How to take care of a covid positive child?

Don’t panic. Very likely he/she would recover from the illness uneventfully, without any need for hospital admission or even supplementary oxygen. 

children who test positive for covid 19 or are suspected to have covid 19 fall into four categories

1. Asymptomatic
2. Mild symptomatic
3. Moderate symptomatic 
4. Severe symptomatic

More than 95% of children fall into the first two categories. They don’t need hospital admission.  Only moderate and severe symptomatic children should be admitted to the hospital. Here we discuss some common questions on this topic.

QUESTION1:DOES ALL COVID POSITIVE CHILDREN NEED HOSPITAL ADMISSION?

Answer: Absolutely no. As I told earlier most (more than 95%) children will not need hospital admission. When you get your child’s covid positive report, you should consult with your doctor. He will classify your child according to severity. Only moderate to severe cases needs treatment in a health facility.

QUESTION2:HOW TO TAKE CARE OF ASYMPTOMATIC COVID POSITIVE CHILDREN?

Answer:

1. NO MEDICINE IS NEEDED(NO MULTIVITAMIN, NO ZINC, NO VITAMIN C OR D)
2. Nutritious homemade food
3. Plenty of water to maintain hydration.
4. Monitor your child(discussed below)
5. Infants and younger children stay with their mothers.
6. If your child is on any medication for other illnesses, continue that.
7. Maintain COVID-appropriate behavior (mask, strict hand hygiene, physical distancing); 
8. Older children and family to stay connected and engage in positive talks through phone, videocalls, etc.
9. Contact your doctor if a symptom appears.

QUESTION 3: WHAT ARE MILD SYMPTOMS?

Answers:

Fever/mild cough/ runny nose(rhinorrhea)/sore throat(pain while swallowing)/loose stool/vomiting/ belly pain/ loss of taste and smell/body pain/ weakness/headache -any of these with SpO2>94% in room air. A child may have single or multiple symptoms.   

QUESTION 4: HOW TO TAKE CARE OF MILD SYMPTOMATIC CHILDREN?

Answer:

1. Paracetamol for fever. 4-6 hourly if needed
2. NO MULTIVITAMIN, NO ZINC, NO VITAMIN C OR D, NO IVERMECTIN, NO DOXYCYCLINE-none of these cures covid.
3. Gargling with salt water for sore throat.
4. For cough-throat soothing lozenges, ask your doctor for cough syrup.
5. Nutritious homemade food. 
6. Plenty of water to maintain hydration.
7. Monitor at home(discussed below)
8. Infants and younger children stay with their mothers.
9. If your child is on any medication for other illnesses, continue that.
10. Maintain COVID-appropriate behavior (mask, strict hand hygiene, physical distancing); 
11. Older children and family to stay connected and engage in positive talks through phone, video calls, etc.
12. Contact your doctor if the symptom worsens.

QUESTION 5:HOW TO MONITOR COVID POSITIVE CHILD AT HOME?

Answer: Most important part of home management. The following parameters are to be observed at home.
1. Respiratory rate: count respiration for 1 minute; it should be<60/min in a baby less than 2 months, <50 /min 2-12 month baby, <40/min in a 1-5 year baby, <30/min in 5year or older child. Respiratory rate should be measured at least three times per day.

2. SpO2 ( in the middle finger of the hand, should be 94% or more)

3. Fluid intake 

4. Urine output– take note of how many times your child urinates in a day, and compare it with urine output before the illness. If less that means he needs to take more fluid.

5. Activity

Stay alert for DANGER signs- grunting/cold extremities/cyanosis or bluish discoloration of skin/chest indrawing(inward movement of the lower chest wall)/decreased activity/decreased alertness or excessive sleepiness/unable to take feed/ convulsion/increased respiratory rate/ SpO2<94%/ decreased urine output/ fever more than 3 day

If any danger sign develops contact your doctor immediately.

QUESTION 6: WHICH CHILDREN ARE AT RISK OF DEVELOPING SERIOUS ILLNESSES?

Answer: Children with the preexisting disease are at risk of developing severe covid 19. 

1. Chronic kidney disease
2. Congenital heart disease 
3. Chronic lung disease(like asthma),
4. Diabetes
5. Obesity 
6. Malignancy
7. Chronic neurological disease etc.