Tag: SARS-CoV-2

What to Do if You Have Been Diagnosed with COVID-19

Do you know what to do if you get diagnosed with COVID-19?

Do you know what to do if you think you might be sick or have already been diagnosed with COVID-19?

What's worse than having a party when you have symptoms of COVID-19? How about refusing to cooperate with contact tracers who are trying to control an outbreak?
What’s worse than having a party when you have symptoms of COVID-19? How about refusing to cooperate with contact tracers who are trying to control an outbreak?

Hopefully you know that you shouldn’t host a party and expose lots of other folks…

What to Do if You Have Been Diagnosed with COVID-19

Unfortunately, lots of mistakes are being made that are causing COVID-19 cases to again rise.

“For COVID-19, a close contact is defined as anyone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before the person began feeling sick until the time the patient was isolated.”

COVID-19 Frequently Asked Questions

One of them is that many people simply don’t understand the importance of staying away from others if they have been diagnosed (isolation) or exposed (self-quarantine) to SARS-CoV-2.

“If possible, have the person who is sick use a separate bedroom and bathroom. If possible, have the person who is sick stay in their own ‘sick room’ or area and away from others. Try to stay at least 6 feet away from the sick person.”

Caring for Someone Sick at Home

What happens if you don’t stay away from other people?

You may expose others, beginning in the days before you start to show symptoms (presymptomatic transmission).

Ideally, folks would be getting this information to self-quarantine after their COVID-19 exposure from a contact tracing team.
Ideally, folks would be getting this information to self-quarantine after their COVID-19 exposure from a contact tracing team.

Once you are diagnosed with COVID-19, be sure to tell all of your close contacts that they have been exposed, which includes everyone who was within 6 feet of you for at least 15 minutes starting from 48 hours before you began feeling sick. That way, if they aren’t fully vaccinated, then they can begin to self-quarantine and avoid exposing others if they get sick too.

How Long Will Your Isolation Last?

How long will you have to stay home, away from other people?

It depends…

The CDC provides a variety of scenarios to help explain how long folks should stay in quarantine.
The CDC provides a variety of scenarios to help explain how long folks should stay in quarantine.

If you are in self-quarantine because you were exposed to someone with COVID-19, then you should stay home for 14 days after your last contact with that person. That’s the incubation period for the SARS-CoV-2 virus. Keep in mind that your quarantine restarts every time you have a new exposure, although there are now options to shorten your quarantine.

On the other hand, if you are in isolation because you have been diagnosed with COVID-19, then you should stay home until:

  • at least 10 days have passed since your positive test (if you have been asymptomatic)
  • you are fever free for at least three days, have improving respiratory symptoms, and it has been at least 10 days since your symptoms began

You might also be able to end your quarantine early if you have two negative tests in a row at least 24 hours apart, of course, while fever free and with improving respiratory symptoms.

And there are new options to end isolation early!

There are new options to end your COVID isolation early, after just 5 days.
There are new options to end your COVID isolation early, after just 5 days.

According to new CDC guidelines, you might be able to end your COVID isolation after 5 days, as long as you either have had no symptoms or your symptoms are getting better, and you will continue to wear a mask for an additional 5 days.

If You Have COVID-19

What if you need to go to the doctor or ER after you have been diagnosed with COVID-19?

Call ahead so that they can be prepared and don’t end up exposing any staff or patients.

Hopefully you will have mild symptoms that will go away as you rest and stay hydrated, but if you develop emergency warning signs or symptoms (trouble breathing, chest pain, confusion, and trouble staying awake, etc.), then seek emergency care, being sure to mention that you have been diagnosed with COVID-19.

What if you need to go somewhere else?

You shouldn’t go anywhere or be around other people if you are in isolation after being diagnosed with COVID-19.

“People who are in isolation should stay home until it’s safe for them to be around others. In the home, anyone sick or infected should separate themselves from others by staying in a specific “sick room” or area and using a separate bathroom (if available).”

Isolate If You Are Sick

When in isolation, you should stay home except to get medical care.

What if you need food, medicine, or something else that you don’t have in your home? Ideally, you would order it and have it delivered, being sure to not expose the delivery person. If that isn’t an option, call your local support services for help.

What about treatments?

If you are at high risk for a severe case of COVID, you should talk to you health care provider about the treatments available, including monoclonal antibodies and oral antiviral drugs.

More on COVID-19

Why There is Still So Much COVID-19 Confusion

Cognitive biases, heuristics, and logical fallacies are likely affecting how you are viewing information and advice about COVID-19.

