Patient education: COVID-19 & children

Can children get COVID-19?

Yes. Children of any age can get COVID-19. They are less likely than adults to get seriously ill, but it can still happen. Since the “Delta” and “Omicron” variants of the virus formed, more children have needed to be hospitalized with COVID-19. These numbers are highest in areas where vaccination rates are low. Vaccination of adults and older children helps protect children who are too young to be vaccinated.

Children can also spread the virus to other people. This can be dangerous, especially for people who are older or who have other health problems.

Are COVID-19 symptoms different in children than adults?

Not really. In adults, common symptoms include fever and cough. In more severe cases, people can develop pneumonia and have trouble breathing. Children with COVID-19 can have these symptoms, too, but are less likely to get very sick. Some children do not have any symptoms at all.

Other symptoms can also happen in children and adults. These might include feeling very tired, shaking chills, headache, muscle aches, sore throat, a runny or stuffy nose, diarrhea, or vomiting. Babies with COVID-19 might have trouble feeding. There have also been some reports of rashes or other skin symptoms. For example, some people with COVID-19 get reddish-purple spots on their fingers or toes. But it’s not clear why or how often this happens.

Serious symptoms might be more common in children who have certain health problems. These include serious genetic or neurologic disorders, congenital (since birth) heart disease, sickle cell disease, obesity, diabetes, chronic kidney disease, asthma and other lung diseases, or a weak immune system.

Can COVID-19 lead to other problems in children?

This is not common, but it can happen. There have been rare reports of children with COVID-19 developing inflammation throughout the body. This can lead to organ damage if it is not treated quickly. Experts have used different names for this condition, including “multisystem inflammatory syndrome in children” and “pediatric multisystem inflammatory syndrome.” The symptoms can appear similar to another condition called “Kawasaki disease.” They include:

●Fever that lasts longer than 24 hours

●Belly pain, vomiting, or diarrhea

●Rash

●Bloodshot eyes

●Headache

●Being extra tired or acting confused or irritable

●Trouble breathing

Call your child’s doctor or nurse right away if your child has any of these symptoms.

What should I do if my child has symptoms?

If your child has a fever, cough, or other symptoms of COVID-19, call their doctor or nurse. They can tell you what to do and whether your child needs to be seen in person.

If you are taking care of your child at home, the doctor or nurse will tell you what symptoms to watch for. Some children with COVID-19 suddenly get worse after being sick for about a week. The doctor or nurse can tell you when to call the office and when to call for emergency help. For example, you should get emergency help right away if your child:

●Has trouble breathing

●Has pain or pressure in their chest

●Has blue lips or face

●Has severe belly pain

●Acts confused or not like themselves

●Cannot wake up or stay awake

If you have a baby and they are having trouble feeding normally, you should also call the doctor or nurse for advice.

Is there a test for the virus that causes COVID-19?

Yes. If a doctor or nurse suspects your child has COVID-19, they might take a swab from inside their nose or mouth for testing. These tests can help the doctor figure out if your child has COVID-19 or another illness.

For more information of getting tested for COVID-19 see information [Link].

What should I do if my child was exposed to someone with COVID-19?

As the number of people with COVID-19 increases, NSW Health is focusing on contacting people at highest risk of catching/contracting COVID-19. You or your child may not receive a text message or call from NSW Health after being exposed to a person with COVID-19.

We ask people with COVID-19 to tell the people they have spent time with from the 2 days before they started having symptoms or 2 days before they tested positive (whichever came first) that they have COVID-19.

If you are told by someone that you have been in contact with a person with COVID-19, use this advice to understand your risk and what you can do to protect yourself, your family and your community. For more information see [Link].

When should I get tested?

If you or your child have any symptoms listed above or concerned that you have been in contact with a COVID-19 then get tested. The Australian Government has developed guidelines and protocols for PCR/RAT testing particularly if there has been a close contact or one has tested positive with COVID-19. Please follow the guidelines below – see [Link].

How is COVID-19 in children treated?

There is no known specific treatment for COVID-19. Most healthy children who get infected are able to recover at home, and usually get better within a week or 2.

It’s important to keep your child home, and away from other people, until your doctor or nurse says it’s safe for them to go back to their normal activities. This decision will depend on how long it has been since the child had symptoms, and in some cases, whether they have had a negative test (showing that the virus is no longer in their body).

Most children who test positive for COVID-19 can be safely cared for at home by their usual household carers, even if they are not vaccinated. When caring for your child with COVID-19 at home:

  • Dress your child in appropriate clothing, so that they are comfortable – not sweating or shivering.
  • Give your child plenty of fluids to drink. They may not feel like drinking much so will need your helpand encouragement.
  • Encourage them to rest and not overdo it.
  • Use paracetamol or ibuprofen, only if you think your child is in pain or appears uncomfortable with afever. Follow the instructions on the label, and do not give more of these medicines than isrecommended in a 24-hour period, as this may be harmful for children.
  • Watch your child for signs that their illness is getting worse.

Monitor your child’s condition and call your GP or NSW Health COVID-19 Care at Home Support Line on 1800 960 933 (8:30am to 8:30pm) or the National Coronavirus Helpline on 1800 020 080 (24/7) if you notice:

  • persistent fever (>39°C) which is not responding to treatment
  • mild breathlessness
  • drinking less than half of what they would normally drink
  • urine output less than half of usual volume, and urine dark in colour
  • moderate vomiting or diarrhoea
  • unable to stand or walk.

