How living through a pandemic like COVID-19 can affect children’s mental health

By Dr. Heather Huszti, chief psychologist at CHOC Children’s, and
Dr. Sheila Modir, pediatric psychologist at CHOC Children’s

Taking care of your mental health, and your children’s mental health, is particularly important during a crisis such as the COVID-19 pandemic we’re currently living through.

There are many possible risk factors affecting children during this time that can lead to mental health distress:

  • Shelter in place orders and disruption in former routines
  • Loss of family from COVID-19
  • Loss of family income
  • Virtual schooling
  • Lack of access to peers
  • Possible violence in the home

These risk factors can compound existing mental health conditions or bring on new mental health challenges.

A study published by the Society for Disaster Medicine and Public Health polled families who faced isolation due to SARS or H1N1 and found that 30% of children met criteria for post-traumatic stress disorder (PTSD) per parent report. This rate was higher among children who received no mental health services and those whose parents had been isolated because of these diseases. If parents had anxiety or PTSD, their children were more likely to be impacted on a mental health level as well.

Research is emerging that suggests adults are struggling with increased mental health problems during the current COVID-19 pandemic. It also shows that many parents are worried about how to help their children’s mental health. These resources can help:

What happens when we are isolated

Research conducted by Australian psychologist and researcher Kimberley Norris found that when people are isolated due to a pandemic, they tend to cycle through different phases of emotion. How we feel and act can vary in these phases based on our age and other factors, but generally the cycle follows this pattern:

  • Confusion – panic-buying, seeking clarity over regulations, or kids feeling unsure why they can’t see their friends at school anymore
  • Honeymoon – finding a routine, adapting to work from home changes, feeling a sense of community
  • Resentment – feeling cooped up or sick of wearing masks
  • Reunion – the phase where we start to step out of isolation and may feel a rollercoaster of emotions. This could be, “I’m scared to get sick but I’m happy to go to the beach.”
  • Reintegration – back to functioning normally in society

Through self-isolating and sheltering in place, we as clinicians worry that people in our community may not feel comfortable seeking the mental healthcare they need. However, telehealth is available and mental health sessions can be conducted from the safety of your home. Here’s advice on deciding where to go for physical healthcare during COVID-19.

The impact of trauma on children during COVID-19

The COVID-19 pandemic is a new mass trauma that can impact children’s mental health both now and later in life. This trauma will likely exacerbate existing mental health conditions and contribute to new stress-related illnesses.

If the signs and symptoms of trauma are left untreated, they can have a lasting impact on the child’s emotional, behavioral and physical well-being.

Signs and symptoms of trauma in children can include:

  • Depression and/or anxiety
  • Regression behaviors such as loss of toileting skills
  • Increase in separation anxiety
  • Changes in sleep, eating and school performance
  • Engagement in risky behaviors
  • Loss of interest in friends and/or activities
  • Isolation
  • Defiance

Tips for building resilience to mitigate the impact of trauma

There are a number of things parents can do to help children build resilience needed to thrive during this chaotic time, as well as help mitigate the impact of trauma. Resilient children tend to be happier, more motivated and engaged, more confident, and adopt a more positive attitude as they encounter more challenging situations. Here are some ideas to try in your own home:

