When to Call Your Pediatrician – COVID-19 Edition

Parents should always feel that they can call their pediatrician when their kids are sick, but that call might not get you a quick visit now that we are concerned about COVID-19.

Why not?

Although we don’t think that kids typically develop serious COVID-19 symptoms, they probably do still get sick and can be contagious to others.

That makes it important to keep them home if they have any symptoms of COVID-19, which unfortunately, can mimic most of the other viral infections that kids get.

When to Call Your Pediatrician – COVID-19 Edition

As more and more pediatricians limit who they will be seeing in their offices, it becomes even more important that parents learn to recognize when their kids have mild symptoms that can safely be treated at home and when they might have urgent problems that need medical attention.

Fortunately, while many parents have gotten used to running to their pediatrician as soon as their kids have a fever, sore throat, diarrhea, or cough, most of these symptoms are caused by viral infections that go away without treatment.

And parents should understand that their pediatricians are still available! Most of us likely won’t be able to see everyone as quickly and easily as we usually do, but the kids who get triaged to stay at home without being seen will almost certainly be those who don’t need to be seen.

Recognizing the signs of a more serious infection will also help you trust your pediatrician’s judgment on home care so that you don’t rush to an urgent care, where they might not be triaging kids with COVID-19 symptoms and are seeing everyone who comes in.

So how do you know if your child has a mild viral infection or if it is something more serious?

Ultimately, you might need to call your pediatrician, but it might help to know that:

• fever itself is not a disease and how high a temperature gets doesn’t tell you how sick your child is. Unless you have an infant under 2 months old with a rectal temperature at or above 100.4°F (38°C) – which is always a medical emergency – your otherwise healthy (no chronic medical problems) older child with a fever doesn’t necessarily need treatment or a visit to the doctor, as long as they are drinking and aren’t irritable and aren’t having trouble breathing etc.
• a sore throat with a runny nose and cough is typically caused by a virus and not strep throat. On the other hand, if your child has the sudden onset of a sore throat and fever, with red and swollen tonsils (tonsillitis), possibly with white patches (exudate) and small, red spots (petechiae) on the roof of their mouth, and tender, swollen lymph glands in their neck, then they might have strep and should have a strep test.
• the flu, although it can be a life-threatening disease, especially in those who are high risk, typically goes away on its own after 5 to 7 days of fever, runny nose, and cough. Unless they are at high risk for flu complications, kids don’t necessarily need a flu test or Tamiflu, so don’t necessarily need to visit their pediatrician when you think they have the flu.
• a runny nose, even if it is green or yellow, doesn’t mean that your child has a sinus infection and needs antibiotics, unless the symptoms are lingering for ten or more days or the child has severe symptoms
• ear pain doesn’t mean that your child has an ear infection and even when your child does, a 2-3 day watching period before starting antibiotics is becoming the standard of care because the great majority of ear infections go away on their own
• a cough, even if has been lingering for a week or two, doesn’t mean that your child needs antibiotics, as most kids with coughs simply have bronchitis, which will eventually go away
• diarrhea can be a sign of a food intolerance or an infection, typically a stomach virus. Either way, you can likely treat your child at home, unless your child has high fever and bloody diarrhea or is dehydrated.
• vomiting, especially when it is accompanied by diarrhea, is also often associated with gastrointestinal infections, and can respond to proper rehydration techniques

Of course, if your child has a chronic disease, like diabetes, asthma, or cystic fibrosis, etc., then even mild symptoms might put them at high risk for serious disease and you shouldn’t hesitate to call your pediatrician any time they get sick.

What are some other “red flag” type things parents should look for? In general, you should seek quick medical attention if your child has viral symptoms and:

• is truly lethargic, which means that they are hard to wake up and not that they are just sitting on the couch watching Netflix instead of running around the house
• has vomiting or diarrhea that has led to dehydration – dry mouth, few tears, only urinating a few times a day, etc
• has vomiting with severe stomach pain
• is breathing fast and hard, which could be a sign of pneumonia
• has a fever and a purplish rash
• is not at all playful or consolable
• is not eating or drinking anything

On the other hand, even if your child has a fever, runny nose, cough, and sore throat, if they are also sometimes playful and drinking, then you likely have less reason to need an immediate visit to the doctor.

What if it’s COVID-19?

Again, most kids are not at big risk to get severe COVID-19 symptoms, so the main reason to see your pediatrician about COVID-19 would be to get tested to help know if you need to quarantine your child. Unfortunately, as most people are aware, testing is still very limited. Your pediatrician likely does not have the ability to test kids yet.

What about well checks and vaccines and other visits to your pediatrician?For that info, you will have to call your pediatrician.

And see if they are set up to do telemedicine yet.

More on Calling Your Pediatrician – COVID-19 Edition

• 30 Uncommon Diseases Parents Should Learn to Recognize
• Treating the Flu and Hard to Control Flu Symptoms
• COVID-19 Presentations and Webinars
• Mixed Messages About COVID-19
• How to Self-Quarantine After Being Exposed to a Disease
• Should You Be Tested for COVID-19?
• What is the COVID-19 Mortality Rate?
• Kids and COVID-19
• COVID-19 Hype or Hazard
• What You Need to Know About a COVID-19 Vaccine
• AAP – When to Call Your Pediatrician
• AAP – 10 Common Childhood Illnesses and Their Treatments
• AAP – The Difference between a Sore Throat, Strep & Tonsillitis
• CDC – What is a chest cold (acute bronchitis)?
• AAP – Telehealth Services for Children
• Diagnosis and Management of Acute Bacterial Sinusitis:2013 AAP Guideline
• Talking to Children About COVID-19 (Coronavirus): A Parent Resource

Last Updated on March 17, 2020 by Vincent Iannelli, MD