Your Child's Safety and COVID-19: An Expert Q&A

(This is the first of two parts.)

For kids and parents, COVID-19 makes this year’s “back to school” preparations unlike any other in recent memory.

The overwhelming concern, of course, is your child’s health. As the debate to reopen school rages across the country, parents ask: Is it safe for my child to return to school?

Our pediatric health experts addressed that question and others at a virtual town hall hosted by Golisano Children’s Hospital of Southwest Florida on July 22. (In case you missed it, the hour-long event can be viewed on Golisano Children’s Hospital Facebook page.)

We revisit some of our experts’ key answers to your questions from last month’s virtual town hall, update others with the latest information available, and ask some of our own questions.

Golisano Children’s Services team members Dr. Emad Salman, medical director, and Dr. Stephanie Stovall, infection prevention medical director – recognizing that the decision-making process for sending a child to school is unique for each district, school, and family – focus on the science around COVID-19 and children.

Q: Can children catch COVID-19?

Dr. Salman: Initially we thought kids were not at risk, but we have learned a lot over the last several months. The science behind COVID-19 is always evolving. Like adults, children can get COVID-19, but they tend to do much better than adults in terms of symptom severity and recovery. Most children diagnosed with COVID-19 at Golisano Children’s Hospital go home healthy and well.

Q:  What happens to kids when they get coronavirus?

Dr. Stovall: Typically, most children develop a milder form of the disease. Severe COVID-19 is rare for children – most recover within one to two weeks. The symptoms of COVID-19 are similar in children and adults. COVID-19 can look different in different people, but for many, having COVID-19 would be a little bit like getting the flu. A child can get a fever, cough, or have a hard time taking deep breaths.

In some rare cases, COVID-19 has been associated with multisystem inflammatory syndrome in children (MIS-C), a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Most children recover with careful observation and treatment. We don’t know yet what causes MIS-C or why some children get with MIS-C and others don’t. We also do not know if children with certain health conditions are more likely to get MIS-C. Most children who were diagnosed with this condition have gotten better with medical care, though, and go home without significant symptoms.

Because MIS-C is so new, symptoms are still being documented and they may vary from child to child. The main thing to watch for is a persistent fever lasting more than 24 hours and usually present for several days, your child appearing fatigued and ill, or loss of appetite or not drinking enough fluids. Symptoms can get worse quickly, so seek timely medical attention if you see anything concerning.

Q: What are the odds that my child gets sick with COVID-19?

Dr. Stovall: We're seeing positivity rate somewhere around the 20 percent to 25 percent, depending on the safety measures you're taking to protect you and your family.

Q: How can parents protect their children from COVID-19?

Dr. Salman: It’s back to the ABCs. Wash your hands, wash your hands, wash your hands. Soap and water is good. Wash your hands for about 20 seconds. Don't forget to include your thumbs and wash up all the way to your wrists. You can also use an alcohol-based sanitizer of 60 percent alcohol. Also, clean surfaces in the house wherever somebody sneezes or touches things. Use a detergent or antiseptic.

Wear a mask and encourage physical distancing, as the Centers for Disease and Control Prevention (CDC) recommends. Children under two years of age should not wear a mask because of the risk of suffocation. But everyone else should wear a mask. We really support masking at our Lee Health facilities. Masking only works if everyone does it. Even if you don't do it for yourself, do it for others.

Q: What can parents of children who have compromised immune systems or underlying conditions like asthma do differently to protect them?

Dr. Salman: We're still learning a lot about how COVID-19 affects people who have an immune compromised system, which means they're on medication therapy or their immune system is not working as well as it should. We know this people are at higher risk. We continue to collect data, such as information from a group of 55 kids with cancer who have been diagnosed with COVID-19 in 90 institutions across the United States. The majority of them have really done well, in terms of recovery.

As far as what we should do, we should practice the same safety precautions as we do with everybody else, such as avoiding someone who is sick, practicing social distancing and especially limiting exposure for children with cancer, children who are immunocompromised or children may have an organ dysfunction, whether it's kidney failure or diabetes. Limiting exposure includes kids with asthma, too, because COVID-19 is a respiratory infection.

Q: What are the long-term consequences of a child who has been diagnosed with COVID-19?  

Dr. Stovall: At this point, we really don't know what the long-term consequences potentially are for children diagnosed with COVID-19.  The overwhelming majority of children treated in our hospital appear to have fully recovered without any long-term effects. As I mentioned earlier, there is a special subset of children who develop MIS-C who may have a greater risk for long-term effects than kids than those who get the respiratory syndrome and then recover.

Q: What are the most effective way we can protect our children in public settings like school?

Dr. Salman: Correctly consistently wearing cloth masks, rigorous cleaning and sanitizing of masks, social distancing, and frequent hand-washing strategies. The CDC recommends all of these in its recently released guidance to reopen America’s schools. They are critical to prevent transmission of the virus in settings involving children and are our greatest tools to prevent COVID-19.

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Dr. Emad Salman, a pediatric hematologist-oncologist, is the medical director at Golisano Children's Hospital of Southwest Florida.

Dr. Stephanie Stovall is the medical director of infection prevention.