood immunizations, including the influenza vaccine,” said Phillip Scott, M.D., a hospitalist at Cook Children’s. In the face of widespread vaccine hesitancy, it is important that we are prepared to talk to our patients and families about the influenza vaccine. Don’t underestimate the importance of a simple conversation. Your patients and their families value your opinion and are relying on your recommendations regarding this year’s influenza vaccine.”

We have a number of resources available to you about the upcoming flu season. Just visit our internal newsroom, cookchildrensconnect.com and click the Flu/COVID-19 updates tab.

Articles include:

• Influenza Vaccine Resources for You
• Flu Season: How To Make a Strong Influenza Vaccine Recommendation
• The CDC’s SHARE Model Helps Health Care Professionals Talk to Patients About the Importance of Influenza Vaccines to Make Informed Decisions
• Tips for Administering Vaccines to Patients Ages 5-11
• Australia’s Bad Flu Season Serves As Reminder For The Importance of Immunization

However, some early indicators say we could see something we haven’t seen in a while: a potentially severe influenza season.

Clinical experts in the U.S. watch the Southern Hemisphere of the world for signs of what might be in store for us in the north. Flu season in Australia can often be an indication of what’s to come in the U.S. Unfortunately, NBC News reports that Australia is nearing the “end of its worst flu season in five years, according to the latest data from the country’s Department of Health and Aged Care."

Alicia Fry, M.D., the chief of the Epidemiology and Prevention Branch of the Centers for Disease Control and Prevention, said the CDC is “very alert for signs of an early and strong flu season in the United States." 

Additionally, Australia’s flu season hit children hard this year. Kids ages 5-9 had the highest rate of flu cases, followed by children 4 and younger and teens.

How effective the flu vaccine is depends on how well experts predict what strains of the flu will be circulating the globe that year.

“The vaccine strains are chosen about nine months before flu season, based on circulating strains from around the world by epidemiologists who are geniuses and do this for a living,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases.

Jason Terk, M.D., a Cook Children’s pediatrician and a national expert on immunizations, adds his voice to other pediatricians and global health experts who say the flu vaccine remains the best way to prevent influenza.

“The great news about the vaccine is that even when it’s not always a perfect match for prevention, the flu vaccine can reduce the severity of the illness, even if you do catch the flu that season,” Dr. Terk said.

To make an appointment for your child’s flu shot, contact your Cook Children’s pediatrician. The vaccine is currently available in many offices and a second shipment will be delivered next week.

If your child is a patient and staying overnight at Cook Children's Medical Center, they may also receive the vaccine during their stay.

“It takes two weeks for the shot to become most effective. Because flu can hit as early as late October or early November, we recommend getting the flu shot as soon as possible and definitely before the end of October,” said Justin Smith, M.D., a Cook Children’s pediatrician.

At Cook Children’s, we want to provide the vaccine to as many patients as possible whether they are making an appointment with their pediatrician or staying overnight at the medical center. 

This flu season we are making the influenza vaccine available to any patient staying overnight at Cook Children’s, beginning in mid-September. Please take the opportunity to talk to your inpatient families about receiving the flu shot while they are staying at Cook Children’s.

Phillip Scott, M.D., knows first-hand the growing number of parents who are hesitant to give their child any vaccine, including one for the flu. But he also understands the power of talking to parents about the importance of immunization for a child.

“We play a critical role as providers in keeping our patients up to date on their routine childhood immunizations, including the influenza vaccine,” said Phillip Scott, M.D. “In the face of widespread vaccine hesitancy, it is important that we are prepared to talk to our patients and families about the influenza vaccine. Don’t underestimate the importance of a simple conversation. Your patients and their families value your opinion and are relying on your recommendations regarding this year’s influenza vaccine.”

So how do you go about talking to a family about the vaccine?

SHARE is a five-part approach that health care professionals can use to communicate with patients about the importance of influenza vaccines and to enable patients to make informed decisions.

If you would like more information about talking to patients regarding the influenza vaccine please see Resources for Vaccinating Inpatients Against COVID-19 and the Flu (cookchildrens.org).*

*Note: You must be connected to the network to access this page.

As we head into the upcoming 2022-2023 flu season, we want to provide you with as much information as you talk to your parents about immunization.

“We play a critical role as providers in keeping our patients up to date on their routine childhood immunizations, including the influenza vaccine,” said Phillip Scott, M.D., a hospitalist at Cook Children’s. “In the face of widespread vaccine hesitancy, it is important that we are prepared to talk to our patients and families about the influenza vaccine. Don’t underestimate the importance of a simple conversation. Your patients and their families value your opinion and are relying on your recommendations regarding this year’s influenza vaccine.”

Information For You*

*Note: You must be connected to the network to access these pages.

• Resources for Vaccinating Inpatients Against COVID-19 and the Flu
• Comfort Menu
• Influenza Vaccination Policy
• Monitoring Flu Vaccine Orders
• Consent/Vaccine
• All Inclusive Packet- English
• All Inclusive Packet – Spanish
• Myth Busters & FAQs
• Talking about the vaccine

Vaccine Hesitancy

• Dr. Whitworth: Flu Vaccine Q&A

How to Make a Strong Influenza Vaccine Recommendation

Based on years of research into vaccine motivators, the CDC has developed a mnemonic device to help health care providers make strong vaccine recommendations. This method known as “SHARE” can help you to make a strong vaccine recommendation and provide important information to help patients make informed decisions about vaccinations.

S- SHARE why an influenza vaccine is right for the patient given their age, health status, lifestyle, occupation, or other risk factors.

“This vaccine can protect you and your family from getting sick from flu. By getting a flu vaccine today, you’ll be protecting yourself and the people around you, like your children and parents, who are more vulnerable to serious flu-illness.”

H - HIGHLIGHT positive experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and strengthen confidence in influenza vaccination.

“In addition to recommending a yearly flu vaccine to my patients, I get one each year to protect myself and my family from flu.”

A - ADDRESS patients’ questions and any concerns about influenza vaccines, including for example, side effects, safety, and vaccine effectiveness in plain and understandable language. Acknowledge that while people who get an influenza vaccine may still get sick, there are studies to show that their illness may be less severe.

“A flu vaccine cannot cause flu infection. The most common side effects of an influenza vaccine are mild, like redness, swelling, soreness, or low-grade fever. This should go away within a few days. Flu vaccines protect against flu illness but aren’t 100% effective, so even if you get vaccinated you might still become sick with flu. It’s important to get your flu vaccine because studies show that even if you do get sick, vaccination may make your flu illness less severe.”

R - REMIND patients that influenza vaccines help protect them and their loved ones from serious influenza illness and complications.

“Flu activity is going to start to pick up, and CDC says to expect more cases in the coming months. That is why I want to make sure I help protect you and your loved ones against flu and its potentially serious complications.”

E - EXPLAIN the potential costs of getting influenza, including potential serious health effects for the patient and time lost (such as missing work or family obligations), financial costs, and potentially spreading flu to more vulnerable family and friends.

“It’s important to vaccinate your children this season because flu vaccination can reduce potential flu illnesses, doctor visits, hospitalizations, and even death. Vaccination can also keep your children from missing school, and you from missing work due to flu, and can protect those around you who are more vulnerable to potentially serious flu complications.

What we know: Fear increases a patient’s perception of pain, therefore, building rapport, quick assessment, preparation, and the use of pain management interventions are beneficial to a child’s coping.

