COVID-19 And Kids

Updated December 8, 2021.

Keeping your kids healthy is a regular daily challenge. Add to that a global pandemic though, and your stress levels are sure to skyrocket. As local and state health authorities continue to issue new guidance about COVID-19 each day, you may be more worried about your child's health than usual. And while it's easy to practice good hygiene and limit physical contact as an adult, protecting your kids from germs isn't always so simple. Here's what you need to know about COVID-19 and children:

Though adults make up most of the severe cases to date, children and teenagers have also made up an increasing share of cases over the last year. As we face a more contagious variant and community transmission increases, a larger proportion of children may be exposed or infected. The good news, however, is that most children with confirmed Covid-19 have generally shown mild symptoms. For many, that means cold or flu-like symptoms like fever, cough, congestion, runny nose, and sore throat. Some children have also experienced sore muscles, headache, vomiting, or diarrhea. Research has shown that children may also not present any symptoms at all, yet test positive for COVID-19, suggesting that they can spread the virus even if they appear healthy. It's important to note though that while there have been fewer hospitalizations for children with COVID-19 than adults, a small percentage of kids may develop severe symptoms, including trouble breathing and significant lung problems. Studies indicate that young infants in particular may be at higher risk for developing these serious symptoms than older children. Rarely, children may develop Multisystem Inflammatory Syndrome in Children (MIS-C), a severe and serious condition that requires prompt evaluation and treatment.

The best way to protect your child is to vaccinate all eligible family members and close contacts, including children ages 5 years and older. Additionally, unvaccinated children over the age of 2 years should continue wearing well-fitted masks with good filtration in all indoor and crowded outdoor settings outside of the home. Older children and adults who are vaccinated should also wear masks in indoor settings where community transmission is high. We recommend practicing good hygiene in the same way you would protect yourself from the cold and flu and teaching your child to do the same. Here are additional some steps you can take to protect your family during COVID-19:

• Social distancing is one of the best ways to keep your kids from being exposed to germs right now. If you are indoors with others outside of your household, maintain a distance of 6 feet in addition to wearing masks. If you are in a crowded outdoor setting, being mindful of social distancing is also prudent. You may want to demonstrate six feet of distance visually by either cutting a piece of rope or putting tape on the floor so they learn how much space to keep. You can encourage your child to stay connected with friends and family through phone calls and video chats.
• Limit contact with older people, unvaccinated people, and those who have underlying medical conditions who may be at higher-risk of becoming critically ill. If someone who is high-risk lives in your home, such as grandparents or elderly caretakers, take extra precautions to limit household exposures.
• If you are going to be interacting with others in an indoor environment, look for spaces with good ventilation and air flow and wear masks.
• Avoid close contact with people who are sick. Close contact is considered more than a few minutes within 6 feet of a sick person or direct contact like kissing or sharing utensils.
• Keep children home from daycare, school, activities, or from close contact with other people if your child becomes sick with respiratory symptoms like fever and cough. Be mindful of others in your household as well. Children and teens who are experiencing symptoms of COVID-19 should be tested for COVID-19, even if symptoms are mild.
• Cover coughs or sneezes with a tissue, then throw the tissue in the trash.
• Wash your hands often with soap and water for at least 20 seconds, and if soap and water aren't available, use an alcohol-based hand sanitizer. A trick to encouraging 20 seconds of handwashing is having your child wash a toy while washing their hands or singing one of their favorite songs. Singing "Happy Birthday" twice, for instance, will indicate when they can stop. You should encourage your child to wash their hands upon entering the house, after using the restroom, and before eating.
• Avoid touching eyes, nose, and mouth with unwashed hands and encourage your child to do the same.
• Clean and disinfect frequently touched toys and surfaces with a householder cleaner daily. This includes tables, doorknobs, light switches, remotes, handles, desks, toilets, phones, and tablets.

The CDC and American Academy of Pediatrics (AAP) recommends that unvaccinated children 2 years and older wear a cloth face covering when indoors with others outside of their household. Older vaccinated children are advised to wear a mask when indoors in areas with high community transmission of COVID-19. Additionally, the CDC and AAP recommend that all children over age 2 years, regardless of immunization status, wear a mask when in the school or childcare setting. Face masks help prevent the spread of the virus from children to others and may offer protection to your child as well. It is especially important that your child wear a mask or face covering if they are experiencing symptoms or need to be around those who may be considered high-risk. Children under age 2 years should not wear cloth face coverings. Given what we now know about the increased transmissibility of the current variant, it is important that children wear masks covering their nose and mouth with a nice snug fit. Masks with multiple layers, filters, or those designated KN95 or KF94 may provide superior protection.

