Sanford L. Swidler, MD, Pediatrics

Over the past few weeks, we pediatricians have all seen the rapid rise in COVID-19 due to the Omicron variant. Cases in children make up a disproportionate share. Fortunately, the level of illness has been mild so far, and we have seen few complications in our patients. Many pediatric offices have experienced a sharp increase in phone calls with questions and requests. Below is a guide we hope you find helpful if your child has been exposed, has symptoms or has tested positive with a home antigen or PCR COVID-19 test.

If your child has symptoms of COVID-19:

• Isolate your child from the public (and as best you can from other household members)
• Try to get your child tested
  
  • PCR testing is in high demand, so results have been taking 1-3 days.
  • A positive home antigen test is accurate. A follow-up PCR test is not needed or recommended.
• If you need a doctor’s note for school, call your pediatrician. If your pediatrician's office has a patient portal, you can upload a picture of the home antigen test with your request.

If your child tests positive for COVID-19:

• Remember, a positive result from an at-home antigen test is accurate. See other testing options in the community.
• Regardless of vaccine status, isolate your child from the public (and as best you can from other household contacts)
• New isolation guidelines from the CDC: Your child may isolate for 5 days instead of 10 days; BUT ONLY IF feeling significantly better, without fever, AND if they are able to consistently mask in public for the next 5 days. IF they still have symptoms, or are unable to mask properly, they should isolate for the full 10 days.*
• At this time, a negative test is not needed to end isolation. Many of these tests will remain positive for a long time after you are no longer contagious.
• Check your school’s return policy. It may differ from these CDC guidelines.
• Treatment is supportive like most viral illnesses: Use Tylenol or Motrin for fever/aches and make sure to keep them well hydrated. Contact us for an appointment if you are concerned about the severity of your child’s symptoms.
• *When calculating isolation or quarantine times, day 0 is when symptoms start (or the day of your positive test if no symptoms). Day 1 is the next day.

If your child is exposed to someone with COVID-19:

• IF FULLY VACCINATED
  • Your child does not need to quarantine
  • For the next ten days, your child should wear a mask at all times while in public (always a good idea when indoors)
  • Testing is recommended on day 5 after the last exposure
  • Check individual school requirements for return
  • If symptoms develop, isolate, and try to test as soon as possible
  • Please email your child's vaccine card to your pediatrician for their records
• IF NOT FULLY VACCINATED
  • Your child should quarantine for 5 days and may end quarantine as long as she/he is able to properly mask in public for the next 5 days
  • Check individual school requirements for return, as stated above
  • If symptoms develop, isolate, and try to test as soon as possible

Returning to competitive sports after COVID-19:

Although rare, some children (especially adolescents) can have cardiac complications after recovering from COVID-19. To be safe, there are guidelines about return to play.

• Children should refrain from high intensity activities during their recovery (at least 10 days)
• If your child had mild or no symptoms
  • After the 10-day rest period, your pediatrician will need to clear them for participation. This may require an office visit.
  • If cleared, your child may return to a team sport if the coach or trainer can provide a 7-day gradual return to play program. (Most teams have formalized this process.)
• If your child had moderate or severe symptoms
  • Your pediatrician will likely need to see your child for clearance.

COVID-19 is surging. What now?

Although we expect this surge to continue for the next few weeks, we are hopeful it will end as quickly as it started. In the meantime, we encourage all our families, patients, and friends to stay safe and follow these guidelines.