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Published on August 17, 2020

Kids and COVID-19

Kids and COVID-19

What are the symptoms of COVID-19 in kids? How can I help my child wear their mask? Suresh Nagappan, MD, MSPH, medical director for the Children’s Unit at Moses Cone Hospital, shares important info on kids and COVID-19 in this week's 2 Your Well-Being discussion with WFMY News 2.

Are some kids more at risk for COVID-19 than others?

“That's true actually. So kids who've got chronic illnesses - we found that they are a little bit more likely than others to get COVID-19. Over the course of these past few months, what we've discovered is kids with asthma and kids with diabetes actually haven't been that much more likely to get COVID - that was the worry in the beginning. But well-controlled diabetes and well-controlled asthma - those kids have actually been doing pretty well. On the other hand, kids with congenital heart disease, chronic lung disease, sickle cell and kids with obesity - those kids have had higher rates of getting COVID and have been a little sicker when they do get COVID. 

“So parents of those kids, they don't have to panic, but they do want to take extra precautions. All the things that you've been hearing this whole time about hand washing and social distancing and masking - that especially applies if you've got a child with a chronic illness.”

How do I teach my kids to practice social distancing?

“Easier said than done for sure, and the younger they are, I think the harder it is. But a lot of it is leading by example, and trying to keep your kids out of situations where they're going to be in crowds, where it's really tough for them to social distance."

How safe is it for children to get together with a few of their friends to play or study?

“So, the truth is that the safest thing you can do is really keep your kids out of situations where they're in close contact with other kids. But we're all human. I have kids too, and it's tough. It's one thing if it's a week or a month, but you know, this is lasting 6 months and maybe a year or more.

“You’ve got to balance your child's social health and emotional health with their physical health and the risk of spreading it to others. I think you've got to look at your own child and your own risk factors in your family. If your child is at high risk or if there's someone in the family that's high risk, then I think being as distant as possible is the best thing to do."

“On the other hand, if you don't have those things, I think you can create a space that your child can interact with other kids, but in a safe way. So always remember the things that really help prevent the spread of COVID is one, outside is better than inside. Number two is wearing a mask - that means even when you're playing outside… then keeping that six foot distance. So it's possible to play, it's possible to get together, if you can respect those three big factors - that's going to make a big difference in preventing spread.

“The other thing that helps is to avoid having kids share food and then also limiting the number of kids that your kids might interact with. So 20 kids is a lot - if it's one or two kids, that's different, and that's probably a better situation."

If a child gets COVID-19, is the risk greater for a child's health or for others in the child's household?

“That's going to be specific to each family. So if your child has some of these risk factors that we talked about, then it might be a bigger risk for them. On the other hand, if you've got an older relative or relatives with chronic disease who are also older in the household living with the child, then it's probably a bigger risk for the child bringing COVID back to the household and spreading it in the household.”

How can I help my child learn to wear their mask?

“I think that's a really tough thing. You know, we are asking a lot of our kids during this time. This is unprecedented in so many ways, and if we think about all of us grown-ups - none of us lived through anything like this when we were kids.

“So, I think number one when your kids won't wear the mask is to have some understanding. Have some empathy for them, that this is a stressful time for them, it's a scary for them. They don't totally understand what's going on. So start with that. Start with that empathy. But then there are a few things you can do to help out."

How can I help older kids learn to wear their mask?

“So if your kids are older, remember a lot of what they're feeling is feeling helpless in all this, and so giving them a role, giving them something that they're doing - it helps a lot. So I'm just honest with older kids – just saying that the reason to wear a mask is to protect others, and that's your role in all of this. Everyone has a role - there's first responders out there, there's essential workers - your role is wear a mask to protect others.”

How can I help younger kids learn to wear their mask?

“Now when you’ve got younger kids, there's some different things you can do. Some of the issue for younger kids is it's just kind of scary to wear a mask… [so] there's a few things you can do to help make it a little bit more normal for them.

“One is have you and your child wear a mask and just look in the mirror and talk about it and talk about what it feels like and what it looks like. You can also have them put masks on their stuffed animals and play with those. Try to make the mask more personalized, decorative – that always helps and makes it feel less cold and clinical and a little bit more of a warmer feeling for them. You can look at pictures of other kids wearing masks, just to normalize it a little more…” 

“Some of it is just keeping that mask on. You can imagine with kids of almost any age, it's really hard to keep having to keep it up and it's not the most comfortable thing all the time to have that mask on. So some of it is just building tolerance. If your kids are at home right now… you can spend that time kind of slowly building up their mask tolerance a little bit more each day to make it a little bit more comfortable, so that they one day might be out and be able to wear the mask for a longer period of time.”

What are the symptoms of COVID-19 that parents should look for in kids? Are they the same symptoms adults experience?

“There's a lot of the same symptoms in adults. As in adults, kids can get short of breath, kids can have breathing problems. There's a few things that are a little bit different. One is that kids tend to have a little bit more of the stomach side of issues: stomach pain, sometimes diarrhea, sometimes vomiting. That's less common in adults and a little bit more common in kids.

“There's also a collection of symptoms that we always want parents to watch for, and that is if you see your child has red, bloodshot eyes, lymph nodes that you can feel in the neck, swelling in the hands and feet, a rash - any of those symptoms can be associated with COVID-19. There's a disease called MISC [multisystem inflammatory syndrome in children], and that disease is associated with COVID. It is quite rare, but we do want people to be on the lookout for it. So, if you see any of those symptoms, that's a good reason to call your doctor.”

Is it safe to bring my child to the doctor's office for their vaccines?

“To that, I would say absolutely. I think it's really important and vital that parents still bring their kids to the doctors for vaccines. As scary as COVID is, what you don't want is to get a whole other disease because you haven't been vaccinated, and the worry is if we get enough people who are nervous about vaccinating, we'll get a critical mass of people who aren't vaccinated and that will allow some of these older diseases to spread. So it's really important that you go in.

“The good thing is knowing all the pediatricians and family doctors in town, these offices are doing a great job trying to keep your kids safe when they do come in. So they are trying to separate sick kids from well kids, that helps a lot. They're trying to reduce crowding in waiting rooms. A lot of offices are using telehealth whenever they can and that also decreases crowding. They're doing a good job cleaning the rooms. So all those things are going to make a big difference. And then most doctor's offices are pre-screening. So they call families before they come in, and if there's a high risk that the child or family might have COVID, then they'll find an alternate instead of bringing them to the office, and that way they don't infect other kids like yours when they come in to get their shots.”

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