  • Making a schedule — Whether times are uncertain or not, all children benefit from having a routine in place. Following a schedule provides consistency, structure and predictability. When we don’t know what the world is going to throw at us next, building in some routine and predictability serves as a buffer from the outside chaos.
  • Emotion identification — Today is a great day for a family movie night, and what movie does a better job of describing the internal world of a child than Pixar’s “Inside Out”? Consider making a family fort and gathering your favorite movie snacks. After the movie, grab some markers and paper and have your child draw what recent feelings they have experienced. What does that feeling look like? What would it say if it could talk? What does that feeling need to feel better or safe?
  • Coping skills — There are different ways to manage big emotions that children feel.
    • Deep breathing – This will help the child calm and self-soothe. Breathe in for 3 seconds, hold it for 3 seconds, and release it for 3 seconds.
    • Progressive muscle relaxation – Tense your muscles as you breathe in, and then relax them as you breathe out. This will help you identify in the future times of stress when you feel tense, and you can use deep breathing skills to help relax your body.
    • Grounding – Bring your attention to the present moment using your five senses. For example, name five things you see in the room, four things you feel, three things you hear, etc.
  • Family coping box — A coping box can include tools that different family members can utilize when feeling stressed. The family box should be located somewhere that everyone can access it easily. Consider items such as a soft stuffed animal, word searches, a book of yoga poses, fidget toys or stress balls.
  • Conflict resolution — Stay at home orders can mean tight quarters, which can naturally lead to disagreements. Establish communication rules for your family, like using “I” statement to express how you feel, not interrupting each other, and taking a timeout when things get heated.
  • Mindfulness – Science has shown that the power of thought can change how we feel and lead to changes in those around us. One example of practicing mindfulness is a loving-kindness meditation. Since we can’t be with many of our loved ones right now, we can send them kindness and well wishes instead. Close your eyes, imagine the person or pet you care about and say aloud or silently, “May you be safe. May you be healthy and strong. May you be happy. May you be peaceful and at ease.”
  • Gratitude — Research has found that teaching gratitude to children increases their happiness, optimism and generosity. Encourage your children to keep a gratitude journal and to write three things every day they are grateful for. At the end of the week, everyone can share their reflections.
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Coronavirus: What parents should know

We know how frightening it may be for parents to hear news reports about the 2019 novel Coronavirus (COVID-19). Get answers to your frequently asked questions – and some peace of mind – in this Q & A with CHOC Children’s infectious disease experts.

What is COVID-19?
COVID-19 is a disease caused by a novel strain of coronavirus. Coronaviruses are a large family of viruses and commonly infect people around the world with mild upper respiratory infections. Sometimes coronaviruses that infect animals can evolve and become a new human coronavirus strain. These can cause more severe illness. The current outbreak began in Wuhan, Hubei Province, China and has spread to other countries, including the U.S.

Who is at risk for COVID-19 infection?
Mostly people older than 60 and those with pre-existing health conditions are at greater risk. Additionally, people who have had contact with people confirmed to have COVID-19.

At this time, there are not many cases in children. Children who did have the virus tend to have mild symptoms. According to the American Academy of Pediatrics, few children with COVID-19 have had to be hospitalized. However, severe illness has been reported in children, most often in infants less than a year.

How do you get COVID-19?
We are still learning exactly how COVID-19 spreads. What we do know though that the virus is spread mainly from person-to-person contact. This can happen when people within 6 feet of each other inhale respiratory droplets produced when someone speaks, coughs or sneezes.

COVID-19 is thought to be spread primarily through inhaling droplets produced when someone coughs or sneezes or by transmission between people in close contact.

Can someone spread the virus without being sick?
The CDC reports that recent studies show a significant portion of individuals with COVID-19 lack symptoms. Even the people who eventually develop symptoms can pass the virus to others before showing symptoms. This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing, or sneezing—even if those people are not exhibiting symptoms.

Can I get COVID-19 from touching an object?
This is not thought to be the main way the virus spreads. However, it is possible that someone who touches their nose, mouth or eyes after touching a surface with the virus on it could possibly get the virus.

What are the symptoms of COVID-19 infection?
Symptoms can include fever, cough and shortness of breath. Symptoms typically appear two to 14 days after exposure.

According to the Centers for Disease Control, the symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms.  Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported.

How can I protect my family from COVID-19?
With no vaccine currently available, the best way to prevent illness is to avoid being exposed. It’s also important to take preventative steps:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. Get more information on hand-washing — and here’s a fun graphic.
  • The CDC recommends laundering items including washable plush toys as appropriate following the manufacturer’s instructions. When possible, use the warmest appropriate water setting for the items and let them dry completely. Laundry from an ill person can be washed with other people’s items.
  • Check out this list of how to prepare your household for a potential COVID-19 outbreak.
Practicing proper cough and sneeze etiquette can help prevent the spread of illness.

