Q & A About COVID-19

Dear Parents and Caregivers:


You may have seen that North Carolina Governor Roy Cooper declared a state of emergency in response to coronavirus (COVID-19). News about the current outbreak has parents wondering what they should do to keep their families protected. Here at Hanover Pediatrics, we wanted to provide you answers to questions.

Q:  What are some of the most common questions you are hearing from patients and their families right now?
The most common thing we are hearing from parents is that their child has a fever and a cough, and they are wondering how worried they should be. Others are asking if they should keep their kids home from school, soccer practice, and other activities. And as we approach spring break, we are also getting questions about whether families should cancel their travel plans.

Q: How susceptible are children to COVID-19? 
We want to reassure all families with young children that of the data from more than 100,000 cases, the pediatric age group is the least affected. So there is a very good chance that your child will not be severely affected even if exposed.

That said, with the general exposure to COVID-19 through mucus membranes, any human being could be susceptible to the disease. Because we know that the virus seems to cause pneumonia, for children with severe asthma or a congenital heart problem, we are recommending parents take extra precautions right now. This could mean keeping them home from indoor play places or activities like gymnastics.

Q: If a child exhibits flu-like symptoms, how do parents know whether the child has COVID-19 versus flu or a seasonal cold?
If your child has a runny nose, chances are it is not the COVID-19 virus that they are fighting. More specifically, if they have a fever, cough, congestion, goopy eyes, stomach pain, nausea and vomiting, it could be the regular flu or a mild viral illness, and we are asking those patients to come into the office so we can test them for influenza. If there is significant concern for COVID-19, we can send you to the appropriate venue to be tested.  All patients coming into the office with cold symptoms should wear a mask, available in the entrance to the office, in order to minimize spread of all contagious illness as we leave the winter season.

Q: What should parents be doing at home to protect against the virus?
In general, practice good hand washing techniques, cover your cough within your elbow, and only wear a mask if you have a flu virus or a runny nose. It is not an exaggeration that most viruses are avoidable with good hand washing. How do you think doctors and nurses stay healthy?

While there is no need to stock up on everything, if you have young children at home, it is a good idea to have at least two weeks’ worth of infant formula, diapers, wipes, and baby food if your baby is eating solids. For toddlers, have on hand some simple activities that you can do at home on the off chance that you become homebound for a little while. A quick trip to the craft store could be a good idea!

If you have older children who are attending daycare or school, follow the standard handwashing protocols. In general, during flu season it is a good idea to give your child a shower or bath when they come home, and remind them to avoid touching their nose, eyes, and mouth.

Q: Should parents of newborn babies keep visitors away? What about older siblings who are in day care and/or school?
If you have a newborn at home, continue to follow your usual hand hygiene practices, breastfeed your baby if possible, and make sure your baby gets plenty of sunlight and fresh air. It is a good idea to use antibacterial wipes to wipe down countertops and diaper-changing stations once a day. Visitors are perfectly OK, especially if they are healthy adults and family. If you would like to be extra cautious, you can avoid closed, indoor spaces and meet them outdoors such as in your backyard or at a local park. As always, all visitors must wash hands before picking up your baby. For young visitors, I usually recommend that they may kiss baby’s feet, but not your baby’s hands or face.

Q: If a woman who is pregnant or breastfeeding becomes sick, should she be concerned that her baby could contract COVID-19?
According to the CDC, “in limited case series reported to date, no evidence of virus has been found in the breast milk of women with COVID-19. No information is available on the transmission of the virus that causes COVID-19 through breast milk (i.e., whether an infectious virus is present in the breast milk of an infected woman).”

In most cases where mom is exposed to a virus or has any symptoms, we recommend that the best thing she can do is continue to breastfeed baby if possible, because, through breast milk, the baby receives the antibodies that mom’s body is producing. Historically, we have seen that with cases of influenza and other viruses, a baby who is breastfed tends to have the mildest version of the illness amongst anyone else in the family.

We don’t have enough information right now about adverse pregnancy outcomes in pregnant women with COVID-19. If you are pregnant, you should practice the usual preventive actions to avoid infection, like frequent handwashing, and avoid spending time with people who are sick.

Q: Should families consider canceling upcoming vacation plans? What travel precautions do you recommend?
Local travel by car is perfectly safe. If you plan to fly, it’s a good idea to exercise caution and use antibacterial wipes to clean airplane surfaces such as tray tables, armrests, and bathroom surfaces that you may touch. And as always, wash your hands with soap and water or use hand sanitizer frequently, avoid touching your face, and cough into your elbow if needed. 
To sum it up....
Parents should follow the same protocols now as during the cold and flu season.  If they have a runny nose, they have a runny nose. If they have difficult time breathing, they should seek care.
Hanover Pediatrics is taking the steps we would for any potential infectious disease outbreak, including preparing their offices to adopt standard infection-control practices, collaborating with local hospital and health systems, and advising families in their practice to stay home from work, school and child care if they are sick. We will continue to advise and update our patient families as the situation evolves.

For the latest information about COVID-19, please visit: https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx
For local health news please visit: https://www.nhrmc.org/coronavirus
Stay healthy and be safe,
Hoke Pollock, M.D.
Kelly Capobianco, NP-C