Early on, it was easy to understand why there was so much confusion about COVID-19, after all, it took some time before we even got a real name for the new or novel virus that is causing this pandemic.

And now?

While there is still a lot more research to do, we have already learned a lot about the best ways to help prevent and treat COVID-19 infections.

Do you know who to turn to for trusted information and advice about COVID-19?

Too many people don’t seem to understand that though…

Why There is Still So Much COVID-19 Confusion

Many people also don’t understand that advice and recommendations often shift and change as we get new information.

“It is irrational to hold any view so tightly that you aren’t willing to admit the possibility that you might be wrong.”

What would it take to convince you that you were wrong?

And of course, you have to expect that to happen when you are dealing with a brand new disease!

So what are people confused about?

Everything from the effectiveness of face masks to prevent the spread of the SARS-CoV-2 virus (they do) to whether our COVID-19 death counts have been inflated (we are probably seeing under-counts).

Surprisingly, some people are still confused about just how deadly COVID-19 infections really are.

If you think made-up news and information is true, you might want to rethink where you regularly get your news and information from...
If you think made-up news and information is true, you might want to rethink where you regularly get your news and information from…

Why are so many people still confused?

“Compared with other Americans, adults who “often” use social media to get news about COVID-19 report higher levels of exposure to the conspiracy theory that the pandemic was intentionally planned.”

Three Months In, Many Americans See Exaggeration, Conspiracy Theories and Partisanship in COVID-19 News

Where are they getting their information???

Who do you trust for information and advice about COVID-19?

I’m guessing it isn’t from experts…

Who to Trust About COVID-19

Adding to a lot of the confusion we are dealing with are folks pushing misinformation.

As you learn who to trust for information about COVID-19, you will hopefully develop the skills you need to be more skeptical about all of the things you see and read.

“Although my main message is that awareness of cognitive biases can lead to more effective messages and measures to mitigate the effects of the pandemic, where cognitive bias is regarded as harmful, it may be helpful to take steps to reduce such bias. Education and awareness of cognitive biases are key, so that individuals and organisations question flawed or traditional thinking habits and try to promote evidence based thinking. At an individual level, the additional advice is to slow down in your thinking, pause and reflect, and seek external views.”

Covid-19 and cognitive bias

And you will hopefully turn to sources that many of us use, including:

Still confused?

Check your biases.

Don’t let them get in your way of following the advice from the experts that could protect you and your family from getting and spreading the SARS-CoV-2 virus.

What does that mean?

Well, if you don’t think anyone should tell you to wear a mask, then you will likely look for information and advice that says masks don’t work and aren’t necessary (confirmation bias).

You will also likely not believe any information and advice that says COVID-19 is deadly.

Why?

Well, if you believed it was deadly, then you would work to avoid it and try to keep those around you safe, including doing things like wearing a mask. Instead, cognitive dissonance, the anxiety you get from believing in two things that contradict each other, will push you towards believing things that reinforce your idea that you don’t have to wear a mask.

What to Know About COVID-19 Confusion

Tired of being confused about COVID-19 and other things?

“It’s sobering to note all the ways in which human brains distort decision processes; perhaps it’s a wonder that any good decision is ever made.”

How to Make Better Decisions About Coronavirus

Be more skeptical and look for new sources of information and advice and understand how cognitive biases, heuristics, and logical fallacies affect our decision making.

More on COVID-19 Confusion

What Did the AAP Say About Sending Kids Back to School?

The AAP has offered guidance for a safe way to get our kids back in school during the COVID-19 pandemic. Will schools follow any of it when they open up?

The American Academy of Pediatrics recently issued some guidance about what to do about kids going to school this fall.

The AAP said a lot more than that parents should send their kids back to school. They offered guidance on how to safely send kids back to school...
The AAP said a lot more than that parents should send their kids back to school. They offered guidance on how to safely send kids back to school…

Not surprisingly, folks are a little confused about what they actually said…

What Did the AAP Say About Sending Kids Back to School?

It is true, the AAP guidance does favor opening up schools this fall.

“With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school. The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020. Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality. Beyond the educational impact and social impact of school closures, there has been substantial impact on food security and physical activity for children and families.”

COVID-19 Planning Considerations: Guidance for School Re-entry

But, that isn’t all they said…

The goal is for kids to be in school this fall...

