While mindful that recommendations are changing as more becomes known about the new coronavirus, Comer Children’s Hospital specialists recommend families continue wearing masks in public and to be mindful of the inherent risks in situations, which may have repercussions for susceptible family members.
In a July 10 panel discussion, Associate Hospital Epidemiologist Allison H. Bartlett said she has had to discuss with her own children why they must adhere to public health guidelines even while others go about their days without wearing masks.
"You have to have a discussion about why it's so important, and kids these days are amazingly resilient but also thoughtful," she said. "They get that you're doing this to keep other people safe, more specific, grandma and grandpa safe. They get it that we do things for other people."
Children, like adults, often experience asymptomatic coronavirus infections — making mask-wearing at all times even more necessary to prevent contagion. But Bartlett said parents also need to be aware that their children may not be able to describe symptoms like a headache or loss of smell.
Bartlett acknowledged experts know little about the factors that increase children's risk for severe coronavirus infections, recommending that the family of a child who has gotten a bone marrow transplant, whom she said is probably at an at-risk group, obey the public health guidelines already in place for such patients to avoid infections.
Pediatric endocrinologist Rochelle Naylor said she is taking her children to visit their great-grandmother, who is from out of town. The children will wear masks, and they will not hug; Naylor acknowledged that this will be awkward, but she said it is the price to pay to keep everyone safe.
Between her work at the hospital and her child who goes to daycare, "We have some potential exposures that I want to protect her from," Naylor said. “I think in the COVID era, you just have to be tough and say, 'These are the circumstances we will visit under, and otherwise we cannot have you guys be in contact.'"
Regarding getting children tested for COVID-19 before taking them to see grandparents, Bartlett said to consider local pandemic conditions and what households have been doing over the two weeks before the trip. The more time spent out in the world, the more risk there is of contracting the coronavirus.
"The other point to remember is just because you have a negative COVID test today doesn't mean that you don't have a COVID exposure that may develop into an infection in a few days," she continued. “It really is that 14-day quarantine period and then, because of the risk of being asymptomatic, always wearing masks and being socially distant unless you decide to expand your 'quarantine therapy.'"
Naylor said groups of children at her daughter's daycare are being kept in cohorts to limit their exposure to their peers. When she or her husband drop their daughter off every morning, they have to answer questions about whether she has been exposed to anyone sick or whether she is experiencing symptoms. Staff take her daughter’s temperature; Naylor is not allowed in, and neither are most outside objects.
"You want to know there are a lot of precautions," she told a parent. "There is a discomfort. Like I mentioned before, each family has to access the members of their household, what it means that they are potentially getting exposed.” Since Naylor and her husband both work at a hospital, they decided allowing their daughter to go to daycare was a risk they were willing to add.
With the beginning of a new academic year looming, Naylor also said parents need to read schools' precautions carefully — specifically for plans about temperature checks, masks social distancing and keeping students in the same cohort peer group every day for the purpose of tracking potential exposure — and decide their own comfort level in sending their children back. She also said families need to think about whether they have at-risk people living at home.
She said that although children typically do not suffer as severely from COVID-19 as do older people and the elderly, they still need to wear masks for the purpose of preventing the disease’s spread to people who are more at risk for bad outcomes.
"The more people have it, the more everyone is at risk — including children, who can have bad outcomes," Naylor said.