Understanding COVID, Your Children, and School/Childcare Return

Everyone wants to know when to worry about COVID — if they might have it, when they should call their doctor, if they could spread it, where they might get it. Here is a breakdown of the current Maine American Academy of Pediatrics, and updated CDC guidelines. This was last updated on December 11, 2020 (third iteration).

Who is least at risk of complications from COVID?

Children! In general, children are the least likely to get sick and/or show symptoms from COVID. This does NOT mean that they can not get extremely sick and/or die from COVID — but it is much less common. Children, however, can spread the disease to their loved ones.

How and when does the Medical community assess for COVID in children?

If you call your doctor’s office, they will screen your child for COVID-like symptoms.

Currently, symptoms are put into two categories — low risk and high risk:

*Low Risk Symptoms: new headache, body aches, runny nose/congestion, nausea/vomiting/diarrhea

High Risk Symptoms: New, uncontrolled cough, shortness of breath/difficulty breathing, new loss of taste or smell, fever (100.4 or higher) and chills, and/or sore throat

* Two low risk symptoms = one high risk symptom

If your child has one low risk symptom that is improving within 24 hours, it is ok to return to school/childcare 24 hours after symptom improves. If symptoms is not improving within 24 hours, then the risk category is raised to high risk and you should call their doctor.

You DO NOT need to call your doctor for a single low risk symptom.

You DO NEED to call the doctor for a high risk symptom, two low risk symptoms, or one low risk symptom that is not improving.

Your child will then either be tested for COVID and/or be seen by a medical provider. While awaiting test results, your child should stay in quarantine.

Here’s where it gets confusing (if you weren’t already confused). There are two types of tests, most easily understood as a Rapid test and a PCR test. The Rapid test is also known as an antigen test. The test is quick, convenient, but not always accurate. If the test is negative, your child will still need to get a PCR test. The PCR test takes several hours (often overnight) to get results and is currently our best tool in testing for COVID.

Many schools now have the option of doing the Rapid test. If the rapid test is negative, and there is no clinical suspicion for COVID and no COVID contacts, then you should follow up with your child’s doctor, who will then determine the need for further testing.

If the COVID PCR test is negative, and if your doctor doesn’t think you have COVID, your child may return to school/chlldcare 24 hours after any fevers end, and symptoms are improving.

If any COVID test is positive, then your child will need to be quarantined for 10 days AND 24 hours after fevers end AND symptoms are improving and the MAINE CDC gives its approval.

What if my child has been exposed to COVID?

An exposure to COVID is defined as greater than 15 minutes spent less than six feet apart from someone with COVID.

If there is a known exposure to COVID, your child will need to stay in quarantine for 10 days, or 7 days with a negative test.

A PCR test is recommended five to seven days after exposure. However, even if the PCR test is negative, your child will have to remain in quarantine.

When to worry if your child has COVID?

Call the doctor, or go to the Emergency Room if your child is short of breath, or struggling to breathe! If your child has a fever that lasts five or more days, call your doctor. If your child is not drinking and urinating over the course of the day, call your doctor. It is always ok to call your doctor just to touch base. When possible, someone from the Maine CDC will be reaching out to you to check in every few days.

Most children with COVID do absolutely fine! The hardest part might be keeping everyone busy and out of trouble during quarantine.

Here is a link to testing sites in Maine: https://www.maine.gov/covid19/restartingmaine/keepmainehealthy/testing

And here’s my plug! One of the most wonderful things about Personalized Pediatrics of Maine is that if you call, I will be the doctor who answers the phone! There won’t be any time spent on hold, or talking to people who do not know your child! I will be able to help guide your child and family through these COVID times. Personalized Pediatrics of Maine strives to be the best Pediatric office in the state of Maine!