To get to that goal of opening schools, the AAP offered a list of key principles that schools should follow, including that:

  • school policies are going to have to be “flexible and nimble” so that they can quickly change as we get new information, especially “when specific policies are not working”
  • schools develop strategies that depend on the levels of COVID-19 cases in the school and community
  • schools make special considerations and accommodations for those who need them, “including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school”

So clearly, this is not a one-size-fits-all, lets open up schools no matter what kind of thing.

“Highest Risk: Full sized, in-person classes, activities, and events. Students are not spaced apart, share classroom materials or supplies, and mix between classes and activities.”

CDC on Considerations for Schools

The AAP didn’t say to simply open up schools without doing anything else…

“No single action or set of actions will completely eliminate the risk of SARS-CoV-2 transmission, but implementation of several coordinated interventions can greatly reduce that risk. For example, where physical distance cannot be maintained, students (over the age of 2 years) and staff can wear face coverings (when feasible). In the following sections, we review some general principles that policy makers should consider as they plan for the coming school year. For all of these, education for the entire school community regarding these measures should begin early, ideally at least several weeks before the start of the school year.”

COVID-19 Planning Considerations: Guidance for School Re-entry

They offered guidance on how to safely open schools.

Or at least how to open schools as safely as possible, as the alternative of keeping kids at home has risks too. And many people are skeptical that a strategy of closing schools is all that helpful in controlling the spread of SARS-CoV-2.

So the AAP guidance says that we open schools and also plan for:

  • Physical distancing – cohort classes, block schedules, rotating teachers instead of students, etc.
  • Cleaning and disinfecting
  • Testing and screening – schools will need a rapid response plan for when a child or staff member develops a fever at school.
  • Face Coverings and PPE – although it won’t be possible in all situations and for all children, “school staff and older students (middle or high school) may be able to wear cloth face coverings safely and consistently and should be encouraged to do so.”
  • Organized Activities – although this isn’t something most folks want to hear, they should understand that opening schools doesn’t mean that everything will be back to normal… “It is likely that sporting events, practices, and conditioning sessions will be limited in many locations.”

If we do all of that, will it really be safe to go to school with these guidelines?

Unfortunately, the most important part of the guidelines, the section on Testing and Screening, was a bit light on details…

“Parents should be instructed to keep their child at home if they are ill.”

COVID-19 Planning Considerations: Guidance for School Re-entry

The guidelines acknowledge that it will be too hard to do temperature checks and symptom screening each day and that schools should have a rapid response plan if anyone has a fever had school, but then what?

“Here in Colorado, I’ve been following our state health department website very closely. They update data every day and include the outbreaks in the state they are investigating. As you can imagine, there are lots and lots in long-term care facilities and skilled nursing homes, some in restaurants and grocery stores. There have been a total of four in child care centers, and we do have a lot of child care centers open. In almost every one of those cases, transmission was between two adults. The kids in the centers are not spreading Covid-19. I’m hearing the same thing from other states, as well.”

Why a Pediatric Group Is Pushing to Reopen Schools This Fall

So what’s going to happen if kids in school start to get sick and test positive for COVID-19?

Among the 950 COVID-19 in Texas daycare centers are 307 children.
Among the 950 COVID-19 in Texas daycare centers are 307 children. (Dallas Morning News)

The 60,000 members of the AAP who didn’t participate in writing the guideline know what’s going to happen…

A ton of parents from the school are going to call their pediatricians looking to get their kids tested!

What likely should happen?

That classroom or cohort and their close contacts should move to self-quarantine and home/online education until they pass the incubation period from their last contact.

“Put in place the infrastructure and resources to test, trace and isolate new cases.”

Safely Reopening America’s Schools and Communities

(I’m guessing we will get more details about this from the AAP soon and well before school starts. )

Most importantly though, our communities should do everything they can to keep their case counts down – wash hands, practice social distancing, wear a face cover.

And if we are going to send our kids back to school, we should make sure that we are protecting all of the folks making that possible.

Can we do all of that?

Sure!

Will we???

Sending Your Kids Back to School

Are you still unsure about whether or not you should send your own kids back to school?

I don’t blame you…

Some things to consider when making the decision:

  • is your child or any of their contacts at risk for a more severe case of COVID-19, including having an underlying, chronic medical condition, keeping in mind that the risk increases with age, especially once you reach age 65 years? If possible, online schooling might be a better option for students in high risk categories.
  • was staying home from school hard for your child? If your child had problems learning at home or the social isolation was an issue, than that would make going back to school even more important.
  • will your school or school district be “flexible and nimble” and respond to new information, rising case counts, and evolve their policies if necessary?

Most importantly, if you send your kids back to school, are you going to be constantly worried that they are going to get COVID-19 or bring home the SARS-CoV-2 virus? If so, then keep them home this fall.

