COVID-19 and children:  frequently asked questions and answers

(available in Greek only)

 

Source:    UpToDate

Free translation: Ε. Athanasopoulou, Α. Makris, College Medical Service

COVID-19 is an infectious disease caused by the newly identified SARS-CoV-2 coronavirus.  The virus first appeared in late 2019 and quickly spread around the world.  Most people infected with COVID-19 will develop moderate symptoms that include fever, dry cough and difficulty breathing or shortness of breath.  Although less common, some people develop serious symptoms that require hospitalization.  Serious problems result when the virus infects the lungs and causes pneumonia.  Isolation of patients, as well as those who came into close contact with them, is recommended in order to reduce the spread of the virus.

The virus is transmitted from human to human, primarily through respiratory secretions released from the mouth of an infected person when that person sneezes, coughs, or speaks.

Transmission is most likely to occur in persons who live in the same household.  However, transmission can also occur when people get together and talk, sing, hug, or share food.  It is less common when someone touches an infected surface and then touches their mouth, nose, or eyes.

The virus can also be transmitted by people who show no symptoms (asymptomatic). For this reason, isolation is considered an effective way to reduce its spread.

Yes.  It is possible for children of all ages to become ill with COVID-19.  Compared to adults, it is much rarer for them to become seriously ill, but not impossible.  In addition, children may transmit the virus to others.  This can be dangerous, especially for the elderly or people with other health issues.  

No, not really.  In adults, the most common symptoms are fever and cough. In more severe cases, patients may develop pneumonia with shortness of breath. 

Children with COVID-19 most often experience the same symptoms, namely fever and cough.  However, they are less likely to fall seriously ill.  Most children with COVID-19 remain asymptomatic, meaning they show no symptoms at all.  Other compatible symptoms in children include fatigue, chills, headache, muscle ache, sore throat accompanied by difficulty swallowing, difficulty breathing, loss of taste and/or smell, abdominal pain, diarrhea, nausea, or vomiting.  They may also experience runny nose or congestion. Babies’ symptoms may include a decrease or loss of appetite.  In some cases, skin conditions have been observed in children, such as reddish/purplish spots on their fingers or toes and other rashes. However, it is not clear why or how often the latter occur. 

Although very rare, it can happen.  There have been a few reported cases of children with COVID-19 developing a generalized inflammatory reaction, which can cause severe organ damage if not treated promptly,   Experts call it “Hyperinflammatory Multiple System Syndrome in children” or MIS-C.  Symptoms are similar to those of a condition known as “Kawasaki disease” and include: fever lasting more than 24 hours, rash, red eyes, severe headache, fatigue, confusion, irritability, abdominal pain, vomiting or diarrhea, and shortness of breath.  If your child displays these symptoms, contact your doctor immediately for instructions.

Call your child’s doctor if he/she has a fever, cough, or other symptoms compatible with COVID-19.  The doctor will tell you if the child should be examined or if a diagnostic test is needed.

If you are caring for your child at home, the doctor will tell you for which symptoms to look out.  It is possible for the health of some children with COVID-19 to  deteriorate suddenly after about a week.  The doctor will advise you when to call him or emergency help.

You should immediately call for help if your child:

  • is having trouble breathing
  • has chest pain or pressure
  • has bluish lips or face
  • has severe abdominal pain
  • is confused and does not seem to speak as usual
  • cannot be awoken or stay awake
  •  

If you have a baby whom you are having difficulty feeding, you should also call your doctor.

If your doctor suspects that your child has COVID-19, he/she will refer your child for a diagnostic check-up.  Molecular testing for the new coronavirus is done by taking a sample from the nose or mouth using a swab.

If you believe that your child may have been exposed to the virus but it is not feasible to have him/her tested, your doctor will guide you. Your doctor will probably advise you to quarantine your child at home, away from other people, and to call him/her if your child’s symptoms worsen.

There is no specific, known treatment for COVID-19.  Most healthy children who become ill will recover at home and usually improve within a week or two.