Here are ways you can help reduce the patient’s fear and provide an emotionally safe experience:

• Build Rapport
  • Speak to both the patient and the caregiver/guardian.
  • Validate any observed fear or anxiety. 
    • “It looks like you are feeling a little bit nervous, let’s talk about what we can do to make this as easy and comfortable for you as possible.”
• Quick Assessment 
  • Ask the patient questions like “How do you typically do with shots/pokes?” or “Do you remember the last time you had a vaccine?”
  • Some patients will have developmental, behavioral, or sensory needs that need to be acknowledged before moving on. Collaborate with the family to make a plan to support the patient’s needs.
  • Based on previous experiences, decide what interventions may be helpful in order for the patient to receive the vaccine. 
    • “It sounds like last time was pretty scary for you, maybe this time would you like to try some distraction to take your mind off of it and take relaxing breaths?”
• Prepare
  • Be honest with the patient and let them know what you are going to do but also let them know they can be a part of the plan.
  • Give the patient and caregiver/guardian a job. 
    • “Your job is to hold as still as you can, you can watch or look away.” 
    • “Let me know if you don’t want to watch so I can give you a heads up before I do it.”
    • “Would you like for me to count ‘1,2,3’ or just do it?
    • “[Caregiver/Guardian], why don’t you sit right here beside [patient] to hold their hand, if they want, or just talk to them to help comfort and distract them.”
  • If the patient or guardian begins to escalate with fear or frustration, validate and de-escalate. 
    • “We need to continue to remain safe while we do this vaccine, your job is to …. And I will do everything I can to help make this as easy and comfortable as possible for you.” 
    • “It seems like your [Caregiver/Guardian] really wants for you to be safe and get this vaccine to keep your body healthy. Let’s work together to get this done.”
• Provide Pain Management and Coping Techniques
  • Comfort position
    • Allow the patient to sit up next to or in a parent’s lap, laying down is the most vulnerable position. When a child feels in control, they act in control.
  • Cold spray (aka “Elsa Spray” or “Mr. Freeze Spray”)
    • Maybe say, “This is a helper so [the patient] doesn’t have to feel the poke as much.”
    • Clean and prepare the vaccine site, spray cold spray for 4-10 seconds and administer the vaccine without delay.
  • Take relaxing breaths
    • Encourage the patient to take a breath in through their nose like they are smelling a flower and breathe out of their mouth like they are blowing out a candle.
  • Therapeutic conversation
    • “Describe your idea of a ‘perfect’ day. What would make it perfect?"
    • “If you could travel anywhere in the world, where would you go and who would you take with you?”
    • “If you could be president for a day, what would you do?”
  • Items for distraction
    • Patient or guardian’s electronic device for listening to music, looking at pictures, etc.
    • I Spy sheet
    • Squeeze ball

Key Points:

• The CDC recommends everyone 6 months and older get an influenza vaccine every year. The influenza vaccine has been shown to prevent millions of influenza illnesses, tens of thousands of hospitalizations, and thousands of deaths each year.
• Children 6 months-17 years old need an influenza vaccine.
• Millions of children get sick from seasonal influenza, thousands are hospitalized, and some children die from influenza each year.
• The influenza vaccine can be life-saving in children.
• Among reported pediatric deaths since 2004, about 80 percent of the deaths have occurred among children who were not fully vaccinated against influenza.
• Children ages 6 months to 5 years old – even those who are healthy – are at higher risk of developing serious influenza complications simply because of their age. Children of any age with certain long-term health problems, such as asthma, diabetes, or neurological and neurodevelopmental conditions, also are at higher risk for complications from influenza

Types of Flu Vaccines For Children

From the CDC:

During the current flu season, the CDC recommends annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine.

• Injectable influenza vaccines (IIV4) are given as an injection (with a needle) and are approved for use in as young people 6 months old. (Indications vary by vaccine.)
• Live attenuated influenza vaccine (LAIV4) is given as a nasal spray and is approved for use in non-pregnant, healthy people ages 2 to 49 years old. However, there is a precaution against the use of nasal spray flu vaccine (LAIV) in people with certain underlying medical conditions. More information about the nasal spray flu vaccine can be found here.

Your child’s health care provider will know which vaccines are right for your child.

When to Vaccinate

The CDC recommends that influenza vaccination should be offered in September or October; however, vaccination should continue throughout influenza season as long as influenza viruses are circulating, even into January or later. Children and pregnant people in their third trimester can be vaccinated as soon as the influenza vaccine is available – even if this is in July or August. Adults, and especially those older than 65, should not be vaccinated early (in July or August) as immunity wanes more quickly in this age group.

Some children 6 months to 8 years of age require two doses of influenza vaccine. Children 6 months to 8 years old getting vaccinated for the first time, and those who have only previously received one dose of the vaccine, should get two doses of vaccine this season.

• The first dose should be given as soon as the vaccine becomes available.
• The second dose should be given at least 28 days after the first dose.
• The first dose “primes” the immune system; the second dose provides immune protection.
• Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.
• All children who have previously received two doses of vaccine (at any time) only need one dose of vaccine this season.

How to Make a Strong Influenza Vaccine Recommendation 

Based on years of research into vaccine motivators, the CDC has developed a mnemonic device to help health care providers make strong vaccine recommendations. This method known as “SHARE” can help you to make a strong vaccine recommendation and provide important information to help patients make informed decisions about vaccinations.

S- SHARE why an influenza vaccine is right for the patient given their age, health status, lifestyle, occupation, or other risk factors.

“This vaccine can protect you and your family from getting sick from flu. By getting a flu vaccine today, you’ll be protecting yourself and the people around you, like your children and parents, who are more vulnerable to serious flu-illness.”

H- HIGHLIGHT positive experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and strengthen confidence in influenza vaccination.

“In addition to recommending a yearly flu vaccine to my patients, I get one each year to protect myself and my family from flu.”

A- ADDRESS patients’ questions and any concerns about influenza vaccines, including side effects, safety, and vaccine effectiveness in plain and understandable language. Acknowledge that while people who get an influenza vaccine may still get sick, there are studies to show that their illness may be less severe.

“A flu vaccine cannot cause flu infection. The most common side effects of an influenza vaccine are mild, like redness, swelling, soreness, or low-grade fever for a flu shot. This should go away within a few days. Flu vaccines protect against flu illness but aren’t 100% effective, so even if you get vaccinated you might still become sick with flu. It’s important to get your flu vaccine because studies show that even if you do get sick, vaccination may make your flu illness less severe.”

R- REMIND patients that influenza vaccines help protect them and their loved ones from serious influenza illness and complications.

“Flu activity is going to start to pick up, and CDC says to expect more cases in the coming months. That is why I want to make sure I help protect you and your loved ones against flu and its potentially serious complications.”

E - EXPLAIN the potential costs of getting influenza, including potential serious health effects for the patient and time lost (such as missing work or family obligations), financial costs, and potentially spreading flu to more vulnerable family and friends.

“It’s important to vaccinate your children this season because flu vaccination can reduce potential flu illnesses, doctor visits, hospitalizations, and even death. Vaccination can also keep your children from missing school, and you from missing work due to flu, and can protect those around you who are more vulnerable to potentially serious flu complications.

• 7 a.m. - 4 p.m., Sept. 20, Pav 1
• 7 a.m. - 4 p.m., Sept. 22, Family Meeting Center
• 8:30 a.m. - 2 p.m., Sept. 27, ROB 1102 ABC meeting rooms
• 9 a.m. - 2 p.m., Sept. 29, Pav 1
• 10 a.m. - 2 p.m., Oct. 4, 901 7^th Ave., 3^rd floor conference room
• 10 a.m. - 2 p.m., Oct. 6, 901 7^th Ave., 3^rd floor conference room

Whether you receive your flu shot in your department or at one of our flu clinics, you must complete a consent form. To sign the consent form electronically through Lawson, follow these steps:

• Scroll down on the left navigation bar and click on “Employee Self Service”
• Then click “Human Resources”
• Then click “Occ Health Portal”
• Then click on “Forms” at the top of the page and click on “Influenza Vaccine Consent” to complete your form

Employees may get their flu shots at another location – from a primary care physician, or pharmacy for instance – and send proof to Occupational Health for their records. The goal? Everyone immunized by Nov. 1.