My family has upcoming travel plans. Should we cancel?
We recommend following the CDC’s guidance for travel.

Should we stay away from gatherings like church, sporting events or amusement parks? What about smaller gatherings?
Recently, some communities have begun gradual reopening efforts of some businesses and places of worship in accordance with state guidelines, a modification of initial statewide stay-at-home orders.

Nonetheless, people are encouraged to watch for symptoms, avoid crowds and maintain proper hand-washing habits. The CDC recommends people avoid gathering in groups.

Here’s a roundup of activity ideas to keep kids entertained, educated and busy during school closures.

Should my children and I wear masks?
The CDC recommends cloth face coverings in public settings in places like grocery stores and pharmacies where social distancing measures can be difficult to maintain. These face coverings can slow the spread of COVID-19, and help people who may have the virus and do not know it from transmitting it to others. Children under the age of 2 years should not wear cloth face coverings.

A May 23 order from the Orange County health officer mandated face coverings be worn in public. This order doesn’t apply to children under age 2, anyone who has trouble breathing,  is unconscious, incapacitated or otherwise unable to remove the cloth face-covering without assistance; persons with a medical or mental health condition, or development disability that prevents wearing a cloth face-covering.

Social distancing and proper hand-washing are still critical.

Here’s guidance from the CDC on how to properly wear a cloth face covering, as well as tutorials on how to make your own mask.

N-95 or surgical masks are not recommended for public use, as supplies are needed by healthcare workers and first responders.

My kids are worried about COVID-19. What can I do?
Check out these tips from a CHOC psychologist about reducing children’s anxiety about COVID-19.

This comic book was developed to help kids understand COVID-19 and lessen their fears.

The Orange County Health Care Agency has developed some kid-friendly infographics to help children understand what they can do to help stay well: English | Spanish

What should I do if I think my child has COVID-19?
Call your healthcare professional if your child has a fever, in addition to a cough or breathing difficulty, and has had close contact with a person known to have COVID-19, or you live in or have recently traveled to an area with an ongoing spread of the virus.

Do not go to the doctor’s office without calling first. Your provider will work with the local healthcare agency to determine whether testing is necessary.

Parents who suspect their child may have COVID-19 should call their healthcare provider before going to the doctor’s office.

Can my child be tested for COVID-19?
If your child has a cough and fever, particularly with underlying health issues, call your doctor to discuss if testing is needed.

How is COVID-19 treated?
There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions.

What is the link between COVID-19 and MIS-C?
Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts become inflamed, and many children with MIS-C have previously been diagnosed with or exposed to COVID-19. Scientists are still studying the correlation, but this Q&A with a CHOC pediatric infectious disease specialist answers parents’ most common MIS-C questions.

Can I transmit COVID-19 to my baby through breastmilk?
Current guidance from the CDC states that a mother who has been confirmed or suspected to have COVID-19 should take all precautions to avoid spreading the virus to her infant. Learn more here.

Can I transmit COVID-19 to my pets?
Until experts learn more about how this virus affects animals, treat pets as you would other human family members to protect them from a possible infection. The CDC offers the following guidance:

  • Do not let pets interact with people or other animals outside the household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash, maintaining at least 6 feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

There is a small number of animals around the world reported to be infected with the virus that causes COVID-19, mostly after having contact with a person with COVID-19. Talk to your veterinarian if your pet gets sick or if you have any concerns about your pet’s health.

If you have a confirmed or suspected case of COVID-19, limit contact with your pets, just like you would with people. If you must care for your pet or be around animals while you are sick, wear a cloth face covering and wash your hands before and after you interact with them.

Call your veterinarian with questions or concerns on your pet’s health before bringing them to the veterinary clinic.

Who can I call for more information about COVID-19?
The Orange County Health Care Agency is taking calls from the public about COVID-19. Call 800-564-8448 Monday through Friday from 8 a.m. to 5 p.m.

Or, speak to a CHOC nurse 24/7 to answer your questions about COVID-19 and your child by calling 1-844-GET-CHOC (1-844-438-2462).

This article was last updated on May 26, 2020.