It is important to keep your child isolated at home and away from other people until your doctor tells you that it is safe for him/her to return to normal activities. This period depends on how long it has been since the symptoms have fully subsided.

The medical community is studying several different treatments for COVID-19. In some cases, doctors recommend such treatments for hospitalized children.

Until the entire population is vaccinated, everyone should observe personal protection measures in order to reduce the chances of infection and slow the spread of the virus. 

If your child is old enough, you can educate him/her to:

  • Wear a mask.  Experts in many countries have recommended masks for the entire population, including children aged 2 years and over. This should be strictly observed when the child is sick, even if symptomless, in order to reduce the chances of transmitting the infection.  Additionally, wearing a mask seems to help protect the child from others who are sick.
    You can use a protective cloth mask to cover your child’s mouth and nose.  Textile masks work best if they have multiple layers of fabric.
  • Social distance.  This means keeping a safe distance from other people, even those who are healthy.  The goal is to slow the spread of the virus that causes COVID-19. Isolating the child at home, when necessary, is an effective way to protect him/her and others.
  • Practice proper hand hygiene.  You should teach your children to wash their hands frequently and thoroughly with soap and water.  Make sure they rub their hands with soap for at least 30 seconds, cleaning wrists, nails, and between fingers.  They should then rinse their hands well with water and dry them using a paper towel that they discard in a wastebasket. 
    Hand cleansing with soap and water is effective.  However, if your child is not near a sink, he/she can use a hand sanitizer instead.  Disinfectants with at least 60% alcohol content are appropriate.
    Attention:  Keep hand sanitizers away from young children as alcohol can be harmful if swallowed.  If your child is under 6 years of age, help him/her use a hand sanitizer.
  • Avoid touching their face with their hands, especially their mouth, nose, and eyes.

Younger children need guidance and frequent reminders in order to achieve the above.

Useful materials (available in Greek only):

Οδηγίες για τη χρήση μάσκας στο Δημοτικό Σχολείο. ΕΟΔΥ, Σεπτέμβριος 2020.

Οδηγίες για τη χρήση μάσκας στο Γυμνάσιο και το Λύκειο. ΕΟΔΥ, Σεπτέμβριος 2020.

Αφίσα για τη χρήση μάσκας. ΕΟΔΥ, Σεπτέμβριος 2020.

 

Social distancing is one of the best ways to control the spread of the virus.  This is because the virus spreads easily through close contact and it is not always possible to know who is infected. 

In the interest of children’s health, it is best that they stay active outdoors, in the fresh air. It is normal and necessary for them to socialize and play with their friends, but is equally important for them to be aware of the risks and to practice precautionary measures.

When outdoors, keep in mind that:

  • The virus can spread both indoors and outdoors, but less likely to do so outdoors.
  • In a public park or playground, it is best to avoid crowds and to go when fewer people are there.
  • Children should ideally keep 1.5–2 meters distance from others, even when they are with friends.
  • The more people who come into contact with your child and the more often this occurs, the greater the risk of the virus spreading.  For this reason, it is best to limit the people you socialize with to a few friends or relatives and curtail the amount of playtime with other children.
  • Frequent hand washing and the use of face masks also help reduce the risk to your child and others.

It is natural for your child to feel anxious or worried about COVID-19.  It is also natural for your child to feel lonely when he/she is not allowed to enjoy usual activities or to see friends and relatives.

You can help your child by:

  • Speaking to your child in simple terms appropriate to his/her age about COVID-19 and explaining that social distancing and wearing a mask are valuable tools.  You can also mention that by following these measures, your family helps protect other people in the community.
    If your child is worried, it is important to stress that most people do not become seriously ill and do not pass away from COVID-19.
  • Buying a textile mask that your child likes and feels comfortable when worn.  You can practice wearing a mask together and encourage him/her to wear it.  Avoid negative comments about the use of masks when your child is present.
  • Limiting your child’s exposure to news reports on television and on the internet regarding COVID-19.
  • Finding activities you can do together.
  • Helping your child keep in touch with friends and relatives.
  • Ensuring that your child is eating healthy meals and exercising daily.