10 Questions about COVID-19 and Kids with Dr. Hasan

Uzma Hasan, MD, Division Chief, Pediatric Infectious Diseases at Cooperman Barnabas Medical Center, answers your questions about COVID-19, what you need to know about the newest Omicron variant, visiting with grandparents for the holidays, and vaccinations. All statistics and recommendations are as of December 7, 2021. For more information, contact your pediatrician’s office.

1. What are the current statistics of COVID-19 in children?

In the last two weeks, we have seen an uptick in pediatric cases, almost a 4% increase. So far there's been 6.9 million cases in children and 132,000 new cases within the last week all over the country. 

2. What do we need to know about the new variant?

We know viruses mutate and sometimes the mutations make them stronger or weaker. The Omicron variant, which was first described in South Africa on November 30th, became a variant of concern. There are about 30 mutations of the spike protein in this variant which makes us a little concerned whether our conventional treatments will will be effective against this variant. We do know that vaccination is still protective and we are still learning about severity of illness related to this variant.

3. Should my five-year-old be vaccinated even though kids mostly do well with COVID-19?

Absolutely. Yes. We do know that vaccination is more than 90% effective in preventing symptomatic illness from COVID in this age group and 100% preventing hospitalizations. We know that we see milder illness in general and children. However, the biggest rise in multisystem inflammatory syndrome is within the last several months has been in the five to 11 age group, and vaccination is protective and preventing hospitalizations.

4. What are the current quarantine recommendations?

So if a child is vaccinated, they do not require quarantine. But the recommendation is that they get tested anywhere between five to seven days, post-exposure. If a child is unvaccinated, the recommendation is that they be tested immediately, post-exposure and then repeat testing is done five to seven days post-exposure in the child who is unvaccinated. Regardless, they have to complete out the quarantine phase of 14 days. Some some clinicians may shorten that phase to ten days depending on what the local health authorities advise them to do.

5. What are the recommendations for traveling internationally?

The CDC has put out a health advisory warning for certain parts of the world. Make sure you check the CDC website before travel. The U.S. now requires a PCR test to be done within 24 hours of returning to the U.S.. Anybody who has traveling needs to check the country that they're traveling to their recommendations or requirements for PCR testing before they travel and anybody with international travel who is unvaccinated is required to have a PCR test done about three to five days post return and then quarantine for a seven day period regardless of what your test shows.

6. If my child has COVID-19, how long do they need to quarantine?

If your child is symptomatic with a COVID infection, the recommendation is that they quarantine for a period of ten days and are fever free for 24 hours without any fever reducing medications and symptoms improved before they can return to their normal routine. If your child is asymptomatic, then the recommendation is again that they quarantine for a 10 day period in that time. If at any point they start developing symptoms or so, they should seek advice from their health care provider.

7. Who is eligible for monoclonal antibody treatments?

This is a medication that is administered to prevent progression of illness As of now, we are using this medication only in severely immunocompromised children who have either diabetes, severe asthma, which is required ICU admissions or intubation or ventilation. Kids who have chronic kidney disease, kids who are severely immunocompromised, like our transplant patients, etc. If monoclonal antibody treatment is a consideration, you must discuss this with your primary health care provider. As well as there is a hotline that has been set up for our health care system, which gets contacted to determine if your child will be eligible and will benefit from this treatment.

8. Who is eligible for booster doses?

Severely immunocompromised children between the ages of 12 to 17 may be eligible for booster doses as per AAP recommendations. If your child is severely immunocompromised, discuss this with your pediatrician. 

9. Is it safe to be around older adults if my child is not vaccinated?

Make sure that all the immunocompromised seniors and your family are vaccinated, including booster doses and especially during the holiday time. We want to be making sure that we protect the vulnerable around us. There should be no laxing and preventive measures. Make sure that you are masking in an indoor setting if you are not vaccinated. Make sure that you are diligently washing hands. And we still say to practice social distancing if able to. 

10. If someone in my child’s class has COVID-19, what steps should be taken?

The local health department is an excellent resource for all school systems. We say that if a child has any high risk symptoms if they have cough, they have shortness of breath or they have loss of taste or smell that warrants testing immediately. If kids have low grade symptoms like where they have a little bit of a headache, they have vomiting or diarrhea, etc., or a sore throat, that two or more symptoms should warrant testing. Usually if there is a cluster of cases that are linked in the classroom for and for most health departments, the magic number varies. For the local health department here, it's four or more cases in the classroom. That's when the school system discusses with the health department whether the class should be quarantined.