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How are teens coping with changes brought on by COVID-19

Changes caused by the COVID-19 pandemic and social distancing have greatly impacted teens. They’re not in school or seeing friends in person, and many are struggling with the reality of missing milestones they had looked forward to celebrating, like graduation or prom.

It’s normal for teens to feel anxious during this period of their lives, and we want them to know they’re not alone. We checked in with our teen advisory council to see how this time has impacted them, how they’re coping with these changes, and their tips for other teens struggling with changes prompted by COVID-19. Despite the challenges of this uncertain time, they also shared good things that have come out of this period.

Read on for their experiences and advice, plus more tips from CHOC experts.

Layla, age 14

Layla
Layla, a CHOC Children’s teen adviser

I’ve had two performances, a school tradition and my spring musical postponed. My volleyball season is paused, and sadly, I do not think that we will be able to resume. The first week of cancellations and postponements was very rough, with more and more bad news piling on top of each other.

Strangely, as much as I miss my friends, I have not been contacting them as much as I thought I would. A huge part of our friendship was seeing each other every day at school and having many opportunities to joke around. Since being in quarantine, I find myself texting them about once a day.

Instead of talking with my friends a lot, I have been having more alone time. This has given plenty of time to think, which has come to be both good and bad. Sometimes when I am alone too long, I begin to feel negative and I put myself down. The most effective way of balancing this out with good is hanging out with my family or trying out new activities and putting my energy toward productive things.

There are good things that have come out of this time. One of my favorite things to do is to discover and listen to new music, and I have had a lot of time to do that recently. Another good thing is that I feel like I got a break.  Before, I was balancing school, theater, volleyball and other extracurriculars, and my life seemed to be moving incredibly fast. This time has given me a chance to reflect and take a breath.

My advice to others is that it’s important to remember that during this time, we are all sacrificing something so that our Earth can heal sooner.

Carina, age 17

Carina
Carina, a CHOC Children’s teen adviser

Some special events that have been canceled or postponed because of stay at home orders includes my junior year softball season and a concert. The softball season getting canceled was really disappointing considering my teammates and I have been practicing hard almost every day before we got the news. Currently, the softball season is over, but I see my teammates and my coaches every Monday through video calls. My concert getting postponed was devastating because it is an experience that you can’t recreate on a video screen. The energy, the music, and the emotion are all something that I was looking forward to, especially since junior year was getting stressful.

I’ve kept in touch with friends by having a group chat via text and group FaceTime with them almost every day. Most of my friends have been keeping themselves busy with schoolwork and video games. However, we know that if someone calls the group chat, they are lonely. That’s why most of us answer the call and talk about school or relationship drama. It is really effective, and we can add anyone to the call at any time. I also play video games with my friends and it helps me work on my problem-solving skills within a group while also joking around and having fun.

The stay at home orders aren’t difficult to follow, but being able to see my friends has taken a toll on my emotions. I have sometimes struggled with motivation to do my schoolwork or exercise but this time has given me a chance to reflect on what I want to do in my future in regard to college and beyond.

During this stressful time, I have noticed that I am more aggravated and have less of a patience with my brothers and family, but that talking to my friends over the phone helps me a lot.

The good thing about these stay at home orders is that I get to spend more time with my family and get to do some of my hobbies. This has given me more time to write in my journal, sew and draw with all my free time. I also have more time to focus on my homework and actually work through problems rather than find a quick solution and not understand the concept.

Lauren, age 15

lauren
Lauren, a CHOC Children’s teen adviser

My church had several events planned that were canceled or postponed. This has impacted me a lot because my faith is very important to me, and with mass gatherings being cancelled it has been quite a challenge to adjust to new routines. My family also had to cancel a few fun events like our kayaking trip and other bonding activities. Having these events cancelled has made me really sad because it prevents me from spending time with some of my family and closest friends.

To keep in touch with friends, I have been FaceTiming and texting them every day so we can chat and catch up. Working together on school assignments has also allowed me to collaborate with my friends.

