My experience as a NICU parent during the COVID-19 pandemic

By Amy Rogeness, mom to Cora and Ellie

My daughters, Cora and Ellie, were born in May 2020 at just 24 weeks and 3 days gestation. They spent several months in CHOC’s Small Baby Unit, a special unit within the neonatal intensive care unit (NICU) that cares for the smallest and sickest babies. You can read more about our SBU journey – and see how well the girls are doing now – here.

Having a child – or in my case, two children – in the NICU is hard, and something that’s difficult to explain to someone who hasn’t experienced it. Becoming first-time parents is hard; becoming parents to twins is hard; having your children in the NICU for 136 days is hard; doing all of that during a global pandemic is that much harder and came with added complexities.

NICU parent holding twins
Amy holds Cora and Ellie in CHOC’s Small Baby Unit.

Feeling safe during a pandemic

Despite the pandemic, we felt safe at CHOC. Our daughters were in the SBU, located on CHOC’s Orange campus, and we visited them every single day. Due to COVID-19, my husband and I were screened every morning before we could check in at the front desk to get a visitor’s badge.

Soon enough after going every day, the screening and front desk teams began to recognize us and would ask how our girls were doing. These small gestures of recognition and concern for our daughters made us feel so welcome and somehow managed to put a smile on our faces, even during the hardest times. The screeners and front desk representatives were invested in the girls’ fight and when we were discharged, they were so excited to hear that we were going home!

Our heroes

The entire team who cared for our daughters are our heroes. Every day the doctors, nurses, respiratory therapists and developmental therapists came to work despite the pandemic. Even during a major health crisis that affected them professionally and personally, they cared so deeply for our girls. Although a scary situation outside of the hospital, when we were in the hospital, it felt like a small oasis away from the uncertainty of the pandemic because the CHOC care team gave the same level of care and concern to our girls that they would have provided during non-pandemic circumstances. Our girls wouldn’t be here without the work of a great medical team at CHOC.

Video: Amy and Brian holding Cora and Ellie in CHOC’s Small Baby Unit

The care team supported Mom and Dad, too

Being in the NICU during a pandemic dramatically changed our experience due to the safety protocols in place to protect the patients and employees. Normally CHOC’s NICU and SBU offers opportunities for parents to meet one another and get together for emotional support. Under normal circumstances, other visitors are allowed, which can help parents emotionally. My husband and I were lucky to have the ability to visit the girls at the same time, due to having twins, but our friends and family were not allowed to visit the girls. We completely understood the importance of a limited visitor policy to reduce the number of people in CHOC buildings during the pandemic, but that meant we relied that much more on the healthcare team for emotional support. The nurses and therapists became our friends and allies during our girls’ fight in the NICU. They celebrated with us, they were our shoulders to cry on, and they were the ones encouraging us to keep going. Not only did they provide excellent care to the girls, but they provided emotional care to my husband and I as parents – even during a pandemic, when they were also experiencing uncertainty in their own lives. This professionalism and personalized care made our experience bearable, daresay even enjoyable at times, because we could connect with them and laugh with them – important interpersonal connections that made us feel like we would get through to the other side.

Thanks to CHOC’s doctors, nurses and therapists, my daughters are doing well, and our family made it through this experience, and I’d like to express my appreciation for all they did for us, especially during a pandemic.

Seeing CHOC from a new perspective

I am in absolute awe of CHOC and its employees. I have always loved and admired CHOC; I grew up connected to CHOC and knew of the amazing work being done throughout the health system. But I was connected through being a doctor’s daughter and a member of the Orange County community; now I am a CHOC parent.

For the first time, I experienced the world-class care CHOC is known for, and the concern and dedication that everyone at CHOC shows to patients and their families. I cannot emphasize enough the highest level of concern for the patient, and the family-centered care delivered at CHOC.

I know that our story is just one example among thousands of others – stories of how much CHOC has done for patients and their families, not only to help heal a patient’s body, but also help them heal emotionally, as well.

Thank you, CHOC, for taking such good care of my daughters – and my husband and me – during our NICU experience throughout the pandemic.

Face coverings during COVID-19: Answers to common questions

Social distancing and proper hand-washing are critical ways to protect yourself and your family from COVID-19. Cloth face coverings are an additional step to slow the spread of COVID-19. Get answers to your frequently asked questions in this Q&A with CHOC infectious disease experts.

Do I have to wear a face covering in public?

The Centers for Disease Control and Prevention recommends cloth face coverings in public settings in places like grocery stores and pharmacies where physical distancing measures can be difficult to maintain. These face coverings can slow the spread of COVID-19 and help people who may have the virus and do not know it from transmitting it to others. It is not necessary for children under the age of 2 to wear cloth face coverings.

