Illustration: Aïda Amer/Axios

The coronavirus outbreak has created a frightening, cash-strapped couple of months for pediatricians, as parents deferred vaccines and care for their kids.

Why it matters: Pediatric offices are still among the hardest hit physician specialties, and doctors are worried important care is falling by the wayside.

What they're saying: "Our patient volumes are slowly increasing, but it's certainly not anywhere close to where it used to be," said Daniel Summers, a private practice pediatrician in the northern suburbs of Boston.

By the numbers: Pediatric office visits dropped by more than 60% from March to April and were the slowest to recover of all other physician specialties going into May, according to researchers at Harvard University and health tech firm Phreesia.

  • Parents had a lot of anxiety about bringing in their kids for routine checkups and shots, knowing a health care setting could be a highly contagious spot.

Where it stands: Pediatricians have changed how they care for kids, with dwindling cash reserves.

  • Most offices pivoted immediately to virtual visits, like other specialties.
  • As they've begun to reopen, they're now better stocked on personal protective equipment, and in-person visits are often staggered. For example, wellness checks could be in the mornings, while sick visits (including potential coronavirus cases) can be reserved for afternoons.
  • Some pediatricians got federal Paycheck Protection Program loans, which has provided some financial stability since they were shut out of the initial health care bailout payments.

The bottom line: Families are still delaying care, even in acute cases — like when one child fell off a trampoline and broke an arm, but waited a day before getting it checked out, said Sara Goza, a practicing pediatrician and president of the American Academy of Pediatrics.

  • "We're missing things because kids aren't coming in," she said.

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The coming child care crisis

Illustration: Aïda Amer/Axios

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The big picture: For months, America's parents have been juggling work, homeschooling and child care — doing whatever they can until the post-pandemic return to normalcy. But now, what seemed like a temporary predicament is turning into an ongoing ordeal.

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A decline in pediatric care during the pandemic has put a lot of children behind the curve on routine vaccinations.

The big picture: As states decide to reopen schools and day care centers, children behind on their shots could pose a threat to themselves and others — on top of the risk of spreading the coronavirus.

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We still don’t know much about the role of children — and thus, schools and day care centers — in spreading the novel coronavirus, inserting a huge wildcard into America’s national return-to-work strategy.

Why it matters: Even as workplaces reopen with new social distancing measures in place, millions of parents will only be able to return if their children have somewhere to go. Alternatively, if schools end up being a breeding ground for new infections, the virus will easily then spread within households.