The pandemic has its ups and downs regarding my emotions and mental health. While staying at home allows me to have more time for myself, it takes away a lot of the social aspects of my life. Staying home has its perks, such as how it has allowed me to dedicate more time to self-care, learn new hobbies, and relieve me of the pressure that comes with going to school with other students and teachers. I’ve also been able to catch up on all the sleep I missed out on during the school year. I have also taken more time to read the books I didn’t get the chance to finish, and to finish learning piano pieces. Distance learning has allowed me to work on schoolwork at my own pace rather than following a specific schedule at school.

I am closer to my family as a whole as a result of being quarantined since we are spending all of our time with each other. We have been going on family walks around the neighborhood and nearby trails.

Zoe, age 16

choc-childrens-teen-advisor-zoe
Zoe, a CHOC Children’s teen adviser

COVID-19 has caused a lot of cancellations. I was planning on spending a day at Disneyland with my friends on my birthday, but Disneyland has closed until further notice. I still find time to catch up with my friends, however. FaceTime and Zoom calls have been a good pastime and a great way to keep in touch.

In terms of my emotional state, it’s been difficult to stay positive when nothing is definitive. Everything is up in the air and there’s no answer to when things will return to normal. There are a few positives, however. I have a lot more time during the day due to the fact that all schooling is online. I get to watch more movies since I can’t go outside and it’s a lot easier to relax. I get to spend more time with my sister and parents which has certainly brought us closer.

Overall the coronavirus has made it hard for everyone in at least some way, but everyone is learning new ways to adapt and thrive in uncertainty.

Christian, age 17

christian
Christian, a CHOC Children’s teen adviser

I am currently a senior in high school and all my senior activities, including prom, graduation and grad night have been canceled. Our graduation ceremony will be virtual, and the day we get to pick up our diploma I must wear a mask and gloves and I am allowed 10 minutes to clean my locker out and leave the campus. My family had to cancel an upcoming vacation that was originally planned to celebrate my graduation and my parents’ 20th wedding anniversary. All these changes made me very upset. I felt robbed because I spent my entire life working very hard to get to this moment of graduation, yet I will not receive a celebration or commencement as others have received.

I am now feeling better and I am thankful that my family and I have been healthy through this pandemic. Also, knowing that I am not the only one dealing with this has helped. I am among many students in this country not able to walk across the stage on graduation and celebrate their achievements with the people they love. I feel this pandemic has brought many students together and knowing my generation, we will come up with a way to make up for our losses.

During this time, I have mostly kept in touch with my friends through texting and social media. I have also played video games with a few of them to pass the time, which has been fun. Although in the end, talking to them through social media or a video game is just not the same as physically being able to talk to them.

Since the start of the stay at home order, I have noticed my mental health change as a result. After a while of no major human contact, except for close family, it starts to get a little lonely. I have also noticed that sometimes I get the feeling of frustration from being indoors all day. Despite these feelings, I try my best to stay occupied so that these feelings do not occur.

While most of the effects of this pandemic have been negative, I have noticed some positives. One example is that I have been able to spend more time with my immediate family. Since the start of social distancing, we have been watching more movies, playing board games together and cooking. Before this pandemic we were all so busy and hardly spent time together. Now we do a lot of activities together and I am thankful for this time with my family.

Trevor, age 16

trevor
Trevor, a CHOC Children’s teen adviser

My volleyball season and my 16th birthday party were canceled due to COVID-19. It’s a shame the season had to end. We went undefeated last year and I was looking forward to repeating our success. My mom did the best she could to still celebrate my birthday under the circumstances. We got takeout from my favorite restaurant and she even had a cake shipped here from New York City.

I’ve kept in touch with my friends through social media and group chats, but I’ve started to feel claustrophobic. My room’s four walls seem closer than usual. I play video games, do homework, browse social media, and even eat some meals in my room for a change in routine.

A good thing that has come out of this time is that I’ve gotten even closer to my mom.

Sam, age 13

Sam
Sam, a CHOC Children’s teen adviser

Some birthdays, graduation and school festivals have been canceled. I have kept in touch with friends through FaceTime, Zoom, texting and phone calls. Once I found out we could do group FaceTimes, I was so excited to be able to talk to more than one of my friends at a time and actually see all their faces at once. Zoom and Google Meet have also been super helpful for soccer team meetings and school meetings.

