With the extension of the movement control order to combat the Covid-19 pandemic, parents are naturally worried about the risk of their young children being infected.
SARS-CoV-2, which causes Covid-19, was just discovered in January, and we are all still learning about it.
With much information circulating in social media, we would like to focus on providing up-to-date facts on the disease as it relates to child health.
Here are some frequently asked questions:
Based on the available evidence, children do not appear to be at higher risk for Covid-19 than adults.
While some children and infants have become sick with Covid-19, adults make up most of the known cases to date.
The symptoms of Covid-19 are similar in both children and adults.
Symptoms in children include cold-like symptoms, such as fever, runny nose and cough.
Vomiting and diarrhoea have also been reported.
It’s not known yet whether some children may be at higher risk for severe illness, e.g. children with underlying medical conditions and special healthcare needs.
There is much more to be learned about how the disease impacts children.
You can encourage your child to help break the chain of infection by practising hand hygiene and avoiding people who are sick.
You can also clean and disinfect high-touch surfaces in household common areas daily, e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks and phones.
Cleaning refers to the removal of germs, dirt and impurities from surfaces; it does not kill germs.
Disinfecting refers to using chemicals to kill germs on surfaces; it does not necessarily clean dirty surfaces or remove the dead germs.
The germ, or microorganism, we are targeting specifically in this case is the SARS-CoV-2 virus, which causes Covid-19.
Therefore, dirty surfaces should be cleaned using a detergent, or soap and water, prior to disinfection, to best lower your risk of infection.
For disinfection, use unexpired diluted household bleach solutions or alcohol solutions with at least 70% alcohol.
You can prepare a bleach solution by mixing five tablespoons (or one-third of a cup) of bleach for every 3.8 litres of water you use, or four teaspoons of bleach for every 950ml of water you use.
Clothes, pillow covers, bedsheets and other items like washable plush toys, should be washed regularly at the warmest water setting possible.
Handwashing is one of the best ways to protect yourself and your family from getting sick.
Teach your children to wash their hands often with soap and water for at least 20 seconds (they can sing the Happy Birthday song twice for the right timing), especially after blowing their nose, coughing or sneezing; going to the bathroom; and before eating or touching food.
If their hands are not visibly dirty, and soap and water are not readily available, then they may use alcohol-based hand sanitiser with a concentration of 80% ethanol or 75% isopropyl alcohol, to cover the entire surface of their hands (back and front) and rubbing their hands together until they feel dry.
The same goes for the adults too.
No, if your child is healthy, there is no need for them to wear a face mask.Only people who have symptoms of illness or who are providing care to those who are ill should wear face masks.
The health authorities will conduct contact tracing to identify close contacts of the confirmed cases or PUI to determine if the nature of their contact poses a risk of virus transmission.
For example, the classmates and teachers of the confirmed patient or PUI are considered close contacts, whereas schoolmates who only share the canteen, but are in different classrooms, might be considered as casual contacts.
The public health team will then decide if there is a need for your child and/or close contacts to be placed under home quarantine.
The health team will make an assessment to see if your child needs to be admitted to the hospital or to be quarantined with a home surveillance order.
However, according to the latest guidelines in Malaysia, a young child who is a PUI, is most likely to be required to be admitted to the hospital for surveillance.
We always try not to separate children from their parents, so one parent or caregiver will be allowed to accompany the child in the hospital.
The caregiver will need to wear a face mask at all times, observe the highest personal hygiene and always clean their hands properly.
Try to explain to your child that they are at risk of being infected and becoming sick in language best suited to their age, and in a kind and reassuring way.
Their normal routine has been disrupted, but try to create a new one to help them to relax and still play as much as usual in the hospital ward or room.
More mature children like adolescents, should be involved in decisions about their own health.
So if they are a PUI, they should have the choice to either be admitted to the hospital or quarantined at home, if allowed by the health team.
If they are admitted to hospital, they are likely to want to stay by themselves, so ensure that they remain in regular contact with you via a phone or email.
Encourage them to establish a routine during isolation to have some structure to their day.
Also, encourage them to communicate their anxiety and doubts through official channels, and not simply believe news from unreliable sources.
Here are some general infection control rules:
- The quarantined person should stay in a separate bedroom and bathroom from the rest of the family (if possible) at all times.
If a separate bathroom is not available, avoid using the bathroom for as long as possible after the quarantined person has used it.
Then thoroughly clean and disinfect the bathroom, especially high-touch surfaces like the sink, toilet and shower knob, before someone else uses it.
- All household members should clean their hands regularly by handwashing with soap and water or using an alcohol-based hand rub, especially the quarantined person and the person who handles their food, utensils, laundry and garbage (only one person should be doing this).
- If the quarantined person needs to come into a communal area – although she should ideally stay in her own room the entire quarantine period – she should wear a clean disposable face mask and practise social distancing to help prevent spreading the coronavirus to other members of the household.
These measures should be explained to your children in language best suited to their age, so that they understand why they cannot go near the quarantined person.
We still do not know if a pregnant woman with Covid-19 can pass the coronavirus to her foetus or baby during pregnancy or delivery.
We still do not know whether a mother with Covid-19 can transmit the coronavirus to her baby via breast milk.
However, whether and how to start or continue breastfeeding should be determined by the mother and the healthcare provider.
If, after counselling, a PUI or Covid-19 patient decides to breastfeed, she should do it safely with the proper hand hygiene before touching her baby and wearing a face mask.
If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any part of the pump or bottle, and follow recommendations for proper pump cleaning after each use.
If possible, consider having someone who is well to feed the expressed breast milk to the baby.
Dr Chin Saw Sian is a paediatrician and Dr Lee Yew Fong is a medical officer currently pursuing her doctorate in biomedicine (Global Health Track) at the University of Geneva, Switzerland. For more information, email email@example.com. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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