The flu is a viral infection of the respiratory tract that can cause fever, chills, headache, muscle aches, cough and sore throat, runny nose, tiredness and other symptoms. Flu shots are the best way to protect yourself against the flu.

For more information, call Occupational Health at 682-885-3837.

 Meetings

We have changed our meeting guidelines:

•  If you are not serving food or you do not have patients or patient families in attendance, you no longer have to social distance at any meeting spaces throughout Cook Children’s. However, you must wear your mask during these meetings.
• If you are serving food or have a patient family in attendance, we ask that you continue to stay 3 feet from one another.

N-95 Fit Testing

•  If Occupational Health reaches out to you for N-95 mask fitting, we ask that you participate. It is important to stay current with your N-95 mask and that it properly fits.

 If you test positive for COVID-19

As a refresher on what to do if you test positive for COVID:

• If you are ill and have completed a home test, please save the test result by taking a photo of it. The COVID team will send you a link to upload the test.
• Please call the COVID-19 Center at 682-303-1661 and alert Occupational Health that you have tested positive.
• You will be placed on in-house isolation for 5 days. The isolation begins on the first day you experienced symptoms.
• Your leader will be told by email that you are in isolation.
• After 5 days of when you were first symptomatic, you may return to work if you are not showing any symptoms.
• When you return to work, please follow our guidelines to wear a mask. Please wear your N-95 mask if you have been fit-tested. Otherwise, please wear an FDA-approved mask.
• If you are still experiencing symptoms after 5 days, call the COVID-19 Center number listed above and Occupational Health will provide guidance.

 We will continue to monitor the CDC and expect more guidance for health care settings in the coming weeks.

 Thank you for your support.

Whether you receive your flu shot in your department or at one of our flu shot clinics this fall, the consent form must be completed first. Consent forms in English are available through Lawson by following these steps:

• Scroll down on the left navigation bar and click on “Employee Self Service”
• Then click “Human Resources”
• Then click “Occ Health Portal”
• Then click on “Forms” at the top of the page and click on “Influenza Vaccine Consent” to complete your form

Karen Mahoney, manager of Occupational Health, said the distribution of doses will start with highest-risk areas such as Hematology/Oncology, the Emergency Department, PICU and NICU, and then to the rest of the medical center and to physician offices in the network.

Consent forms in Spanish will be available on paper at our eight on-site flu shot fairs, which begin Sept. 13. “We’ll have enough vaccine for everybody,” Karen said.

Employees may get their flu shots at another location – primary care physician or pharmacy for instance – and send proof to Occupational Health for their records. The goal? Everyone immunized by Nov. 1.

The flu is a viral infection of the respiratory tract that can cause fever, chills, headache, muscle aches, cough and sore throat, runny nose, tiredness and other symptoms. In the United States, flu season is from October to May.

“It’s the best protection we have against the strains of the flu that are currently circulating,” Karen said. “If we can get our shots every year and prevent illness, that’s a great thing for our employees and our patients.”

For more information, call Occupational Health at 682-885-3837.

As a reminder, Cook Children’s changed its policy several months ago regarding when an appointment can be made for a child, following an active COVID-19  infection.

Patients can now be seen throughout the system 10 days after a positive COVID-19 test.

 Out of an abundance of caution, we do ask that families of severely immunosuppressed patients continue to wait for 21 days before making an appointment. Examples include children who are on active chemotherapy or recently received a transplant.

Otherwise, we are allowing patients to return to an appointment 10 days after they tested positive. This is a change from our former policy of waiting 21 days between appointments, and this change overrides all previously communicated guidance. 

 We have made this change, based on recent science that the “majority of the SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and 2-3 days after.

IMPORTANT:  If there is a compelling reason for the patient to be seen during the 10 days (21 days for severely immunocompromised) after a positive COVID-19 test, please make sure the patient and their family members wear a well-fitting mask and are in appropriate isolation while in the clinic.  Compelling reasons include such things as getting a cast removed, chemotherapy, new diagnosis of diabetes, or other things that, in the opinion of the physician, should not wait.

Please make sure that patients and their families wear their masks at all times during their appointment.  

Thank you to IT and the Epic team for adding this new policy into all current screening questions when a patient family visits Cook Children’s.

Click the images below for EPIC screenshots.

Meetings

• Please wear masks during meetings.
• Please consider going back to Zoom, or other virtual options, as much as possible.
• If it is critical to meet in person, please use your best judgment to keep staff safe. We ask that you consider the meeting space and the duration of the meeting.
• Please space out as much as possible, with a minimum of 3 feet.
• We ask that everyone in the room wear masks regardless of vaccination status.
• Please do not serve food or drink at any meetings at this time.

Masks  

• Please continue to wear masks indoors at all Cook Children's location, including professional buildings and offices. 
• We ask that all patients and their families wear masks at any Cook Children’s location.
• Please remind anyone who pushes back on these guidelines that we are caring for medically fragile children and we need to provide them with the safest place possible. Along with the COVID-19 vaccines, masks remain the most important way to protect ourselves against this virus.

Visitors

Inpatient

• We allow two  immediate family members at a time in the patient’s room between 8 a.m. - 8  p.m.. (visiting hours).  
• You must request visitor exceptions for more than two immediate family members.
• Siblings are allowed as long as everyone over the age of 2 wears a mask. 
• Immediate family members can trade out/take turns on a daily basis.  Banded primary caregivers can stay 24 hours/day.
• Immediate family members can switch out on the floors.
• Others can wait in areas such as the cafeteria/amenity areas on first floor only.
• We will no longer have visitors wear stickers.

Note:  This does not apply to the emergency room or end-of-life situations when more than two individuals may be needed, as well as exceptions made for clergy.. These situations will be handled on a case-by-case basis.

Outpatients (including CCPN offices, Urgent Care Centers, Neighborhood Clinics, Dodson Specialty, etc.)

Please recommend to families that they only bring two people to a visit. However, we understand with the rising outdoor temperatures, we do not want to keep people in the car and it may be necessary to bring more than family members in for a patient visit. Please work with families to make sure they wear their masks and work to keep families 6 feet apart from one another as much as possible.

Waiting areas and room visits

• We ask that you remove any toys or play structures in waiting areas,  in an effort to prevent the spread of germs.
• If possible, please space out a total of 3 seats for families and a distance of 6 feet apart.
• Please get patients and their families in a room as soon as possible. Check them in and out in that room if you are able to do so.

Business Travel

Domestic

At this time, we are not placing any restrictions on business travel. We do encourage you to wear your mask while traveling, preferably an N-95 mask as the safest option.

International

We are not allowing any international travel for business.

As we continue to monitor community COVID-19 numbers, we will make any necessary changes to keep our patients, their families and each other as safe as possible.

Personal Travel

• You are no longer required to show any proof of a negative COVID-19 test after any personal travel (including air travel or a cruise). 
• It is not necessary to get tested 3 to 5 days after your return from any travel. 
• While it is not a requirement, the CDC does recommend test for anyone who is returning to the U.S. from a trip. 
• If you begin to feel ill or show symptoms of COVID-19 after  travel, please call the COVID-19 Center at 682-303-1661 or send  an email to COVID19OHS@cookchildrens.org. 

Thank you for your cooperation.

With COVID-19 numbers down dramatically at many locations, it’s time to revisit our travel guidelines.

Domestic Travel:

Regardless of your vaccination status, you are no longer required to provide a negative COVID-19 test on your return from work. You may return to work immediately.

If you are not vaccinated, continue to wear your mask.

If you begin to show symptoms, please get tested immediately.

Masks:

After a recent federal court decision in Florida, masks are not required during travel for most public transportation.

However, the CDC and your Cook Children’s Infectious Diseases specialists still recommend wearing masks while in an enclosed space crowded with people, such as in a bus, subway or train. Traveling on planes remains more of a question with claims of good ventilation. But until more data is provided, our ID teams say it’s best to continue to wear a mask on a plane over your nose and mouth. 

What about Business Travel?

