COVID-19 in Child care : Symptoms, Care and Prevention - Tips for families and children (Coronavirus)

Does your child seem out of shape or has a cough or fever? Wondering what to do during this time of pandemic? Here are the recommendations for children affected by COVID-19

COVID-19 in Child care : Symptoms, Care and Prevention - Tips for families and children (Coronavirus)

What are the symptoms of COVID-19?

Fever (0-5 years: rectal temperature 38.5°C [101.3°F] and above; 6 years and above: oral temperature 38.1°C [100.6°F] and above), cough and breathing problems are the most common symptoms seen in children. Some may also experience sore throats, muscle aches, runny noses, diarrhea or vomiting, severe fatigue or loss of appetite. Infected children may experience a sudden loss of smell or taste without nasal congestion.

Doctors have observed that some children infected with the coronavirus may have frostbite spots on their toes and fingers that may be accompanied by a burning sensation. This symptom would not pose a health risk and the spots would disappear on their own over time.

However, the presence of these spots does not automatically mean that a child is infected. In fact, several children with this symptom have tested negative for COVID-19. Parents should therefore not be alarmed.

In general, children infected with COVID-19 show only mild symptoms. Very few are hospitalized and severe cases are extremely rare. Therefore, children appear to be less affected than adults. In addition, there is some evidence to suggest that children may be less contagious than adults and therefore less likely to transmit the coronavirus, especially when they have few or no symptoms.

A rare form of the disease in children?

Since the beginning of the pandemic, some children have presented in hospitals with symptoms similar to those of Kawasaki disease: abdominal pain, gastrointestinal disorders and heart inflammation. In addition, blood tests performed on these children detect signs of significant inflammation.

Some of the children with these symptoms tested positive for COVID-19 while others tested negative. According to the Canadian Paediatric Surveillance Program (CPSP), there may still be a link between the COVID-19 pandemic and this inflammatory disease. The CPSP will be setting up an alert for health professionals to report potential cases.

Physicians are advised to be vigilant, as the condition of affected children may deteriorate rapidly. If left untreated, Kawasaki disease can cause heart damage in some children.

However, this type of complication would be very rare. Moreover, by treating affected children quickly, complications can be avoided.

What do we know about COVID-19?

COVID-19 is a respiratory tract infection. It is caused by the SARS-CoV-2 virus.

• Age: Children of any age can be affected by COVID-19. However, fewer children are infected with COVID-19 than adults. Although complications are very rare in children, those under 1 year of age are more likely to experience complications.
• Symptoms onset: Symptoms develop on average 5 to 7 days after infection. However, it can take up to 14 days between exposure to the virus and the onset of symptoms.
• How it is spread: The coronavirus is mainly spread through close contact between infected people. The virus is spread through droplets from respiratory secretions, such as when an infected person coughs or sneezes. Infection can also occur if a person touches a contaminated surface and then touches their eyes, nose or mouth.
• Containment: If you are waiting for your child's test result for VIDOC-19 or if your child has received confirmation that he or she is infected, make sure the whole family stays home in isolation. This isolation should be maintained at least 14 days after the onset of symptoms and 72 hours after the fever has resolved and respiratory symptoms have improved. For more information on how to attend a child care facility when symptoms of COVID-19 are present, see our article COVID-19: When can a sick child return to daycare?

How is COVID-19 treated in children?

• Ensuring the child's comfort
• Suggest that your child wear light clothing.
• Keep the room temperature at about 20°C (68°F).
• Encourage your child to get plenty of rest.
• Make sure your child drinks enough fluids and doesn't get dehydrated, especially if he or she has vomiting or diarrhea. If your child shows signs of dehydration, you can give your child rehydration solutions such as Pedialyte at the pharmacy if needed. Don't hesitate to ask your pharmacist for advice.

Watch for worsening symptoms such as difficulty breathing, rapid breathing, confusion or bluish lips. If these signs occur, your child should be seen by a doctor.

Appropriate medication

If your child is over 3 months old and has a rectal temperature over 38°C (100.4°F), you can give acetaminophen (Tylenol, Tempra or other), depending on the product directions and your child's weight.

If your child is over 6 months old and acetaminophen does not bring the fever down, you can give your child ibuprofen (Advil, Motrin or others) in addition to acetaminophen.

However, never give acetylsalicylic acid (Aspirin® or others) to a child or youth under 18 years of age.

Precautions to avoid contagion at home

Ideally, one person should take care of the sick child. This person should not have a health condition that makes them vulnerable to VIDOC-19.

When caring for an infected child, be sure to wash your hands thoroughly and dry them with disposable paper towels. Also avoid touching your eyes, nose and mouth with unwashed hands. Your child's clothing and bedding can be washed with the rest of the family laundry, but use hot water and dry it well.

Your child should not play with other children or share personal items, food or drinks with other family members.

Asthma and IDVOC-19

To date, there is no evidence that children with asthma are more affected by COVID-19 than other children. However, it is true that any respiratory virus can cause an asthma attack. Therefore, the main recommendation for these children is to continue to avoid what could trigger an attack and to take the right medications to control their condition.

How can we prevent it?

There are a number of steps that can help reduce the spread of the virus and thus reduce the risk of children being exposed to it.

• Encourage your whole family to wash their hands thoroughly.
• Make sure everyone sneezes and coughs into their elbows.
• Avoid touching your eyes, nose or mouth.
• Stand 2 metres away from people who are not part of your family.
• Clean and disinfect surfaces in your home such as doorknobs.
• Avoid contact with sick people.

Some people may be tempted to voluntarily expose their children to the virus by bringing them into contact with an infected person in order to develop natural immunity to VIDOC-19. However, doctors strongly discourage this. It is a risky strategy because there is currently no treatment to intervene in the event of complications. In addition, experts still do not know if catching the disease guarantees immunity. 

When to consult?

If your child has only mild symptoms, you do not need to go to the emergency department. He or she can stay with you at home.

• Your child is less than 3 months old and has a rectal temperature over 38°C (100.4°F);
• Your child has a chronic illness or a condition that affects the immune system and has a rectal temperature over 38°C (100.4°F).
• However, if your child has any of the following symptoms, go to the emergency department and mention that your child has COVID-19 or is waiting for a test result :

Your child seems very sick, has no energy and you are having trouble waking him/her up;

symptoms get worse, such as rapid breathing, difficulty breathing, confusion or an inability to recognize you.

Some more vulnerable children

Children may suffer from a disease that increases the risk of complications if they are infected with VIDOC.19 The risk of complications is higher in children than in adults:

• those with heart problems ;
• those with cystic fibrosis;
• those with neurological or neuromuscular disorders;
• those with sickle cell anemia or cancer;
• those whose immune system is not functioning as well as children who have received organ transplants or who need to take steroids on a regular basis.

These children need to take extra precautions to avoid becoming infected with VIDOC-19. For example, the Ministry of Education and Advanced Education emphasizes that any student with a health vulnerability should not return to school until further notice. If your child has a chronic medical condition and you have questions about the safety of returning to school, you can contact your child's treating physician to ask questions about it.

Sources : Ministère de la Santé et des Services sociaux du Québec, CHU Sainte-Justine, Société canadienne de pédiatrie, Radio-Canada, Le Devoir, Agence de la santé publique du Canada, Le Droit, Harvard Medical School, Société canadienne de pédiatrie, Société canadienne de pédiatrie, INESSS, Radio-Canada, ministère de l’Éducation et de l’Enseignement supérieur, CDC, Programme canadien de surveillance pédiatrique