The governor of California has mandated that face coverings be worn by the general public when outside the home. This applies to high-risk situations such as entering public spaces; obtaining medical attention; riding public transit; certain work settings; and while outdoors in public spaces when maintaining a physical distance of 6 feet from persons who are not members of your household is not feasible. Exemptions include children age 2 and younger; persons with a medical condition, mental health condition or disability that prevents them from wearing a face covering; the hearing impaired or those communicating with them; persons seated at restaurants while eating or drinking, provided they maintain physical distancing; and those engaged in outdoor work or recreation alone or with household members while maintaining physical distancing from others. Read the full order here.

Is there anyone who should not wear a face covering?

Children under age 2, or anyone who has trouble breathing, is unconscious, incapacitated or unable to remove the mask without assistance should not use a cloth face covering.

What’s the right way to wear a face covering?

Wash your hands before putting on your face covering. It should cover your nose and mouth, be secure under your chin, and fit snugly against the sides of your face. Make sure you can breathe easily while wearing your mask.

The CDC recommends the following for increased protection:

Knotting the ear loops or twisting the ear loops of a mask and then tucking in and flattening the extra material close to the face. It’s important that the mask is secure over the nose, mouth and sides of your face. There should be no gaps.

Don’t put the covering around your neck or up on your forehead. Avoid touching your face covering. If you do, wash your hands.

Should I wear a surgical mask?

N-95 or surgical masks are not recommended for public use, as supplies are needed by healthcare workers and first responders.

How can I make my own face covering?

The CDC offers tutorials for sewn and non-sewn face coverings.

What’s the best way to remove my face covering?

Untie the stings behind your head or stretch the ear loops. Only hold your face covering by these ties or strings to avoid transferring any germs that may be on your hands onto the portion of the cloth that covers your nose and mouth.

Wash your hands after removing your face mask.

How do I wash my face covering?

Wash your face covering frequently, using one of these methods:

In the laundry – It’s OK to include your face covering in your regular laundry. Use your regular laundry detergent and the warmest possible setting for the cloth used in your face covering,

By hand – When washing face coverings by hand, the CDC suggests using a bleach solution by mixing 5 tablespoons (or 1/3 cup) of household bleach per gallon of room temperature water OR 4 teaspoons of household bleach per quart of room temperature water.

Soak the face covering in the bleach solution for five minutes. Then thoroughly rinse with cool or room temperature water. Always check the label on your bleach before using. Ensure your bleach is intended for disinfection, and that it’s not past its expiration date.

Never mix household bleach with ammonia or any other cleanser.

Why should I wear a face covering?

Many people with COVID-19 have no symptoms. Wearing a face covering helps protect others in your community – like those with autoimmune disorders or the elderly – in case you’re infected but don’t have any symptoms.

How can I help my child who is afraid of face masks?

Some children may incorporate mask wearing into their daily lives with ease, while others may find it odd, uncomfortable or even scary. If your child is having trouble wearing a mask, here’s advice from a CHOC pediatric psychologist on how to ease their fears.

Additional resources

The Orange County Health Care Agency has a printable graphic that offers an overview of how to wear and wash your mask available in multiple languages:

This article was updated on Feb. 12, 2021.

A day in the life of: CHOC’s director of safety, security and emergency management

As CHOC’s director of safety, security and emergency management, Calvin Fakkema is also the CHOC’s safety officer. His responsibilities include leadership over CHOC’s safety program, security department, parking and valet departments, workplace violence program, emergency management program, and business continuity program.

CHOC’s director of safety, security and emergency management
Calvin Fakkema, CHOC’s director of safety, security and emergency management

Throughout the COVID-19 pandemic, Calvin has also served as a Co-Incident Commander — alongside CHOC’s chief nursing officer — in CHOC’s COVID-19 Command Center. Activated in March 2020, the command center has been tasked with overseeing planning, response, mitigation and business continuity amid the pandemic. Through its virtual database that tracks various activities, the command center has logged more than 5,000 entries of decisions, actions, documents, algorithms and preparedness efforts throughout the health system thus far in the pandemic.

Follow along for a day in the life of Calvin, amid the COVID-19 pandemic

2 a.m. — My cellphone rings, and I open one eye trying to see who from the hospital may be calling. It is one of my security staff members, calling to notify me of something going on and seek direction. I calmly give him directions, then hang up and call a few other hospital staff for updates. Everyone involved follows policy and procedure, and I get a call back a few minutes later letting me know that all is well. No matter the day or time, the safety of our patients, families, clinicians and staff is always on my mind.

