COVID-19 Update From Dr. Newton
- Covid cases usually present with a range of flu-like symptoms (such as fever, body aches, sore throat, cough, congestion). It’s important to realize that not every person shows the same combination or severity of symptoms. If your child experiences these symptoms, it is reasonable to have them tested for Covid. They can test as soon as they are symptomatic.
- We have two testing options available in our office, both of which require a nasal swab: rapid testing (with results in 15 minutes) and send out laboratory testing (with results usually available in 48 hours). The send out testing is what is referred to as a ‘PCR test’ and has a higher likelihood of detecting the virus. You must schedule your child for a sick visit with one of our providers to have a Covid test. We do not have saliva based or cheek swab testing available in our office at this time.
- Home rapid antigen tests are reportedly as sensitive as office-based rapid antigen tests when evaluated in lab settings. It has not been confirmed that these tests work as well in real world settings. It is reasonable to assume a positive home test is reliable, but a negative test should be interpreted with some caution, depending on the specific situation.
- Tests do not specify which variant of Covid is present. This should not matter because once infected, there is not likely to be a significant difference in the outcome of the infection (delta variant is more easily spread, but there is no evidence that shows it is any more serious than other strains once you get it). It is currently safe to assume that a positive test means you have the delta variant as that is reported to be the vast majority of circulating infections.
- We do not perform antibody testing in our office. If appropriate, we can order antibody testing through an outside draw station. In general, there is limited benefit to antibody testing. Antibodies tend to fade after several months, but that does not mean that Covid immunity has faded. A negative antibody test does not rule-out prior infection or ongoing immunity. Asymptomatic cases may test positive for Covid antibodies, but it is unclear whether this provides lasting protection from re-infection. Antibodies generally do not become detectable until 10-14 days after the onset of illness, so immediate testing post-exposure is not helpful in medical decision making.
If your child tests positive to Covid
- Fortunately, the vast major of children who get Covid will have a short lasting cold or flu-like illness. Treatment is based on symptoms and mainly includes fever-reducers, pain relief, hydration and rest.
- There are no approved or recommended outpatient prescription medications for Covid for kids and no need to try any popularized off label medications.
- Respiratory difficulty (labored breathing, shortness of breath) is the main sign/symptom of worsening illness that you should monitor. You should seek immediate medical attention for your child if this develops.
- Children should quarantine for 10 days from the start of their symptoms, they should also be fever free for 24 hours (without fever reducing medication) and have improving respiratory symptoms before returning to school/social activities.
- If a child tests positive without having any Covid symptoms, then they should quarantine for 10 days from the date of the positive test.
- There is no need to retest after being diagnosed with Covid. Some people can have positive tests even after they are no longer contagious (the tests can detect non-infective viral particles).
- We can only provide return to school notes for patients assessed in our office by one of our providers. If your child is diagnosed outside of our office (home test, urgent care, etc.) we cannot give clearance if we have not done our own assessment.
Covid Exposures (Unvaccinated Children)
- A Covid exposure is defined by the Centers for Disease Control (CDC) as contact within 6 feet of a known case for a total of 15 minutes over a 24-hour period. If both parties are masked, then this is not considered a close contact.
- People are considered to be contagious with Covid starting two days before the onset of their symptoms.
- Unfortunately, the Texas Education Agency (TEA) and the Centers for Disease Control (CDC) have differing recommendations/requirements for quarantine after Covid exposure in schools which makes giving advice about handling an exposure for your child difficult. TEA does not require schools to quarantine exposed students and each school may set its own policy. You should check with your child’s school to understand their specific Covid contact and quarantine requirements. Most schools are not allowing for extra absences for Covid quarantine, making it difficult for parents to follow CDC recommendations and keep their exposed children home. When possible, we recommend following the CDC guidelines on post-exposure quarantine (see next bullet point), but we understand this may not be an option for some children. If an exposed child does go to school during the recommend quarantine period, we strongly suggest they wear a mask and get tested if they show any possible Covid symptoms.
- CDC guidelines for Covid exposure are the same as last year. An exposed child should quarantine for 10 days from their last exposure to the contagious individual; they may return after 7 days from exposure if they have a negative Covid test after day 5.
Covid Exposures (Vaccinated Children)
- Vaccinated individuals may still become infected by Covid and be contagious to other people, but the risk is lessened compared to unvaccinated people.
- If a vaccinated child is a close contact to a contagious person, they do not need to quarantine, but it is recommended that they wear a mask and get tested 5 days after the exposure to make sure they are not spreading the virus.
- If a vaccinated child tests positive for Covid, they should follow the quarantine recommendations discussed above.
- It is our recommendation that children 12 and above get vaccinated with the currently authorized Pfizer mRNA Covid vaccine.
- Please see our video: detailing the risk/benefit assessment of the Covid vaccine.
- We are not administering the vaccine in our office at this time. There are many convenient vaccination options available through the area’s local pharmacies.
- Children who have had Covid should consider getting a vaccine 90 days after their infection The risk of significant illness with a second infection in an otherwise healthy child is extremely low, so we suggest you discuss this with your physician when in the office for more detailed discussion if you have questions about the risks/benefits.
- There is currently no vaccine approved for children under 12. The best estimates indicate that vaccine trials in this age group will not be completed until sometime this winter.
- We do not recommend children under 12 trying to get the vaccine until study data for this age group is released and reviewed. It should be noted that the vaccine trials are using lower vaccine doses in this group, so there is virtually no safety information for children in this age group getting the vaccine approved for 12 and up.
- If your school does not require universal masking, your child can still wear a mask if you choose
- Individual masking with a cloth mask probably provides limited protection against acquiring Covid in a school full of unmasked students, especially with the increased contagiousness of the delta variant.
- If you want to maximize your child’s protection by masking, then we suggest ordering a properly fitting N-95 or KN-95 mask and instruct your child on proper and consistent use.
- We strongly encourage all children to wear a face covering when they have cold/respiratory symptoms such as cough, runny nose or sore throat. We hope this may limit the spread of many infections beyond just Covid. Children with fever should stay home from school and consider being tested for Covid.