Madeline Gagnon, MD with a patient before COVID-19 masking protocolsPhoto taken before COVID-19 safety protocols were established


Approximately 13-17% of all children have special health care needs. These children are at an increased risk for hospitalizations, intensive care admissions and other care complexities that can lead to overwhelming challenges for families. At Gillette, our complex care pediatricians work closely with parents and guardians, primary care providers, other sub-specialty providers and school systems to navigate care and identify gaps in this population’s care coverage.

According to the most recent data from the CDC, approximately 1.7% of all COVID-19 cases in the U.S. (February 12-April 2) affected children under the age of 18. Of those patients, 13% had underlying medical issues. Of pediatric patients for which information on hospitalization and underlying medical conditions was available, 77% of hospitalized pediatric patients had at least one underlying medical condition. The top underlying medical conditions reported in all pediatric patients during this time included:

  • Chronic lung disease (including asthma)
  • Cardiovascular disease
  • Immunosuppression

Madeline Gagnon, MD, the Medical Director of Complex Care Pediatrics at Gillette, has identified actions that caregivers and providers can take now to support pediatric patients who are considered ‘at risk’ for complications of communicable disease, including COVID-19. These actions include:

  • Establish and optimize a baseline health status
  • Promote telemedicine visits when possible
  • Have emergency medical plan in place
  • Ensure sufficient stockpiles of homecare supplies (ex: enteral feeding supplies, respiratory equipment, etc.)
  • Encourage guardians to train others in the care of their child
  • Encourage guardians to create a care plan of their child’s daily cares
  • Encourage guardians to evaluate their homecare (ex: limit number of PCAs/RNs in the home, evaluate their other professional roles, etc.)

Gillette’s Complex Care providers are available for clinical consultations with primary care providers every day, and can help providers understand baseline health status and recommend emergency medical plan directives, homecare options and more. If you are a clinical partner and would like to consult with Complex Care, please call our One-Call team at 651-325-2200.

To view Dr. Gagnon and Dr. Marsh’s free CME-credited webinar on COVID-19 and its impact on children and young adults with complex medical needs, visit: COVID-19 and complex medical needs: Supporting those 'at-risk' CME webinar 


Madeline Gagnon, MD

Ketzela Marsh, MD

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