- Care tips for parents from a Family Nurse Practitioner
- When to test, when to worry, & when to quarantine
Recently, we had the chance to get some serious face/Zoom time with Erin Percy, an FNP at Urgent Care for Children in Madison. In the wake of the highly contagious Omicron strain, we collected questions from RCM Readers about what to do if your kid gets Covid, and how to best treat kids at home.
Watch the interview in its entirety above, or read through the highlights below.
What To Do When Your Kid Has Covid
Erin Percy is a Family Nurse Practitioner and Clinical Director for North Alabama and Telemedicine – she’s been practicing for six years in pediatrics and family urgent care. Please note the general answers she gives here pertain to children that are healthy with no other underlying illnesses or conditions.
Home Treatment for Kids with Covid
Q.) What is the best home treatment protocol for kids? – Heather M.
Q.) What over the counter medicines can help relieve symptoms for children? – Lauren L.
A.) For most otherwise healthy children without a chronic illness, that have mild to moderate symptoms, you would treat Covid-19 the way you would treat a cold or flu. The biggest things are keeping your child hydrated with plenty of fluids, and letting them get plenty of rest as their bodies fight off the virus. For over the counter medications, Acetaminophen (Tylenol) and Ibuprofen (Advil, Motrin) are totally fine to take for children ages six months and up.
Fever Tip: Keep in mind you want to treat a high fever PLUS an uncomfortable child. So if they have a fever of 100.9 but the kid is playing, drinking fluids, and acting OK, you don’t need to treat the fever unless it or symptoms get worse. But if your child is uncomfortable, listless, complaining of a headache, sore throat, body aches, or if their fever gets really high (like 102+) it’s OK to start treating with OTC medications.
Q.) What should I do when alternating ibuprofen and acetaminophen are not effective in reducing a high fever? – Deana W.
A.) If a child’s fever isn’t going down using those, it’s time to start watching them more closely. Every child is different, so we usually don’t start to get nervous until it’s 105+. There are other good ways to help bring down a fever. If a child is shivering, parents tend to pile on the blankets and heavy pajamas – take those off and don’t do that. It seems cruel, but I promise you, you’ll know your child is not actually freezing because they have a fever. Taking off the extra layers or taking a lukewarm (not cold!) bath can help naturally bring down body temperature and your child will get more comfortable. A cool washcloth to your child’s forehead or neck, popsicles, or drinking cool beverages can also help.
Q.) How do I know when to go to the ER, especially when it’s so crowded? How many days with a fever is safe? At what point is it a concern? – Christa L.
A.) If your child has had a high fever for more than five days at that point it’s time to be concerned. If they are stable, it’s best to go see your pediatrician instead of the Emergency Room. As far as the ER goes, that’s why I love Urgent Care for Children – we really bridge that gap because we’re there after hours and on the weekends.
Respiratory distress is what you need to look for in order to consider going to the ER. So, if your child is short of breath, which can look like breathing very fast and hard. In younger babies and toddlers it can look like flaring of the nostrils, or changing color – looking a little blue or gray. Babies will also pull at their ribs if they are experiencing difficulty breathing – anything like that and it’s time to go to the ER, Covid or otherwise.
Q.) What is the best way to care for babies that get Covid? – Stacy H.
Unfortunately for younger children, there aren’t a lot of decongestants because they’re really not safe for that age group. The reason is because that can lead to pneumonia, so instead of a cough suppressant, you want them to get it out. Nasal saline & a bulb syringe or nosefrida every two hours, while unpleasant, is the best way to help decongest an infant or baby.
Q.) How long can omicron symptoms last in younger kids? – Sallie K.
Omicron is still a new Covid variant, so the problem is once we learn about a variant it’s gone – past its peak – and then we’re learning about the next one. Typically, Omicron Covid symptoms stick around for about 5-7 days. Kids that are vaccinated seem to be symptomatic a little bit shorter, 3-4 days. I usually advise parents to plan on 3-4 days of getting worse followed by 3-4 days of getting better and a cough can linger after that. I also have some great tips on helping your child through a Covid test should they need one.
Isolation & Quarantine for Kids with Covid
Q.) Do we need to call the doctor if we tested positive at home? At what point would they suggest seeing a doctor vs at home care? – Allis J.
A.) I think if your child tests positive using a home test, you should definitely call their primary care doctor and just let them know. If needed, they’ll be able to offer additional advice specific to your child. If your child has a chronic illness, or anything where they are seen by a medical specialist, please call that specialist as well. The doctor that knows your child best can advise you best.
Q.) What are the practical points of isolation? (Ways to isolate at home from other family members.) Lydia F.
We see this all the time – parents get a positive diagnosis in one child and they worry about exposing their other children. We don’t all live in huge houses – if you live in a two bedroom apartment it’s a lot harder to isolate everybody. You can’t put a 3-month old in their room and say “Good Luck!”. Kids come in all ages and sizes and needs.
My advice is always just to do the best that you can. The common sense thing is to wash your hands, and isolate when you are able to other rooms, but many families just aren’t able to do that. Unfortunately, Omicron is so contagious, when it hits a household everyone usually gets it. Just be prepared for that – you can do everything right and you might still get it.
Q.) Should the entire family quarantine if only one kid has Covid? Wendy J.
