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 Centers for Disease Control 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. The CDC has identified muscles aches and loss or taste or smell as additional possible symptoms. For an updated list of possible symptoms as reported by the CDC, click here.

Symptoms typically appear two to 14 days after exposure.

According to the CDC, 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:

  • The CDC recommends the use of cloth face coverings in public for those over age 2
  • 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 listof 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, and for using public transportation.

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 be mindful that physical distancing reduces the likelihood of transmission of COVID-19.

In addition to practicing proper handwashing, people should watch for symptoms and avoid going out if they feel ill. When outside the home, people should physically distance from others whenever possible, and are strongly encouraged to wear a face covering.

How can my family stay safe when venturing out?

If you have COVID-19 symptoms or have been exposed to someone with COVID-19, stay home and away from other people. If you choose to leave home, be mindful that the more closely you interact with others and the longer the interaction, the higher the risk of COVID-19 spread.

Before leaving home, the CDC recommends people think about:

  • How many people will you interact with?
    • Being in a group with who people who are not practicing physical distancing or wearing face coverings increases your risk, as done engaging with people who don’t live with you.
  • Can you keep 6 feet of space between yourself and others? Will you be outdoors or indoors?
    • The closer you are to other people who may be infected, increases your risk of getting sick.
    • Indoor spaces are more risky than outdoor spaces where it might be harder to keep people apart and there’s less ventilation.
  • What’s the length of time you will be interacting with people?
    • The more time you spend with others, the higher your risk of becoming infected, as well as their risk of being infected if there’s any chance you have COVID-19.

Before leaving home, consider the following questions to help determine your level of risk:

  • Is COVID-19 spreading in my community? The CDC’s latest COVID-19 information and map of states with reported COVID-19 infections can help you determine your risk.
  • What are the local orders in my community? Check updates from the OC Health Care Agency.
  • Will my activity put me in close contact with others? Practice physical distancing from anyone who doesn’t live in your home by staying 6 feet apart whenever possible. The CDC recommends wearing cloth face coverings in public. Choose outdoor activities and places where it’s easy to physically distance, like parks.
  • Am I, or is someone in my home, at risk for severe illness? If so, take extra precautions. Older adults and anyone with underlying health conditions can be at increased risk for severe illness from COVID-19.
  • Do I practice everyday preventive actions? Continue to monitor for symptoms, staying home if you’re sick, practice proper handwashing and physical distancing, and wear a face covering in public.
  • Will I have to share items or equipment with others? Choose places where there is limited sharing of items and where any shared items are cleaned and disinfected between use.

See the CDC’s full guidance of venturing out safely.

Should my children and I wear masks?
The CDC recommends cloth face coverings in public settings in places like grocery stores and pharmacies where physical 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. It is not necessary for children under the age of 2 to wear cloth face coverings.

In a June 11 order, Orange County health officials strongly recommended the use of face coverings in public when people are unable to maintain six feet of physical distance from other people.

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.

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 June 16, 2020.

Get more information on Coronavirus (COVID-19)

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7 ways to help kids cope with coronavirus (COVID-19) anxiety

If the ongoing spread of coronavirus (COVID-19) is causing anxiety, stress and uncertainty for grownups, consider how troubling it may be for children.

Depending on their age and media exposure, children may know more about the virus than grownups think. And even if unaware, children still might sense tension and anxiety from adults around them.

Here, CHOC Children’s pediatric psychologist Dr. Sabrina Stutz offers seven things parents can do to help reduce their children’s anxiety about COVID-19.

Meet children’s concerns with validation, compassion

  • Listen carefully to their concerns and learn where they heard their information. Validate their fears by saying something like, “It can be frightening when a new illness comes around that we don’t know everything about.”
  • Gently correct any misconceptions they may have heard and encourage them to continue to ask questions.
  • Maintaining a routine can provide children a sense of security. Keeping a usual schedule – including school, activities and chores – will protect mental and physical health.

Stick to developmentally appropriate facts

  • ​Avoid having adult-level conversations about COVID-19 around children. Similarly, carefully monitor children’s exposure to media reports about the virus.
  • Answer questions with brief, developmentally appropriate explanations. For example, you might tell a young child, “coronavirus is a new type of cold/flu, and so it is important for us to wash our hands more and sneeze in our elbows to keep healthy.”
  • Remind children that doctors and other experts around the world are working hard to stop the virus. This can help kids understand that smart, capable people are taking action.

