Coronavirus and Attending School - A Medical viewpoint

Evidence to date shows that:

  • Children are less likely to get severely ill with COVID-19.
  • Caution needs to be exercised in a small group at very high risk e.g. post-transplant.
  • Approximately 70% of child cases have fever OR cough OR shortness of breath.
  • However, many positive cases are asymptomatic.
  • Children are not particularly significant vectors of the virus.
  • Children are less likely to be the index case in a household (an index case is the first identified case).
  • Children who test positive contract the virus from an adult in the vast majority of cases.
  • Child to child transmission remains very low.
  • Teenagers (aged 13 and above) are more like adults in terms of transmission.
  • Children who are very unwell probably have a different diagnosis and not COVID-19.
  • Children with a runny nose but who are not systemically unwell and without sick household contacts are unlikely to have COVID-19.
  • Children under 3 months with a fever need immediate referral to hospital (high risk of sepsis).

PRACTICALITIES:

If your child falls into any of the categories below, isolate your child and phone your GP immediately:

  • Fever (greater than or equal to 38.0°C) OR
  • A new cough, shortness of breath or deterioration in an existing respiratory condition OR
  • Symptoms of anosmia (loss of sense of smell), ageusia (loss of sense of taste) or dysgeusia (distortion of sense of taste) OR
  • Minor respiratory symptoms in a child who has other ill contacts, is part of an outbreak or is a contact of a proven case OR
  • Has been in close contact with someone who has tested positive for coronavirus or has been living with someone who is unwell and may have coronavirus.



If a GP is referring a child for a test, then everyone that the child lives with should also restrict their movements, at least until the child gets a diagnosis from their GP or a COVID test result. This means not going to school, childcare or work. It does not however affect the children in the child’s pod or bubble class in school or creche as per current guidelines.


If a child tests positive, then there are implications for the pod and potentially the bubble class the child was part of in school or creche.

The Public Health team will be in contact with any parents whose child has been identified as a close contact of a positive case.


Negative (not-detected) test result or another diagnosis: Your child can return to their normal activities once they have been given either a negative (not-detected) test result and are 48 hours without symptoms and, or another diagnosis, that is not coronavirus. You and anyone your child lives with will no longer need to restrict your movements.

Positive test result or not tested and no alternative diagnosis: Your child will need to remain in self-isolation until both of these apply: they have not had a high temperature (38 degrees Celsius or over) for 5 days AND it has been 14 days since they first developed symptoms.

Children with a blocked or runny nose but no fever can attend school or childcare BUT if they need paracetamol or ibuprofen for their symptoms, they must not attend for 48 hours and testing may be indicated.

Diarrhoea, vomiting or abdominal pain: These symptoms are unlikely to be the sole symptom of COVID-19.

Children with a chronic cough who are not systemically unwell do not usually require testing unless the cough deteriorates, or they become unwell.

Paediatricians strongly advise that medically vulnerable children should not be deprived of their education and any concerns should be discussed with their specialist team.

This is understandably a very worrying time for parents and children. The medical experts have put a lot of time and effort into ensuring that we have guidelines to follow when children get ill.

We will all have to try to adapt to the ‘new normal’ as best we can. We must learn to live alongside this virus for the foreseeable future and all do our best to keep transmission as low as possible.

Please do not forget basic public health advice – self-isolation when unwell and phoning your GP, washing our hands and physical distancing.

With thanks to the Author: Dr Fiona Kelly, Bank Clinic, Castletownbere 

 

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