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COVID-19

 

COVID-19 Advice Page – Updated 12/6/2022

 

We know there are many questions about COVID-19 as this pandemic continues to evolve. Below are a list of helpful resources and some general information regarding treatment, isolation, quarantine, and testing. The websites below will have answers to most of your questions regarding COVID-19. We encourage you to familiarize yourselves with these sites as they are a helpful resource now and as future questions arise:

Testing

PCR tests remain the gold standard for detection, but at-home antigen tests are now widely available and a great tool for early identification of COVID-19.

  • Rapid antigen tests:
    • If your at-home rapid antigen test is positive, your child has COVID. A confirmatory PCR is NOT necessary.
    • If your antigen test is negative but you have been exposed or have symptoms you should have a PCR test or consider repeating the antigen test in 48 hours
  • PCR testing
    • If your child is ill and needs a PCR test, please make a sick visit with a provider.
    • If your child is asymptomatic and needs a clearance PCR you can make a nurses-only appointment here
  • More information on COVID testing can be found here:

Isolation

We recommend using the CDC Isolation Calculator to help navigate your family’s COVID-19 isolation. Please use this tool BEFORE calling the office for guidance. 

Recommendations for people who test positive for COVID-19 (regardless of vaccination status):

  • Isolate for 5 days
    • The first day of symptoms or the day a positive test was taken is considered Day 0
  • You may end isolation after 5-days if you are afebrile and  have no/ improving symptoms 
  • You must wear a well fitting mask at all times through day 10; or, if you have 2 negative antigen tests separated by 48 hours, you may remove your mask sooner.
  • Other considerations
    • Do not travel during this 10-day period
    • Do not go places where you cannot wear a mask at all times during this 10-day period
    • If your child is too young or cannot wear a mask, they should stay home for the full 10 days
    • Guidelines may be different for people with severe disease or compromised immune systems so please consult with your doctor
    • Follow rules/guidelines regarding return to school as directed by your school

Quarantine

Based on the CDC’s most recent guidance, quarantine after COVID-19 exposure is no longer routinely recommended. However, if you have a known COVID-19 exposure, you should:

  • Wear a mask for 10 days after exposure and
  • Get tested 5 days after the exposure.
  • Isolate and test if you develop symptoms after an exposure.
  • If your child is less than 2 and unable to wear a mask, the CDC states that “other prevention actions (such as improving ventilation) should be used to avoid transmission.”

These recommendations may vary by school district or daycare, and may vary based on community transmission levels.

Evaluation

Your child should be evaluated by a medical provider if:

  • They are having any trouble breathing, wheezing, or have significant chest pain
  • They have signs of dehydration or if they are lethargic
  • They have fever 100.4 or higher lasting 5 days
    • Note:  Infants under 3 months of age should be evaluated for any rectal temperature 100.4 or higher, and they should go to the ER right away if under 2 months of age
    • Infants under 12 months of age should be seen if fever lasts 72 hours
  • They have muscle aches, chills, or significant fatigue lasting more than 4-days
  • Note: most kids who test positive for COVID-19 will not need to be evaluated during their isolation period as most children’s symptoms (which are usually sore throat, runny nose, cough, body aches, or GI symptoms) remain mild and improve after a few days

Prevention

Help protect your kids from getting COVID-19 by:

  • Wearing masks if/where recommended or based on personal preference 
    • Data continues to demonstrate that wearing a well fitting, high quality KN95 or N95 can reduce risk of contracting COVID-19
    • Masking guidelines change based on local conditions. Stay up to date here
  • Staying up to date with vaccines and boosters.  All children > 6 months are now eligible for primary COVID vaccine series.  Children > 5 years old should receive a booster shot >5 months after their primary series to be considered ‘up to date.’
    • You can find the most up-to-date vaccine guidance: here
    • You can find some FAQs about the 6 month to 5 year age group: here
    • Individuals with moderate or severe immune compromise may be eligible for additional dose of primary vaccine series and an additional booster. Talk with your doctor to see if your child would qualify
    • All adults age 50 and older should receive a 2nd booster 4 months after completing the first booster.
  • Staying home if you have symptoms
  • More can be found at:

Management 

If your child has COVID-19 please rest assured that the majority of children will experience only mild symptoms. For all children: 

