Questions and answers for parents caring for children with COVID-19 at home
- Date : 2022-03-17
- Hit : 1142
Questions and answers for parents caring for children with COVID-19 at home
Q1. What should be done when children with COVID-19 develop a sudden aversion to eating and drinking fluids?
It mostly means they have difficulty swallowing due to a sore, scratchy throat. Give them cold foods (cold water, ice cream, etc.) to help soothe pain.
Dehydration can be caused by many factors such as vomiting and diarrhea, but decreased food intake due to a sore throat is its leading cause.
For dehydration caused by decreased food intake due to a sore throat, administer an antipyretic analgesic (acetaminophen, ibuprofen, and dexibuprofen) to soothe pain and feed cold foods (cold fluids, ice cream, etc.). Dehydration can entail hypoglycemia, and thus it is recommended to feed chilled rice gruel.
For dehydration due to vomiting, feed slightly salted thin rice porridge or gruel (one spoonful per 5-10 minutes) to provide moisture and prevent hypoglycemia.
* Those unable to eat or drink for an extended period of time due to continued vomiting may require an IV injection.
For dehydration due to diarrhea, increase the amount of porridge or gruel to a slight extent provided that vomiting. It is recommended to feed tepid formula in small amounts frequently for infants during lactation.
It is most important for caregivers to check if the amount and color of the child’s urine has changed. If the amount of urine decreases by more than half for one day, contact 119 for immediate assistance.
Q2. What should be done when children with COVID-19 develop a high fever?
Prevent possible dehydration due to a high fever.
Feed the patient water frequently and give two types of fever reducers (acetaminophen and ibuprofen) alternately every 3-4 hours.
* Massages with lukewarm water help reduce the fever.
** Although fever reducer injections are fast-acting and easier to administer than pills, they entail pain during administration and are same as oral medications in terms of efficacy.
A high fever induced by COVID-19, although varying by age and individual condition, is mostly resolved within 2-3 days. As such, keep following the physician’s instruction to reduce the fever and closely monitor the child’s condition.
Q3. My child complains about ear pain. Should I consult the physician for the possibility of otitis media?
Many children with COVID-19 develop a severe sore throat and nasal congestion. Ear pain* is often associated with nasal congestion.
* Mostly resulting from salpingitis caused by viral infections
Ear pain after the onset of COVID-19 symptoms is rarely caused by bacterial bacterial otitis media. As such, it is not necessary to administer antibiotics. Reduce pain with antipyretic analgesics such as acetaminophen and ibuprofen.
Q4. My child complains about pain in legs and is unable to walk.
Check if your child feels pain when moving knee joints and hip joints while lying in a comfortable position.
* As it is difficult to accurately check the development of pain with infants and toddlers, caregivers must look for other symptoms such as edema and heat.
Immediately request face-to-face consultation with an orthopedic specialist if your child is unable to walk due to severe muscle pain or other abnormalities.
Although it is rare to develop joint abnormalities due to COVID-19 infection, some may feel muscle pain in calves, which mostly subsides within several days.
Q5. My child developed sudden rashes.
Rashes*, which may develop due to COVID-19 infection, are resolved by sufficiently moisturizing the skin and treating itching. Physicians can check rashes and issue prescriptions in a contact-free manner.
* Rashes may include ① Viral rashes ② Rashes caused by aggravated atopic dermatitis, etc.
Q6. How should we respond to a sudden nosebleed?
Children with COVID-19 often develop severe nasal congestion, with inflammation and edema in the upper airway mucus, and this may lead to a sudden nosebleed.
A nosebleed can be stopped through simple steps as instructed. It is also recommended to consult the physician for nasal congestion in a contact-free manner.
Q7. My child’s eyelids are swollen and eyes are bloodshot.
As the eyes and nose are connected, upper airway mucus inflammation can affect the conjunctiva.
Contact-free consultation with an eye specialist is recommended for prescription of drugs to reduce inflammation. Make sure to keep your child from rubbing eyes to prevent secondary infections.
Q8. Are children allowed to take oral treatments for COVID-19?
The safety of oral treatments for COVID-19 for children and adolescents has yet to be scientifically proven, and they are currently administered to adults only.
Q9. My child’s complains about chest pain with a dry cough. Should I consult the physician for the possibility of a heart problem?
It is very rare to develop a heart problem due to COVID-19 infection.
Face-to-face consultation is recommended as chest pain may require a thoracic spine X-ray.
Q10. My child complains about abdominal pain and shows symptoms of vomiting and diarrhea.
If the pain is felt near the navel or solar plexus and the child’s abdominal area feels tender when he/she is not whining, the child is likely to be suffering from enteritis caused by COVID-19.
Simply treat the pain with antipyretic analgesics and feed fluids as it is resolved within 2-3 days in most cases. Consult the physician in a contact-free manner if deemed necessary.
Q11. Physicians appear reluctant to prescribe antibiotics through contact-free consultations.