• While we continue to discourage business travel, we understand some travel is deemed necessary or essential to the operations of Cook Children's Health Care System. In these situations, business travel should be approved in advance by a company president, or VP or above.
• Currently, no international travel for business will be approved by Cook Children's.

Cruise Ship and River Cruise Voyages

Regardless of your COVID-19 vaccine status, you may return to work after your trip.

Get a COVID-19 viral test 3-5 days after your cruise, regardless of your COVID-19 vaccination status.

To learn more about what you need to know before traveling on a cruise, click here.

International Travel:

Regardless of your vaccination status, you can return to work immediately, but please ensure the following criteria:

• Proof of obtaining a COVID test during days 3-5 after returning to the U.S. is sent to Occupational Health at IntlTravelProof@cookchildrens.org.  
• Home tests are accepted as long as you provide a picture that includes two things: your Cook Children’s badge and test kit result. Send both to Occhealth@cookchildrens.org.
• If you receive a test from a company that witnessed the test, please forward the original email sent to you from that organization which includes your results and your employee number/name.
• Occupational Health will alert the manager of receipt of this information.
• If the employee does not submit proof of testing for COVID-19 on days 3-5, the employee will be taken off of the schedule by their department.
• You cannot return back to work until proof of testing is received during that time period or after 5 days of quarantine (if no test is obtained during the time frame of days 3-5). 
• The International Travel Team/Occupational Health will notify department leadership and HR if no proof is received.
• If you are positive, contact the Infection Prevention COVID hotline immediately. COVID19OHS@cookchildrens.org or 682-303-1661

Recommended For ALL Travelers:

• Get tested with a COVID-19 viral test 3-5 days after travel.
• Find a U.S. COVID-19 testing location near you.
• Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
• Follow all state, tribal, local, and territorial recommendations or requirements after travel.

We encourage you to download and share the fliers in your break areas, nursing stations, etc. You can download the fliers on the right-hand side of this page. 

PPE requirements for FULLY-VACCINATED employees against COVID-19 

PPE requirements for EMPLOYEES NOT VACCINATED against COVID-19 

Recently, we’ve been able to relax our COVID-19 guidelines because of the decline in COVID-19 cases in our area and within our system. However, we must continue to take certain safety precautions for our patients, their families and each other.

Employee Information:

As a reminder:

• We require that outside guest speakers must be vaccinated in order to come on campus. The maximum for these events is 25 attendees.
• The only non-Cook Children’s employees allowed onsite must be here for a meeting or for training purposes.
• We are not allowing any employee family members or friends onsite to visit at this time. We must still limit the number of people on campus as much as possible.

Eyewear: 

For all patient encounters, you must wear at least a surgical mask and eye protection.

Goggles and N-95 Masks

Fully vaccinated employees:

• Are no longer required to wear goggles and N-95 masks for aerosol generating procedures (AGP) on inpatients who have tested negative for COVID-19. However, you must continue to wear surgical masks and eye protection. This applies to inpatients who are all routinely tested on admission.
• Are no longer required to wear goggles and N95 masks for aerosol generating procedures (AGP) in outpatients who have not been tested, but they have answered “no” to the screening questions for COVID symptoms and exposures.
• Are no longer required to wear goggles and N-95 masks for giving nebulized treatments in the outpatient setting. However, you must continue to wear surgical masks and eye protection for this procedure.  This procedure is not believed to produce much aerosol and is lower risk.

Employees who have received an exemption or are not yet fully vaccinated:

• You must continue to wear goggles and N-95 masks during all these procedures.

Screening:

At this time, please continue with all current screening questions/protocols for patients and their families entering Cook Children’s.

Drive-thru testing

The drive-thru for patient testing located on main campus are now closed.

Primary care practices and Neighborhood clinics continue to offer COVID testing to their patient populations during an office visit as needed. The Urgent Care locations are no longer offering COVID test only services but do continue to have testing available for any patient seen during their visit to a UCC if necessary. 

Patient and Family Visitation Information:

• At Cook Children’s Medical Center, two designated caregivers may be with each child while they are a patient in the medical center.
• This does not apply to the emergency room or end-of-life situations when more than two individuals may be needed. These situations will be handled on a case-by-case basis.
• All surgery and procedural areas at the medical center and Dodson ASC, including the main OR, surgery waiting areas, etc. will follow the two designated caregivers policy in place for the medical center.

At other locations, including Primary Care and Specialty Care offices, such as Dodson and the Infusion Center; Urgent Care Centers; Neighborhood Clinics; Outpatient Surgery Centers in Hurst and Prosper; Rehab; Home Health office, our guidelines are:

• Any two people from the child’s household may come with the patient to any appointments or visits. For example: mom and sister; dad and daughter; mom and grandmother.
• Those visiting our locations will be screened upon entering (temperature checked/symptoms of illness).

Thank you all for your cooperation to keep everyone safe.

Since the beginning of the pandemic, Cook Children’s has followed the latest Centers for Disease Control and Prevention guidelines.

 Based on the latest guidance from the CDC, we will continue our current mask mandates for all Cook Children’s employees throughout the system (including areas such as the ROB and Calmont).

As you may have seen, the CDC revised its public indoor mask guidance, allowing most people to go without a mask  whilein public indoor settings if they choose. However, those revisions do not include health care settings. Click here to read more from the CDC.

 For the general public, the CDC now looks at hospital capacity and COVID-19 cases instead of transmission rates to decide risk levels. The CDC looks at the following to create community levels:

• New COVID-19 admission per 100,000 population in 7 days.
• The percent of staffed inpatient beds occupied by COVID-19 patients.
• Total new COVID-19 cases per 100,000 population in the past 7 days.

For public indoor mask wear, the CDC states that:

At high level: everyone should wear their masks in public settings, including schools.

At medium level: People at higher risk for severe COVID-19 infection, such as the elderly and immunocompromised, should talk to their doctor about wearing a mask.

At low level: the CDC says that most people can go without masks in public settings, but that they should be vaccinated and boosted, and tested if they are sick. 

The community spread level in Tarrant County is currently at medium.

For the protection of our employees throughout the system and following the CDC, we will require masks at this time throughout the system. As numbers continue to drop, we will re-evaluate the situation.

Thank you for your cooperation.

Currently, the community level in Tarrant County remains high (Red), however, the hospitalization rates at Cook Children’s and DFW hospitals overall has greatly reduced. We are currently averaging 15 or fewer COVID-19 patients daily, with a seven-day average positivity rate in the single digits.

In consultation with Infectious Disease and Infection Control, the COVID Command Center Team is making the following adjustments to our COVID Safety/Health protocols, which returns us to a posture which was in place prior to the impact of the omicron variant:

• Allow meetings, tours and gatherings with a decrease in social distancing from 6 feet to 3 feet.
• Resume physician recruitment outings.
• Require that outside guest speakers must be vaccinated in order to come on campus. The maximum for these events is 25 attendees.
• The only non-Cook Children’s employees allowed onsite must be here for a meeting or for training purposes.
• We are not allowing any family members or friends onsite to visit at this time. We must still limit the number of people on campus as much as possible.
• Allow eating and drinking in meetings and break areas with 3 feet social distancing (this does not include Camelot Court).
• Allow employees to take their masks off while outside and be able to have walking meetings or exercise together outside without masks.
• Resume domestic business travel on March 1, following all federal guidelines on mask wearing. Continue the pause on international business travel.
• Maintain current visitation policy of two caregivers for inpatient and outpatient visits.
• Finalize a saliva testing option for exempt employees. If approved, this test will be provided at our campus drive-thru location only.

Finally, we want to address the seating situation at Camelot Court. Because it’s not possible to ensure social distancing in this area and for the protection of our patients and their families, we ask that you follow these guidelines while in Camelot Court:

• 6 feet separation of employees while eating or drinking.
• Employees eat alone at a table.
• Do NOT sit at a booth. These are reserved for patient families only. Please let any of your students on campus know they should not be sitting at a booth as well.