On the other hand, if they are healthy, have no high risk contacts at home, and are eager to go back to school, then you should probably feel comfortable sending them if the school follows the guidance offered by the AAP.

More on COVID-19

What to Do if You Have Been Exposed to COVID-19

Folks need to understand that they should begin self-quarantine as soon as they learn that they have been exposed to someone with COVID-19.

Do you know what to do if you have been exposed to someone with COVID-19?

Because they could have been exposed to SARS-CoV-2, the virus that causes COVID-19, anyone who attended the party should self-isolate.
Because they could have been exposed to SARS-CoV-2, the virus that causes COVID-19, anyone who attended the party should self-isolate.

Hopefully you already know that you shouldn’t go to a party and expose lots of other folks…

What to Do if You Have Been Exposed to COVID-19

Unfortunately, lots of mistakes are being made that are causing COVID-19 cases to again rise.

“For COVID-19, a close contact is defined as anyone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before the person began feeling sick until the time the patient was isolated.”

COVID-19 Frequently Asked Questions

One of them is that many people simply don’t understand the importance of self-quarantining themselves for 14 days (or consider one of the options to shorten your quarantine) after they have been exposed to SARS-CoV-2 if they aren’t fully vaccinated.

While the original guidelines were to quarantine for a full 14 days after exposure, there are options to shorten the quarantine period.
While the original guidelines were to quarantine for a full 14 days after exposure, there are options to shorten the quarantine period.

What happens if you don’t self-quarantine?

You may expose others in the days before you start to show symptoms (presymptomatic transmission).

But can’t you just get tested after your exposure to see if you have it?

Sure, you can get tested, but if it is negative and you are early in your incubation period, it doesn’t mean that you still won’t become sick later on. For example, you could have a negative COVID-19 test two days after being exposed to the virus, but then develop symptoms of COVID-19 two days later.

“Yes, you are still considered a close contact even if you were wearing a cloth face covering while you were around someone with COVID-19. Cloth face coverings are meant to prevent someone from transmitting the disease to others, and not to protect someone from becoming infected.”

COVID-19 Frequently Asked Questions

What if you’re not sure if you have COVID-19 and you are waiting on your test results?

That should be a no-brainer.

Self-quarantine yourself why you are waiting for your COVID-19 test results!

Ideally, folks would be getting this information to self-quarantine after their COVID-19 exposure from a contact tracing team.
Ideally, folks would be getting this information to self-quarantine after their COVID-19 exposure from a contact tracing team.

And if you think you have COVID-19, be sure to tell all of your close contacts, which includes everyone who was within 6 feet of you for at least 15 minutes starting from 48 hours before you began feeling sick.

Of course, social distancing and wearing a mask are important too.

But folks need to understand that they should begin to self-quarantine as soon as they learn that they have been exposed to someone with COVID-19. That’s the easiest way to limit the spread of SARS-CoV-2 and the size of outbreaks.

More on COVID-19

5 Things You Need to Know About COVID-19

5 things you need to know to protect yourself, your family, and your community until we finally get COVID-19 beat.

As cases start to rise again after our initial efforts to flatten the curve, you are either ready to throw up your hands, wondering what’s next, or are resigned to staying home for awhile.

“Plan A, don’t go in a crowd. Plan B, if you do, make sure you wear a mask.”

Dr. Anthony Fauci

But what if you do have to go out?

5 Things You Need to Know About COVID-19

While a lot of folks are making mistakes, it’s certainly not time to throw in the towel.

“It is important to remember that anyone who has close contact with someone with COVID-19 should stay home for 14 days after exposure based on the time it takes to develop illness.”

When You Can be Around Others After You Had or Likely Had COVID-19

Here are 5 things you need to know to protect yourself, your family, and your community until we finally get COVID-19 beat.

  1. While people probably aren’t contagious if they don’t have symptoms, they can be contagious in the days just before they develop symptoms. Unfortunately, you don’t know when that might be, which is why it is important to self-quarantine after you have been exposed (or think that you might have been exposed) for a full incubation period.
  2. Understand that SARS-CoV-2 is typically spread through close contact with someone who is infected (again, this is also in the days before they show symptoms). That means you can likely avoid getting sick if you practice social distancing (stay 6 feet away from other people), wash your hands often, and avoid touching your face, etc. To protect others, you should also cover your coughs and sneezes and wear a mask.
  3. Protect yourself if you are caring for someone at home with COVID-19, limiting contact, shared spaces, and shared personal items, etc.
  4. Avoid other people if you have COVID-19 until you are fever free for 3 days AND your respiratory symptoms are improving AND it has been at least 10 days since your symptoms first started.
  5. Get a viral test for current infection (not the antibody test) if you think you are sick and want to get tested for COVID-19.