I have noticed that I am becoming much less social since I have not seen my friends in more than one month. Though I have been talking to my friends on the phone, it is different from being able to interact and see them in person.

During this quarantine, I have much more down time to spend with my family. Since both my parents work in the hospital and work pretty much every day, I have had a ton of time to get to know my grandpa and learn more about him since he doesn’t live with us full-time. I have also learned to be more productive and active during the day because of this extra time from no school or soccer practice. I have taken this time to really take care of myself and family.

Tips for parents of teens struggling with stay-at-home orders

Many teens are complying with stay at home orders and social distancing during the COVID-19 pandemic. However, many of us have also heard stories about teens who were seen hanging out with friends in large groups, celebrating birthday parties in person, as well as being upset with parents who are trying to implement rules to keep their families safe. For those cases where teens are struggling to understand the seriousness of the pandemic, and observe social distancing, the question is, how do we promote increased teen understanding and compliance? Read more from a CHOC mental health therapist here.

How to help your teen cope with COVID-19 cancellations

To high school seniors, schools being closed doesn’t equal a vacation – to them, this is time they won’t get back with their friends. It’s normal for teens to feel anxious during this period of their lives, as they close one chapter and begin another. However, teens may feel especially anxious as they realize they may never walk through their high school hallways again, attend prom, perform in their final theater production, compete in their final season, or celebrate graduation.

If you’re a parent or guardian of a teen who is struggling with a loss of control and trying to cope with canceled celebrations, we have tips for talking about it and coping. Read more from a CHOC psychologist here.

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Multisystem inflammatory syndrome in children (MIS-C) and COVID-19: What parents should know

While the majority of cases of COVID-19 in children result in no symptoms or mild symptoms, some hospitals have recently reported an increased  number of cases of children with a multisystemic inflammatory syndrome that shares many characteristics with Kawasaki disease, an inflammatory disease of childhood that can affect blood vessels. The Centers for Disease Control (CDC) has named this new syndrome multisystem inflammatory syndrome in children, or MIS-C.

Research on the apparent link between COVID-19 and MIS-C is limited, but scientists around the country are working to learn more about the correlation. Here, we share information parents should know about MIS-C in this Q&A with Dr. Negar Ashouri, pediatric infectious disease specialist at CHOC Children’s.

What is MIS-C?

MIS-C is a condition where different body parts – such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs – become inflamed. Many children with MIS-C have previously been diagnosed with COVID-19 or have been exposed to COVID-19.

Is MIS-C dangerous?

MIS-C can be serious, but most children have recovered MIS-C, like Kawasaki disease, can be a very uncomfortable illness because it causes prolonged fever, irritation and inflammation in many tissues of the body. The main concern with MIS-C and Kawasaki disease is heart and blood vessel involvement.

The coronary arteries are the blood vessels that provide the heart muscle with an oxygen-rich blood supply. Conditions that involve inflammation in the heart, such as MIS-C or Kawasaki disease can affect the heart in different ways. They may cause the heart muscle to be irritated and inflamed, affecting the overall function of the heart. Or, it can weaken the wall of one or more of the coronary arteries causing them to bulge or balloon out. Blood clots can form in the ballooned area and possibly block the blood flow through the coronary artery. When this happens, the heart muscle will no longer receive an adequate supply of oxygen-rich (red) blood, and the heart muscle can be damaged.

What are the symptoms of MIS-C?

Not all children will have the same symptoms. Contact your child’s pediatrician if they experience any of the below symptoms. Your pediatrician will let you know if your child needs to be seen in the office or if you need to go to the emergency department.

  • A fever that won’t go away
  • Abdominal pain, diarrhea or vomiting
  • Bloodshot eyes
  • Rash or changes in skin color

Seek emergency care if your child displays any of the following:

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain

What should I do if I think my child has MIS-C or Kawasaki disease?

The symptoms of MIS-C may look like other conditions or medical problems. Always consult your child’s health care provider for a diagnosis.

