COVID-19 And Kids

Updated May 17, 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 known cases to date, children are not immune to COVID-19. The good news, however, is that most children with confirmed Covid-19 have generally shown mild symptoms. For many, that's meant 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 may be able to 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.

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 some steps you can take to protect your family during COVID-19:

• 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.
• Keep your family home as much as possible. Social distancing is one of the best ways to keep your kids from being exposed to germs right now. If you take your kids outdoors, make sure it's an activity where they can stay 6 feet away from others. That means steering clear of playground equipment and limiting in-person playdates with children from other households. You may want to demonstrate that 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 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 separate your child from them as much as possible.
• Avoid touching eyes, nose, and mouth with unwashed hands and encourage your child to do the same.
• 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.
• Stay away from daycare, school, activities, or other people if your child becomes sick with respiratory symptoms like fever and cough. Be mindful of others in your household as well.
• Cover coughs or sneezes with a tissue, then throw the tissue in the trash.
• 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.
• Wash stuffed animals and other plush toys, following manufacturer's instructions, and using the warmest water possible.

The CDC recommends that children 2 years and older wear a cloth face covering when in the community setting. The face covering helps 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.

Currently, 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. At this time, we encourage all pregnant women to practice the appropriate preventative measures and to reach out to their provider if they begin to experience symptoms.

If your child is experiencing COVID-19 symptoms or has been exposed to someone who has tested positive in the last 14 days, 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, New York, Phoenix, Chicago, Los Angeles, Orange County, Portland, and Boston, 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 member 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 the 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 12 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 12 is currently underway. For more information on the COVID-19 vaccine, see here.

Pregnant or lactating women, and people who are immunocompromised are able to get the vaccine. If you have questions, you should talk to your provider to make an informed decision for your unique situation. More information about pregnancy and the vaccine is available on our blog post 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.