Why is all of this important?

You can reduce your risk of COVID-19 by wearing a mask, washing your hands, and watching your distance.

Because there are still no real treatments for COVID-19, so while we wait for a vaccine, our best hope is simply to keep from getting sick.

More on COVID-19

Getting Tested for COVID-19

Do you want or need to get tested for COVID-19? Do you know which test to get?

We have been hearing it over and over for some time now – anyone who wants a test can get a test.

The CDC is now shipping its laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to qualified state and local public health laboratories.

As testing has become more widely available, that is somewhat true.

There are still some problems with COVID-19 testing though.

Chief among them is making sure you get the right test!

Getting Tested for COVID-19

First things, first.

Do you really need a test?

Many people who are not hospitalized might not need to be tested for COVID-19.

“Most people will have mild illness and can recover at home without medical care and may not need to be tested.”

Testing for COVID-19

The main reason that testing can be important though is that it can help limit your exposing others to SARS-CoV-2 once you have been exposed or suspect you are infected. And it can also help trace the people you have already been in contact with before you knew that you should be in quarantine.

Which COVID-19 Test Do You Need

If you think you are sick and want to get tested, do make sure you get the right test though, a viral test for current infection.

You do not want the antibody test (blood test), even though it may give rapid results, if you think you are sick now. The antibody test only checks for past or recent infections.

“CDC does not currently recommend using antibody testing as the sole basis for diagnosis of acute infection, and antibody tests are not authorized by FDA for such diagnostic purposes.”

Overview of Testing for SARS-CoV-2

Once you have narrowed down your test to the viral test for current infection, you might still have a choice to make, as there are several types, including:

  • Molecular Diagnostic Tests for SARS-CoV-2 – uses nucleic acid amplification techniques (PCR) to detect the RNA of the virus. These tests don’t necessarily take long to run, but since samples typically have to be sent out to a lab, that slows down the time to get results, sometimes up to 7 business days.
  • Antigen Diagnostic Tests for SARS-CoV-2 – detects fragments of proteins that the virus makes. Can give rapid results, in 15 minutes, but are more prone to false negatives than molecular tests.

Ready to get tested now?

There is still the problem of where to get tested…

Ideally, you might want to go to some kind of mobile, drive-through testing site, so that you don’t have to expose anyone else as you get tested. Unfortunately, those kinds of testing centers are not widely available.

Another ideal choice would be your own pediatrician. Are they doing COVID-19 testing?

With the Sofia2 analyzer, pediatricians can get rapid test results in just 15 minutes.

Lastly, you might just have to see if you county or state health department has a list of places doing testing.

What to Do After Your COVID-19 Test

What happens after your test is done?

  1. You are waiting for test results. Stay in isolation until you know the results!
  2. You are positive for COVID-19. You should stay home, in isolation, unless you need medical attention, only ending your isolation until you have gone 3 days without fever AND your respiratory symptoms have improved AND it has been 10 days since your symptoms first appeared. You should also tell all close contacts (anyone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before the person began feeling sick until the time the patient was isolated) that you tested positive so that they can self-quarantine for 14 days.
  3. You are negative for COVID-19 and don’t have symptoms after a recent exposure. Since the incubation period for SARS-CoV-2 is 7 to 14 days, a negative test before the end of the incubation period doesn’t mean that you won’t eventually develop COVID-19. You should likely remain in self-quarantine.
  4. Your COVID-19 antigen test was negative and you do have symptoms. Since this might be a false negative, depending on your health care provider’s suspicion that you could actually have COVID-19, they might now do a molecular diagnostic test for SARS-CoV-2. Or they might just recommend that you remain in self-quarantine.
  5. Your COVID-19 molecular diagnostic test was negative and you do have symptoms. Although more accurate than the antigen test, there is still the possibility that this could be a false negative. Whether or not you remain in self-quarantine depends on your health care providers suspicion that you could have COVID-19. Did you have a known, close exposure to someone with SARS-CoV-2, for example?

Are you ready to get tested?

More on Getting Tested for COVID-19

Those COVID-19 Death Comparisons

Don’t be mislead by the folks making false comparisons about COVID-19 deaths.

Have you seen folks trying to compare COVID-19 deaths to other things?

What other things?