If everyone is unvaccinated, they definitely need to all quarantine. And here’s the part people don’t like to hear… If you have a child that is unvaccinated, you need to quarantine for that child’s 10 contagious days plus five to ten days after that depending on if they can mask, even if you are vaccinated.
If your entire family is vaccinated, isolate the positive person as best you can. Practice safe Covid protocols while at school or work, and monitor everyone else closely for symptoms. CDC Quarantine FAQs
Q.) What should I do if my kid is positive with NO symptoms? Karen G.
If they remain asymptomatic on Day 5, your child can return to school… if they can wear a mask 100% of the time. You have to know your children – if they wear their mask down below their nose most of the time, they are probably not a good candidate to go back into the world after just five days. Parents should know it’s OK to take the full 10 days because kids are still contagious at that point.
Testing & Masking Kids with Covid
Q.) If I get a positive result with a rapid test, should I wait for the PCR results? – Heather P.
False positives are incredibly rare. If you get a positive rapid test and a negative PCR I would think the PCR is wrong. The tests have a sensitivity and a specificity – positive almost always means positive, but negative does not always mean negative. What a negative rapid test really means is “not detected in that swab at that moment”. Last winter of 2020 a few places did get a bad batch of Flu/Covid combo tests, and that bad batch did result in positive Covid falsely due to manufacturer error, but that was an anomaly. But if you have a positive rapid at-home test and you get a PCR test done at a clinic that comes back negative, don’t automatically assume the PCR is correct.
If you test positive for Covid using an at-home rapid test, there’s no point coming to a clinic just to get tested – you have Covid. Testing sites likes ours at Urgent Care for Children are overwhelmed right now, and one way to help the community is to not get unnecessarily tested.
Additionally, there’s no way to “test out” of quarantine. The rules laid out by the CDC and ADPH are hard and fast and make no mention of retesting. The rule is for symptomatic patients on Day 10, if you are fever-free and your symptoms have generally improved (they may not be totally gone), you can come out of quarantine. You can still test positive anywhere between 15 and 60+ days later. One gentleman we had at UCFC tested positive for more than 90 days! We know so much more about Covid now, and we are able to shorten the quarantine time with that knowledge.
Q.) If my family is exposed to Covid, when should we test at home? – Stephanie W.
A.) Try to fight the urge to test right away – figuring out when you were exposed is key. So if grandpa was visiting yesterday and then tests positive for Covid today, there’s no need for you to test today unless you’re feeling bad. As long as you don’t have symptoms it’s best to wait five days and then test.
Hot Tip: If you know you’ve had a direct Covid exposure, jump on our website, and go ahead and make a reservation online in five days to be tested. If you don’t need it, you can always cancel it, and there’s no cancelation fee. You can also do this if you wake up feeling bad and want to go ahead and snag an appointment time.
Q.) My kid had Flu A over Christmas and now has a lingering cough. Covid tests are negative. How do I know for sure I can send them back to school? – Sandy A.
The honest answer is, it’s hard to know because Covid is so prevalent right now and we have lots of asymptomatic people walking around. That said, Flu A can have a post-viral cough (aka bronchitis) that lasts up to six weeks, which is pretty standard. The thing to look for is the cough should be improving, not getting worse over time. For example, it’s only bad when he’s laying down instead of coughing around the clock, or he mainly coughs when he gets worked up playing. So if your child is testing negative and symptoms are improving and not getting worse, you’re probably on the right track. If the cough keeps getting worse, or fever returns after being gone a while, your child might have caught something new, which could be Covid or another viral upper respiratory illness, or they’re having a complication from the flu, which usually happens 10-14 days afterward.
Q.) What masks do you recommend since there isn’t an N95 standard for kids? Lydia F.
For going out, I recommend a mask that is at least two layers, most cloth masks are, and the most important thing is one that fits your child’s face. Every child’s face shape is a little bit different – what worked for one of my kids didn’t work for the other. Find one that stays comfortable and doesn’t droop or make it to where your kid is constantly adjusting it with their hands.
The other important thing is that kids probably need at least 2-3 masks at school throughout the day. When masks get wet, it’s time to switch it out. Masks shouldn’t keep moisture trapped against your face. Some kids are heavy breathers and need to switch out more than others. Packing three well-fitting masks to wear throughout the day is probably better than one N95 mask for kids.
Q.) My kid had Covid last Fall – how quickly could she catch it again? – Beth R.
A.) We still like to use the 90 day rule so she’s probably safe. We are seeing people who had one Covid variant in the Spring and another one in the Fall. Just because you had Covid in October doesn’t mean that you can’t catch another variant now, so stay vigilant, wash your hands often, wear a mask when you can outside of your house.
Q.) What can the community do to better support you & other medical professionals?
A.) The community has been so great. The biggest thing parents can do is have patience. We try our best to space out appointments and run on time, but we are an Urgent Care that sutures stitches, cares for sprains & breaks, and have staff shortages due to Covid. Just know we’re doing the best we can. A thank-you from our patients can go a very long way. Making a reservation online is also helpful – we do take walk-ins but reservations take priority when possible.
Covid Testing at Urgent Care for Children
Rocket City Mom is a website about raising children in and around Huntsville, Alabama. Started in late 2010 by a local mom and newcomer to Huntsville, Rocket City Mom has grown into a thriving community of local parents and now boasts a staff of four, thirteen regular contributors, and tens of thousands of Tennessee Valley readers making it the #1 Parenting Resource in North Alabama.