Yes, by now you have heard that we are knee deep in the Third Wave of Covid-19, this time with Gauteng leading the scoreboard. Couple that with ongoing restrictions, stage 4 load shedding icy cold weather conditions as well as the the usual cases of winter colds and cold and it all seems a bit bleak and tedious.
We are definitely finding more positive cases amongst our paediatric population this time. Many schools in and around Johannesburg have closed to allow for quarantine after positive cases and contacts were reported. As last year, they have again resorted to online learning. Understandably this may leave many parents uncomfortable, concerned and anxious.
Remember that what we see in the Paediatric age group is only a reflection of the situation in our greater community. If more cases are reported in the general population, there will be a knock-on effect in the kids. We still feel that most kids get infected from adults and not the other way round. Therefore it is more probable the birthday party, social event or contact sport that everyone attended unmasked, than the kids going to school which seem to lead to increasing cases being reported. Luckily, as with the first and second waves, children seem to be getting a milder form of this illness, and only in a few, very isolated cases are they sick enough to be admitted.
Covid-19 symptoms overlap greatly with the usual illnesses we see in winter. Blocked noses(it can be the only symptom), runny noses, sore throat, coughing, sneezing, headaches, fever, fatigue, vomiting and diarrhoea are some of the symptoms associated with Covid-19. Here-in lies the dilemma; it is also the symptoms for just about all the conditions that kids present with at this time of year. The same symptoms are seen in cold and flu-like illness, bronchitis, bronchiolitis, pneumonia’s as well as gastroenteritis.
It is standard practice to request a Covid test should a little one present with the above mentioned symptoms.The more children we test, the more positive cases we will identify, and this is why we are seeing increased numbers amongst kids… we are testing more. It is important to identify positive cases so that they can isolate and prevent further spread into the community and also to limit exposure of those family members who may be more vulnerable and have co-morbid conditions.
Lets look at a few scenarios and what to do;
1. My little one has a runny nose. I am sure its only a cold or allergies. Can I send him to school?
That child should ideally see his Paed or GP, who will decide if a Covid PCR swab is needed. As I have said previously, it is difficult to distinguish between the winter ailments and Covid, rather have the test done to be safe and to limit spread into the community.
Regardless of a negative test result they should be kept home until completely well. Do not send any child with any sign of illness to school. If positive, the child as well as the family should isolate for 10 days. Should anyone become symptomatic , they should have a Covid PCR swab, and if positive the 10 day isolation is again counted from that day forward.
Please note that a rapid antigen test is less likely to be positive if there are no symptoms. The PCR swab is far more sensitive and therefore the test of choice. Even little ones will have a nose swab ( smaller than those used for adults ), and they tolerate this remarkably well.
2. My child had definite close contact with a Covid positive person. Can I do the rapid antigen test on Day 5 or 6 and send him to school if negative?
The safest way is to isolate him for 10 days and to test only if he becomes symptomatic. Should there be no symptoms and he is completely well, he can go to school on day 11. A test on day 5 or 6 after contact is mostly used for healthcare workers who, if negative may then return to work. Remember that we will use proper PPE for all patient contacts, and that most healthcare workers have by now been vaccinated. A different story altogether!
3.We have had contact with a positive case. Can my child attend a birthday party or play contact sport if he is asymptomatic?
Sorry, but again the answer is no; Isolate for the full 10 days after contact and resume normal activities if still asymptomatic by day 10. It is in fact better to avoid attending and hosting birthday parties and social events altogether until this wave has passed. Stick to your own tiny bubbles and be safe. We have had plenty of reports of parties and social gatherings causing widespread outbreaks of Covid-19.
I think most schools have stopped all contact sporting events for the time being, and that is absolutely the right thing to do. We all have Covid fatigue, and are missing life as it used to be. Absolutely understandable, but only if we all do the right thing, have we got any chance to get back there someday soon.
- How do we go about isolating if one parent tests positive?
It is a tricky situation and often impossible for a parent to isolate away from the family, especially if there are young children and babies involved. The best advice I can give is to isolate together as a family for 10 days and test anyone who becomes symptomatic. If there is enough help available to a parent, the sick parent can attempt to isolate in a room separate from the others. The chances of the kids and the other parent getting it, or having it already, is high, and therefore self isolation as a family unit is key.
Covid has taught us many lessons; what’s important and what not. Family, love, unity, compassion and kindness is what matters… the rest can wait. This is the one case where I can say what’s good for one is good for all. Lets all do our bit and so help each other…and please help register your parents and grandparents and other elders if they are eligible for vaccination.
Stay warm and stay safe
XOXO Dr Christa