Protect our children from COVID-19

Tracy Evans Gilbert

Contributor

Children are just as likely as adults to be infected with the virus that causes COVID-19. The difference is that the majority present with mild symptoms or no symptoms at all.

Why is this?

During the outbreak in Wuhan, China, children were on winter break, so they already began home isolation. Scientists suggest that in children, the virus does not bind effectively to gain entry into the cells of the body. Children’s immune systems may respond differently or previous exposure to other respiratory viruses may help them fight infection with COVID-19

Does this mean children are safe from COVID-19?

No, it does not. Although children 19 years or younger have mainly mild symptoms, all age groups can develop moderate to severe symptoms. Infants are particularly vulnerable and could present with shortness of breath with low oxygen levels that require hospitalisation, or have multi-organ or severe lung involvement requiring admission to intensive care. Most children recover. To date, there have been two infant and two teen deaths, globally. Older persons are more vulnerable but young people, 20 years and older, are being hospitalised and have died from COVID-19.

What are the symptoms in children?

Children usually present with fever and cough. Other symptoms may include shortness of breath, sore throat, headache, vomiting and diarrhoea, muscle ache, and feeling unwell. Children may not have a fever. Symptoms are similar to other viral illnesses. Contact with an infected family member or someone who recently travelled makes infection with COVID-19 more likely.

What should I do if my child has symptoms of COVID-19?

If your child has symptoms of fever, give your child fluids to prevent dehydration. Give paracetamol, also known as cetamol or Panadol, as per instructions as necessary until the fever breaks. This medicine will also help with headaches and muscle aches. Fluids such as water, Pedialyte, or coconut water are best if your child has diarrhoea or vomiting. Avoid sugary drinks or soda, which can make diarrhoea worse. Offer small amounts of fluid frequently after each loose stool or vomit. For decreased appetite, feed small amounts at regular intervals. If your child has a persistent high fever, shortness of breath, persistent vomiting, or drowsiness and is unable to drink, contact your doctor or the emergency room and go there immediately.

What can I do to protect my child?

The virus can be transmitted from droplets when someone is coughing and from contact with the virus left on surfaces. Studies suggest that the virus may briefly linger in the air. Persons in the home who are having symptoms should wear a mask and be isolated from others. Wash hands often with soap and water to remove germs before preparing food, formula, or while breastfeeding. Clean surfaces regularly, including toys. Wash hands before handling infants. Faeces do not spread COVID-19. Until further evidence is available, keep the lid of the toilet seats down when flushing and wash hands.

Ensure sufficient rest, hydration, balanced meals, and exercise. Open windows or go outside while maintaining social distance for fresh air. Maintain contact with friends and family. Children on medication for other conditions, for example, asthma, HIV, diabetes, and hypertension, should have at least a one-month supply of drugs. Ensure that they take it to keep their disease under control.

What about routine vaccines and well-child checks?

Vaccinations are important. Health centres are seeing only those with scheduled immunisation appointments or children who are acutely ill. Well-child visits are being rescheduled. Contact your private doctor, who may be limiting the number of persons seen at each visit.

What else can I do?

Children are at home. Ensure that structure is maintained with meals and sleep patterns and allow them to play. Ensure access to educational material. Monitor Internet activity. Keep the environment safe from medications and poisonous substances. Children are vulnerable to abuse if caregivers develop anxiety, depression and frustration during social isolation. Get a family member to assist with child-rearing responsibilities and seek help. Financial challenges may impact the provision of food for children. Start a backyard garden, reach out to family, friends, and church organisations. Get assistance through non-government and government resources for vulnerable children and those with special needs.

Dr Tracy Evans Gilbert is a senior associate lecturer at The University of the West Indies and a consultant in paediatrics, tropical medicine and global health at the Cornwall Regional Hospital.