What to Do If Your Child Is Exposed to COVID-19

With school back in session and the holidays looming, the elephant in the room needs to be addressed: what happens if your child is exposed to someone with COVID-19?

The City of Chicago reported on Nov. 12, when Mayor Lori Lightfoot issued a Stay At Home Advisory, that the city’s positivity rate was above 14%.

If your child is exposed at school, a day care or in a gathering that includes more than immediate family, there are a few general precautions that parents can take to ensure that the spread is contained as much as possible.

Dr. Anita Chandra-Puri is a Chicago pediatrician and spokesperson for the American Academy of Pediatrics who highlights two possible scenarios for families. The first is if children are exposed to someone who had coronavirus, and the other is if kids are symptomatic themselves.

In the first scenario, the general recommendation is to quarantine for 14 days and then get tested. But testing is optional if there is not an onset of symptoms.

“Most of the time, in general with healthcare, we recommend testing or something if you know you’re going to be able to do something with the outcome of the result,” Chandra-Puri says.

In the City of Chicago, a negative test result five to nine days after exposure is not enough to be sent back to school. The full 14-day quarantine is necessary, which means that the test result will only confirm what a family’s next steps are moving forward. Testing also can determine who else in the household needs to be quarantined.

The Illinois Department of Public Health handles a positive case in the classroom by conducting an interview with the parents/guardians of the COVID-positive child to identify everyone they had contact with. (Contact is defined as 15 minutes of un-masked exposure at less than six feet.)

For children with symptoms, IDPH explains that “Probable and confirmed cases should complete 10 days of isolation from the date of first symptom onset, demonstrate improvement of symptoms and be fever-free for 24 hours without use of fever-reducing medications before they are allowed to return to school/day care.” If parents choose not to test their kids, the same rule applies.

Chandra-Puri believes that the Polymerase Chain Reaction test – or PCR test – is the best for anybody, including children, due to its accuracy. A PCR roughly translates to taking a trace amount of DNA and amplifying it so that the virus’s genetic material can be detected. The way this test is administered is with a mucus sample through the nose or throat.

“No test is 100% accurate so you have to correlate the test result with the symptoms that the child has,” Chandra-Puri says. “But the PCR test is as good of a test as we have. The rapid antigen testing that’s out there is not very accurate and has a lot of false negatives which can be a problem.

“What we’re finding just from the school year so far in Chicago is that we haven’t seen much spread in classroom settings from student to student. Most of the positives have actually been exposure from outside of the classroom setting. I think I would have to say it’s because the children in school are wearing masks and teachers are really trying to keep the social distancing rules and guidelines and there’s a lot of self assertion or screening that happens before every child comes to school.”

Testing can help eliminate curiosity and decide how a family should be quarantined. For those who are able to work from home and have groceries delivered, it might not be as urgent of a need.

But for essential workers, or those who are unable to continuously stay home, Chandra-Puri says, “You have to keep looking at the domino effect; one person gets sick and everyone surrounding that person has to be quarantined and then if one person in that bubble gets sick then the people near that group need to be quarantined so it kind of keeps going and going.”

The best advice Chandra-Puri can offer is for everyone to call their primary doctor to discuss what the best plan is for that individual child. For factors that parents might not consider, pediatricians are at the ready.

For example, age can easily determine where a child needs to be placed if they need medical care. Northwestern Hospital tests children ages 6 years and older while Lurie Children’s Hospital tests younger children and babies.

“There’s a lot of websites that tell you very specifically how to follow this through but always always always feel free to call your pediatrician because we are now very well versed in how to deal with this,” Chandra-Puri says. “Unfortunately, the numbers are rising so there’s just more and more exposure concern. So in 2019 we might’ve sent our child to school with a bit of a runny nose, but in 2020 you can’t do that. You have to figure out what it is before you send them back to being around other people because you don’t want to be spreading illness.”

The City of Chicago recommends a few ideas to protect those around you from infection when a household member is sick:

  • Keep people at higher risk separated from anyone who is sick.
  • Have only one person in the household take care of the person who is sick.
  • Provide a separate bedroom and bathroom for the person who is sick, if possible.
  • If you need to share a bedroom, separate the ill person’s bed.
  • If you need to share a bathroom, clean and disinfect the frequently touched surfaces in the bathroom after each use.
  • Maintain six feet between the person who is sick and other family or household members.
  • If you are sick, do not help prepare food. Also, eat separately from the family.

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