We will continue to monitor community and hospital rates related to patients and employees and recommend adjustments as conditions change.

For COVID testing only: 

If you need a COVID test while the center is closed on weekends, please page the on-call Infection Prevention nurse via Vocera, or the medical center operator, and they will schedule a test for you. 

Please note: It may take up to an hour for a return call, as the on-call Infection Prevention Nurse may not be at a computer. Do not call while in the drive-thru line.

For all other issues, please leave a message at 682-303-1661 (ext. 31661) or email COVID19OHS@cookchildrens.org and it will be returned during normal hours on weekdays. 

 Monoclonal Antibody:

Key points to remember: as of this writing, supply is critical and may have reached zero.

1. Sotrovimab is the only monoclonal antibody with effectiveness against the omicron variant. Click here to read this referencing article. 
2. They are now only using Sotrovimab at the regional infusion center. However, currently the infusion center is out of antibody. If it becomes available again, we can still refer patients via the website : New Order (stateoftexasinfusionhotline.com)
3. Cook Children's is currently out of  Sotrovimab.
4. Please do not send patients to the Cook Children's Emergency Department for this, without speaking to the Infectious Diseases physician on-call. 

Criteria for using Sotrovimab:

1. Patients have to be unvaccinated, or under vaccinated, or not believed to be able to respond to the vaccine.
2. Patients must be actually infected with the virus. We would not use this for post exposure prophylaxis now. 
3. After the first two criteria are met, cases would be individualized by calling the Infectious Diseases doctor on-call.
4. The Infectious Diseases team will review logistics of Remdesivir in outpatients after we run out of Sotrovimab. Hopefully we won't have to.

NIH risk stratification is being used by the infusion center, when they do have Sotrovimab available.  You can call the infusion center to check availability.  1.800.742.5990

There are other treatments that may be available, or hopefully, become more available.

We want to provide you with an update on Cook Children’s COVID-19 travel restrictions. Cook Children’s is continuing to discourage all business travel. 

As we shared this summer, we realize there are situations where travel is necessary or essential to the operations of Cook Children’s Health Care System. In these situations, business travel should be approved in advance in writing/email by a company president, or VP or above. 

As previously communicated, no international travel for business will be approved by Cook Children's at this time.

We are hopeful COVID-19 numbers in our community will decline even more, and we will revisit these travel restrictions by the end of February 2022.

Thank you for your patience and understanding.

Click here to see Updated International Travel Guidelines. 

However, these masks are meant for use outside of work. They are not meant to be worn while you are at Cook Children’s.

OSHA guidelines states that Cook Children’s is responsible to fit test any N95 mask brought in and used by the employee.

While the masks cannot be worn at work, they may be a better alternative for you and your family members at home. The CDC states that these masks offer more protection against COVID than loose fitting masks or cloth masks.

Marc Mazade, M.D., Medical Director of Infection Control and Prevention, states the “bottom line is that the TIGHTNESS OF FIT is what is most important and that gaping masks are not likely to provide as much protection as masks that fit tightly to the wearer’s face.”

Individuals who take part in the mask distribution program will be limited to three masks per person to make sure everyone who wants a mask will be able to receive one in this nationwide program.

The same federal programs used to distribute the COVID-19 vaccines will be put in place to provide masks to individuals. This means that you will be able to visit similar locations to get your masks, such as most local pharmacies.

 If you are feeling ill or showing signs or symptoms while at work or home, please call or email our COVID-19 Center and let them know.

 This experienced group will work with you to schedule a test at Cook Children’s if you are at or near the medical center.

If you test positive for COVID-19, please take the following steps: 

• Call or email the COVID-19 Center. 

• Please provide your: 
• Name 
• Employee ID 
• A phone number for someone to call you back 

If you had a positive at-home test: 

• Please leave your contact information with the COVID-19 Center. 
• After you speak with someone from the Center, a link will be sent to you. 
• Complete the link that will allow you to upload your positive home test. 

Please remember the COVID-19 Center is very busy right now. We ask for your patience and kindness with dealing with this team that has worked hard throughout the pandemic. Thank you for your cooperation.

A new program launched by the federal government allows for all Cook Children’s employees who receive health insurance coverage to request up to eight free at-home COVID tests a month through their insurance plan. 

You can read more  here.  

Insurance companies and health plans are required to cover eight free at-home tests per covered individual per month. For example, if you have four family members covered by your insurance plan, you would be able to get 32 tests per month.

As an insurance member, you have two options:

1.      Over the counter: Purchase the tests on your own. Save your receipts and file a manual claim with your insurance provider. If you purchase a test, you may be eligible for reimbursement with the new outlined plan.

2.      Use your pharmacy: Visit the pharmacy covered by your insurance plan. Submit the claim to your insurance provider. As a member, there is the potential of no out of pocket cost to you.

Here’s how it works:

CVS Caremark OTC COVID-19 Tests Without A Prescription Under The Pharmacy Benefit Solution

• Direct Member Reimbursement (post service reimbursement program): Reimbursement for over the counter (OTC) COVID-19 tests without a prescription after purchase, starting Jan. 15, 2022 until the end of the Public Health Emergency (PHE). Members can upload a copy of their receipt of the OTC COVID tests purchased via Caremark.com to submit for reimbursement or submit a paper claim.
  • Member will be reimbursed, and the plan will pay. Once a plan meets all components of the direct coverage safe harbor, the member will be reimbursed, and the plan will pay, the lesser of (i) the full retail price paid by the Member, or (ii) the lesser of the $12 per test reimbursement limit established by the Administration in the direct coverage safe harbor.  

AND

• Direct Coverage (i.e. “Pharmacy Benefit Manager (PBM) adjudication at pharmacy point-of-service”): Plan will cover the cost of OTC COVID tests with direct reimbursement to the pharmacy and no upfront out of pocket cost for members.
  • CVS Caremark will adjudicate claims at a rate comparable to the pharmacy’s U&C rate. This is for participating pharmacies. Not all Pharmacies will choose to participate.
• Quantity limit of eight tests per 30 consecutive days across both coverage capabilities.

Tests delivered to your home

Along with the tests you may receive through your insurance, a one-time order of four free tests per residential address can be requested Beginning Jan. 19, Americans can order the tests online at COVIDTests.gov. The tests will typically ship within 7-12 days of ordering.

Can these tests be used at Cook Children’s?

If you are feeling ill or showing symptoms of COVID-19, you may submit a rapid test result to the COVID-19 Center by  sending your name, employee ID number, phone number to COVID-19OHS@cookchildrens.org . Then someone will contact you to complete your evaluation form. 

This testing will not take the place of regularly scheduled COVID testing if you are an employee who received a vaccine exemption.

Infection Control asks that you only test if you are showing symptoms and not waste a test if you don't have any symptoms. Timing of the test is critical. Sometimes testing too early in the illness could result in a false negative.

To read more about at-home tests, click here.

As we have stressed since the beginning of the pandemic, our main priority remains the safety of you and our patient families. As COVID-19 numbers continue to rise, we must have everyone’s cooperation in wearing proper PPE.  Click here for an infographic on proper PPE.

Eyewear is still required for EVERY patient/family encounter. If you are meeting with a patient family, or in an area where you are in frequent contact with them, you must wear your approved eyewear.

Masks are to be worn at all times, unless: 

• You are eating or drinking while keeping proper social distancing.
• You are alone in an enclosed area.

We are all in this together and we ask that you take these precautions to protect one another. If you see a fellow employee not wearing their mask or they aren’t wearing the appropriate PPE, please remind them of our policy.

It is all of our responsibilities to keep each other safe.

Thank you for your cooperation.

Click here to read the latest mask guidelines from the CDC.