All Dr. Phil revealed was that he shouldn't have been talking about COVID-19...
All Dr. Phil revealed was that he shouldn’t have been talking about COVID-19…

Basically anything and everything, from smoking, drowning, and car accidents to the flu…

Those COVID-19 Death Comparisons

It’s not that surprising that those comparisons were made when the COVID-19 pandemic first got going.

It’s like Jenga?

But it is disappointing that some folks are still making these arguments.

“I’m not denying what a nasty disease COVID-19 can be, and how it’s obviously devastating to somewhere between 1 and 3.4 percent of the population. But that means 97 to 99 percent will get through this and develop immunities and will be able to move beyond this. But we don’t shut down our economy because tens of thousands of people die on the highways. It’s a risk we accept so we can move about. We don’t shut down our economies because tens of thousands of people die from the common flu.”

Senator Ron Johnson of Wisconsin, chairman of the Senate’s Committee on Homeland Security and Governmental Affairs

What’s even worse, they seem to be using the arguments to discourage others from social distancing and wearing masks!

Fortunately, most people understand that you can’t really compare COVID-19 deaths to those other things.

It is like comparing apples to oranges. Sure, they are both fruits, but they aren’t the same kinds of fruits.

So why do some people make these false comparisons?

They do it to make you think that both sides of the argument are the same or are equal. After all, it makes easier to downplay COVID-19 deaths if ‘they’ can make you think they are the same as deaths from car accidents, drownings, and the flu, etc.

Instead of the death rate, it is more appropriate to use the case-fatality rate, which factors in the folks who actually had COVID-19.
Instead of the death rate, it is more appropriate to use the case-fatality rate, which factors in the folks who actually had COVID-19.

So why shouldn’t you make these comparisons?

For one thing, deaths from COVID-19 spiked suddenly. They haven’t been spread out over a year or many years, like deaths from car accidents, drownings, and cigarette smoking, etc..

“The demand on hospital resources during the COVID-19 crisis has not occurred before in the US, even during the worst of influenza seasons. Yet public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic.”

Faust et al on Assessment of Deaths From COVID-19 and From Seasonal Influenza

Also, unlike car accidents and drownings, COVID-19 is contagious.

And don’t forget, we go to great lengths to reduce deaths from car accidents and drownings, with everything from seat belts, air bags, and life jackets to fencing around swimming pools and laws against distracted driving.

Does anyone say “life is about risk,” while throwing their toddler in the pool and walking inside?

We make efforts to reduce that risk!

What is your risk of being in a car accident?
What is your risk of being in a car accident?

We also go to some effort to understand those risks…

“If we overestimate our risk in one area, it can lead to anxiety and interfere with carrying out our normal daily routine. Ironically, it also leads us to underestimate real risks that can injure or kill us.”

National Safety Council on Odds of Dying

So what is your risk of being in a car accident?

Believe it or not, it is fairly low, with the average person filing a claim for a car accident once every 17.9 years.

And since only about 3 in 1,000 car accidents are fatal, the chance of you being in a fatal motor vehicle accident is also fairly low.

“The total number of confirmed COVID-19 deaths in the U.S. exceeds 115,000, outnumbering each of the leading causes of preventable injury death (58,908 preventable drug overdose deaths, 39,404 motor-vehicle deaths, and 37,455 fall deaths in 2018). However, the full impact of COVID-19 is even greater than the number of deaths and confirmed cases. The rapid increase in COVID-19 cases, the uncertainty regarding how long the pandemic will last and the disruption to normal everyday activities is impacting society like no other safety issue in modern history.”

COVID-19 Cases in the United States

How does that compare to getting and dying from COVID-19?

Where do you live? Are folks around you wearing a mask?

If you are working from home in a small town with few COVID-19 cases, then your risk is obviously much, much lower than someone who works around the public in a bigger city with rising case counts.

Do you have any risk factors for a more severe case of COVID-19?

While the overall case fatality rate is about 1%, that starts to go up as you approach age 50 and is higher for those with many chronic health conditions.

Most importantly, what are you doing to lower that risk?

Just like your risk of dying in a car accident is going to be much higher than average if you drink and drive, don’t wear a seat belt, talk on your phone, and speed, your risk of getting and dying from a SARS-CoV-2 infection is going to be higher if you live in or travel to an area with a lot of cases, are around a lot of people who aren’t social distancing or wearing masks, and you are in a high risk group.

The bottom line though, whatever your risk, are you going to take steps to increase that risk for your self and those around you or are you going to lower that risk?

