COVID-19 (Coronavirus)

COVID-19 is the name of the illness caused by the virus that has resulted in the worldwide pandemic. This virus had never infected people until this outbreak began but now has gained the ability to easily move from one person to another.

COVID-19 appears to cause a much less severe illness in children compared to adults. While fever, cough and shortness of breath are seen in both children and adults, children with COVID-19 almost all have a very mild illness that may be less severe than our usual respiratory viruses such as influenza or RSV. Children may also have a red throat and runny nose, and some will have an upset stomach, vomiting or diarrhea. Severe infection requiring admission to the hospital has been very uncommon in the experience in China, Europe and so far in the United States.

The most common time that people who are exposed to COVID-19 develop symptoms of illness is around 1 week after exposure but can be as early as two days and as late as 14 days after being exposed. In most patients with COVID-19, symptoms are improving around one week into the illness though for some patients some symptoms may last longer. As with all illnesses, it is important to make sure your child is continuing to improve. If your child seems to be getting worse, you should call your doctor.

While many children with chronic illnesses do experience more important infections with many viruses, the experience from China, Europe and the United States seems to suggest that severe illness from COVID-19 may be less common than with viruses like influenza and RSV. While we may identify some types of chronic illnesses that may lead to more important illness, the experience to date is reassuring that many, if not most, children with chronic illnesses will recover without needing to be admitted to the hospital. If your child with COVID-19 seems to be getting worse as the illness goes on, you should call your doctor.

COVID-19 is spread from one person to another when someone with it comes in close contact (less than 6 feet) with someone who does not have it. If the uninfected person is exposed to secretions or droplets produced by coughing or sneezing, they can become infected. The uninfected person can also be infected by touching surfaces that the secretions and droplets have fallen on. It is unclear if COVID-19 can be spread through contact with stool.

Information from China, Europe and the United States shows that people with COVID-19 may begin to be contagious 1-2 days before developing symptoms, however it is not known if they are as contagious at this point as when they have symptoms.

Preventing the spread of COVID-19 from one person in the family to others can be challenging but can be accomplished. For families with other household members with chronic illnesses, consideration should be given to try to have that person stay with another relative while your child with COVID-19 recovers. IF that is not possible, you should work to separate your child from as many of the other household members as possible. This could be accomplished by having the child with COVID-19 stay in one part of the home, while those with chronic conditions stay in another part. In addition, keeping your child with COVID-19 more than 6 feet away from the other people in your home combined with frequent handwashing and cleaning areas like door handles and hard surfaces with bleach containing products can be successful. You should also teach your child with COVID-19 to cover their cough with their elbow and to wash their hands frequently, especially if they are going to be in common areas used by others in the home.

Some children with symptoms that might be consistent with COVID-19 may not be tested. The decisions on whether to test a child for COVID-19 are made more on whether the test will change care (for now) while testing availability is somewhat limited. While testing is being performed for those who are very sick, most children with COVID-19 do not get very ill and care will not change IF they are found to be positive.

For children like this, we would recommend following the recommendations as if your child had a positive COVID-19. For families with other household members with chronic illnesses, consideration should be given to try to have that person stay with another relative while your child with COVID-19 recovers. IF that is not possible, you should work to separate your child from as many of the other household members as possible. This could be accomplished by having the child with COVID-19 stay in one part of the home, while those with chronic conditions stay in another part. In addition, keeping your child with COVID-19 more than 6 feet away from the other people in your home combined with frequent handwashing and cleaning areas like door handles and hard surfaces with bleach containing products can be successful. You should also teach your child with COVID-19 to cover their cough with their elbow and to wash their hands frequently, especially if they are going to be in common areas used by others in the home. IF your child symptoms worsen, you should contact your PCP for guidance.

In general, you should maintain “social distancing” within your household for at least 7 days after onset of your child’s symptoms and until it has been at least 3 days after resolution of their fever and their cough is improving.

We do not recommend you send your child with a chronic medical condition to school. Many states and cities have closed their schools, so you should first check to see if your child’s school is open. If it is, you may need to contact your PCP or specialist to get a letter allowing you to keep your child home from school.

We would recommend avoiding daycare if possible.

We recommend considering rescheduling all elective appointments. If you have any questions about the need for keeping an appointment with your PCP, please call them and follow their advice.

The need to keep elective follow-up visits with your specialist can be decided by your doctor. You may be asked to get lab tests without an in-person visit with your doctor.

One parent/guardian can come along for the visit to your child’s specialist. Please do not bring any other children.

This is a decision you should discuss with your child’s specialist. They will decide if testing can be delayed or if it needs to be done immediately in order to best care for your child.

This is a decision you should discuss with your child’s specialist. If possible, it would be best if you could get these treatments in your home.

The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. Read more from the CDC.

Yes.

Yes.

Please call your child’s specialist for further guidance. After talking with your specialist, you may be referred to your PCP – who you should call ahead of time.