6 a.m. — My daughter shows up next to my bed to warmly greet me with a, “Good morning, Daddy.” I slowly open my eyes and greet her with a hug and a “Good morning,” back. As I get myself ready for the day, I make sure both kids are all settled in with breakfast. I quickly glance at my schedule for the day and check emails and text messages for anything that needs an urgent response. I grab my coffee as I head out the door and kiss my beautiful wife goodbye with a whisper to have a great day.

Calvin and family
My family and me.

7 a.m. — I arrive at work and greet my valet staff on the front driveway and see how they are doing and how operations are running this morning. Our valet staff members are often the first person that patients and families see when they come to our main hospital campus, and it’s important to me that they feel appreciated for all they do, and that they strive to make a positive first impression. I then make my way down to my office to get situated for the day. I take another look at my emails and listen to any voicemails that have come through overnight. I take my last sip of my coffee as I continue to follow up with team members who have questions or need support.

7:30 a.m. — First touch base of the day with Harving Parra, CHOC’s safety and workplace violence program manager. Harving’s job is to manage the physical safety aspects of our hospitals as well as to ensure that our staff have a safe work environment. Harving then heads off to the daily safety briefing where representatives from all areas of the hospital campus brief one another on updates from the past 24 hours and any anticipation of potential safety issues to arise in the coming 24 hours. Harving will keep me in the loop with anything discussed in this safety huddle. He is also part of our command center team, so he has been a huge support throughout the pandemic.

8 a.m. — I prepare briefing notes ahead of my daily meeting with the other members of CHOC’s COVID-19 Command Center team. I want to be sure to keep them in the loop on my team’s work as part of CHOC’s overall ongoing response to COVID. I do this with Chris Riccardi, CHOC’s business continuity manager. Chris has been actively involved in our COVID response, which like a lot of our command center team, has involved a lot of work on top of our typical responsibilities.

8:30 a.m. — Every morning at this time, I meet with our command center team, comprised of physicians, infection prevention specialists, nurse managers, CHOC’s chief nursing officer, CHOC’s chief government relations officer, and representatives from purchasing, business continuity and emergency management. We go through COVID-19 updates and plans. We review yesterday’s case numbers; the status of any plans for our hospitals, clinics and Outdoor Evaluation Centers; get updates from the infection prevention team; discuss logistics including our levels of personal protective equipment (PPE); hear from our government relations team on pending legislation or support; discuss local updates within the county and region; go over current support for our patients, staff and community; touch base on telehealth operations and making these visits more accessible to families, and any other emergency management matters at hand.

9:30 a.m. — It’s time for a meeting with our logistics chief and infection prevention leaders to review our current supply of PPE. While CHOC is not exempt from the global shortage of PPE prompted by the COVID-19 crisis, we are aggressively managing our supply chain; working with existing and new manufacturers and vendors to augment our supply; and following expert guidelines for equipment use. We are confident that we have ample PPE to protect our physicians and staff and provide the highest quality and safest care to our patients. We have been grateful for the support of our community and their generous PPE donations as well.

10:30 a.m. — I head back to my office for an outfit change, of all things. I don my Grinch costume and join a safe holiday celebration called Deck the Halls planned by the CHOC Foundation, in an effort to spread joy to our patients and staff. Due to COVID-19 restrictions, many typical holiday celebrations at the hospital were canceled or reimagined. We wanted to keep the magic of the holiday season alive and well for our patients and families, so the event included delivering goody bags to patient rooms, and
broadcasting a virtual celebration from Seacrest Studios and livestreaming all the festive décor throughout the hospital.

During typical years, I participate in holiday celebration planning efforts to ensure that all decorations are appropriate and safe for the hospital environment. Each year this always brings the tough part of my job as we have a standard of care and safety we need to ensure, which means someone must be the “Grinch” and say no to certain ideas or décor. To bring a spark of joy during a tough couple of months, I thought it was only appropriate to dress up as the Grinch and participate in some fun activities in our Seacrest Studios.

The Grinch costume
Donning my Grinch costume before the virtual holiday celebration.

Noon — Back to the office to change back into work mode after a fun adventure as the Grinch. Clean up, check my emails and text messages and reply to anything urgent, and quickly eat some lunch.

12:30 p.m. — I have a quick update call with the Orange Police Department’s Chief of Police to touch base on how things in the community are going and to see how CHOC is holding up through the pandemic. We have built a relationship with our local law enforcement officers and fire department, as we all play a part in keeping our community safe and healthy. Before the COVID-19 pandemic, we would bring police vehicles and fire trucks to the front driveway of our hospital in Orange for patients and their siblings to explore. It was always so rewarding to see the smiles it would bring to the children’s faces, and I know the law enforcement officers and firefighters enjoyed it as well. I’m looking forward to organizing more of those visits in the future, after the pandemic is over and it is safe to do so.