More on COVID-19 Deaths

Getting a Covid-19 Test Before Going to Summer Camp

Who told your child’s summer camp to test all of their kids for COVID-19?

Are your kids among the 11 million kids who usually go to a summer camp or day camp each year?

Do you have any memories about summer camp from when you were a kid?
Do you have any memories about summer camp from when you were a kid?

Are they going this summer?

Did you plan for a COVID-19 test?

Getting a Covid-19 Test Before Going to Summer Camp

While many parents are likely thrilled that their kids can still even go to camp, they might be confused on why they need to get a COVID-19 test if their child hasn’t been sick.

Your pediatrician is likely shaking their head about it too.

Memories of summer camp this year might include a weekly nasal swab for COVID-19 testing.
In addition to pushing tests while staff and kids are at camp, some camps want to have kids tested before they arrive.

After all, there is no recommendation for general testing in the guidelines for opening up summer camps.

Instead, the CDC says to “screen children and employees upon arrival for symptoms and history of exposure.”

“He said that optimally camps would retest each camper upon arrival and several times more through the summer: six times for a seven-week session and four times for a five-week session.”

Summer Camp Kids Are America’s Coronavirus Test Subjects

The CDC guidelines on Youth and Summer Camps do mention testing.

“Some camps might have the capacity to conduct COVID-19 testing. CDC has guidance for who should be tested, but these decisions should be made in conjunction with state and local health departments and healthcare providers.”

CDC on Suggestions for Youth and Summer Camps

But still, that guidance isn’t to test everyone, but only those who are high risk, with symptoms, or with suspected COVID-19.

What’s the problem with testing everyone at camp?

It could lead these camps to rely too much on testing instead of cleaning and disinfecting and encouraging hand hygiene, respiratory etiquette, cloth face coverings, and social distancing, etc.

Remember, COVID-19 tests can give false-negative results, so some people might actually be infected with the SARS-CoV-2 virus and have a negative test. Without a healthy environment at camp, that person might get many other kids and staff members sick.

And a true negative test just means that you are negative when the test was done. It doesn’t mean that you will remain negative until you have your next test.

Also, just because you aren’t testing everyone doesn’t mean that you can’t test those kids and staff members once they begin to show symptoms.

Are your kids going to summer camp this year?

Do they need a COVID-19 test before they go and while they are at camp?

More on COVID-19 Tests for Summer Camps

Are Kids Spreading SARS-CoV-2?

While new studies suggest that kids may transmit SARS-CoV-2, some other studies say they don’t…

Why do some folks think that kids aren’t spreading SARS-CoV-2, the virus that causes COVID-19?

Paul Thomas doesn't talk about any of the studies that do suggest children can spread novel coronavirus to others.
Paul Thomas doesn’t talk about any of the studies that do suggest children can spread novel coronavirus to others.

The usual suspects…

Are Kids Spreading SARS-CoV-2?

As Paul Thomas highlights, there have been studies and case reports that suggest children are not spreading SARS-CoV-2 to others.

“Studies of multiple family clusters have revealed children were unlikely to be the index case, in Guanzhou, China, and internationally A SARS-CoV2 positive child in a cluster in the French alps did not transmit to anyone else, despite exposure to over 100 people.”

An evidence summary of Paediatric COVID-19 literature

On the other hand, there are studies that suggest they do.

Another study found viral loads in children which suggests that they could pass the virus on to others.
Another study found viral loads in children which suggests that they could pass the virus on to others.

Something Paul Thomas doesn’t mention!

“Prolonged shedding of SARS-CoV-2 in stools of infected children indicates the potential for the virus to be transmitted through fecal excretion.”

Prolonged presence of SARS-CoV-2 in feces of pediatric patients during the convalescent phase

So what’s the answer?

Like much about COVID-19, we don’t know yet.

“Asymptomatic infection is least likely to pass on the infection, with a chance of 33 per 100,000 contacts.”

Modes of contact and risk of transmission in COVID-19 among close contacts

It would make some sense that kids might not be a big source of COVID-19 infections though, as they often are asymptomatic or only have mild symptoms when they get sick.

“Two new studies offer compelling evidence that children can transmit the virus. Neither proved it, but the evidence was strong enough to suggest that schools should be kept closed for now, many epidemiologists who were not involved in the research said.”

New Studies Add to Evidence that Children May Transmit the Coronavirus

But we won’t know until more research is done, especially as much of the current research is contradictory.

Research that will be important as we consider opening up schools again.

More on Kids Spreading SARS-CoV-2

What is the COVID-19 Multi-System Inflammatory State?

