COVID-19 FAQ
If Your Child Tests Positive for COVID-19
Isolation/Quarantine
What does isolation mean?
Keep your child at home in one space, away from other family members where possible. When providing care to your child, you should be wearing a mask and washing hands after contact. 油
How long does my child have to be isolated?油
Current Centers for Disease Control and Prevention (CDC) guidelines updated on Jan 4, 2022油recommend a minimum of 5 days from the start of symptoms (day 0) if your child is without fever (and no Tylenol速/Motrin速 for 24 hours) and showing improvement of symptoms. They should continue to wear a mask for an additional 5 days when around others at home and in public. If they continue to have symptoms such as fever or cough at day 5, or they cannot wear a mask, they should isolate for 5 additional days (day 6 through day 10). If they had a severe course for example they were in the Intensive Care Unit (ICU) in the hospital or are immunocompromised (they have an autoimmune disease or are receiving certain types of cancer care) recommended isolation may be longer (20 days). Some symptoms can linger (e.g., loss of smell, fatigue, etc.) beyond this period but that does not mean they are contagious.油
What if they never had symtoms but tested positive? How long do they have to be isolated?油
If they never had symptoms then day 0 is the day they tested positive and day 1 is the first full day following the day they were tested. They should be isolated for at least 5 days from the last positive test (i.e., days 0 through 5) if it can be assured that a well-fitting mask be worn when around others at home and in public. If your child cannot wear a mask they should continue to isolate for 10 days. If they develop symptoms soon (i.e., within a week) after their positive test result, the clock restarts at day 0 on the day of symptom onset.油
Should they be tested again to see if they are negative and can come out of isolation earlier than 10 days or if they should stay isoluated for longer?
If you have access to a test and want to test your child, the best approach is to use an antigen test no earlier than day 5 of isolation. If your childs test result is positive, they should continue to isolate until day 10. If their test result is negative, they can end isolation as long as a well-fitting mask can be worn at home and in public for 5 additional days (day 6 through day 10).
How do I care for them while they are isolated?油
CDC has guidelines on how to take care of loved ones when they are sick including advice on having a separate trash can, using gloves and masks when handling waste or getting within 6 feet of the patient, disinfecting high surface touch points, etc.
How long do family members have to be quarentined?油
For family members who have received all vaccine and booster doses recommended by the CDC, they do not need to quarantine. They should wear a well-fitting mask around others for 10 days from the day the child was isolated from them. If the child was unable to be isolated from a family member, then that family member should continue to wear a mask for 10 days from the day the child was able to come out of isolation (e.g., 10+10 days = 20 days).油
For family members who have not received all recommended vaccine doses, including a booster dose for people 12 years of age or older, a 5-day quarantine period is recommended if it can be assured that a well-fitting mask be worn when around others at home and in public for 5 additional days (day 6 through day 10) following the last exposure to the child. If the child was unable to be isolated from a family member, then that family member should quarantine for 5 days from the day the child was able to come out of isolation (e.g., 10+5 days = 15 days).
Treatment
Are there any medications that are helpful for treatment?油
For nonhospitalized patients with mild to moderate disease, treatment is supportive (fluids, over-the-counter medications for fever, cough, etc.). Remdesivir, dexamethasone, antibody treatments, etc., are possible considerations for patients who have certain high-risk conditions or are sick enough to be in the hospital. Antibiotics are only helpful if there is concern for bacterial pneumonia. Vitamin D, zinc and other supplements are not routinely recommended for children without known deficiencies. Inhalers may be helpful in patients with known asthma but any patient with new wheezing or difficulty breathing should be assessed by a provider.
Is Motrin速 OK?
There are no studies that clearly show Motrin速 is harmful for children with COVID-19, but for now we would prioritize giving Tylenol速 first for fever or pain and then Motrin速 if necessary.
Should they gety an X-ray or lab testing?油
Without any clinical signs of pneumonia or trouble breathing, a chest X-ray is not helpful a patient would not be admitted on the basis of a chest X-ray alone and a chest X-ray may not show a pneumonia early in the course. Lab testing may be helpful for looking for signs of Multisystem Inflammatory Syndrome in Children (MIS-C) but only when there is suspicion for the syndrome (e.g., having fever with red eyes, swollen lymph node, rash and looking very sick). If there is concern your child is sick enough to suspect MIS-C they should be assessed by their provider. Otherwise, labs for mild disease do not help predict their course.
If there are no medications that are helpful, what can I do to help my child?
- give Tylenol速 to keep them comfortable when they have fever or aches
- encourage drinking plenty of fluids to stay hydrated
- allow them to rest when needed but also encourage them to get up and stay active as tolerated
- keep the window shades open during the day so they can keep track of day/nights during isolation and keep them engaged with activities in their room
- closely monitor their temperature, breathing, drinking/urinating and mental status
When should they go to the Emergency Department?油
- chest pain (continuous, not just pain with coughing)
- labored breathing (grunting, breathing too fast to count, working very hard to breathe or blue/pale lips)
- confused or cannot be woken up 油
Should they sleep on their belly?油
Prone positioning is something that may be used in a hospital setting when there is concern for respiratory failure. This is NOT recommended for patients at home.
