We thought we’d try to address circumstances and questions about kids and COVID19 that are coming up more and more as this epidemic progresses and the situations change. Please remember, there is no existing playbook for this and, though frustrating, even science sometimes doesn’t have the exact solution immediately.  We all want definitive answers, but they just may not exist at the current time.  Some fits and starts and trial and error are inevitable.  We hope these guidelines and updates help you in your decision-making going forward, but remember they’re not absolute and may inevitably change over time.

Want to learn about what we are doing at our office as the state reopens? Check out our blog on our new office protocols.

Should I send my child to daycare?

As Colorado reopens, we realize this is a very difficult decision for families—weighing the needs for childcare outside the home vs health risks. If you can feasibly keep your children home, that is still the least risk for potential infection. We feel it is reasonable to have your children return to daycare if it is limiting class size to less than 10, has safety protocols and precautions for limiting class mingling, handwashing, screening for fevers/illness, and keeping parents out of the building. 

It continues to appear that children are less likely to get severe illness compared to adults, and maybe even get fewer infections with SARS CoV-2 overall.  

So, the biggest risk is that they bring an infection home to their family.  Who lives in your house (grandparents, parents or siblings with underlying health conditions) may play a big part in your decision making.  

Most of all, if you decide to send your child back to daycare, please be a good citizen and keep your child home if they are sick with fevers, cough, sore throats or vomiting/diarrhea.  You should also keep them home if you are sick with any of these symptoms.  This is the best protection for our daycares and children against larger outbreaks.

Should my child participate in socializing/youth sports, camps and activities?

We recognize these are some of the things everyone is missing the most and will be one of the harder decisions as we reopen. Our best advice is to keep any social gatherings to less than 10 people and continue to maintain as much distancing as possible, as well as using masks when warranted.  

As for sports and camps…certain sports—those that don’t involve close physical contact — will be easier to restart than others. Each youth sports organization will likely be establishing guidelines unique to their sports—for instance baseball will look very different than swimming, than soccer, etc. Sports may involve smaller teams or practices, little or no travel, fewer if any spectators and attempts to distance within whatever parameters are established.  

Letting your child play in a sport will be a very individualized decision based on the potential risk of the sport, and your own risk tolerance for your child and family. Keep up to date on any CDC, state or youth organization updates. 

Camps will probably have to be approached similarly to daycare with attention paid to limiting participants and co-mingling of groups at a camp, as well as screening and health safety precautions put in place. Outdoor day camps would likely be much less risk than an indoor camp or sleep-away camp.  

Similarly, gyms should be limiting usage at any one time, staggering equipment use and have good cleaning protocols.  

Remember that any guidelines or recommendations will potentially change as reopening progresses.  As frustrating as this can be for all of us, it is unavoidable in such a new, unique situation.

I’m worried about my kid’s mental health. What can I do?

These unprecedented times and social changes can lead to increased anxiety or depression symptoms.  During the COVID19 outbreak, kids and parents are dealing with many different stresses—single or two parenting kids at home while trying to work, losing jobs, concerns regarding food insecurity or losing shelter if can’t pay rent or mortgage, teenagers missing out on milestones such as proms or graduations, social isolation and lacking normal outlets and supports.  

Pay attention to cues that might be concerning, and don’t hesitate to call us for advice, a telehealth consult, or to arrange therapy through our JCMH providers.

What kinds of COVID19 testing are available for kids?

Serology testing, or antibody testing, is a way to try to determine if a person has had an infection in the past.  This is different than the tests that have been most prevalent so far—the nasopharyngeal swab tests that check for current infection with SARS CoV-2.  

There is a lot of talk about serology testing for SARS CoV-2 being used, or even being necessary, for safe reopening.  However, at this time, there are many tests being made available that are too unreliable to give good information.  Many of them have lots of crossover with other coronaviruses that cause the common cold that all of us may have had.  So, at the moment, we wouldn’t recommend routine serology testing.  At this point, a positive result may only be a 50/50 chance of being a true positive (meaning you have had the infection) compared to a false positive (meaning test error).  There is no way to make reliable decisions based on those odds.  Furthermore, it is unclear if having positive antibodies is even protective against getting infected again.  We will continue to monitor the evolution of serology testing.  

However, PCR testing by nasal swabs will continue to be important in finding infected patients and then being able to isolate them quickly.  While we haven’t had the means to do much testing out of our office, the state is steadily increasing its testing capabilities and we are getting close to the point where we can arrange testing for any symptomatic child.  Currently most of that is done through Children’s Hospital, but we hope to be able to do more tests out of our clinics in the future.

Is my child at risk of contracting MIS-C (Multisystem Inflammatory Syndrome in Children)?

There are increasing reports (and tremendous media attention) to a multisystem inflammatory illness in children that seems to be COVID-19 related, though potentially a delayed immune system response occurring beyond the time period of initial symptoms.  First, it is extremely rare.  The cases seem to generally start about 1 month after an area’s peak in COVID infections.  It involves very high fevers and potentially other signs or symptoms such as  abdominal pain, vomiting and diarrhea, and less commonly rashes, problems breathing or red eyes.  Remember, that these are extremely ill kids so if your child has mild vomiting and diarrhea or a rash but isn’t having fevers over 101 or isn’t terribly sick appearing, it is far more likely to be another cause.  

It has been compared to an illness called Kawasaki Disease, but unlike KD, which is more common in toddlers, it seems to happen more often in  older children.  The first cases in Colorado have just been reported as of May 20, but continue to think about this with the perspective that it is a very rare complication of COVID illness.  

Call us if you have questions or concerns, but, again, remember that this syndrome is extremely rare.  Most children will have mild symptoms and illness if they get COVID-19.

What are some simple steps I can take to protect my kids from COVID19?

As we reopen, keep washing your hands, wearing masks in public and avoiding large gatherings to minimize risk to you, your children and our communities.  

Follow state and local public health guidelines and keep yourself informed of updates through the CDC and state health department. 

If you or your child is ill, avoid contact with other people during that time period.  

Call us if you have questions, think your child needs to be seen or if testing may be warranted.  We will continue to try to provide reassurance through these uncertain times.