Instead, he said, he met them on their front lawn, where he popped the girl’s joint back in. “It is a very easy thing to do, but it made a huge difference for them,” he said. Gulbransen has had to rethink how he runs his pediatric practice on Long Island since the coronavirus crisis started. “We’re in the heart of the storm,” said Gulbransen. His practice remains open and now also welcomes some non-pediatric patients who have had trouble being seen by a doctor. He said his practice has been physically rearranged to keep sick patients away from those who are well. Other recent adjustments include doing telemedicine, although he is unsure how insurance reimbursements will work with such consultations. He said he was worried about his pediatric patients picking up on their parents’ anxieties, as well as the health and financial welfare of his staff. “The anxiety level is palpable,” said Gulbransen. “But it’s a privilege,” he said, adding, “you’re here for your patients. You gotta push and do whatever it takes.”  New York state, the epicenter of the pandemic in the United States, had a coronavirus death toll exceeding 10,000 as of Tuesday, out of more than 28,000 across the country. The disease looks different in children than it tends to with adults, said Gulbransen. “We had a 6-week-old with COVID, and really (the infant had) no other symptom than a runny nose,” said Gulbransen. He has also treated “quite a few toddlers and plenty of schoolage children,” who were all doing well. Cases of the illness involving children are “dwarfed by adult cases, although some of the (child) cases can be quite severe,” according to Dr. Lorry Rubin, director of pediatric infectious diseases at Cohen Children’s Medical Center, part of the Northwell Health network. Sometimes previously healthy children, often adolescents, develop pneumonia “and that can be severe and possibly lead to them needing oxygen or ventilatory support,” Rubin said. Still, most pediatric COVID-19 patients do well. Rubin said he was aware of only one child who had died, who also had a terminal congenital illness. Among infants under 60 days old in whom COVID had been detected, “all of them have done quite well,” he added. “The frequency of pediatric illness requiring hospitalization is low,” Rubin said. “No question, it’s not as bad in children and less common than in adults.”  But with New York’s healthcare system at full throttle treating coronavirus patients, Gulbransen wants to take no risks. His motto is: “Whatever you do, don’t send someone from this office to the ER.”
'Don't go to the ER': how a New York pediatrician is dealing with the coronavirus outbreak.