Are kids with COVID-19 developing symptoms of Kawasaki disease?

Breaking News – The CDC reports at least 1,000 confirmed cases of MIS-C and 20 deaths in the United States. (see below)

Kids aren’t supposed to get serious COVID-19 symptoms, right?

As we are learning more and more about SARS-CoV-2, that seems to be holding true most of the time.

That doesn’t mean that kids are unaffected though.

Remember, it is still thought that kids get asymptomatic infections that they can spread to everyone else. And tragically, they sometimes get life-threatening infections.

What is the COVID-19 Multi-System Inflammatory State?

What else are we seeing when kids get SARS-CoV-2?

As they reassure parents that “serious illness as a result of COVID 19 still appears to be a very rare event in children,” the Paediatric Intensive Care Society issued a statement discussing an NHS England email alert about kids presenting with a type of multi-system inflammatory disease.

“The alert indicated ‘the cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19 in children. Abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation’.”

PICS Statement: Increased number of reported cases of novel presentation of multi-system inflammatory disease

This statement followed the release of a study in Hospital Pediatrics, COVID-19 and Kawasaki Disease: Novel Virus and Novel Case, that discussed a similar case.

“We describe the case of a 6-month-old infant admitted and diagnosed with classic Kawasaki disease (KD), who also screened positive for COVID-19 in the setting of fever and minimal respiratory symptoms.”

Jones et al on COVID-19 and Kawasaki Disease: Novel Virus and Novel Case

And an alert of more frequent cases of Kawasaki disease in France and Italy.

“In several Italian centers, where the incidence of Covid-19 was higher – Professor Ravelli told ANSA – more frequent cases of Kawasaki disease have occurred than we have observed before the arrival of the coronavirus.”

Coronavirus: Prof. Ravelli, investigation of Kawasaki disease report (google translated)

And New York.

“The NYC Health Department contacted PICUs in NYC during April 29-May 3, 2020 and identified 15 patients aged 2-15 years who had been hospitalized from April 17-May 1,2020 with illnesses compatible with this syndrome (i.e., typical Kawasaki disease, incomplete Kawasaki disease, and/or shock).”

2020 Health Alert #13: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19

Following a report of 15 cases in New York City, the New York State Department of Health issued an advisory to healthcare providers about 64 potential cases throughout the state.

As of 8/20/2020, CDC has received reports of 694 confirmed cases of MIS-C and 11 deaths in 42 states, New York City, and Washington, DC. Additional cases are under investigation.
As of 8/20/2020, CDC has received reports of 694 confirmed cases of MIS-C and 11 deaths in 42 states, New York City, and Washington, DC. Additional cases are under investigation.

And next came an alert from the CDC on what they are calling multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19).

MIS-C case definition

Most people will find the MIS-C case definition more helpful than the new name.

Also helpful is a recommendation to “report suspected cases to their local, state, or territorial health department.”

“This syndrome has features which overlap with Kawasaki Disease and Toxic Shock Syndrome. Inflammatory markers may be elevated, and fever and abdominal symptoms may be prominent. Rash also may be present. Myocarditis and other cardiovascular changes may be seen. Additionally, some patients have developed cardiogenic or vasogenic shock and required intensive care. This inflammatory syndrome may occur days to weeks after acute COVID-19 illness.”

Health Advisory: Pediatric Multi-System Inflammatory Syndrome Potentially Associated With Coronavirus Disease (Covid-19) in Children

So what does this mean?

It may means that we can add SARS-CoV-2 to the list of possible viruses that can trigger Kawasaki disease.

“Various studies have described an association between viral respiratory infections and KD, ranging from 9% to as high as 42% of patients with KD testing positive for a respiratory viral infection in the 30-days leading up to diagnosis of KD.”

Jones et al on COVID-19 and Kawasaki Disease: Novel Virus and Novel Case

And continue to be reassured that “serious illness as a result of COVID-19 still appears to be a very rare event in children.”

“If the above-described inflammatory syndrome is suspected, pediatricians should immediately refer patients to a specialist in pediatric infectious disease, rheumatology, and/or critical care,as indicated. Early diagnosis and treatment of patients meeting full or partial criteria for Kawasaki disease is critical to preventing end-organ damage and other long-term complications. Patients meeting criteria for Kawasaki disease should be treated with intravenous immunoglobulin and aspirin”

2020 Health Alert #13: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19

Still, everyone should be on the alert for MIS-C, especially as COVID-19 cases once again surge.

More on COVID-19 in Kids

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