If you are vaccinated, you can return to work immediately, but please ensure the following criteria:

• After returning to the U.S., send proof of receiving a COVID test during days 3-5 to Occupational Health at IntlTravelProof@cookchildrens.org. 
• Home tests are accepted as long as you provide a picture that includes two things: your Cook Children’s badge and test kit result. Send both to IntlTravelProof@cookchildrens.org.
• If you receive a test from a company, who witnessed the test, please forward the original email you received from that organization. Include your name, employee ID number and results.
• Occupational Health will alert the manager of receipt of this information.
• If the employee does not submit proof of testing for COVID-19 on days 3-5, the employee will be taken off of the schedule by their department.
• The employee cannot return back to work until proof of testing is received during that time period or after 10 days of quarantine (if no test is obtained during the time frame of days 3-5). 
• If you are COVID positive, contact the Infection Prevention COVID hotline immediately.  COVID19OHS@cookchildrens.org or 682-303-1661.

If you have not been fully vaccinated, the previous guidance is in effect and you will need to follow CDC guidelines:

1.    The CDC warns against traveling internationally if you are not fully vaccinated.

2.    Check your destination’s COVID-19 situation and travel requirements before your trip.

3.    Countries may have their own entry and exit requirements.

4.    When you travel to the U.S. by air, you are required to show a negative COVID-19 test before you board your flight. The timing of this test depends on your vaccination status and age.

5.    You will need to notify Occupational Health prior to you traveling internationally.  

o   ​Click h​ere to send an email to complete Cook Children's COVID-19 Vaccinated Employee International Travel Process.

o   You can also click here to download this form, which should then be completed and emailed to IntlTravelProof@cookchildrens.org. This will inform them to expect a test result after your return.

1. You will be REQUIRED to get a test prior to the flight back to the United States by the airlines. 
2. If you test positive, you will not be allowed to return until the isolation period is over. Contact the Infection Prevention COVID hotline immediately.  COVID19OHS@cookchildrens.org or 682-303-1661
3. You must remain off work for 10 days after you return (7 days if you are tested on days 3-5 and the result is negative).
4. You will need to coordinate your quarantine time off with your department leadership and the time off will require PTO.

Click here to visit the travel information for employees.

With the spread of illness among employees and our community, you must have an appointment scheduled through the COVID hotline to receive a test from our COVID Drive-thru.

Please take note of the following information regarding our Drive-thru:

Testing Hours (Due to staffing these hours may change. You MUST have an appointment to receive a test):

• Weekdays: 8 a.m. to 9 p.m. 
• Weekends: 10 a.m. to 4 p.m.
• Testing sites are also available throughout your area. To find a testing location near you, click here. If you receive a positive test from a testing location that is NOT Cook Children’s, please email your test result to COVID19OHS@cookchildrens.org and copy your supervisor.

To Schedule a Test:

Only employees who schedule an appointment through the COVID-19 Center may use the Drive-thru:

• Telephone: 682-303-1661 (ext. 31661)
• Email: COVID19OHS@cookchildrens.org
• Testing must be ordered in EPIC before 4 p.m. through the COVID center.  We cannot place an order after that time and it may delay employees getting a test

Why Appointments Must Be Scheduled:

These hours are subject to change based on staffing. Scheduling an appointment requires someone to be on call to order the test, and provide quarantine information. We also need to ensure that we have someone to administer the test. Please be patient, and thank you for your understanding.

Happy New Year!

Sweet, adorable, glasses-wearing, curious, socially smiling, six-month old former preterm infant, Danica, and her 17-year-old mother, Mitzi, visit your office for a check-up. 

They are doing well. Baby Danica has chronic lung disease for which she uses bronchodilators, and has pulmonary hypertension.  She is no longer on home oxygen. Her weight is up nicely since the time of her last visit when it was 3.5 kg. 

Mitzi has a rheumatologic disorder, has been vaccinated for COVID-19, but takes immunosuppressants, which may have prevented her from responding well to her vaccines. 

They ask you to help come up with a plan to prevent COVID-19 infection or to ameliorate disease if they develop infection. Use the table below to determine which of the following statements are true regarding treatment and prevention strategies for COVID-19 in high risk persons. More than one may be true:

 A.      Before prescribing Paxlovid for Mitzi for pre-hospital treatment of COVID-19 infection, it would be important to check for medication interactions with the CYP3 inhibitor, ritonavir, which is included in the co-packaging to slow the metabolism of the COVID-19 active nucleoside analog, Niraltrelvir. You take a few minutes at this time to run her list of meds and consider listing ritonavir as a medication precaution if you find an interaction.

B.      Due to the concern for cartilage and bone damage, oral antiviral treatment with Molnupiravir should be avoided for pre-hospital treatment of COVID-19 in mother, Mitzi, until she is 18 years old.

C.       Due to the age-restrictions of the EUA issued on December 2, 2021, only Mother Mitzi, but not Baby Danica, would be eligible for the one-time IM administration of the dual monoclonal antibody, Evusheld, which may afford some protection for 6 months.

D.      At this time, Danica does not meet the age requirement for pre-hospital treatment of COVID-19 with the GSK monoclonal antibody, Sortrovimab.

 Thanks for taking the time to educate yourselves!

 Marc

COVID-19 Therapeutics and Preventatives

¹ Conditions associated with high risk to severe disease and or death are not limited to, but may include older age (for example ≥65 years of age) • Obesity or being overweight (for example, adults with BMI >25 kg/m2 , or if 12 to 17 years of age, have BMI ≥85th percentile for their age and gender based on CDC growth charts, https://www.cdc.gov/growthcharts/clinical_charts.htm) • pregnancy • chronic kidney disease • diabetes • Immunosuppressive disease or immunosuppressive treatment • Cardiovascular disease (including congenital heart disease) or hypertension • chronic lung diseases (for example, chronic obstructive pulmonary disease, asthma [moderate-to-severe], interstitial lung disease, cystic fibrosis and pulmonary hypertension) • sickle cell disease • neurodevelopmental disorders (for example, cerebral palsy) or other conditions that confer medical complexity (for example, genetic or metabolic syndromes and severe congenital anomalies) • having a medical-related technological dependence (for example, tracheostomy

 ² For a complete list of medication interaction see “Fact Sheet for Healthcare Providers Emergency use authorization for Paxlovid^TM” https://www.fda.gov/media/155050/download.

 As the director of Infection Prevention and Control, Sharon’s life revolves around COVID. She issues daily reports on the number of patients and employees who have tested positive for the virus, provides advice to the Command Center and oversees the team that provides support through the COVID-19 hotline and email.  

But instead of getting a reprieve from COVID, the virus followed Sharon and her family to Galveston where she, along with other family members, tested positive for the disease.

 “We are so busy right now and we have staff members who are dealing with illness like everyone else. We are trying our best to keep up with all the phone calls and emails,” Sharon said. “Right now, we ask for your patience and kindness. We are working as fast as we can to get back to you as soon as possible.”

If you are able to find an at-home test or receive one at another location, please feel free to do so and then email the COVID-19 Center  at  COVID19OHS@cookchildrens.org with your results. 

What To Do If You Are Getting Tested

If you are showing symptoms and want to be tested at Cook Children’s, please email COVID19OHS@cookchildrens.org or call 682-303-1661. Please remember that the abbreviated number to call is ext. 31661 (not 51661). To leave a message, please provide the following information:

• Your name, employee number and department where you work.
• Your phone number for someone to call you back.
•  When and where you were exposed to the virus.
• If and when you started showing symptoms.
• If you received a home test that shows you are positive, please send a photo of the results to the email above.

 A couple of important notes to remember:

• Please copy your supervisor or inform them that you will be out if you test positive. Please don’t assume that someone will let your supervisor know you will not make your shift.
•  When you email or leave a message with your phone number, please answer any phone calls that come your way until you hear back from someone in Infection Control at Cook Children’s. Because Infection Control members are short staffed and some team members are working from home, a variety of personal phone numbers and numbers from Cook Children’s are calling staff back, so please answer your phone.

