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. Based on available evidence, healthy children do not appear to be at higher risk for COVID-19 related complications compared to adults, according to the CDC.

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. 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 list of how to prepare your household for a potential COVID-19 outbreak.

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.

The governor of California has mandated that face coverings be worn by the general public when outside the home. This applies to high-risk situations such as entering public spaces; obtaining medical attention; riding public transit; certain work settings; and while outdoors in public spaces when maintaining a physical distance of 6 feet from persons who are not members of your household is not feasible. Exemptions include children age 2 and younger; persons with a medical condition, mental health condition or disability that prevents them from wearing a face covering; the hearing impaired or those communicating with them; persons seated at restaurants while eating or drinking, provided they maintain physical distancing; and those engaged in outdoor work or recreation alone or with household members while maintaining physical distancing from others. Read the full order here.

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.

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?
Fluctuating numbers of COVID-19 cases have led to changes in what businesses and organizations may operate. See updated guidelines here.

When visiting entities that are open, people are encouraged to be mindful that physical distancing and wearing face coverings reduce 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 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 does 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.

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.

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).

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?
Speak to a CHOC nurse 24/7 to answer your questions about COVID-19 and your child by calling 1-844-GET-CHOC (1-844-438-2463).

Also, 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.

This article was last updated on July 14, 2020.

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What is social distancing?

To slow the spread of the 2019 novel coronavirus (COVID-19), health officials have urged the public to practice social distancing.

The Centers for Disease Control defines social distancing as avoiding mass gatherings and maintaining distance (approximately 6 feet) from others when possible. The CDC also recommends remaining out of congregate settings or crowded public places where close contact with others may occur, such as shopping centers, movie theaters or stadiums.

Tips for practicing social distancing:

  • Avoid shaking hands, hugging, high-fiving or otherwise greeting with contact. Instead, use a wave or nod.
  • Avoid non-essential travel.
  • Avoid crowds.
  • Contact your employer regarding work-from-home policies.
  • Stay home if you are sick.
  • Avoid medical facilities, long-term care facilities or nursing homes unless you have a medical reason for being there.

How does social distancing help?

COVID-19 is spread through respiratory droplets, which can be expelled from people through coughing, sneezing or talking. Once the virus lands on a surface, it can survive for some time and potentially infect anyone who touches that surface before touching his or her eyes, nose or mouth.

Temporary closures at places where people gather — such as schools, community centers and workplaces — allow for social distancing to happen. Closing these places means people cannot gather, which creates necessary space between people. The key to slowing the spread of COVID-19 is to limit social interactions as much as possible.

Do healthy people need to practice social distancing?

People are thought to be most contagious when they are showing symptoms. Many people, including children, with COVID-19 may show only mild symptoms. Some spread, however, might be possible before people show symptoms. In these cases, they can still pass this virus onto others who may be at higher risk, including older adults and people who have serious chronic medical conditions.

What can I do while practicing social distancing?

The California governor’s March 19 order instructs all California residents to stay at home, except for critical infrastructure work or essential activities like going to the grocery store, pharmacy or bank. Read the full order here.

During this time, you can help protect your family from transmission through washing hands frequently with soap and water for at least 20 seconds, and cleaning and disinfecting surfaces often. Avoid touching your face with your hands and teach your children how to properly cough and sneeze into their elbow or a tissue.

At home, surround yourself with relaxing colors, sounds and scents. You can use this time of solitude to do something you enjoy and be creative.

It’s still a good idea to exercise and get fresh air during this time. It is important though, to maintain safe distances, ideally 6 feet, while doing so. If possible, stay in a closed yard.

Here’s a CHOC psychologist’s tips for establishing structure and routine for kids during this time. And here’s a list of activity ideas for kids during COVID-19.

Maintaining social connections

People may experience anxiety related to the disruption of their normal routine caused by COVID-19 and social distancing. Continue to reach out to friends and family using methods such as the phone, video chat, email and text.

When can I stop practicing social distancing?

The governor’s March 19 stay at home order is in effect until further notice.

This article was last updated on March 25, 2020.

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20-second songs to sing while you wash your hands

How long do you have to wash your hands? At least 20 seconds each time. This equates to the time it takes to sing “Happy birthday” twice. But if you’re looking for a refresh on your hand-washing set let,  Kevin Budd, a CHOC Children’s music therapist, has compiled this list of 20-second snippets of your favorite songs, to sing while you wash your hands. (And you can get more hand-washing tips from a CHOC Children’s pediatrician here.)