1 p.m. — I hop on another COVID-related phone call, this one with other hospitals in the county and Orange County Emergency Medical Services. We receive county and local updates, followed by a state update. Each hospital representative also shares a status update. As part of the Healthcare Coalition, it is important to always continue open communications on what is going on around the county, assist those in need, and keep our continued preparedness levels high. Before the COVID-19 pandemic, we met monthly in person. It gave us the opportunity to meet and see one other, catch up, and continue working through planning efforts and preparing for potential scenarios. Now that we are in the middle of a pandemic, the objectives of these calls are tailored to COVID, and it has been very beneficial for everyone to understand what is happening locally and at the state level.

2 p.m. — Time to review the daily documentation sent to the state government and federal government. Our command center utilizes a system to track data every day from key areas within our health system to submit to the state and federal COVID-19 response dashboards. There are many people involved in this effort, in order to ensure the data is captured, accurate and safe-guarded. During the week, Leeza Guardado, CHOC’s business continuity coordinator, holds down the fort for our command center documentation. On weekends, managers from my team and I rotate responsibilities for documentation and submission, to ensure that all weekend data is covered. This documentation covers approximately 80 questions we need to answer daily. We review any outstanding items that may need to be updated for the next morning, which leads into many emails sent out and reviewed for follow-up.

3 p.m. — I participate in a few internal virtual meetings regarding updates on projects and programs, while going through the command center log on the side for any new updates.

Calvin training
Pre-COVID, at a professional development conference with other emergency preparedness professionals.

4 p.m. — Before I head home for the day, I carve out some time to work on upcoming webinars, presentations and other projects in the works. Throughout COVID-19, my team and I have developed a number of presentations on not only lessons learned during COVID-19 in terms of proper emergency management and business continuity while dealing with the pandemic, but also best practices on other emergencies, mass casualty response, emerging infectious diseases, and security-related presentations and podcasts. CHOC is fortunate to have experts in the field of emergency management, safety and security to provide these types of education opportunities to the community, colleges, government officials and other healthcare personnel and executives.

5 p.m. — Time to wrap up my day in the office with a few last-minute emails and voicemails. As I get home, my kids are waiting patiently, looking out the window, waiting for me. That is the part of the day that I look forward to the most, getting my daily hugs and updates on what they were up to all day. We wind down by eating dinner together, doing homework, playing board games, building Legos, and spending quality family time together.

Celebrating winter holidays during COVID

With the holiday season in full swing, and COVID-19 cases rising both in our community and around the country, families are making plans to observe their favorite traditions in a much different way than in years past. CHOC experts provide the following recommendations for how to celebrate the winter holidays safely amid COVID-19.

“The holiday season – filled with celebrations and family traditions – can be such a magical time for kids. We want all families to enjoy quality, happy time together, but it’s essential that these celebrations are done in a safe way,” says Melanie Patterson, CHOC’s vice president of patient care services and chief nursing officer. “We understand some people are experiencing “COVID fatigue” after months of juggling remote learning, working from home and other measures in place in our communities. But now is the time to be as vigilant as ever in doing our part to curb the spread of COVID-19.”

These recommendations are meant to supplement, rather than replace, any local or statewide regulations.

Celebrate with your household

The safest way to celebrate the holidays this year is to celebrate with people in your own household. Travel and gatherings with family and friends outside your household can increase your chances of getting or spreading COVID-19 or the flu.

Celebrate virtually with others

Use technology such as FaceTime, Zoom or Skype to enjoy a holiday meal or gift exchange with loved ones who don’t live in your household. Consider sharing recipes between family members and friends ahead of time, and cooking each of your meals together over video chat. Even Santa Claus is offering virtual visits this year!

Children can also use video chat to do a festive craft project with cousins and friends outside their household.

Set up a virtual cookie decorating or gingerbread house building party with neighbors, friends or loved ones from outside your household.

Or, have a virtual, interactive watch party for your favorite holiday movie using Netflix Party or Disney+’s GroupWatch. These services allow you to synchronize your show or movie with friends and family, and chat while you’re watching.

Celebrating virtually is especially important if you are celebrating with family members over the age of 65, or those who are immunocompromised and have underlying conditions that put them at greater risk of complications from COVID-19.

You can also make crafts or cookies as a family and deliver them to neighbors, friends and family in a safe way, such as leaving them on their doorstep.

