As of 3/1/2024, the CDC updated guidance on COVID-19 illness.
The recommendation includes avoiding contact with others until symptoms have been improving for at least 24 hours and fever has resolved (if initially present with illness) for at least 24 hours (without use of fever reducing medications like ibuprofen or acetaminophen).
Then, for at least 5 days after returning to normal activities, it is recommended to take additional precautions to protect against illness spread, especially to those who are at higher risk of severe illness (adults over 65 years or those who are immunocompromised).
Once returned to normal activities, some may feel comfortable continuing to wear a mask for 5-10 days, while others will choose not to do this. The same will be true for COVID-19 testing, with some choosing not to test and others desiring testing.
Additional guidance can be found on the following websites: Why did the recommendations change?
Most fevers are good for children and a sign that the body is fighting infection. The goal of therapy is to bring the fever down to a comfortable level. True fever begins at 100.4 (using rectal, ear or forehead thermometer); many fevers associated with a virus fluctuate between 100.4-104 degrees for 2-3 days. Fevers only need to be treated with medicine if they cause discomfort, which usually means fevers of 102 degrees and higher. Ear temperatures are not accurate before 6 months of age.
Treatment for fevers:
Medication for fevers:
If your child is over age 2, have them blow their nose frequently. For younger children, gently suction their nose with a suction bulb whenever nasal passages are blocked, and they can’t breathe through their nose. Congestion can drain down the back of the throat and into the stomach causing decreased appetite, looser stools, and even vomiting. It can also go into the lungs and cause coughing. Maintaining good hydration is especially important to help thin mucous so it can be expelled more easily. Try to clear passages prior to feeds, naps and bedtime so child can eat and sleep more comfortably. Congestion and runny nose can last 2-3 weeks or more.
Treatment for congestion
Medications for congestion
Coughing up mucus is very important for protecting the lungs from pneumonia. We want to encourage a productive cough, not turn it off. For vomiting that occurs with hard coughing, reduce the amount given per feeding. Coughs can last 2-3 weeks or more, and often as a virus begins to resolve, a cough becomes more productive or “phlegmy.” This is not concerning as long as it is not causing trouble breathing, wheezing, shortness of breath, or preventing sleep at night.
Treatment for coughs
Medication for coughs:
o Age 1 Year and Older: Use honey 1/2 to 1 tsp (2 to 5 ml) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. (If not available, can use corn syrup.) OTC cough syrups containing honey are also available. They are not more effective than plain honey and cost much more per dose.
o Age 3 Months to 1 year: Give warm clear fluids (e.g., apple juice or lemonade) to thin themucus and relax the airway. Dosage: 1-3 teaspoons (5-15 ml) four times per day
First, try not to worry. With the Omicron variant, we are seeing COVID spread much more readily. Each family will handle this scenario differently. Any of these plans are reasonable; do what feels best for your family. You can:
No. This is not helpful. A PCR test can remain positive for 60-90 days, again, after no longer contagious. We determine when it is safe to leave quarantine based on the CDC guidelines for when symptoms started or when the test appeared positive (for cases with no symptoms). See top of handout under “Quarantine” section.
Return to sports after COVID-19 illness
A very rare complication of the COVID-19 virus is myocarditis (inflammation of the heart muscle). Though this only occurs in a very small percentage of the pediatric population after a COVID-19 illness, it is still important not to miss. it is important to discuss returning to physical activity, and in some instances do a physical exam, before returning to sports participation after COVID-19 illness.
We follow the American Academy of Pediatrics return to play guidelines. Children fall into 2 main categories and recommendations for follow-up are below. The primary reason for follow-up before beginning exercise is to ensure there are no cardiac symptoms. Symptoms to watch for include chest pain, shortness of breath more so than with a typical cold, new-onset heart palpitations (feeling like the heart is “beating funny”) or passing out (or feeling like he/she is about to pass out). If any symptoms occur, stop exercise immediately and call our office.
Once cleared, follow a gradual return-to-play exercise progression
Day 1 and Day 2 – (2 Days Minimum) – 15 minutes or less: : Light activity (walking, jogging, stationary bike), intensity no greater than 70% of maximum heart rate. NO resistance training.
Day 3 – (1 Day Minimum) – 30 minutes or less:Add simple movement activities (eg. running drills) – intensity no greater than 80% of maximum heart rate.
Day 4 – (1 Day Minimum) – 45 minutes or less- Progress to more complex training – intensity no greater than 80% maximum heart rate. May add light resistance training.
Day 5 and Day 6 – (2 Days Minimum) – 60 minutes – Normal training activity – intensity no greater than 80% maximum heart rate.
Day 7 – Return to full activity/participation
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