 Click here to read more on Cook Children’s “return to work policy” for those infected with the COVID-19 virus and those who have been exposed.

 Dr. Mazade praises the work of the Infectious Control and Occupational Health teams, but reminds us that we are all in this together.

 “We have to do our part to protect each other and the families under our care,” Dr. Mazade said. “With the number of cases on the rise again, we have to go back to where we were in 2020. That means wearing our masks at all times, even when we aren’t at work, washing our hands, social distancing, and most importantly getting all of us who can vaccinated and boostered. I know everyone is tired of hearing about this, but we have to continue to do the right things so we can fight this virus.”

Jan. 4, 2022

 Current Situation

With the arrival of the very contagious omicron variant, we have seen our COVID-19 positive cases for our patients and employees increase dramatically over the past few weeks. At this time, there are more than 120 employees out with COVID, and the vast majority are vaccinated.

 In our community, the percent positivity rate has risen to more than 30%, and with recent holiday gatherings, we expect the rising numbers to continue over the coming weeks. (Source: Fort Worth Star-Telegram.)

 Learn more by watching this story with our own Mary Suzanne Whitworth, M.D., Medical Director for Pediatric Infectious Diseases, which aired today on CBS This Morning, a national news program.

 As has always been the case, keeping you safe and protecting our patients and their families are our top priorities.

 On Jan. 3, 2022, our President & CEO Rick W. Merrill, other senior leaders, members of the Command Center and our health care experts held several meetings to reevaluate how our health care system can minimize our risks and protect everyone as much as possible from this extremely contagious new variant.

 Below you will find new updated guidance, which overrides any previously communicated guidance, and all of this information applies to the entire Cook Children’s Health Care System.

 Meetings, Gatherings and Remote Working

• Whenever possible, you are highly encouraged to host all meetings virtually at least through January (and possibly longer, depending on our numbers).  Yes, Zoom and Skype will continue to be our friends!

• This guidance applies to vendors, other business associates, job candidates, etc.
• If you feel it is “business critical” to bring someone to any Cook Children’s location, please visit with your manager, and follow all safety protocols, i.e.  practice social distancing of at least 6 feet; do not offer any food or drink; and wear a mask at all times.

• Please stop all social gatherings immediately. This includes birthday parties, baby showers, department potlucks, retirement celebrations, etc.
• Please do not go out to eat lunch together or share a table at work together during lunch. While eating, please practice social distancing.
• Additionally, we are noticing that many employees are gathering in Camelot Court over a meal, and we ask that this stop for the time being.

Until further notice, employees who are able to work from home should do so as much as possible. Do you want to work remotely and believe it is possible for your role? Please talk to your manager about your department policies for remote working, and learn what may be possible for you.

 Masking and Social Distancing

• Please wear your mask at all times while at Cook Children’s, even when working out at the Wellness Zone, or walking outside. Exceptions include: 1) when you are eating; or 2) when you are alone in an enclosed area.
• Please go back to the basics for safety. Examples include:

• Maintain social distancing (at least 6 feet);
• Frequently and thoroughly wash your hands; and
• Wear your masks or proper PPE at all times.

• You can help set an example and be a community role model, too! While you are away from work. 

•  Please wear an FDA approved mask when you are out and about; and
• Follow the safety guidelines above.

 Outside Visitors and Guests (non-patient related)

• Do not bring your children, other family members or friends to your work location. We want to keep the number of visitors to a minimum and we are doing everything possible to keep everyone safe.

 Patient Visitor Policy Remains Unchanged and More

• We are continuing to follow our current visitation policy for patient families, which allows for two caregivers at the medical center and any two people for other locations.
• Please continue to follow the visitor exception policy detailed here.
• We have no plans at this time to postpone or cancel any surgeries or procedures. 

 Had a COVID-19 Exposure?

Please become familiar with the latest FAQ and our process and procedures on testing, exposures and quarantine here.

 If you have an exposure and have an urgent COVID question or situation that impacts your ability to be at work, please email the details to COVID19OHS@cookchildrens.org and COPY YOUR MANAGER. The information you need to include in your email includes:

• Your full name
• Your employee number
• Name of your department
• Name of your manager or immediate supervisor
• Your phone number (cell or home)
• When and where you were exposed to the virus.
• The date you started showing symptoms.
• If you receive a home test that shows you are positive, please send a photo of the results to the email listed above.

The bottom line is we need you well and healthy so we are all ready for the patients and families who are counting on us. With your help and support, we can do just that. Thank you for following this latest guidance, and helping us protect everyone entrusted to our care.

Keeping You Updated

We will continue to evaluate and monitor this ongoing and every evolving situation, and keep you updated as we know more. And you can always find the latest updates on our new Cook Children’s Connect Newsroom here.

 As we close, there is some good news coming out of South Africa, where the omicron variant was first detected. The latest data suggests the rise and fall of this current wave lasts only weeks rather than months like previous COVID-19 waves. We hope this holds true here in North Texas.

 Either way, we will get through this peak together just like we did the others.

 Thank you for all you are doing to fulfill Our Promise and for the care and service you provide to our patients, their families, our community, and each other.

 #WeAreCookChildrens

Still have questions? Please email COVID19Questions@cookchildrens.org.

Instructions for submitting visitor exception requests:

• Please email visitorexceptions@cookchildrens.org
• Subject Line: SECURE - APPROVED or NEEDS APPROVAL (select one), Date of visit, Location
• Body:
  • Patient Name
  • Room Number/Clinic
  • Names of people being granted exception
  • Time of arrival
  • Reason for exception

(Offsite clinics are to continue to handle their own visitation exceptions internally within the clinic.)

Throughout the COVID-19 pandemic, we have followed the Centers for Disease Control and Prevention’s guidance closely. With the recent surge in omicron cases in our area and throughout our system, we are updating our return to work policy for employees infected with the COVID-19 virus.

The following changes are based on new scientific information from the CDC that “the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. Therefore, people who test positive should isolate for 5 days and, if asymptomatic at that time, they may leave isolation if they can continue to mask for 5 days to minimize the risk of infecting others.”

If You Test Positive for COVID-19 (Regardless of vaccination status):

• Stay home for five days.
• If you have no symptoms or your symptoms are getting better after five days, you may return to work with or without a negative test.
• If you have a fever, continue to stay home until your fever stops for at least 24 hours without fever-reducing medications.
• Continue to wear a well-fitting mask at all times for five additional days. If you are a health care personnel who has been fitted for an N-95 mask, we ask that you wear that mask upon your return from infection (for at least the next five days).
• Please do not eat or drink around others for five days after your return if at all possible. Please wear your well-fitted mask at all times, practice social distancing and frequently wash your hands.

For employees who have been exposed to the virus:

If you are fully vaccinated and/or received booster:  Please continue to come to work and you do not have to report the exposure. 

If you are not vaccinated: You must stay home for 10 days. We ask that you report your exposure to the COVID-19 center by either calling 682-303-1661 or sending an email to 682-303-5033. Please provide your name, email and a good phone number to reach you. 

Throughout the COVID-19 pandemic, we have followed the Centers for Disease Control and Prevention’s guidance closely

Lately, we have seen a dramatic rise in COVID-19 cases among employees with the arrival of the omicron variant in our area.

Because of the increase in cases during the holidays, we want to provide you with a quick FAQ to go over a few important details:

Cook Children’s Changes Return to Work Policy for Those Infected by the COVID-19 Virus

With the recent surge in omicron cases in our area and throughout our system, we are updating our return to work policy for employees infected with the COVID-19 virus.

The following changes are based on new scientific information from the CDC that “the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. Therefore, people who test positive should isolate for 5 days and, if asymptomatic at that time, they may leave isolation if they can continue to mask for 5 days to minimize the risk of infecting others.”

