Answering your more pressing questions about kids and COVID-19

HOUSTON – From masks to mental health, we have been getting a lot of questions regarding kids and COVID-19. We asked Dr. Charisma Garcia, pediatrician, Texas Children’s Health Plan The Center for Children and Women to help us answer some of your questions.

What do pediatricians say about kids returning to school?

Dr. Garcia: “The updated American of Pediatrics policy is pushing for states to have the option of in-person education for all students. That is because the school offers a lot more than an academy institution. School offers a safety net, mental, and physical health care screenings, it provides families with meals and time for exercise. It also gives children a chance for socialization, to be good citizens, to work as a team but also learn life skills that you need to be successful in the future. Kids will be disproportionally affected if they have special education. They won’t get the special speech therapy, their occupational therapy and they won’t have their accommodations at home that they would have with a special ed teacher.”

Are there certain kids who should just not go back to in-person school? For example, kids with a history of asthma or kids who live with grandparents.

Dr. Garcia: “In general, we are pushing for everyone to go back to school. Kids with special healthcare needs are actually going to be disproportionally affected by remote care. The AAP recommends pushing for accommodations instead of exclusions. So if your child has very severe asthma, we would recommend talking to your pediatrician, updating emergency profile, make sure you have a plan, but in general, all children should go back to school.”

Why is the rule that kids under 10 should not wear a mask?

Dr. Garcia: “Kids have more delicate airways. Their airways are shorter, so it’s difficult for them to breathe with the mask on. But not only that, they can’t help but touch their faces. So they are going to be touching their face. So they are going to be touching the mask and putting more germs on the mask than if it just wasn’t there. They touch little desks then they wipe their nose and that’s worse than if it was just free. But also kids don’t tend to have a very strong cough or sneeze so they are not able to propel droplets as far as adults can.”

What is the latest with the Systemic Inflammatory Response in children?

Dr. Garcia: “It’s still exceedingly rare in children. That being said, it is mostly seen in children so that’s why people are worried about that. Children have that immune response that is strong that wants to fight and sometimes it gets confused and starts attacking the body. The reason we were able to draw that together is that children sometimes get an infection called Kawasaki disease. But this is still exceedingly rare. In fact, I have not seen a case myself in the patient setting.”

For kids in Houston who are getting COVID-19, what symptoms are you seeing?

Dr. Garcia: “About half of the cases we are seeing, they are asymptomatic carriers. They get tested because mom or dad got sick, and they had COVID and the child got tested. About half of them are asymptomatic or very mild. A case of running nose, or maybe they vomited once and now they are perfectly healthy. The other half just look like they have a really bad cold. There’s a couple that looked like they had pneumonia. In general, they are largely well. Which could mean they are more likely to spread it because they may not actually know they are ill because they are fighting it off so well.”

Should kids get tested if the parent has COVID-19? (Why are some doctors saying kids don’t need to get tested?)

Dr. Garcia: “In general we are not recommending testing for all children because they don’t need to go to work, they can stay home, they can ride it out for two weeks. Testing, though it’s great for the public health initiative and slowing the spread, is also a finite amount of tests. We can’t just test everyone, or else we wouldn’t be able to do that for the people that really need it.”

What kids should get tested for COVID-19?

Dr. Garcia: “The kids that we are testing is because maybe they have an elderly grandmother who is diabetic, who cares for them on the weekends. It’s not that we are concerned about the child not being well but the people around them that have to have contact with that might be their caregiver.”

Are kids protected from COVID-19 because of the childhood vaccines they get?

Dr. Garcia: “We don’t have a link right now to any magic vaccine preventing COVID-19 but we are working on it. One reason we think kids are doing well is that in general, they are healthy. They don’t have diabetes, they have good, healthy lungs because they are outside exercising. In general, they are strong, they eat good diets, they sleep well. It’s the adults, with time they are not taking as much good care of ourselves or have medical problems. So it’s our medical history that is likely to make us sensitive to coronavirus. Kids should always get vaccinated because vaccines save lives.”

What are you telling parents who are concerned about sending kids back to in-person school?

Dr. Garcia: “I am saying, I’m standing on the side of science and evidence. 2020 has been crazy and it’s constantly evolving. But there’s an entire medical community, a government community that is working together to make sure your kids are taken care of and healthy. I think the benefits of school far exceed the risk. I think in general, kids are excited to go back to school. We want to give them that option. It may not work for every family.”

What is the long-term impact this (quarantine, etc) will have on kids mentally?

Dr. Garcia: “Kids are resilient. That being said, part of development is learning that nurture and being nurtured is physical closeness. I’m already noticing it with patients who used to run and jump into my arms. Now they are scared to even come near me, even when I’m in the gown and gloves. I get that, it’s a scary time.”

What can we do for our kids right now to help them with this?

Dr. Garcia: “In the home, you should embrace physical touch, embrace closeness in your home that way you can have that. Also, talk through the emotions. Kids are internalizing it. They are having more mental health issues so creating that new normal with that strict schedule, setting expectations, focusing on overall health and wellness is key. Yes, they are more likely are going to be long-term mental and physical health complications. We will keep addressing them as they arise and that is what we are here for.”

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