Antibiotics do not treat viral infections and thus are not effective for resolving symptoms of COVID-19. Antibiotics should be administered to the minimum possible extent based on the physician’s careful diagnosis.
Q12. My child refuses to eat after developing a high fever. Her voice seems to have changed, sounding hoarse when breathing.
Many symptoms of COVID-19 are similar to those of acute obstructive laryngitis.
The child experiences difficulty swallowing, cracks in his/her voice*, and even shortness of breath due to the swollen upper airway (pharynx and larynx) and vocal cords.
* Often entailing a “barking” cough or hoarseness
Record the coughing, crying, or breathing sound of the child for the physician to refer to during face-to-face or contact-free consultation.
Short-term adrenal cortical hormone treatment (steroids) may be considered based on the diagnosis.
Immediately request help with 119, etc., if the patient’s condition continues to aggravate and the patient has difficulty breathing.
Q13. My child had been diagnosed with COVID-19 once and tested positive again this time. Is this possible?
Although less likely, it is theoretically possible. As such, it is essential to focus on personal hygiene (wearing a mask, washing hands, etc.) even after recovering from COVID-19.
Q14. My child tested positive. What drugs do we need? Can I feed my child OTC cold medications stocked at home?
You will need medications for cold symptoms, vomiting, and diarrhea, as well as two types of fever reducers to take alternately.
Most patients with COVID-19 experience part or all of the following symptoms: high fever, headache, bodyache, cough, nasal congestion, vomiting, and diarrhea.
Cold medications that relieve nasal congestion can be of help.
Children often develop severe nasal congestion if the upper airway swells as their nasal cavity is narrower.
Prescription of steroids (in a contact-free manner) can be an option if deemed necessary.
In principle, all medications must be newly prescribed in accordance with each patient’s condition.
* OTC cold medications stocked in your medicine cabinet may be used in emergency situations (make sure to check their expiration dates before use).
Q15. How long does it take to recover from COVID-19 (Omicron)?
Symptoms of COVID-19 (Omicron) mostly subside within 7 days from the date of onset. A dry cough may last up to 2-3 weeks but will ultimately subside.
Q16. What are the situations that require face-to-face consultations with physicians?
When a high fever of 38°C or higher continues for more than 72 hours without signs of improvement (lengthening intervals between attacks of fever, decreasing peak levels, etc.)
* A high fever surpassing 39°C is frequently witnessed in pediatric patients with COVID-19. As such, the onset of a high fever alone does not necessarily require face-to-face consultations.
When seizure symptoms such as uncontrollable jerking movements of the arms and legs, dilated pupils, etc., are detected
When the child experiences trouble breathing and intercostal retractions, with the sunken appearance of the upper part of the collarbones and the lower part of the ribs.
When the notable decrease in the amounts of food intake and urine continues for more than 24 hours
When chest pain and non-specific stomachache continue or aggravate
When the child appears unresponsive and seems to be experiencing clouding of consciousness
Q17. How can a caregiver identify the signs of shortness of breath?
The major signs of shortness of breath are nasal flaring, intercostal retractions, stridor when not whining, fast and shallow breathing, etc. Make sure to request face-to-face consultation or emergency care through 119.
Q18. My child tested positive. What are the next steps?
Pediatric patients under at-home treatment are categorized as the group subject to general management and monitored for changes in symptoms at home. Telephone consultations and prescriptions are offered if necessary.
Telephone consultations and prescriptions are offered by community hospitals/clinics, respiratory clinics, healthcare providers designated for respiratory system examination, and at-home treatment guidance centers. Details about these hospitals and clinics can be viewed by searching “hospitals and clinics offering telephone consultations for COVID-19” on Naver, Daum, etc., or on the Health Insurance Review and Assessment Service website (www.hira.or.kr).
Those who test positive in PCR testing performed at screening stations can select a local hospital/clinic for telephone consultations and prescription. Those who underwent testing at a respiratory clinic or healthcare provider designated for respiratory system examination can receive at-home care by the respective healthcare provider*.
* Patients may contact other healthcare providers of their choice to request telephone consultations and prescriptions.
[Healthcare Providers for Telephone Consultations and Prescriptions]
Those who test positive at respiratory system clinics and healthcare providers designated for respiratory system examination
In principle, confirmed cases must receive telephone consultations and prescriptions from the healthcare providers at which they underwent diagnostic testing.
They may also receive telephone consultations and prescriptions from the healthcare providers of their choice.
Those who test positive at screening stations
Confirmed cases may receive telephone consultations and prescriptions from the healthcare providers of their choice (with test result notifications, etc., presented to the respective healthcare providers by patients).
The 24-hour at-home treatment guidance center is available for nighttime consultations and prescriptions, while the At-Home Treatment Promotion Team of each public health center with jurisdiction and 119 can be contacted for emergency care and patient transport.
Q19. Can I go outside to purchase fever reducers for my child when I am a confirmed case myself?
