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11 Questions Parents May Have About COVID-19

By Jessica Grose | March 24, 2020 | The New York Times

Schools across the country have closed in response to the new coronavirus and many parents have questions about how to go about their daily lives while managing their children, whose personal boundaries and hygiene levels are not always ideal.

Because the situation is evolving rapidly and the virus is new, the advice may continue to change as we learn more. “We’re not seeing much in the way of serious illness among children,” said Dr. Peter J. Hotez, M.D., Ph.D., the dean of the National School of Tropical Medicine at Baylor College of Medicine.

On March 18, the Centers for Disease Control and Prevention released new preliminary data on the outcomes of the first 4,226 Americans infected with the new coronavirus, finding no fatalities or admissions to intensive care units among those under 19.

Earlier this week, researchers from China published a study online in the journal Pediatrics, which examined more than 2,000 children under 18 who either had or were suspected of having Covid-19, the disease caused by the new coronavirus. The researchers found that while the majority of children in the study had either no symptoms, mild symptoms or moderate symptoms, nearly 6 percent became more seriously ill — particularly those under 5. However, it’s unclear if the children with more serious symptoms were sick with Covid-19 or with another respiratory virus, said Dr. Sean O’Leary, M.D., an executive member of the American Academy of Pediatrics’ Committee on Infectious Diseases.

Still, this study “confirms what we have been suspecting, that it’s almost certainly less severe in children, but it’s not zero,” he said, agreeing that it was prudent for many schools to close. “We’re in the midst of something that no one alive has really experienced before,” he said.

With that in mind, here are some answers to common questions.

Can I still take my child to public places?

The situation is changing by the hour, so your best bet is to regularly check your state and local public health department websites for recommendations, Dr. O’Leary said.

But as of now, the general advice is to practice social distancing, Dr. Hotez said, which means sticking close to home and avoiding large groups of people. On March 16, the Trump administration announced new guidelines to help stop the spread of the new coronavirus, which included closing schools that were still open and avoiding bars, food courts, restaurants and groups of more than 10 people. You can’t be sure that popular public spaces like playgrounds are risk-free — the virus is estimated to survive on metal, glass and plastic surfaces for anywhere from 2 hours to nine days. New York City, for example, does not regularly clean outdoor furniture and play equipment, said Meghan Lalor, director of media relations at the New York City Department of Parks and Recreation. “We have not yet committed to changing our standard operations due to coronavirus, but we will continue to monitor the situation as it develops,” she said. On March 17, all New York City “recreation centers and nature centers are closed to the public until further notice,” Lalor said, though city parks and playgrounds remain open.

At this point, some communities are closing their playgrounds; considering school is out and we don’t want children congregating all together, Dr. O’Leary said playgrounds are “probably not the safest place right now.” For city dwellers, he recommended going to big, wide-open parks when available, where kids can stay six feet apart from each other and not touch equipment. Remember there are other options for solo outdoor play, like riding on a scooter or a bike. There are also options for indoor movement — for example, there are kids’ yoga videos all over YouTube you and your family can enjoy together.

As always, encourage hand washing when children come in from outside and before and after meals. Kids should sing “Happy Birthday” twice to know how long to wash their hands, and then make sure they are drying them thoroughly. There’s some evidence that paper towels are more hygienic than hand dryers in public bathrooms. Hand washing is also more effective than hand sanitizer, though hand sanitizer can be used when hand washing is not an option.

Should I cancel my kid’s birthday party?

It’s probably safest to err on the side of caution and cancel. “Larger gatherings are becoming increasingly risky,” Dr. O’Leary said. It’s also unclear what you should do about more intimate interactions, like play dates, but Dr. O’Leary said it’s probably OK to hang out with another family you know well — just make sure nobody is showing any symptoms first. Ideally, he said, you’d have them get together outside and keep six feet apart from each other. “You want to find that balance of keeping your kids sane by having interactions and keeping them safe.” (It’s worth noting that there is not consensus among medical experts about whether even group interactions under 10 people are OK. Use your discretion.).

The store is out of hand sanitizer. Should I make my own?

Recipes for homemade hand sanitizer are circulating online, but none of the experts I spoke to recommended making your own, even if stores have run out. Many popular brands of hand sanitizer, like Purell or Highmark, have established concentrations of alcohol, generally between 60 and 95 percent, said Dr. Rebecca Pellett Madan, M.D., a pediatric infectious disease specialist at N.Y.U. Langone’s Hassenfeld Children’s Hospital, which helps ensure their effectiveness. Additionally, she said, “we have experience using it in hospitals, and we know how effective it is.” The same evidence base for homemade recipes doesn’t exist yet.

