*Updated April 7, 2020*
Do I need to worry about my kids getting COVID-19
It would be great if no child got this illness, but the one good thing about this virus is that it appears to be less severe in children compared to adults. The journal Pediatrics recently published an examination of all of the pediatric cases reported by the Chinese Center for Disease Control. Their data showed that over 90% of all pediatric cases were asymptomatic, mild, or moderate cases. Only 6% of pediatric patients became seriously ill compared to 18.5% of adults. Of those children who were seriously ill, more than 60% were age 5 and under and 32% were under 12 months old. Of the 2143 children confirmed or suspected to have COVID-19 in the study, there was only 1 death. All of this confirms that children are more likely than adults to have mild symptoms and in general tolerate this illness better than adults. However, it also showed that very young children, and children with chronic medical conditions are still at risk for serious illness.
If children don’t get sick, why are schools closed and government officials recommending Social Distancing for everyone?
While the risk of death or serious injury is low for those that are young and healthy, this is a very dangerous illness with significant risk of mortality for those who are immunocompromised, have chronic medical conditions, or are over the age of 60. The mortality rate of COVID-19 for people age 50 years and under who have no pre-existing conditions is around 0.2%, which is similar to the Flu. For people age 80 and older that number jumps to 15-25%. The current recommendations for social distancing and cancelling of large gatherings is intended to “Flatten the Curve” of the illness. The less we all have interactions with each other, the less opportunity there is for the virus to spread, and the less likely that more people get sick than we have the ability to care for. These efforts can be thought of as being similar to the herd immunity that the community receives from vaccines. When we vaccinate all who are able to be vaccinated, we protect those who are not able to be vaccinated. In the same way, when we all minimize our exposure to large groups of people and avoid unnecessary social gatherings we are doing our part to protect those who are most vulnerable to COVID-19 in our community.
How do I protect myself and my children?
The virus is spread from person to person when one person coughs or sneezes and another person inhales the infectious droplets or touches a surface that the infectious droplets are on and then touches their mouth, eyes, or nose. The good news is that we can only spread these infectious droplets about 6 feet when we cough or sneeze, and a much shorter distance when we cough into our elbow. The bad news is that one study showed that the virus can live in the air for up to 3 hours and on some surfaces for up to 3 days, although it is unclear how these studies translate to real world spread of the illness. Based on this information, it is clear that the best way to prevent getting COVID-19 is to wash your hands and stay 6 feet away from anyone who has a cough.
To clean your hands of any infectious particles, wash them with soap and water for 20 seconds. If soap and water are not available, then use an alcohol based hand sanitizer that contains at least 60% alcohol and allow it to sit on the hands for 20 seconds. Do not apply hand sanitizer and then immediately wipe it off, it needs time to kill any germs on your hands. It is especially important to clean your hands prior to meals or any activity when you will be putting your hands near your face. Check out this video to learn proper hand washing technique.
Avoiding large crowds or public places is the best way to ensure that you have a 6 foot buffer between you and strangers. If it is necessary to go to a public place, then be mindful of your surroundings and make sure that your gatherings are limited to no more than 10 people. There are special types of masks that can filter out small viral particles called N-95’s, however these should be reserved for use by healthcare professionals as there is currently a global shortage. There is evidence that regular masks, often referred to as surgical masks, can provide some protection when in public places. A recent article from the New York Times reported, “When researchers conducted systematic review of a variety of interventions used during the SARS outbreak in 2003, they found that washing hands more than 10 times daily was 55 percent effective in stopping virus transmission, while wearing a mask was actually more effective — at about 68 percent. Wearing gloves offered about the same amount of protection as frequent hand-washing, and combining all measures — hand-washing, masks, gloves and a protective gown — increased the intervention effectiveness to 91 percent.” If you have a cough and must be around other people, then it is necessary to wear a mask. During this outbreak, the only reason a person with cough should leave the house is to seek medical care. For instructions on how to properly use a mask click here.