If You Test Positive for COVID-19 (Everyone regardless of vaccination status):

• Stay home for 5 days.
• If you have no symptoms or your symptoms are getting better after 5 days, you may return to work with or without a negative test.
• If you have a fever, continue to stay home until your fever stops for at least 24 hours without fever reducing medications.
• Continue to wear a well-fitting mask at all times for 5 additional days. If you are a health care personnel who has been fitted for an N-95 mask, we ask that you wear that mask upon your return from infection (for at least the next five days).
• Please do not eat or drink around others for five days after your return if at all possible. Please wear your well-fitted mask at all times, practice social distancing and frequently wash your hands.

For those who are on quarantine for exposure, we will provide updated information at a later date.

Q: What if I’m fully vaccinated and had an exposure to COVID-19?

If you are fully vaccinated (two doses of Moderna or Pfizer at least two weeks out or a single dose of Johnson & Johnson at least two weeks out) and had an exposure, you may continue to work, while following all safety protocols, such as proper PPE. You do not need to alert Infection Control unless you develop symptoms and/or test positive.

Q: What if I am fully vaccinated and have tested positive for COVID-19?

If you are fully vaccinated and you have been exposed to COVID-19 and tested positive for the virus, you can save time by emailing the COVID team with the below information. You may call the hotline at 682-303-1661 and leave a number, but please be aware the wait times are long. The COVID team will reach out to you as soon as they are able.

You may also send a short email to COVID19OHS@cookchildrens.org. In the email provide the following:

• Your name, employee number and department where you work.
• Your phone number.
• When and where you were exposed to the virus.
• If and when you started showing symptoms.
• If you receive a home test that shows you are positive, please send a photo of the results to the email listed above.

What if I am not vaccinated and have had an exposure or tested positive?

Q: If you are not vaccinated, please call 682-303-1661 and leave a phone number and email for someone to reach out to you.

What to do if you are showing symptoms or need someone from Infection Control to call you back?

A: If you are showing symptoms and want to speak to someone, please send your contact information to COVID19OHS@cookchildrens.org or leave a message at 682-303-1661. We ask for your patience in waiting for a reply. Our staff is answering questions as quickly as possible.

Important: When you email or leave a message with your phone number, please answer any phone calls that come your way until you hear back from someone in Infection Control at Cook Children’s. Because of the holidays, we are short staffed and some team members are working from home. A variety of personal phone numbers and numbers from Cook Children’s are calling staff back, so please answer your phone.

What if I have general questions?

A: If you have general questions, please email us at COVID19Questions@cookchildrens.org. If you would like someone to call you back, please leave a return number.

Please have your badge visible when entering Cook Children's buildings so that desk staff can easily identify employees.

Thank you for helping us keep everyone safe and protected! 

Ayass Bioscience, a testing lab in Frisco, confirmed two cases of the new variant Wednesday night involving a 35 and 40-year-old. Neither has a recent travel history. 

This news comes after the first case was detected in the Houston area on Monday. The first case of omicron in the U.S. was identified on Dec. 1, 2021.

“At this time we are still waiting for scientific data to answer everyone’s questions about this variant such as whether or not it is more contagious, whether or not it causes worse disease, and whether or not our vaccines can prevent it,” said Susi Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s.

The CDC stresses that “vaccines remain the best public health measure to protect people from COVID-19, slow transmission, and reduce the likelihood of new variants emerging.”

While the vaccine remains the most effective way to combat COVID-19, data from the American Academy of Pediatrics (AAP) released on Dec. 1, 2021, found that only 12% of young Texans, ages 5-11 years old are immunized, and 61% of Texas teens have received at least one dose of the vaccine.

Dr. Whitworth and the Centers for Disease Control and Prevention (CDC) recommend that everyone 5 years and older protect themselves from COVID-19 by getting fully vaccinated. They also strongly advise that everyone ages 18 years and older should get a booster shot at least two months after their initial J&J/Janssen vaccine or six months after completing their primary COVID-19 vaccination series of Pfizer-BioNTech or Moderna.

At this time, Cook Children’s is not providing a booster. However, there are several ways to find a vaccine provider near you. Click here to find a COVID-19 vaccine near you and here for more helpful information.

“COVID-19 vaccines are highly effective at preventing severe illness, hospitalizations, and death,” the CDC adds. “Scientists are currently investigating Omicron, including how protected fully vaccinated people will be against infection, hospitalization, and death.”

What We Know about omicron (From the CDC)

• How easily does omicron spread? The omicron variant likely will spread more easily than the original SARS-CoV-2 virus and how easily omicron spreads compared to Delta remains unknown. CDC expects that anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don’t have symptoms.
• Will omicron cause more severe illness? More data is needed to know if omicron infections, and especially reinfections and breakthrough infections in people who are fully vaccinated, cause more severe illness or death than infection with other variants.
• Will vaccines work against omicron? Current vaccines are expected to protect against severe illness, hospitalizations, and deaths due to infection with the omicron variant. However, breakthrough infections in people who are fully vaccinated are likely to occur. With other variants, like delta, vaccines have remained effective at preventing severe illness, hospitalizations, and death. The recent emergence of omicron further emphasizes the importance of vaccination and boosters.
• Will treatments work against omicron? Scientists are working to determine how well existing treatments for COVID-19 work. Based on the changed genetic make-up of omicron, some treatments are likely to remain effective while others may be less effective.

Click here to learn more about the best tools to fight omicron and more general information from the CDC.

What we know:

Here are ways you can help reduce the patient’s fear and provide an emotionally safe experience:

Build Rapport:

• Speak to both the patient and the caregiver/guardian.
• Validate any observed fear or anxiety, “It looks like you are feeling a little bit nervous, let’s talk about what we can do to make this as easy and comfortable for you as possible.”

Quick Assessment:

• Ask the patient, “How do you typically do with shots/pokes?” “Do you remember the last time you had one?”
• Some patients will have developmental, behavioral, or sensory needs that need to be acknowledged before moving on. Collaborate with the family to come up plan to support the patient’s needs.
• Based on previous experiences, decide what interventions may be helpful in order for the patient to receive the vaccine. “It sounds like last time was pretty scary for you, maybe this time would you like to try some distraction to take your mind off of it and take relaxing breaths?”

Prepare:

• Be honest with the patient and let them know what you are going to do but also let them know they can be a part of the plan.
• Give the patient and caregiver/guardian a job.
  • “Your job is to hold as still as you can, you can watch or look away.”
  • “Let me know if you don’t want to watch so I can give you a heads up before I do it.”
  • “Would you like for me to count ‘1,2,3’ or just do it?
  • “[Caregiver/Guardian], why don’t you sit right here beside [patient] to hold their hand, if they want, or just talk to them to help comfort and distract them.”
• If patient or guardian begins to escalate with fear or frustration, validate and de-escalate. “We need to continue to remain safe while we do this vaccine, your job is to …. And I will do everything I can to help make this as easy and comfortable as possible for you.” “It seems like your [Caregiver/Guardian] really wants for you to be safe and get this vaccine to keep your body healthy. Let’s work together to get this done.” 

Provide Pain Management and Coping Techniques:

• Comfort Position
  • Allow patient to sit up next to or in parent’s lap, laying down is the most vulnerable position. When a child feels in control, they act in control.
• Cold Spray (aka “Elsa Spray” “Mr. Freeze Spray”)
  • Maybe say, “This is a helper so [the patient] doesn’t have to feel the poke as much.”
  • Clean and prepare the vaccine site, spray cold spray for 4-10 seconds and administer the vaccine without delay.
• Take relaxing breaths
  • Encourage the patient to take a breath in through their nose like they are smelling a flower and breathe out of their mouth like they are blowing out a candle.
• Therapeutic conversation
  •  “Describe your idea of a ‘perfect’ day. What would make it perfect?
  • ” “If you could travel anywhere in the world, where would you go, who would you take with you?”
  •  “If you could be president for a day, what would you do?”
• Items for distraction
  • Patient or guardian’s electronic device for listening to music, looking at pictures, etc.
  • I Spy sheet
  • Squeeze ball