From now on, the youngest victim of the epidemic in Poland is a 4-month-old boy from the Cieszyn poviat – informs the Provincial Sanitary and Epidemiological Station. While children are less likely to have COVID-19 and usually have mild or asymptomatic conditions, they are not quite immune to the SARS-CoV-2 virus. What should parents know in this situation? Should alertness be triggered by a single cough / sneeze? What to do if a child shows signs of infection? Explains the drug. Lidia Stopyra, specialist in paediatrics and infectious diseases.
- What to do if we are seeing mild symptoms of an infection in children? Pediatrician: if a child has mild symptoms, he or she does not require medical attention, because we can deal with these symptoms ourselves. So it makes best sense to keep your baby at home for three or four days
- If the child’s condition does not improve, we should see a doctor. Most often it is a primary care physician. However, if the child’s condition worsens, disturbing symptoms appear, such as shortness of breath – go to the hospital
- Lidia Stopyra: however, it is not good to test for SARS-CoV-2 on the first day after the onset of symptoms. We often have false negative results then. According to the recommendation, the optimal time to perform the SARS-CoV-2 test is the fourth – fifth day of infection
- Expert: Parents should remember that risk cannot be completely eliminated. However, the precautionary measures taken must be appropriate to the situation, reasonable and consistent
- Lidia Stopyra: a mildly ill child does not have to and should not go to the hospital. His place is at home. The parent will distinguish the moment when things start to go wrong with the child and when it is necessary to bring him to the infectious ward
- More information about the coronavirus can be found on the TvoiLokony home page
Lidia Stopyra is a specialist in paediatrics and infectious diseases. Head of the Infectious Diseases and Pediatrics Department of the Specialist Hospital S. Żeromski in Krakow.
Monika Mikołajska / Medonet: We get a lot of signals from parents who seem scared, but at the same time do not really know how they could tell that something is wrong with their child? So let’s explain what symptoms in children should not be underestimated?
Lidia Stopyra, specialist in paediatrics and infectious diseases: The symptoms of COVID-19 in children are less typical than in adults (mainly respiratory symptoms occur here, health and life are threatened when viral pneumonia leads to respiratory failure). On the other hand, infected children much more often do not have symptoms or present symptoms of a banal infection, such as runny nose, fever (not necessarily high), coughing. Diarrhea is also common.
Viral pneumonia in the course of COVID-19 in children is rarely serious and absolutely exceptionally leads to respiratory failure. In contrast, severe COVID-19 courses and deaths among children around the world have been reported in the course of immune syndromes resembling Kawasaki’s disease.
What to do if we see even the slightest symptoms of an infection in children?
We should leave such a toddler at home, not bring him to school or kindergarten. In the current epidemiological situation, we must assume that even if we do not know that the child has contacted someone infected, it may be the symptoms of COVID-19.
It happens that an infection in a child is difficult to recognize. An adult experiencing muscle aches or feeling “broken” knows that this may be the beginning of the disease. In a similar situation, the child will simply whine – and it is difficult to treat each toddler’s whining as a sign of coronavirus infection. Nevertheless, even with very delicate symptoms of infection – let’s react.
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So a single sneeze should arouse anxiety and be a reason for not sending the child to kindergarten?
If it is a single sneeze, it might not be, especially if it is in response to some obvious stimulus. However, when we see that a toddler has glazed eyes, he whines, behaves differently than usual – we have to watch him closely. The basis here is not to take the test or administer any medications as soon as possible, but to keep the baby at home.
If a child has mild symptoms, he or she does not require medical attention, because we can deal with these symptoms ourselves. So it makes best sense to keep your baby at home for three or four days.
What to do if the child’s condition does not improve?
We should see a doctor. Most often this is a primary care physician, but you should be vigilant – if the child’s condition worsens, disturbing symptoms appear, such as shortness of breath – go to the hospital. It does not necessarily mean COVID-19, the child may have a completely different disease, but we leave diagnostics to specialists.
The very question of testing for SARS-CoV-2 infection does not always depend on the severity of the symptoms. Sometimes it happens that for 1,5 days the child will have a temperature of 37,5 – 38, a bit of runny nose, an occasional cough and then everything will go away. These are very mild symptoms, but the coronavirus usually works like this. The only characteristic symptom is a significant disturbance in the sense of smell and taste, and here the probability of infection is very high.
Is it then necessary to test the child for SARS-CoV-2?