How is MIS-C diagnosed?

If your child has several of the symptoms listed above, your child’s doctor may explore a possible diagnosis of MIS-C. If your child has not had a confirmed positive case of COVID-19, your pediatrician may arrange for an antibody test, which can indicate previous exposure to COVID-19.

Your physician will start with taking a medical history and performing a physical exam. Tests may include:

How is MIS-C treated?

Kawasaki and MIS-C are best treated in the hospital by a qualified multidisciplinary group of pediatric specialists. Your child’s care team will determine the exact treatment plan, which will aim to reduce inflammation and minimize long-term damage of the heart. It may include plasma transfusions to reduce inflammation, steroids, aspirin, antibiotics or supportive oxygen.

Is MIS-C contagious?

MIS-C is not contagious.

What are the long-term effects of MIS-C?

MIS-C is a new illness and medical professionals are actively studying it to learn more,. Children who have had serious cases of MIS-C should be followed by a multidisciplinary group of specialists who will watch oversee their care.

This article was updated on May 21, 2020.

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Answers to your most common telehealth questions

During these challenging times, CHOC Children’s is offering parents peace of mind when it comes to caring for their children’s health and well-being. All medical care for kids is essential, including well visits, immunizations and access to specialty care. That’s why we’ve kept our offices open with additional safety measures in place and why we are offering telehealth appointments when appropriate, giving you access to our experts from your home.

We understand that many parents and families are new to telehealth, so we’ve prepared this guide of frequently asked questions on telehealth, to give parents peace of mind and help them prepare for their child’s first telehealth appointment.

What is telehealth?

Telehealth appointments are virtual visits with a CHOC provider via a smartphone, tablet or computer. You and your child can take these appointments from home or anywhere with internet access that you feel comfortable. During the appointment, you will see and hear your usual physician or specialist and will be able to interact, ask questions and answer your provider’s questions.

Are all appointments eligible for telehealth?

Primary and specialty care physicians can safely and appropriately deliver care for many conditions via telehealth technology. Some types of visits require an in-person appointment. Your child’s provider will determine if a telehealth appointment is ideal for you.

Is CHOC’s telehealth technology safe and secure?

CHOC uses a special version of Zoom, a video conferencing software, with additional layers of security to ensure the protection of our patients and their personal health information. Our telehealth platform has always been and continues to be safe.

What happens once my telehealth appointment is scheduled?

Once approved for a telehealth appointment, you will receive an email with instructions, troubleshooting tips and a link to access your video appointment. Follow the instructions. First, you’ll see a virtual “waiting room” that will instruct you to wait for your child’s physician to admit you into the appointment. Do not exit this screen. Once admitted, you will be able to see and hear your child’s provider, and they will be able to see and hear you. Make sure your child is with you so the provider can properly assess them.

Watch this video on what to expect during your first telehealth appointment and get tips for a successful telehealth appointment.

Who needs to be present?

Please ensure the patient is present for every telehealth appointment so your provider can properly assess them.

Which doctor will we see during my child’s telehealth appointment?

You will see your regular primary care physician or specialist.

What will we talk about during a telehealth appointment?

You and your child can speak with your provider about anything you would bring up during an in-person appointment. Discuss symptoms, your care plan and any questions or concerns you may have. If needed, your physician can share lab results and X-rays with you as they would in person. Your physician may ask you to help by taking your child’s temperature or by showing them a child’s rash, for example.

How much does a telehealth visit cost?

Telehealth visits are billed the same way as in-person appointments. You may be billed your standard co-pay for a visit. Telehealth visits feature your primary care physician or specialist, so you can expect the same high-quality care you’d receive at any CHOC appointment.

Do I have to have a telehealth appointment?

While telehealth may seem awkward or uncomfortable, your physician may prefer to see you via a telehealth visit so that he or she can see you sooner than they would be able to in person. If you prefer an in-person appointment, ask your pediatrician’s office or the Patient Access Center (PAC) when you call for an appointment to see if your provider is OK with waiting until the first available in-person appointment.

Ger more information on telehealth

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