Just the Way You Are – Bruno Mars
When I see your face
There’s not a thing that I would change
’cause you’re amazing
Just the way you are
And when you smile
The whole world stops and stares for a while
‘Cause you’re amazing
Just the way you are

Mr. Brightside – The Killers
Jealousy, turning saints into the sea
Swimming through sick lullabies
Choking on your alibis
But it’s just the price I pay
Destiny is calling me
Open up my eager eyes
‘Cause I’m Mr. Brightside

Love on Top – Beyoncé
Baby it’s you
You’re the one I love
You’re the one I need
You’re the only one I see
Come on baby it’s you
You’re the one that gives your all
You’re the one I can always call
When I need to make everything stop
Finally you put my love on top

Stressed Out – Twenty One Pilots
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out

Can’t Hold Us – Macklemore
Can we go back? This is the moment
Tonight is the night; we’ll fight till it’s over
So we put our hands up
Like the ceiling can’t hold us
Like the ceiling can’t hold us X2

Some Nights – fun.
Some nights, I stay up cashing in my bad luck
Some nights, I call it a draw
Some nights, I wish that my lips could build a castle
Some nights, I wish they’d just fall off
But I still wake up, I still see your ghost
Oh Lord, I’m still not sure, what I stand for oh
What do I stand for? What do I stand for?
Most nights, I don’t know anymore

Truth Hurts – Lizzo
Why men great ‘til they gotta be great
Don’t text me; tell it straight to my face
Best friend sat me down in the salon chair
Shampoo press, get you out of my hair
Fresh photos with the bomb lighting
New man on the Minnesota Vikings
Truth hurts, needed something more exciting
Bom bom bi dom bi dum bum bay

Whatever it Takes – Imagine Dragons
Whatever it takes
‘Cause I love the adrenaline in my veins
I do whatever it takes
‘Cause I love how it feels when I break the chains
Whatever it takes
You take me to the top I’m ready for
Whatever it takes
‘Cause I love the adrenaline in my veins
I do what it takes

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CHOC Foundation events postponed

We understand there are rising concerns about coronavirus (COVID-19). We want to assure you that CHOC is taking precautions to protect the health and well-being of the community. One precautionary measure we have decided to take is to postpone all Foundation events and activities through April 30, 2020.

Below is a list of events that have been postponed or cancelled.

Postponed
March 16, 2020 – Jack & Jill Tee it Up for CHOC

Canceled
March 28, 2020 – Lamp Lighter & Squires – Cheers CHOC

Postponed
March 27-28, 2020 – CHOC Follies

Postponed
April 30, 2020 – Unidos Por CHOC

This was a difficult decision, but we believe it’s in the best interest of our family of supporters and the community at large. We will miss engaging with you, our wonderful partners, and sincerely appreciate your understanding. We will reschedule our beloved events when the time is right, and we will be thrilled to see all of you then.

CHOC leadership, including our internationally recognized infectious disease team, will continue to work with health and governmental agencies to ensure we continue to deliver high-quality care to the children and families who depend on us to be there for them.

The safety of our staff and community is our utmost priority. Thank you for your understanding and your continued support of our passionate defense of childhood.

View all Foundation events here.

For all inquiries related to these events, please contact communityengagement@choc.org.

This article was last updated on March 16, 2020.

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Measles outbreaks: What parents need to know

Measles is one of the most contagious infections. It is so contagious that up to 90% of close contacts of someone with measles will also get measles if they are not immune. To prevent the spread of measles in a community, about 95% or more of the population must be vaccinated or immune to measles. This is called herd immunity.

Q: What caused the current measles outbreak?

A: Because of global outbreaks and frequent travel, measles is brought back to the U.S. and can spread in populations of under-vaccinated individuals.

Q: What are symptoms of measles?

A: Measles is highly contagious and transmitted through the air. Contagious particles can remain in the air for hours after an infected person leaves an area. Symptoms typically begin eight to 10 days after initial exposure to the virus, and then develop in stages. Early symptoms include a high fever – typically between 103 and 105 degrees Fahrenheit – cough, red watery eyes and runny nose. A rash develops around the third day of symptoms, starting on the face and continuing to spread downward over the body as the disease progresses. People are contagious for about four days before the rash begins and four days afterward, according to the U.S. Centers for Disease Control (CDC).

Q: How do you treat measles?

A: There is no specific antiviral treatment for measles. Supportive care is provided while monitoring for possible complications, such as dehydration due to diarrhea or pneumonia. The CDC reports that pneumonia is the complication most likely to cause death in young children.

Q: When can you receive the measles vaccine?

A: The MMR vaccination — which covers measles, mumps and rubella — is administered in two doses. The first does is usually given between 12-15 months and the second dose at 4-6 years of age. However, the second dose can be given as soon as 28 days after the first dose. For children traveling internationally, the vaccine is recommended as an extra dose for infants 6 to 11 months of age. To protect those who are unable to receive the vaccination, it’s vital that everyone eligible be vaccinated. Some people, including those with a weakened immune system due to disease or medical treatments, or pregnant women may not be eligible. Ask your healthcare provider for more information. Here’s some tips for making shots less stressful.

Q: Do I need an MMR booster?

A: According to the U.S. vaccination schedule, people who received two doses of the MMR vaccine as children are usually considered protected for life and don’t need a booster dose.

Q: Is the measles vaccine safe?

A: The measles vaccine is safe and readily available. Following the vaccination, some children have mild reactions, such as short-lived, low-grade fever.

Q: Can you die from measles?

A: Measles is a very dangerous disease and can lead to complications including ear infections, pneumonia, a brain infection called encephalitis, and death. Before mass vaccination in the 1980s, measles affected three to four million people per year in the U.S., and 400 to 500 died. We have a very effective and safe vaccine to prevent measles. Getting the measles vaccine is the very best way to prevent measles. All parents should be vaccinating their children at the recommended ages.

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