Patients under at-home treatment are not allowed to leave the place of residence and visit other places for purposes other than those pre-defined (physician consultations, etc.).*
* Face-to-face consultations, unavoidable circumstances (disasters, medical conditions requiring emergency care, risk of crimes, etc.), and inadvertent actions (dementia, mistake, etc.)
If caregivers are also placed under at-home treatment, they are not allowed to leave home to purchase medicines and daily necessities.
If all co-living household members are isolated as confirmed cases, they must seek assistance of an acquaintance or the respective local government (administrative guidance center, etc.) to purchase medicines and collect prescribed drugs.
Q20. What should I do to request face-to-face consultations with physicians instead of telephone consultations?
Face-to-face consultations at an outpatient center should be reserved in advance.
The list of the outpatient centers offering face-to-face consultations can be viewed on the Health Insurance Review and Assessment Service website (www.hira.or.kr). Public health centers with jurisdiction provide information on the nearest outpatient center for patients via text message.
* The nearest outpatient center and its contact information are offered through at-home treatment notifications (for groups subject to focused management and general management) via text message.
Patients are allowed to walk, drive private vehicles, or take infection control taxis to the hospital.
Make sure to strictly follow infection control guidelines and keep sufficient distance from others while staying outside. Immediately return to the place of residence after the consultation.
Q21. Do I have to contact hospitals myself for hospitalization?
All confirmed cases are to be placed under at-home treatment in principle, and only those diagnosed to have risk factors for hospitalization are eligible for hospitalization.
Contact the At-Home Treatment Promotion Team* or 119 if the patient is demonstrating signs of a medical emergency such as shortness of breath and consciousness disorder while under at-home treatment.
* Refer to the telephone number notified in the text message sent by the respective public health center as follows.
※ Example (At-Home Treatment Promotion Team of [ ] District Office)
★★24 hour emergency call★★ (1) 00 Hospital 000-000-0000/ (2) 00 District At-Home Treatment Promotion Team 000-000-0000
When making an emergency call to 119, make sure to inform that you are under at-home treatment.
Patients are transported to healthcare providers as instructed by public health centers with jurisdiction using ambulances of public health centers, healthcare providers, 119, etc.
Documents and materials to be delivered to healthcare providers and facilities, to which patients are transported, must be contained in plastic bags, etc., and carried by those accompanying patients to prevent further infections.
Q22. We would like to consult the physician in charge at the local clinic we used to go to. How can we find out whether the clinic offers telephone and face-to-face consultations?
Pediatric patients are categorized into the group subject to general management and eligible for telephone consultations and prescriptions at local hospitals/clinics of their choice.
Local hospitals/clinics offering telephone consultations and prescriptions can be checked by searching “hospitals/clinics offering telephone consultations for COVID-19” on Naver, Daum, etc., or on the Health Insurance Review and Assessment Service website (www.hira.or.kr).
The list of the outpatient centers offering face-to-face consultations can be viewed on the Health Insurance Review and Assessment Service website (www.hira.or.kr).
* The nearest outpatient center and its contact information are provided through at-home treatment notifications (for groups subject to focused management and general management) via text message.
Q23. How long is the period of isolation? When can my child return to the daycare center?
The isolation period for those placed under at-home treatment is 7 days from the date of diagnostic testing (date of specimen collection), and patients are automatically released from isolation at 24:00 on the 7th day.
▶ (Example) Asymptomatic cases
If specimens are collected on Nov. 1 and no clinical symptoms are detected afterwards, patients are released from isolation at 24:00 on Nov. 7.
▶ (Example) Symptomatic cases
If clinical symptoms continue to show for 3 days: Demonstration of symptoms at 12:00 on Nov. 1 → Specimens collected on Nov. 2 → No fever without specific treatment and improvement of other clinical symptoms for 24 hours after 12:00 on Nov. 4 → Patient released from isolation at 24:00 on Nov. 8
Children can start attending daycare centers immediately being released from isolation.
However, it is recommended to voluntarily follow the living guidelines* for 3 days after the release from isolation.
* Wearing a KF94 mask or a mask of a level equivalent to KF94 at all times, refraining from visiting high-risk facilities (facilities frequented by large groups of people, facilities vulnerable to infection, etc.), and refraining from participating in private gatherings
Q24. Where should inquiries about other administrative matters be forwarded?
Non-medical matters including living activities during the isolation period, patient services available, the term of isolation period, and living allowances should be forwarded to the at-home treatment guidance center operated by individual local governments.
The telephone number of the at-home treatment guidance center is sent to confirmed cases by the public health center with jurisdiction via text message.
* Refer to the number notified in the text message sent by the respective public health center as follows.
※ Example (At-Home Treatment Promotion Team of [ ] District Office)
■ At-home treatment guidance center: 000-000-0001~5
Forward inquiries about non-medical matters including living activities during the isolation period, patient services available, the term of isolation period, living allowances, etc.
Visit community hospitals/clinics for contact-free consultations and forward inquiries to the at-home treatment guidance center at night time and on weekends and holidays.
Also available in Korean at: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=2&CONT_SEQ=370529