PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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Navigating Cold Season in the Era of COVID

In addition to “when is this pandemic going to be over,” one of the most frequent scenarios I hear is: “I think it’s just a cold; can I send my child to school? There’s no fever or anything and we have been really careful.”

As the coronavirus months march on, one thing we have learned quite clearly is that without a test, it’s impossible to tell the difference between cold symptoms and COVID-19. Unfortunately.

Here is my general guidance: If your child is exhibiting any cold or flu-like symptoms it is best practice to keep them home until symptoms improve and yes, it’s still important to test them. Definitely for COVID-19, but maybe for influenza as well, depending on the local circulating rate of the virus.

If it’s just a cold without a fever, the guidance is to stay home for about 48 hours from the onset of symptoms, to be sure that their condition is headed in the right direction. Once you notice symptoms starting to subside, it is safe to resume activities as long as there has been no direct COVID-19 exposure and their test(s) is(are) negative.

If it is a cold with a fever, or temperature of 100.4 degree Fahrenheit or above, it is a clear sign your child should remain home. Assuming the COVID-19 test is negative and there’s no exposure, your child should be fever-free for a full, uninterrupted 24 hours before it is safe to return to school or daycare. Kids should be able to return to school and be productive learners, and in order to do that, they need to feel good.

Parents often ask me what they can do to speed up recovery. The short answer is that recovery from viral infection takes time, rest, hydration, and more rest. The big takeaway is that if a child is diagnosed with a viral infection, antibiotics will not help them. In fact, in some situations giving unnecessary antibiotics can make things worse, causing diarrhea and stomach upset. Gentle, supportive recovery methods are the best way to ensure your child starts feeling better sooner. Supportive care can include methods like hydration, ibuprofen and acetaminophen as needed for discomfort, using a humidifier, and plenty of sleep.

As a parent, I know it’s challenging to keep kids home from school, especially since the data show the average 2 year old experiences 6-8 upper respiratory infections per year, each of which can last for 7-10 days, and usually all within the winter months. You can decrease your chances of adding influenza in the mix by getting everyone in your family a flu vaccine. It’s not too late to get the flu shot! And, of course, if you are eligible to receive a COVID-19 vaccine, please proceed. In my experience kids tend to tolerate both immunizations and mild illnesses better than adults, but no one wants to see a little one feel bad. All we, as parents, can do is take the necessary precautions to keep our children and communities safe and healthy. Hang in there, everyone. I’m sending all of my good vibes your way!

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