According to the current rules, it is best to contact a primary care physician with such symptoms, who may order a test. When symptoms are mild, he or she can give you teleportation. Especially if it is an older child, because a newborn or infant, even during the examination, is not easy to evaluate, and evaluation by teleportation is almost impossible.
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On the websites of the NFZ branches there is a list of points that have a contract with the fund and perform such swabs for free (e.g. http://www.nfz-szczecin.pl/vtt5i_news_2974_bezplatne_testy_na_obecnosc_koronawirusa_.htm – editor’s note). However, it is not a good idea to perform such a test in the first 2 hours after the onset of symptoms. We often have false negative results then. According to the recommendation, the optimal time to perform the SARS-CoV-XNUMX test is the fourth – fifth day of infection.
When, after these few days, we see that the symptoms are gone, the child feels better and better and could be sent to kindergarten – this is the time when it would be good to do the test. If it is negative – the child may return to school / kindergarten immediately after the infection. If the result is positive, the current rules require 13 days of isolation (from the first day of symptoms, the last three days must be completely asymptomatic). After this time, the child may return to school on the basis of a decision from the primary care physician.
And if the child is not tested, we limit ourselves to isolating it?
If during these 13 days we isolate the child at home and the symptoms of the infection have subsided, then the child will be able to return to school after that time.
Does it depend on the doctor’s decision?
A child who for some reason has not been tested is not diagnosed with SARS-CoV-2 infection and has not been formally placed in isolation, so there is no need to release from isolation.
Of course, when you leave your child at home, we will look after them. But in this situation, should we also stay at home – for our own safety and for the safety of the people we work with?
A sick little child cannot be isolated and left alone. Even if the toddler has COVID-19 and the parent is negative, the sick child needs to be cared for. And it’s usually obvious, and I’ve never encountered a problem in this situation.
So the parent stays at home with the child with the infection and although I know that not everyone has the conditions for this, it would be best for the caregiver and the child to isolate themselves from the rest of the household for the duration of the infection. Thanks to this, other family members could function normally. Of course, by following the applicable procedures, that is: wearing masks and trying to keep your distance.
Let us remember that we have these rules so that in a situation where someone comes into contact with, for example, an infected child, we can be protected. We see it in our medical practice – these precautions are effective, if we follow the basic rules – we are safe.
And yet positive people are among us, although we do not know about it …
That’s it. Recently, two teenage boys who had a scooter accident came to our department. Upon examining them, it turned out that both of them were infected with SARS-CoV-2. During the interview, it turned out that an hour before they got on the scooter, they were at the store. They did not know that they were infected, they had no symptoms … We cannot avoid such situations. That’s why we have masks and a distance command.
What can a parent do to protect their child as much as possible?
Above all, parents should remember that risk cannot be completely eliminated. It is impossible. However, the precautionary measures taken must be appropriate to the situation, reasonable and consistent.
It is known that the parent has little influence on what is going on at school. What it can do is first and foremost not to send a sick child to a facility – although it is more of a protection for other children, it is nevertheless very important.
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The second very important thing is vaccinating the child against the flu – this way we will reduce the number of infections. It is also important to shape certain rules and responsibilities in children – e.g. the need to wash their hands. However, all this must be within reason, because it is easy to overdo it the other way, which can result in neurosis or obsessions. You have to convey simple rules and the knowledge that if we follow these rules, we are safe. After all, there is so much untrue and dishonest information …
So we should stay calm and remember that with mild symptoms in a child – we will cope.
Yes. What needs to be made parents aware is that even if a child gets COVID-19, we can handle everything. If he is mildly ill, the worst that is facing him in terms of isolation right now is these 13 days. Mild symptoms usually do not require medical consultation – if a child has, for example, a fever of 38 degrees, the parent most often knows what antipyretic drugs to administer. Of course, he can always visit a GP.
If the course of the infection is more severe, the parent may bring the child to the hospital, in the infectious diseases and paediatrics ward. And there is no fear that if there is no COVID-19, she could catch it in the hospital – isolation is full. Maybe a bit burdensome – no company, no playroom or ward kitchen, but thanks to that it is safe.
We should remember that a mildly ill child does not have to and should not go to the hospital. His place is at home. The parent will distinguish between the moment when things start to go wrong with the child and when it is necessary to get in the car and bring him to the infectious ward. We’ll take care of him there.
And the issue of strengthening immunity …
Unfortunately, this is not something that can be done in a week or two. We work for a long time for good resistance. Healthy lifestyle and positive thinking. It cannot be denied that not everything depends on us. What matters most in illness is the psyche. Especially in this disease, which is filled with so many false stories and conspiracy theories.
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