COVID–19 and Children

Do I need to seek medical help if my child tests positive for COVID-19, but has no symptom? How to take care of a sick child safely at home? Many parents wonder what to do if their child is infected with COVID-19. Here is what you need to know.

Symptoms of COVID-19

In general, COVID-19 symptoms in children and babies tend to be milder than those in adults, and some infected children may not display any signs of being sick at all.

Symptoms of COVID-19 may surface 2 to 14 days after exposure and can include:

• Cough
• Fever or chills
• Shortness of breath or difficulty breathing
• Muscle or body aches
• Sore throat
• Difficulty in feeding
• Loss of taste or smell
• Headache
• Lethargy
• Congestion or runny nose

In an episode uploaded to the WHO website, Dr. Maria Van Kerkhove shared that some children may have gastrointestinal symptoms like diarrhoea or vomiting, but they tend to be milder.

Complication of COVID-19

Complications can include respiratory failure, heart attacks, blood clots, and other long-term problems.

According to the Ministry of Health, children who get infected with COVID-19 can develop serious complications like Multisystem Inflammatory Syndrome (MIS-C). This is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

When to see a doctor?

Seek medical help from your doctor if your child has difficulty in breathing, a fever, cough, sore throat, belly pain, vomiting, diarrhoea, rash, dizziness, or shows signs of fatigue. If your child has been in contact with someone infected with COVID-19, do inform your doctor about it.

Do I still need to bring my child to see a doctor even if he is well?

Under Protocol 2 (Please refer to Well and Test Positive, or Condition Assessed Mild by Doctor), the Ministry of Health recommends the following high-risk individuals who test positive to see a doctor even if they are feeling well:

• Children aged less than 12 months old;
• Children aged less than 12 years old who have:
  • any congenital or chronic condition that affects the heart, lungs, brain, nerves, or muscles;
  • Diabetes Mellitus or Hypertension.
• Pregnant women
• Persons who are/have:
  • on dialysis;
  • diagnosed with HIV or AIDS;
  • had organ transplant surgery;
  • been diagnosed with cancer before;
  • any disease or taking medications that weaken the immune system;
  • any disease affecting their heart, lungs, kidneys, liver, or brain that required hospital admission in the last 6 months.

When to rush to the hospital?

You should seek emergency medical care if you notice that your child

• has breathing problems
• is confused or very sleepy
• has chest pain
• has cold, sweaty, pale, or blotchy skin
• is dizzy
• has very bad belly pain
• is unable to keep down any liquids
• has bluish lips

A study by the Centers for Disease Control and Prevention of the United States indicates that children under the age of 2 and children who are born prematurely may be at a higher risk for a serious case of COVID-19 and therefore require medical care in a hospital.

How to care for a sick child at home?

If the doctor assesses that your sick child can stay at home for recovery, below are things you can do to take care of him/her.

First and foremost, you should follow the instructions from the doctor and other guidelines from relevant authorities regarding movement and diagnostic tests.

Second, you should assign only one person who is in good health, fully vaccinated, and below 60 years old with no chronic health conditions, to take care of the sick child.

Third, if possible, your sick child should stay in a separate room with a bathroom. It is critical to have good ventilation in that designated room. Your child should also have his/her own cups, utensils, towels, and bed linens.

Fourth, whenever your child receives care, he/she should wear a medical mask, the same goes for the caregivers. Once the caregivers leave the designated room, they need to wash their hands immediately. It is also recommended for the caregivers to wear gloves while taking care of the sick child. The gloves should be disposed of properly after usage.

Fifth, you should clean and disinfect any frequently touched surfaces by the patient and any waste generated from that patient should be packed safely.

Furthermore, you should monitor the symptoms of your child closely and seek medical help immediately if your child has:

• difficulty breathing
• chest pain
• confusion
• loss of speech or mobility
• difficulty to be breastfed
• high fever
• bluish face or lips

Lastly, you should monitor yourself and others in your home for any symptoms of COVID-19, including fever, sore throat, muscle or body ache, congestion or runny nose, nausea or vomiting, diarrhoea, shortness of breath dry cough, or tiredness. Get yourself tested with ART (Antigen Rapid Test) if you have any of these symptoms or whenever you deem necessary.

Preventive measures for COVID-19

On 27th June 2022, the Ministry of Health said that a one-and-a-half-year-old Singaporean boy, who had no past medical history and was previously well, passed away. The cause of his death was Encephalitis due to COVID-19. The Ministry of Health also mentioned that COVID-19 can result in severe disease, even in children and those without pre-existing medical conditions. This makes it important to prevent infection among children. Here is how children, parents, and guardians can do together to reduce the risk of infection:

COVID-19 Vaccination

Ensure that all family members receive COVID-19 vaccinations and boosters as soon as they are eligible. Vaccination reduces the risk of infection, and more importantly, significantly reduces the risk of hospitalization and death.

In Singapore, children who have crossed their 5th birthday in 2022 are eligible to book a vaccination appointment. Pfizer-BioNTech/Comirnaty COVID-19 vaccine has been assessed to be safe for use on persons aged 5 years and above. The Ministry of Health is currently studying the effectiveness and safety of the COVID-19 vaccine in children under the age of 5.

Wash hands frequently for at least 20 seconds

Children should wash their hands after using the bathroom, sneezing, coughing, or blowing their nose, before eating, and immediately after coming inside from outdoors.

Wash hands frequently using soap and water with a duration of at least 20 seconds.

Hands off face

Keep hands off faces. Parents should remind children to avoid touching their faces as much as possible. To keep their hands busy, you may allow your kids to carry a toy, but you should remember to wash those toys regularly.

Keep things clean

Wipe down your child's toys at least once a day.

Clean the floor and commonly touched objects at least once a day at home.

Cough and sneeze with care

Educate your child and other family members to cover the mouth and nose with a tissue or flexed elbow while coughing and sneezing. Dispose of the used tissue immediately and wash hands with soap and water. Do not touch any objects or face after coughing or sneezing.

Lastly, do not let your child come into contact with anyone who has a cold, fever, or flu-like symptoms.

1. Episode #22 - Children & COVID-19

2. COVID in Babies and Kids: Symptoms and Prevention

3. Well and Test Positive, or Condition Assessed Mild by Doctor

4. What to do if you or your child gets sick with COVID-19 at home