If your child is experiencing COVID-19 symptoms we recommend scheduling a testing appointment. You can learn more about COVID-19 testing at One Medical here. We advise that your child remains isolated from non-household contacts until:

• At least 10 days have passed since their symptoms first appeared

AND

• They have had no fever for at least 24 hours without the use of fever-reducing medication

AND

• Other respiratory symptoms have improved

If someone in the household becomes ill, it is safest to keep them separate from other family members and have them stay in a specific room and use their own bathroom if possible. You might consider designating one adult to care for a sick child if there are multiple children in the home. For more information on caring for someone with COVID-19, see here.

If you have questions about caring for your child or your child's symptoms, you can use the One Medical app to contact our virtual medical care team 24/7.

Symptoms that should be addressed immediately, and may warrant visiting an ER, include the following:

• Any fever in children less than 12 weeks of age
• Fever above 104°F
• Fever for longer than 4 days in a child of any age
• Fast breathing or trouble breathing
• Bluish lips or face
• Ribs pulling in with each breath
• Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
• Not alert or interacting when awake
• Seizures
• Fever or cough that improves but then returns or worsens

We are testing kids 14 and younger at all offices in locations where we offer pediatric services, including the San Francisco Bay Area, NY, Washington DC Metro Area, Phoenix, Chicago, Los Angeles, Orange County, Seattle, Boston, Austin,and Portland, by appointment. Children over the age of 14 can be tested at any One Medical location in all markets with an appointment.

If you have questions about your child's symptoms, or your child needs to be examined, it is best to book a "sick visit" with one of our Family Practice providers. COVID-19 testing appointments are for testing only, while "sick visits" allow for time with a provider to ask questions and examine your child. Of course, you can always reach out to our virtual medical team with more urgent concerns. Please note that if multiple kids are being tested, each family needs their own appointment, which can be booked on the One Medical app.

Your child may be nervous about their first time being tested. Not sure how to assuage their fears? We've got you covered. Here are some reassuring ways to explain to test to your children to help ease their nerves beforehand:

• Young kids: The provider will use a soft Q-tip to take some boogers out of your nose and put it in a tube. It will only last 10 seconds and we can all count together. It won't hurt, but it might make your nose tickle. You can sit on me (the parent) while the provider does the test and I can help hold your head still in case it tickles.
• Older kids: The provider will use a soft swab, like a Q-tip, and make little circles in each of your nostrils. It takes about 10 seconds. The swab only goes into your nose a little bit and is not painful, but might make your nose tickle.

If your child is 5 years or older, they are eligible to receive the Pfizer/BioNTech COVID-19 vaccine, which currently is the only COVID-19 vaccine authorized for children under 18. The CDC now considers receiving the COVID-19 vaccine at the same time as other recommended vaccines to be safe. Research on the effectiveness and safety of the COVID-19 vaccine in children under 5 is currently underway. For more information on the COVID-19 vaccine, see here.

Though the risk of severe illness is low, pregnant individuals are at increased risk of severe illness from COVID-19, including hospitalization and death, compared to others. Early data, however, suggests that pregnant women who receive a COVID-19 mRNA vaccine, develop the same level of protection as non-pregnant women. As a result, both the American College of Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine, who set national health care guidelines, as well as reproductive health clinical leaders at One Medical recommend that all pregnant individuals be vaccinated against COVID-19.

At this time, it is not known whether COVID-19 can be passed from mother to baby or what developmental impact this may have. It is thought that transmission of COVID-19 to newborns is primarily through respiratory droplets from an infected mother or caregiver. Some preliminary research, however, has detected antibodies in the infants of individuals fully vaccinated during pregnancy, suggesting that vaccination during pregnancy may provide protection for newborns as well.

If you have questions, you should talk to your provider to make an informed decision for your unique situation. Learn more about pregnancy and COVID-19 vaccinations here.

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The One Medical blog is published by One Medical, an innovative primary care practice with offices in Atlanta,Boston, Chicago, Los Angeles, New York, Orange County,Phoenix, Portland, San Diego, the San Francisco Bay Area, Seattle, and Washington, DC.

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.