If you are using store-bought hand sanitizer, make sure that it’s at least 60 percent alcohol and that it fully dries before you or your child touch anything — otherwise it won’t work as well. Also keep in mind that hand sanitizers are not as effective when used on “visibly dirty or greasy” hands, according to the C.D.C.

My child has mild cold or flu symptoms. Should I take him to the hospital?

No. Coronavirus symptoms can include fever, dry cough or shortness of breath. If your child has other symptoms, like mild fever, runny nose or sore throat, you should call your pediatrician first before going anywhere. From what we know so far, runny noses — which are a near-constant among preschoolers — are rarely a symptom of infection with the new coronavirus, but sore throats sometimes are. “We want people who are not critically ill to stay out of the hospital,” Dr. Madan said.

If your child develops more severe symptoms, such as trouble breathing, an inability to eat or drink or a change in behavior, you should visit a doctor, Dr. Madan said.

If my child is very sick, will she be able to get tested?

Unless your child has a history of direct contact with someone who has tested positive for the virus, a history of travel to affected areas or is sick enough to be hospitalized, it is unlikely she will be tested.

“Availability of testing depends on where you are,” Dr. O’Leary said. “Even in the best case scenario, you can’t test everyone because there aren’t enough test kits at this point.” Older and higher-risk patients are being prioritized for testing because they tend to develop the most severe symptoms after infection.

If your child does get tested, it’s unclear how quickly her results will come back — and the time frame will most likely depend on where you are, which lab is testing her and how long she’s been sick. “It’s all over the map,” Dr. O’Leary said. Anecdotally, he has heard about results taking anywhere from a few hours to seven days, depending on the state and the level of demand.

A greater number of labs will be able to provide testing in the coming days, according to Dr. O’Leary. But because there may also be increased demand, it’s unclear whether that will speed up testing time overall.

Should I take my child to her scheduled well visit?

If you have a newborn, toddler or young child who is still receiving immunizations, it is important to take her to her well visit, as long as you can do it safely, according to new guidance released from the A.A.P. on March 18. “We don’t want those kids to miss their vaccines,” Dr. O’Leary said. “Then we’ll have unprotected infants,” who will be susceptible to other diseases. Your child’s first newborn visit to a pediatrician is particularly important, Dr. O’Leary said, as your doctor will want to check her weight, test for jaundice and help troubleshoot any breastfeeding issues.

If your child is older and has received all of her immunizations, the A.A.P. recommends that you consider postponing your well visit for the near term. The organization also has tips for doctors to help keep their patients, parents and staff safe during their visits, including keeping well visits in the morning and restricting visits for kids who are sick to the afternoon. It also urges doctors to see kids who are sick in different facilities, rooms or floors, and to increase the use of telemedicine.

Is it safe to take my child on public transportation?

It is not recommended. New York City has urged commuters of all ages to avoid getting on packed subway cars and to walk or bike to work, if possible. New York City Mayor Bill de Blasio said he had no plans to shut down the subway.

What if my child has a compromised immune system?

Because there isn’t much information yet about how children react to this virus, it’s tough to say if there are any additional measures folks should take beyond the isolation already recommended for the general population, Dr. Hotez said. But Dr. Madan said that parents of children who have compromised immune systems should be taking it “day by day.” If your child has asthma, available evidence suggests they are not at increased risk for the virus, but that may change as we learn more.

Should my family be taking any extra hygienic measures beyond hand washing?

You can wash bedsheets and towels more often. Jolie Kerr, a cleaning expert and frequent New York Times contributor, said that you could also wash stuffed animals more often (here’s how) and clean hard toys with antibacterial wipes regularly — particularly after outdoor use.

Should Grandma still come visit?

Older adults, especially those who have compromised immune systems, should not travel on planes right now, Dr. O’Leary said, since they seem to be the most vulnerable to the new coronavirus. Some areas are calling for more extreme measures: For example, California called for people over 65 to stay in their homes. For more general guidance on whether you should cancel your family’s travel, read our piece on vacation planning. The State Department is currently warning Americans not to travel on cruise ships and is asking people to reconsider traveling abroad.

If you are a grandparent who lives locally, does not have a compromised immune system, your entire family is practicing social distancing, and no one in the family has a job where they are interacting with a lot of people, Dr. O’Leary said that visits were still acceptable, though not entirely without risk.

Are newborns more susceptible to coronavirus?

There is little data specifically about newborns at this time, Dr. O’Leary said. He recommended taking the usual hygienic precautions you would with infants, who are particularly vulnerable to other respiratory viruses, like respiratory syncytial virus (R.S.V.) and the influenza virus: Wash your hands before handling an infant, and avoid taking your infant to crowded places.

This article was written by Jessica Grose from The New York Times and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com

Jessica Grose
The New York Times