  • They should isolate per CDC guidelines
  • Provide supportive care:
    • Give acetaminophen (any age) or ibuprofen (6 months or older) as needed for fever or pain
    • Drink plenty of liquid to stay hydrated 
    • Use a humidifier or stand in a steamy bathroom to help with congestion or cough
    • You can give 1 teaspoon of honey as often as needed to help with cough if your child is at least 12 months old
    • Kids 12 years of age and older can use over the counter decongestants
    • Use nasal saline drops or sprays for congestion
  • Expect symptoms such as sore throat, headache, fever, fatigue, muscle aches, chills, or GI symptoms to last for a few days
  • Expect some symptoms, such as cough, congestion, change in sense of taste or smell, to potentially last longer
  • Avoid exercise during the isolation period
  • If your child is 12 or older and involved in athletics, they should be evaluated after their isolation period has ended to make sure it is safe for them to return to sports (see below)

For children 12 years old and older and at high-risk for severe disease there are antiviral medications and monoclonal antibodies available.  The CDC defines high risk as: 

  • Body mass index (BMI) ≥85th percentile 
  • Immunosuppressive disease or receipt of immunosuppressive therapies; 
  • Neurodevelopmental disorders (eg, cerebral palsy, trisomy 21);  
  • A medical-related technological dependence that is not related to COVID-19 (eg, tracheostomy, positive pressure ventilation, g-tube);  
  • Sickle cell disease;  
  • Congenital or acquired heart disease;  
  • Chronic lung disease (eg, interstitial lung disease, tuberculosis); asthma or other chronic respiratory disease that requires daily medication for control;
  • Diabetes;
  • Chronic kidney disease;
  • Chronic liver disease (eg, cirrhosis, autoimmune hepatitis);
  • Pregnancy

You can find more information about these therapies here. If your child falls into one of these categories, please contact your doctor to discuss the risks and benefits of these treatments.  

Return to Sports/Activities 

There is a small risk of developing a condition called myocarditis during or shortly after a COVID-19 infection. It can be dangerous to exercise with this condition.  In this light, the AAP has recommend the following about return to sports after COVID-19 infection:

  • For those with moderate symptoms of COVID-19 (≥4 days of fever >100.4°F, ≥1 week of myalgia, chills, or lethargy, or a non-ICU hospital stay and no evidence of multisystem inflammatory syndrome in children [MIS-C]), an in-person evaluation by their primary care physician (PCP) is recommended
  • After the isolation period, all children younger than 12 years with COVID-19 may progress back to sports/physical education classes according to their own tolerance 
  • After the isolation period, children 12 years and older should perform the following progression once isolation is completed and physician clearance has been obtained if indicated:
    • Asymptomatic/mild symptoms: Minimum 1 day symptom free (excluding loss of taste/smell), 2 days of increase in physical activity (ie, one light practice, one normal practice), no games before day 3. A face mask should be worn for ALL physical activity, including games or scrimmages, until 10 full days from positive test or symptom onset have passed.
    • Moderate symptoms: Minimum 1 day symptom free (excluding loss of taste/smell), and a minimum of 4 days of gradual increase in physical activity (one light cardio workout on own, two light practices, one full practice), no games before day 5. A face mask should be worn for ALL physical activity, including games or scrimmages, until 10 full days from positive test or symptom onset have passed.

Potomac Pediatrics

We are committed to providing the best possible care for you and your family. Currently, we are:

  • Sanitizing rooms and medical equipment between each patient
  • Minimizing time in the waiting room as much as possible
  • Requiring that all of our staff be up to date with COVID-19 vaccines (including boosters)
  • Wearing appropriate PPE
  • Offering vaccines and boosters to patients and family members
  • Offering COVID-19 testing to patients and parents

To help keep everyone in our office as safe as possible, we ask that you follow our office’s current COVID-19 policies:

  • Notify us in advance of your visit if you or your child have tested positive for COVID-19 as the check-in process may differ
  • Face masks are required at all visits for anyone age 2 and up (masks with exhalation valves or vents should not be worn as they do not contain droplets)
  • Only 2 caretakers per family
  • Siblings (age 11 or older) of children with appointments should remain at home
  • Siblings (10 years or younger) of children with appointments may attend if necessary. However, to limit the number of people in our office it is preferred that you secure alternate childcare to avoid bringing them.

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