COVID-19 and children

Do all children need to be tested for COVID-19? If your child has been in contact with a COVID-19 positive person, but does not have any symptoms, you should remain watchful for symptoms until 14 days after the initial contact. If at any point within the 14 days after contact, the child develops symptoms like a fever, cough, runny nose, vomiting, loose stools, etc. then you should get them tested for COVID-19. You should also get your child tested if they have any symptoms, even if you aren’t sure if they have been in close contact with someone who has tested positive for COVID-19 or has symptoms. Medical advice from the child’s designate pediatrician / family doctor / health facility should be sought for children who have any symptoms. Early diagnosis and treatment are critical. Initial reports suggest that in most cases, children with COVID-19 respond well to symptomatic treatment at home.

What should I do if my child tests positive for COVID-19? Your child will be advised to stay at home and isolate. During this time:

• Record temperature and oxygen saturation with a pulse oximeter if available at home, every six hours. Measure their temperature frequently. If it is more than 100-degree F, then you can do tepid sponging with tap water and give them syrup or tablet paracetamol. If fever is >100°F, give paracetamol 10–15 mg/kg/dose.
• Continue to follow good hand and respiratory hygiene practices like regular handwashing with soap so that your child is protected against other viruses and bacteria causing diseases.
• Continue to follow personal protective measures for yourself and your child. Your child should wear a surgical mask anytime they are around people. Change the mask after eight hours of continuous wear. Caregivers interacting with the child should wear gloves and a mask.
• Feed your child home-cooked food and keep them well hydrated. Give plenty of liquids and give a soft and light diet.
• One may give vitamin C, zinc to boost overall health and immunity. Other nutritional supplements like syrup multivitamin, vitamin D, calcium can be given as per their doctor’s advice.
• Be watchful for danger signs (explained below). If any of these signs are present, seek urgent medical advice at your nearest hospital.

What are the danger signs and symptoms to monitor in children with COVID-19 at home? If your child is isolating at home with COVID-19, it’s important to know, and look out for the following five symptoms: 1. High Fever lasting beyond three days 2. Decreased oral intake by the child 3. Child becoming lethargic 4. Increasing respiratory rate 5. Oxygen saturation dropping below 95 per cent at home (ensure proper recording with good displayed waves). In such a situation, you should consult your pediatrician / family doctor / health facility and take your child to a facility with COVID-19 care. When should I take my child with COVID-19 to hospital?

My child has a chronic disease. Do I continue his steroid treatment or other treatment? Most of the treatment of pre-existing diseases need not be altered unless your child contracts serious disease. In such children, preventive care and some extra precautions at home to avoid infection are important. If such a child contracts an infection, it is advisable to consult your doctor for specific advice about ongoing medications.

We have heard about steroids, Favipiravir, Remdesivir, Tocilizumab, etc. When do we use them? These drugs have limited use in childhood COVID-19 patients. Some are used only in serious patients usually in ICU. So far, they are almost never needed in children with COVID-19. Medicines should always be prescribed by a doctor.

What about medicines such as azithromycin, ivermectin, doxycycline, hydroxychloroquine (HCQ), ayurvedic, homeopathic, etc.? There is no scientific evidence to use these drugs for the treatment of COVID-19 in children. Some of these drugs are used when adults are hospitalized with serious disease. There is no role of these drugs in-home treatment.

My child tested COVID-19 positive one week ago. He is due for his routine vaccinations in two weeks. What should I do? Routine immunization can be continued two weeks after the child is asymptomatic (of COVID infection). If a child needs some higher medications such as high-dose steroids, which suppresses the components of patient immunity, immunization needs to be deferred for three months after the medication.

Do children need to wear a mask and what kind of mask should my child wear? Yes. The Indian Academy of Pediatrics recommends that masks need to be worn by all children above the age of two. WHO recommends that children who are in general good health can wear a non-medical or fabric mask, and children with underlying health conditions should, in consultation with their medical providers, wear a medical mask. If your child is above two and willing to wear a mask, assist them in wearing their mask properly and over their nose. Create fun games around wearing masks. WHO also recommends that if children under five years wear a mask, a parent or other guardian should be within direct line of sight of the child to supervise the safe use of the mask.

How can I help my child to wash their hands properly? To eliminate all traces of the virus on your hands, a quick scrub and a rinse won’t cut it. Below is a step-by-step process for effective handwashing.

• Step 1: Wet hands with running water.
• Step 2: Apply enough soap to cover wet hands.
• Step 3: Scrub all surfaces of the hands – including the back of hands, between fingers and under nails – for at least 20 seconds.
• Step 4: Rinse thoroughly with running water.
• Step 5: Dry hands with a clean cloth or single-use towel.

What precautions can my family take against COVID-19 while travelling? While travelling, all parents should follow standard hygiene measures for themselves and their children:

• Wear your mask and ensure your children always do the same during the journey and when outside your accommodation (including while taking photographs).
• Washing hands properly with soap.
• Carrying sufficient hand sanitizer.
• Avoiding close contact with anyone who is coughing or sneezing.

While at your hotel or accommodation:

• Use a disinfectant wipe to clean key surfaces, doorknobs, remote controls, etc.

While in transit:

• Clean your seat, armrest, touchscreen, etc. with a disinfecting wipe once inside an aircraft or other vehicle.

What is COVID-19? Coronavirus disease 2019 (COVID-19) – ‘CO’ stands for corona, ‘VI’ for the virus, and ‘D’ for disease – is a disease caused by a new strain of coronavirus first identified in Wuhan, China.

Can pregnant women pass coronavirus onto their unborn child/children? At this time, there is not enough evidence to determine whether the virus is transmitted from a mother to her baby during pregnancy, or the potential impact this may have on the baby. This is currently being investigated. Pregnant women should continue to follow appropriate precautions to protect themselves from exposure to the virus, and seek medical care early, if experiencing symptoms, such as fever, cough or difficulty breathing.

Is it safe for a mother to breastfeed if she is infected with coronavirus? All mothers in affected and at-risk areas who have symptoms of fever, cough or difficulty breathing should seek medical care early and follow instructions from a health care provider. Considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, a mother can continue breastfeeding while applying all the necessary precaution e.g. wear a medical mask while breastfeeding the baby; wash your hands with soap and water or use alcohol-based hand rub before feeding; and routine clean and disinfect surfaces around you.

Sphere India