Festive outdoor celebrations

As temperatures begin to dip in Southern California, be sure to dress warmly before engaging in any physically distant outdoor activities. Consider a nature scavenger hunt, hiking or taking a drive through a neighborhood near you that is decked out in holiday lights and décor.

Holiday travel

Traveling can increase your chance of getting or spreading COVID-19. Staying home is the best way to protect yourself and your family.

The California Department of Public Health issued a travel advisory Nov. 13, urging visitors to California or residents returning home from non-essential travel to self-quarantine for 14 days and limit their interactions to their immediate household, in order to slow the spread of COVID-19. California also announced on Dec. 3 regional stay-at-home orders, which can be triggered by a region’s intensive care unit (ICU) bed capacity falling below 15%. Read more about this regional stay-at-home order, including how it impacts travel.

Add a flu shot to your to-do list

Your flu shot is more important than ever this year. Influenza and COVID-19 can have over-lapping symptoms. They also utilize the same resources, including personal protective equipment (PPE), hospital beds and equipment. Protecting yourself – and your family – from the flu can help limit a potential strain on these resources. Learn more about the importance of this year’s influenza vaccine.

Navigating holiday disappointment

By this point in the COVID-19 pandemic, many children have experienced disappointment about missing out on birthday parties, family vacations or special occasions they had been looking forward to. If your child or teen feels disappointed right now over missed holiday celebrations, this article from a CHOC pediatric psychologist can help.

How parents can help kids navigate holiday disappointment during COVID-19

By Dr. Mery Taylor, pediatric psychologist at CHOC

mindfulness
Dr. Mery Taylor, pediatric psychologist at CHOC

By this point in the COVID-19 pandemic, many children have experienced disappointment about missing out on birthday parties, family vacations or special occasions they had been looking forward to. If your child or teen feels disappointed right now over missed holiday celebrations, let her express her feelings, and validate them. Share your own disappointments and how you are managing your feelings.

As a parent, it is difficult to see your child experience disappointment. As adults, we have the perspective of knowing that there will be other holiday seasons in their future. During this time, children will be most comforted by parents’ words of reassurance that you will get through these challenging times together, and that life will return to normal eventually.

Remind children why things have changed

It can be helpful to remind them about why things are different right now. Remind your child that as a community, we are all doing our part to curb the spread of COVID-19

Discuss changes in plans earlier vs. later

For most young children, it will be helpful to start to discuss changes in plans earlier than later. Start slow and return to the topic several times, each time adding a little more detail. Ask for your children’s input on how they would like to spend the holidays given the stay-at-home order and how they might celebrate with loved ones who they cannot see in person. For example, they can help you bake your favorite holiday recipe to drop off on someone’s doorstep or create a special holiday craft to mail to a loved one who lives far away.

Limit children’s exposure to the news

At this point, all but very young children are clear that something has drastically changed in their world. While it is important to keep very young children away from the daily news which can include death tolls and speculations, parents should be honest about what we are trying to accomplish by social distancing. Here’s an explanation of social distancing. It could be helpful to ask them what they already know, debunk misinformation, and provide additional information for better understanding and clarification.

Let them use their imagination

Have fun thinking about what makeup holiday celebrations and other gatherings with family and friends would look like. Let them use their imaginations on what decorations they would have, food they would eat and people they most want to see.

Celebrate special events in a creative way:

  • Use technology such as FaceTime, Zoom or Skype to enjoy a holiday meal with loved ones who don’t live in your household. Consider sharing recipes between family members and friends ahead of time and cooking your meals together over video chat.
  • Host a virtual party — decorate a backdrop, make a music playlist and create a themed game.
  • Join friends for a virtual cookie or gingerbread house decorating party.
  • Have a virtual, interactive watch party for your favorite holiday movie using Netflix Party or Disney +’s GroupWatch. These services allow you to synchronize your show or movie with friends and family, and chat while you’re watching.
  • If your traditional outings during the holiday season aren’t an option due to COVID-19, consider planning a virtual field trip and inviting families from other households. Many museums and other attractions are offering free virtual visits during this time.
  • Help your child prepare a special meal or dessert for the holiday or special day.
  • Go into nature for a scavenger hunt or take a drive through a holiday light display.
  • Organize a Zoom or Skype call with family and friends to sing your favorite holiday songs.

Building resiliency

Although this pandemic is not the situation that we would have chosen for our kids to face, experiencing adverse events, with their parent’s support, will help kids build resiliency. They will be able to look back on this time and reflect on how they were creative in finding ways to celebrate holidays and how they found new ways to entertain themselves at home, while persevering over new challenges.