For instructions on how to clean your home for Coronavirus, go here.
How do I know if my child has COVID-19
Unfortunately it is very difficult to tell from the symptoms alone if someone has COVID-19 as this virus is in the Coronavirus family which is a family of virus that cause the common cold. As a result COVID-19 starts as a common cold, but in some people it progresses to also cause viral pneumonia. The symptoms of viral pneumonia are similar to bacterial pneumonia which are fever and shortness of breath. The fever with COVID-19 often shows up several days into the illness which is different from the flu which typically has fever in the first 1-2 days of symptoms. Another distinguishing characteristic is that the shortness of breath typically does not show up until the second week of illness.
Below are the symptoms typically associated with COVID-19 as well as other conditions that may look like it. Due to the rapid spread of this illness, we advise that anyone with cough self quarantine.
- Itchy eyes
- Stuffy nose
- Runny nose
- Body Aches
- Worsening Symptoms
- Shortness of Breath
- Worsening symptoms
- Exposure history
How do I know if my child has been exposed to COVID-19?
Close contact per the Dallas Health Department is defined as:
- Being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case
- Having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on). If such contact occurs while not wearing recommended personal protective equipment (PPE), criteria for PUI consideration are met.
- Affected areas are defined as geographic regions where sustained community transmission has been identified. For a list of countries with sustained community spread, visit this CDC website. For information regarding cities in the United States with high rates of spread, go here.
Can I still bring my kids to the office?
Yes, if they don’t have fever or cough. In an effort to limit the spread of the virus we are not allowing any children or parents who have symptoms consistent with COVID-19 to enter the office. Instead we will evaluate these children by Virtual Visit. If we determine that a child needs an exam or a test, we will schedule a way to do that safely while minimizing exposure to anyone else in the office. These measures will allow us to continue seeing well visits in the office without fear that they may encounter someone who is sick.
Can my child be tested for COVID-19?
*UPDATE* Per the CDC guidelines we are not routinely testing for COVID-19. The current guidelines are that if a person has cough or fever, they need to stay home and self quarantine for 14 days. If the person is having labored breathing, dehydration, or significant worsening of symptoms, then they should present to a local Emergency Department or facility that is providing testing. The following facilities are offering testing:
Medical City ER Stonebridge
8995 W University Dr., McKinney, TX 75071
Medical City ER Red Oak
317 East Ovilla Road, Red Oak, TX 75154
Medical City ER Flower Mound
4351 Long Prairie Rd, Flower Mound, TX 75028
Medical City ER Park Cities
5974 W Northwest Hwy, Dallas, TX 75225
If you are concerned that you or your child may have COVID-19, please schedule a Virtual Visit so that we can evaluate your child and help you come up with a plan. If you are referred to a facility for testing, please call before going so they can prepare for your arrival.
Yes, we now have the ability to test for COVID-19, but we do not have the proper protective equipment to protect our staff when doing the testing and we do not anticipate to have that equipment anytime soon. To get around this problem we are making drive by testing available in the parking lot of our Mesquite office, however the child must first be evaluated by virtual visit. Once the doctor has determined that testing is appropriate and the child is not sick enough to require immediate evaluation in the Emergency Department, an order for the test will be created. A member of our staff will then call the parent and schedule a time to arrive at the Mesquite clinic for testing. We will not accept walk in appointments or attempts to get swabbed for COVID-19 without first having a virtual visit. This test is covered by insurance and takes 48-72 hours to get the results. If you do not have insurance the cost of the test is $150. If you would like testing for yourself or you are unable to bring your child to our Mesquite clinic for testing, Magnolia Diagnostics will deliver a kit to your home, collect the kit, and then contact you with the results. To request a testing kit email: firstname.lastname@example.org with your name, address, phone number and the amount of household swabs you would like to be performed. Please be aware that the cost of this service is $300.