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Little girl who might have COVID

Think Your Child has COVID-19? Here’s What to Do

who to contact and what to know about testing

By now, we’ve all heard so much about COVID-19. But what do you know about the specifics of what to do if you suspect a family member has contracted the illness? We connected with Dr. Carla Garcia Carreno, pediatric infectious disease specialist at Children’s Medical Center Plano, to share everything you should know if you think your kiddo (or you) may have contracted the virus.

If you believe your child might have COVID-19, is your first step always to call your pediatrician? Could you go to a pharmacy and get the test more quickly? Your pediatrician is always the best person to contact when your child is ill. Many pediatrician’s offices have testing for SARS-CoV2, the virus that causes COVID-19, available.

Primary care providers would know your child’s history, including existence of underlying conditions that can place your child in a higher risk category for a more severe infection. He or she would also know your family history and if there is anybody living in the household also at risk for severe disease. Your pediatrician may suggest scheduling an evaluation of your child—this may include a telehealth visit—and will consider testing if necessary. Your pediatrician’s office will guide you on the type of test that needs to be done and where to go if they do not have testing available in their office.

If you think your child might have COVID-19, you should take the following steps: Let your pediatrician know how your child is doing, including signs and symptoms; monitor your child’s condition—if he or she is having difficulty breathing, changes in skin color, altered mental status or signs of dehydration, including decreased urine output, you should seek medical attention as soon as possible; isolate your child from others at home—preferably in a single bedroom with private bathroom.

Maybe a child has the sniffles and a little cough—symptoms parents might have not worried about a year ago. Should the child stay home from school, no question? Our world and routines have certainly changed since the beginning of the COVID-19 pandemic. Children with COVID-19 infection can present with a wide range of manifestations: from no symptoms at all to very mild disease—nasal congestion, cough, sore throat —to a more severe picture like many adults, with fever, chills, headache, difficulty breathing, vomiting, diarrhea, abdominal pain, muscle pain, loss of sense of taste and/or smell.

If your child presents with any of these symptoms, it is best to keep him or her at home. The majority of COVID-19 symptoms may be seen with other diseases, so even if it is not COVID-19, it may still be another infectious process, like strep throat or influenza, that could still be spread at school.

Other situations when you should keep your child at home are if they have been exposed to a person infected with COVID-19 or if they have tested positive for COVID-19.

Should kids with any symptoms get tested? Yes, that is the approach recommended by the Center for Disease Control and Prevention (CDC). As mentioned earlier, symptoms of COVID-19 may be seen with other conditions, and the only method we have available to differentiate COVID-19 from other infections, like influenza, is by having the test done. Diagnosing a person suspected of having COVID-19 will help to isolate that person from others in the household, especially those at risk for more severe disease—older people, and those with underlying health conditions like diabetes, high blood pressure, cardiac and lung disease, and obesity.

The molecular testing, in which a health care provider collects fluid from a nasal or throat swab, isn’t the most pleasant process. But we’ve heard about the rapid test—which we understand can be more comfortable—is less reliable. What do you advise? Molecular tests, or PCR, are the gold standard for diagnosis of COVID-19. Those tests have the best performance for diagnosing COVID-19 in a reliable manner. Rapid tests are useful but certainly have a lower sensitivity compared with molecular tests. In other words, they can miss some cases of infection.

If a rapid test is negative, but the suspicion for COVID-19 is high—either because of symptoms or because of exposure to a known infected person—it may need confirmation by molecular test. If a rapid test is positive, however, the diagnosis of COVID-19 is reliable. Rapid tests are most useful in early stages of the infection, when the amount of virus is the highest in the respiratory airways. Compared to molecular tests, rapid tests diagnose accurately 84–97% of those tests that are positive by molecular test.

As mentioned earlier, if you think your child might have COVID-19, you should let your pediatrician know about your child’s symptoms. The pediatrician will consider evaluation and testing if necessary. If testing is suggested, your primary care provider will provide guidance about which test would fit best for your child. Your pediatrician will also be familiar with activity of COVID-19 in your community; this prevalence may also affect the interpretation of the rapid tests.

What is the turnaround time for a rapid test versus a molecular test? We’ve heard a lot of variance in the times. The rapid test, known as the antigen test, offers results in less than one hour—usually about 15 minutes. For the PCR or molecular test, time varies depending on the platform used. There is a rapid PCR that can have results in 45 minutes. However, the majority of the PCRs offer results in one to two days. Depending on the demand—meaning, if a lot of tests need to be run by PCR—it may take up to one week. We had a time during the summer in  North Texas when we had increased COVID-19 activity in the community and a lot of more testing being done. Testing was taking more than a week to be resulted, but it had to do with the number of tests needing to be completed.

If a parent thinks they might have COVID, what actions should they take in relation to their child? Should they isolate themselves as best they can in the house? Send their child to stay with a relative or friend if possible? Get the child tested too, even if there are no symptoms? People that are infected or think they are infected with COVID-19 should isolate themselves. If there are no alternate caregivers at home, arranging a caregiver that can take care of the children while the parent recovers would be ideal. The sick person should stay in a single room with private bathroom if possible. If that person needs to leave the room, he or she should always wear a mask; the sick person should clean and disinfect objects that were frequently touched by that person—doorknob, light-switch, phone—and wash hands with soap and water as often as possible.

Testing contacts of a sick person is the recommended approach, including asymptomatic contacts. But even if that contact tests negative, he or she should still comply with quarantine for 14 days from the last contact with the infected person.

Children’s Health has more information on COVID-19 and resources for families on its website. Visit childrens.com/covid-19.

Image courtesy of iStock.