Your child has symptoms compatible with early coronavirus disease: mild cough, a runny nose, and a borderline fever. What do you do?
1. Stay calm. As more and more cases of Coronavirus (COVID-9) disease occur around the world, children continue to be infected far less frequently than adults, and when infected, the vast majority show either no symptoms, or mild, common cold-like symptoms. Rough estimates (no statistics available) are that less than two percent of cases occur in young children. Very few pediatric patients have required hospital admission. There have been no known deaths in children under the age of ten years. By comparison, at least 144 children in the U.S. have died after contracting the flu so far this flu season, says the CDC.
2. Familiarize yourself with facts. Yes, your child may have coronavirus (COVID-19) disease. However, the early signs are indistinguishable from those of the common cold and the flu. In fact, chances are that your child’s symptoms are not COVID-19-related. Children in daycare and in the first few years of school have on the average of three or four colds per year, with most of them occurring around this time of the year. Flu is also common at this time of the year, possibly more so this year than in other years. This is unrelated to COVID-19. Having had flu shots reduces considerably the chances of having the flu, but the possibility does exist.
3. Isolate your child promptly. COVID-19, flu and colds are all contagious. You, the parent, can’t differentiate one from the other during the early stages. Why risk spreading any of these viruses to others? Therefore, no daycare or school, no playdates, and no visits from the elderly or the immunosuppressed until you have more information. The main purpose for isolating possible cases of COVID-19 is to protect others.
4. Let experts decide whether your child needs prompt medical attention. Call your child’s pediatric office. Let them make the decision. They are aware of the COVID-19 situation in your community. Give them your observations: Is your child’s nose running continuously, coughing and sneezing a lot, and febrile? Is he or she happy, active, and playful? Make sure the medical personnel are aware of your child’s medical history, if significant, and whether household members have important medical issues.
5. Visiting a medical facility during a contagious disease outbreak can be counterproductive. Will the visit help your child or are you risking having your child pick up an additional respiratory infection? Pediatric medical facilities are ideal places for that. Moreover, unnecessary visits overburden facilities that may already be working at capacity. Generally, children with minimal respiratory symptoms need not be examined. The Rx for such children: No medications. Isolate. Do nothing. Observe carefully. Stay in touch. Call back, even within the hour, if there are changes.
6. However, visits are imperative when children appear ill. Ill means “not being themselves,” being listless, coughing, having fever and drinking less liquids than usual, for example. They could have the flu, for example, a disease that mimics OVID-19. Flu can be diagnosed with a simple test and can be treated.
7. The number of children diagnosed with COVID-19 disease will likely rise rather sharply in the near future. This is not an alarming turn of events but merely the result of more children being tested. Testing kits have been in short supply in many parts of the country and early tests were not totally reliable. Also, testing has been reserved for adults, especially older adults and particularly adults with underlying ongoing conditions. Children have had low priority for being tested because they have mild or no symptoms.
8. However, testing young children for COVID-19 is important. The two main reasons: One: Positive tests will detect asymptomatic children who require strict isolation for two weeks. Two: To help public health researchers better understand the role that children (and adults) play in the spread of COVID-19. Do children who are asymptomatic or have minimal symptoms shed virus? And if so, when and for how long ? Does shedding begin before symptoms appear and/or continue after symptoms disappear. All are possibilities. Such data are essential to formulate sensible recommendations regarding daycare and school attendance. Also unknown is whether becoming infected requires mere casual contact with an infected individual (passing in the school hallway, for example) or more prolonged contact (sitting opposite at a table at lunch, for example). Presently, the only solution is to close schools and daycare facilities indefinitely.
9. Formulate plans on how to handle COVID-19-related disruptions. Schools may close suddenly and unexpectedly which may affect your work schedule. Will babysitters want to watch an infected child? Are there immunosuppressed individuals in your home?. And should an outbreak occur in your community, are you prepared to discuss it with older children. Such events can be stressful for both adults and children. Try to stay calm, and reassure children that they are safe and will continue to be safe in spite of what is happening in the adult world.
10. Miscellaneous. Many health care facilities have established formal telemedicine centers staffed by specially trained personnel to answer questions via telephone or email and, in many cases treat children via COVID-19-related issues… Estimates are that the virus can be detected in the air for up to three hours after it was aerosolized with a nebulizer, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel… Launder washable toys as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely… Dirty laundry from an ill person can be washed with other people’s items.
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