Reassure kids by empowering them

  • Telling kids how they can help provides a sense of agency and can turn anxiety into an actionable goal.
  • Reassure children that they can protect themselves and others by practicing proper hand-washing and cough etiquette and taking other healthy steps.
  • Kids can also be included in other family-wide preparations. For example, if you were preparing for the possibility of being home for a while, ask the child what they might want to snack on or what activities they might enjoy during that time.

Look for kid-friendly methods

  • Make learning about hand-washing and other preventative measures fun. Help kids learn about germs by giving them some lotion and then sprinkling glitter on their hands. Tell them the glitter is like germs, and then ask the child to try to wipe it off with a paper towel or just water. They won’t get far! Then you can explain how soap and warm water removes the glitter – and germs – best.
  • Teach kids how long to wash hands for by singing a 20- to 30-second song together. “Happy Birthday” or the “ABCs” are classics. You can also be creative and estimate 20-to-30 seconds of any song the child likes.

Emphasize kindness

  • As always, it is helpful to teach kids to continue to be kind to all people, regardless of their country of origin or their appearance. Kindness is always possible – even when they feel afraid.
  • To help children more realistically assess risk, educate children that most people who visit the doctor or wear a mask probably don’t have the virus.
  • It is important to remind children that we are all trying our best to stay healthy and it’s not anyone’s fault if they do get sick.

Remember to model positive behavior

  • Parents who show good coping skills can help reassure kids that they are safe. After all, kids learn from their parents how to react in new situations.
  • Remember that kids make mistakes. If your child accidentally does not wash their hands or doesn’t sneeze into their elbow, gently remind them. Scaring children with the potential consequences of their mistakes is not helpful.
  • Adults should model self-care behaviors: Maintain activities and sleep schedules. Eat healthfully and practice hand hygiene and cough etiquette.
  • It’s also helpful for grownups to limit their own media consumption around coronavirus (COVID-19) and stick to a few trusted resources such as the Centers for Disease Control to prevent information overload and anxiety.

Watch for behavior changes

  • Changes in a child’s sleep, appetite, interest in being with friends or leaving the house, or levels of reassurance seeking, as well as excessive hand-washing can be signs that more help is needed.
  • If basic stress reduction techniques like deep breathing, distraction or guided imagery don’t help, reach out to your primary care provider for additional support.
Get more information on Coronavirus (COVID-19)

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Hand-washing 101

When kids and adults alike come into contact with germs, they can become infected just by touching their eyes, nose or mouth. Proper hand-washing is the best way to stop germs from spreading.

Don’t underestimate the power of hand-washing, says Dr. Reshmi Basu, a CHOC Children’s pediatrician.

pediatrician
Dr. Reshmi Basu, a CHOC Children’s pediatrician

“Besides getting an influenza vaccine, washing your hands is the single best way to protect yourself against illness, including the seasonal flu,” said Dr. Basu. “Hand-washing is much more effective in preventing the spread of infection than wearing a mask.”

In general, wearing masks in public does not prevent people from getting sick, according to the Journal of the American Medical Association. Masks may only be useful if you live with someone who is infected, and the mask use is started immediately after the person has become infected.

Improper hand-washing can also lead to food contamination and foodborne illnesses. But when, how long, and with what should we wash our hands? Dr. Basu offers tips for parents:

Hand wash rules

  • Use warm water and soap for best hand hygiene
  • Scrub vigorously, and remember the backs of hands, between the fingers, under the nails and the wrists.
  • Wash your hands for at least 20 seconds — or the time it takes to sing “Happy birthday” twice
  • Rinse and dry with a clean towel

When to wash your hands

It’s important to wash your hands frequently throughout the day. However, a few times it’s especially needed:

  • Before and after cooking or eating
  • After using the restroom
  • After cleaning around the house
  • After touching animals, including family pets
  • Before and after visiting or caring for sick friends or relatives
  • After blowing your nose, coughing or sneezing
  • After changing a diaper
  • After being outside — playing, gardening, walking the dog, etc.

What kind of hand soap is best?

Using a moisturizing hand soap is best during winter months, when more frequent hand-washing is necessary, Dr. Basu says. To avoid further drying out the skin, choose a soap labeled “moisturizing” or “conditioning,” she adds.

Are hand sanitizers OK?

The Centers for Disease Control recommends washing hands with soap and whatever whenever possible because hand-washing reduces the amounts of all types of germs and chemicals on hands.

But if you’re on the go, and soap and water aren’t available, use a hand sanitizer with at least 60% alcohol that will kill at least 99% of germs.

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