Should they get a pulse oximeter or Owlet or other such monitoring device?油
Hypoxia (low oxygen saturation) has been shown to predict worse outcomes in adults but this is not something that is recommended to check for children at home. Some equipment is not appropriately sized or calibrated for children. If there is any concern for difficult or labored breathing, they should be seen by a provider right away.
Recovery
How long does it take to recover?油
COVID-19 is extremely variable in its course depending on the severity. Most cases in children are mild or even asymptomatic, meaning most will not develop pneumonia, hypoxia, respiratory failure or MIS-C. For those with mild symptoms, most recover by 2 weeks but some symptoms (e.g., loss of smell/taste, fatigue, cough, etc.) can linger for another month. There are reports of rare cases of long COVID where they have continued lung problems or neurologic issues in which case they should be seen by us and potentially referred to specialists.
Can they return to fultime school?油
Similar to concussion, return to activity may need to be gradual. Some children may be too fatigued to do full-day distance learning and need a modified schedule. Some are ready to go back to full-time school right away. If a child needs modifications for school and has not been seen by us yet, they should be given an appointment to discuss their ongoing symptoms with their provider.
Can they return to exercise?油
If they were asymptomatic for COVID-19, they should refrain from exercise/sports activity for 2 weeks. If they had significant symptoms and are 12 years or older, they will need a normal EKG at least 2 weeks after symptoms have resolved. If they were hospitalized for COVID-19 or have cardiac symptoms, they must refrain from exercise until cleared by a cardiologist.
Should they be tested for antibodies to see if they recovered or are in danger of getting it again?油
No, the currently available antibody testing is not always specific to the type of Coronavirus that causes COVID-19 and we do not know how well children make these specific types of antibodies and for how long. The results will not provide much useful information.油Even after having COVID-19 it is possible they could get it again and would need to practice the same precautions similar as those that have not had it.
Testing for COVID-19
Where can I get my child tested?油
Please refer to our油COVID-19 testing page油for the most up-to-date information on testing options.
COVID-19 testing options for children may vary if your child:
- has symptoms for a COVID-like illness
- doesnt have symptoms but may have been exposed to someone who does
- needs testing for a procedure/school, etc. 油
油Talk to you child's doctor for some specific recommendations
Where can I (parent) be tested?
Go to your countys website or talk with your own adult physician.
What are the different kinds of tests?油
There are 2 main types those that look for油current infection with SARS-CoV-2 virus油and those that look油for油recent or past infection.油They may be called油antigen, molecular or antibody tests. Please know that it is possible for your child to receive a false negative result (when they actually do have the virus) with any of them.油The timing and method of collection can affect the accuracy of the test testing too early of a child with very low levels of virus, for instance. Another example would be if a sample collected from a swab at home didnt collect enough virus. This is why your child may need to be swabbed again for a test to confirm the result.
Are these tests accuate?油
False positive results are also possible, so a second test may be recommended in certain circumstances to confirm the result. In general, one kind of test (molecular) obtained after the 3rd油day of symptoms and at least 57 days after exposure tend to be more accurate but great care needs to be taken to follow Centers for Disease Control and Prevention (CDC) guidelines on isolation/quarantine no matter what the test result shows.
What is a "rapid COVID test" that I see advertised?油
This could refer to any of the types of tests that are available. Check to see exactly what kind of test it is and whether the test is run in a lab or not.
If my child was exposed, should they be tested?油
Your child should get tested at least 5 days after they had close contact with someone with COVID-19, and follow isolation recommendations if their test result is positive.油If your child does not have symptoms, please remember they are most contagious in the days just before and in the beginning phase of symptoms. A negative test early in the course of exposure may falsely reassure you, only to have symptoms develop later. We recommend quarantining the child for 5-10 days from last contact, depending on their vaccine status and whether they can wear a mask consistently (see above).油
If my child tested positive for the virus that causes COVID-19, should they be tested again to see if they are negative and can come out of isolation earlier than 10 days or if they should stay isolated for longer?油
Repeated PCR or similar油 tests for the SARS-CoV-2 virus in children are not helpful because kids can shed parts of the virus for some time and have a positive result but not necessarily still be contagious. Once they have completed the recommended isolation period and have recovered from symptoms, they do not need a repeat test.油
If my child tested positve for the virus that causes COVID-19 in the past 90 days, do they need to quarentine after an exposure?油
Repeated PCR or similar油 tests for the SARS-CoV-2 virus in children are not helpful because kids can shed parts of the virus for some time and have a positive result but not necessarily still be contagious. Once they have completed the recommended isolation period and have recovered from symptoms, they do not need a repeat test.油
Additional Resources
Check out these helpful resources for more on COVID-19, and how to keep you and your family safe during this time.
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During the pandemic, 消消消消消消消娼瞳 Children's leaders have been called upon to share expertise, tips and advice to educate families locally, nationally and internationally.油