Keeping our children safe during the COVID-19 pandemic

Parents will undoubtedly be worrying about their children’s health during the crisis of coronavirus COVID-19. As research continues, medical experts such as Dr Gautam Kulkarni, a leading UK paediatrician, can provide the public with trustworthy advice to keep their children safe. Dr Kulkarni shares his professional knowledge in this article. Read on to learn about COVID-19 and its effect on children, as well as who’s more at risk and how to keep kids motivated during a lockdown.

Isn’t COVID-19 just another bad flu?

It’s much worse. As this is an originally zoonotic (animal-based) virus, the human immune system can be clueless about how to respond. This means that we have no protective immunity and that our immune system can also misfire damaging cytokines, which are proteins that are produced by the cells. This miscommunication between proteins in our immune system can cause damage to our organs.

How do I know if I have a cold, the flu or COVID-19?

COVID-19, the flu and the common cold have many overlapping symptoms. The ones most identifiable and frequent regarding COVID-19 are fever and cough. This table below provides insight on how common overlapping symptoms are for each condition.

Why doesn’t coronavirus make kids sick with COVID–19?

We do know that children have a milder response to the virus but that some children may get very sick. We think their immune systems’ may react differently compared to adults’, though children with underlying medical problems may indeed have a more severe illness as a result of contracting the virus.

Which patients are at a higher risk from Covid-19?

Children who have chronic conditions that affect the lungs or heart, for example, are at a higher risk. Children with diabetes and children with weakened immune systems due to ongoing treatment or existing conditions are also considered as vulnerable.

Are children with asthma at a higher risk than others from COVID-19?

Most children with asthma should be ok unless they need frequent courses of oral steroids. Please continue with inhalers as prescribed.

Can I give Ibuprofen to my child?

The jury’s still out on if NSAIDs (ibuprofen) can make COVID-19 worse because there is currently no strong evidence to prove that ibuprofen can make coronavirus symptoms worse. Until we know more, use paracetamol as needed for an illness involving a fever.

For parents of children with a fever-related illness who are worrying about their child’s temperature not settling after having tried regular paracetamol, in my personal opinion, it's ok to give a one-off dose of Ibuprofen to prevent a febrile seizure.

Do fewer children catch the virus?

Children are likely to be infected with coronavirus at the same rate as adults. In fact, up to 60% of the population is expected to catch the virus before the crisis is finished. Children do not seem to have the same severity of illness, although very few may get critically unwell. However, children are significant in spreading the virus as they may have no symptoms and may spread it to grandparents.

How will children’s illnesses show if they get sick?

Younger children seem to get sicker and this appears to happen quickly, from the first appearance of symptoms to very sick in about 5-7 days. They will also continue to get sick with their existing illnesses. It’s possible that children can be infected but show no symptoms.

What about testing?

Currently, as of the 24^th of March 2020, in the UK we are testing only sick children who are admitted to hospital but this may change. There are two types of tests:

• swabs to check if one is actively carrying the virus
• blood tests (which will hopefully be available soon) that will confirm if someone has been infected in the past and is immune

What about any medications?

There are several medications being tried and again and presently, we really don’t know which is effective.

Currently, anti-malarial medicines seem promising according to some experts. But, if any child presents to me during this time with a bad cough, I may consider a course of azithromycin, which is a perfectly safe antibiotic for chest infections. We believe it may have a beneficial effect in reducing the virus’ replication to more of the body’s cells.

And finally, how to keep kids motivated during a lockdown?

This will be a testing time for parents and children alike. In the modern world, where we are so used to our individual freedoms, I hope this makes families closer. One would aim for a balance of some physical activity, education and learning a new skill or a language.

I hope that children also learn to be more responsible and to understand and share some of the pressures that their parents might be facing. It’s of course very important as parents to pick up subtle signs that our children are getting worried and reassure them as they will have a lot of insecurity about their own health, future and health of loved ones such as their grandparents.

When do we see an end to this?

It is indeed possible that many of us would get infected unknowingly and develop an immunity to COVID-19, which gives us protection. Certainly, I see this happening in children as their bodies are forever being exposed to new viruses and vaccines that they cope with incredibly well. For the rest of us, hopefully, a vaccine is being developed at breakthrough speed!

Dr Gautam Kulkarni a leading consultant paediatrician. Visit his profile to learn how he can help you look after your child’s health.