If you are concerned that your child is seriously unwell, has difficulty breathing, is severely dehydrated or fainting, please call Triple Zero (000) immediately and inform the operator that your child has COVID-19. For further information [LINK].

How can I prevent my child from getting or spreading COVID-19?

Getting your child vaccinated is the best way to protect them. Experts also recommend that children 12 and older should get vaccinated.

Experts are studying vaccines for children under 5, and these will eventually also be available.

People who are fully vaccinated have a much lower risk of getting sick from the virus. The best way to protect babies and very young children is for as many older people as possible to get vaccinated, including siblings, parents, and caregivers.

In addition to vaccines, there are other things people can do to reduce their chances of getting COVID-19. These things will also help slow the spread of infection.

If your child is old enough, you can teach them to:

Wear a face mask in public. Experts in many countries recommend this for everyone, including children 2 years and older. This is mostly so that if your child is sick, even if they don’t have any symptoms, they are less likely to spread the infection to other people. It might also help protect your child from others who could be sick. Make sure the mask fits snugly against your child’s face and covers their mouth and nose.

You can buy cloth masks and disposable masks in stores or online. You can also make your own cloth masks. Cloth masks work best if they have several layers of fabric.

Practice “social distancing.” This means staying at least 6 feet (about 2 meters) away from other people. In places where the virus is still spreading quickly, keeping people apart can help slow the spread.

When your child goes out or plays with friends, keep in mind that the virus can spread both indoors and outdoors. But being outdoors is less risky. Also, the more people your child comes into contact with, the higher the risk of spreading the virus.

Wash their hands with soap and water often. This is especially important after being out in public. Make sure to rub the hands with soap for at least 20 seconds, cleaning the wrists, fingernails, and in between the fingers. Then rinse the hands and dry them with a paper towel that can be thrown away. Hand washing also helps protect your child from other illnesses, like the flu or the common cold.

Washing with soap and water is best. But if your child is not near a sink, they can use a hand sanitizing gel to clean their hands. The gels with at least 60 percent alcohol work the best. It’s important to keep sanitizer out of young children’s reach, since the alcohol can be harmful if swallowed. If your child is younger than 6 years old, help them when they use sanitizer.

Avoid touching their face with their hands, especially their mouth, nose, or eyes.

Younger children might need help or reminders to do these things.

If you work in health care, or have another job that puts you at risk for COVID-19, take care to follow your workplace’s recommendations for prevention. These likely include measures like wearing protective gear and washing your hands before and after certain tasks. When you get home from work, consider changing out of your work clothes and shoes before you see your children. If a child in your home is at increased risk for severe disease, you might also choose to stay 6 feet (2 meters) apart and wear masks at home. Depending on the climate, you might also open windows or doors and use fans to keep air circulating.

Is my child safe at school or day care?

Decisions around how to run schools and day cares are complicated. Experts understand the importance of having in-person learning, activities, and childcare. But they also have to think about the risks to children, as well as teachers and other adults who work in these places.

In general, schools and other programs can run when there is a plan in place to keep everyone safe. This includes guidelines around:

●Vaccines – The more people who are vaccinated, the harder it is for the virus to spread. Some schools have policies to require staff to be vaccinated. Children 5 years and older should also get vaccinated to protect themselves as well as younger children who can’t yet get a vaccine.

●Masks – Having all staff and children wear masks lowers the risk of spreading the virus.

●Cleaning and air quality – Staff should make sure everyone washes their hands frequently and that common areas are cleaned regularly. It’s also important to make sure there is good ventilation (air flow) throughout the building.

●Distance – Classrooms and activity areas should be set up in a way that allows for distance between people. Some expert groups say 3 feet between people is enough if everyone is wearing masks and following other safety guidelines. Keeping people in the same groups, or “cohorts,” also helps lower the risk of spread. Having activities outdoors whenever possible is also a good idea.

●Illness or exposure – Schools, day cares, and other programs should have clear rules around students and staff members staying home if they feel sick. There should also be a specific plan for what to do if someone tests positive or was exposed to the virus that causes COVID-19.

The exact plan for each program depends on many different things. These include the size of the building and what kind of ventilation it has, the age of the children attending, and how many cases of COVID-19 there are in the community.

What if someone in our home is sick?

If someone in your home has COVID-19, they should stay in a separate room if possible. They should also wear a face mask if they need to be around other people at all. Everyone in the house should wash their hands often and clean surfaces that are touched a lot.

If you are sick and you have a baby, it’s important to be extra careful when feeding or holding them. Even though experts do not know if the virus can be spread through breast milk, it is possible to pass it to your baby or other children through close contact. You can protect your baby by washing your hands often and wearing a face mask while you feed them. If possible, you might want to have another healthy adult feed your baby instead.

How can I help my child cope with stress and anxiety?

It is normal to feel anxious or worried about COVID-19. It’s also normal for children to feel stressed if they can’t do all of their normal activities.

You can help children by:

●Talking to them simply about COVID-19 and what they can to do protect themselves and others

●Getting vaccinated, and getting your child vaccinated as soon as they are able

●Making or buying them a face mask that is comfortable, and encouraging them to practice wearing it

●Limiting what they see on the news or internet

●Finding activities you can do together

●Finding safe ways to spend time with friends and relatives

●Taking care of yourself, including eating healthy foods and getting regular exercise

Where can I go to learn more?

As we learn more about this virus, expert recommendations will continue to change. Check with your doctor or public health official to get the most updated information about how to protect yourself and your family.

For more information from the NSW Department of Health please see [Link].

COVID-19 patient education topics: