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COVID-19: Symptoms in Kids, Returning to School, Doctor’s Visits and Play Dates

Posted on Jun 08, 2020

As things start to reopen in the Tampa Bay area, there will be scrutiny on the number of COVID-19 (coronavirus) cases and the changes in precautions families may need to take. On this week’s On Call for All KidsJuan Dumois, M.D., a pediatric infectious diseases physician at Johns Hopkins All Children's Hospital, gives an update on the current status of the COVID-19 pandemic in the Tampa Bay area, and top questions being asked by parents.

Is it true that only the elderly and people with underlying medical conditions are being affected by COVID-19?

Although the majority of the cases do occur in people who fall into those categories, there have been many reports of healthy younger people affected by the virus and some dying unexpectedly of this disease. It’s important to note, though, that most children who are sick with the coronavirus have fewer symptoms and are less sick than adults. Symptoms in children can include: 

  • Fever
  • ​Cough 
  • Shortness of breath 
  • Muscle aches 
  • Sore throat 
  • Unexplained loss of taste or smell 
  • Headache 
  • Diarrhea 

What do we need to know about this new pediatric multisystem inflammatory syndrome in children? 

Pediatric multisystem inflammatory syndrome (PIMS), also called multisystem inflammatory syndrome in children (MIS-C) causes symptoms that resemble Kawasaki disease and toxic shock syndrome. While the condition is rare and treatable, it can be dangerous. The condition has typically affected children age 2-15 and can include a fever lasting more than 24 hours with the following symptoms: 

  • Unusual weakness or fatigue 
  • ​A red rash 
  • Abdominal (belly) pain 
  • Vomiting and diarrhea 
  • Red, cracked lips 
  • Red eyes 
  • Swollen hands or feet 

Children with MIS-C could often have heart problems such as heart failure, when the heart muscle is weaker than normal and has trouble effectively pumping blood to the rest of the body. Doctors at Johns Hopkins All Children’s Hospital know how to recognize this condition and treat it. 

Is it now OK for children to go play with their friends? 

The pandemic has not ended, so any activities that involve close contact with other persons outside your family entail a risk of getting infected. Although most children are not getting as sick as adults with COVID-19, they can bring it home to the adults in the household who may be more likely to be hospitalized for it. With that said, it is still a good idea to have children minimize contact with other kids and conduct social distancing outside the home. If they will be around any other people, they should wear a mask. This is even more important in situations where social distancing isn’t possible. 

When should parents think about taking their sick child to the doctor? 

If your child develops a fever with a rash, has any of the symptoms mentioned above or looks ill, he or she should be seen by a doctor. Pay attention to signs in little ones if they are irritable, clingy, have a decreased appetite, or are just not responding normally. Many pediatric facilities like Johns Hopkins All Children’s Hospital have developed protocols to ensure safety if you need to bring your sick child to be seen by a doctor. So don't avoid taking your child to the clinic or Emergency Center for fear of exposing him or her to COVID-19. 

Is the pandemic ending soon and will our children be able to go to school in the fall? 

The pandemic will probably continue into next year for a couple of reasons. The first reason is that this coronavirus is so contagious that it is not going away anytime soon. Secondly, Johns Hopkins Medicine reports that less than five percent of most Americans, outside the New York City area, have immunity to it – this is based on several recent studies. Therefore, returning children to classrooms as things were before the pandemic could be very risky. Many school officials are meeting with health department officials, infectious disease specialists, emergency management experts and government officials to come up with contingency plans for how to restart education. The plans for specific schools, intended to keep students and staff safe, will depend upon each school’s resources, recommendations from the health department, and the status of the pandemic in the weeks preceding the start date. 

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit each Monday for the latest report.  

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