As parents, many of us are familiar with our kids having a constant case of the sniffles, once it becomes cold outside. But, this year when our little ones fall under the weather—especially now that flu season is upon us—there’s more of a panic setting in.
COVID-19 symptoms manifest like those of the flu and it’s hard to decipher which illness they may be. To help us understand how we should handle these unprecedented times, and the best ways to keep our families safe this season, we talked to Dr. Nikolas Papaevagelou, a board-certified pediatrician in New York City. He breaks down how each illness presents in children, when to keep our kids home, what to do when they do get sick, and ways to help protect ourselves throughout the flu season.
In addition to COVID, it’s also flu season. Many parents are going to be nervous if their child shows signs of sickness. Is there a way to tell the difference between flu and COVID symptoms?
That is a complicated answer. The possible impact of co-circulation of COVID-19 with influenza is unknown. Unfortunately, the possible symptoms of flu and COVID-19 are very similar since they’re both respiratory viruses. For both viruses, the severity could range from asymptomatic to mild…all the way to severe illness. From my experience within the pediatric population, those I’ve treated with COVID-19 have not had severe responses to the virus.
When it comes to the flu, the most common symptoms are fever, runny nose, sore throat, cough, malaise, chills, body aches, and sometimes diarrhea. These symptoms can last 10 days or more, and if a flu vaccine has been taken prior to getting sick, it can reduce the illness duration to just 3-5 days.
In terms of COVID-19, the most common symptom is fever and diarrhea in younger children. In older kids, you can potentially have a cough, runny nose, fever, diarrhea, chills, and body aches.
It’s important to note, because the test is uncomfortable and invasive, most pediatricians will only test kids if they are in close contact with someone that was COVID positive—so hard to account for asymptomatic.
So, as the symptoms are so similar, it’s best to proceed with caution, talk to your doctor and potentially get a test if the symptoms are manifesting.
Many parents have their kids in daycare. When do you recommend that our kids should stay home? Do sniffles count?
The Department of Health recommendations are evolving almost weekly, if not daily, depending on uptick of COVID-19 in each state and city. Daycares, while still open, are instructed to look at the CDC for general guidelines; and, of course, their own state recommendations depending on their risk zone.
My recommendations on when to keep your child home are similar to those prior to the pandemic. If a child has fever (temperature above 100.4F), a persistent cough, a constant runny nose, diarrhea, and/or vomiting—keep them home. Other non-covid related reasons to stay home are eye discharge and pink eye. Remember, the best thing for your child is rest, so staying home will be best.
If our kids do get sick, when is it time to see a doctor? If a child is in daycare or school and gets sick, the only way to return to daycare is by getting a doctor’s clearance. Although it’s not necessary to get a COVID test every time your child gets sick, many daycares and schools will not allow a child to come back unless there’s a negative test. I would advise parents to check with the daycare for their rules and regulations and to see if COVID testing is necessary or just a doctor’s note.
What if they get a fever—how can we set their room up for faster healing? Should it be hot or cold? What about a bath or steam? What about the old wives’ tale of putting our kid’s face in the freezer for a cough (a lot of questions, we know!)? For any fever, the use of antipyretics might be necessary if temperatures exceed 100.4F. But, other simple homeopathics can be used such as lukewarm baths, cold compresses on the forehead and armpits, and keeping the environment cooler to help bring a temperature down faster.
As for putting a child’s head in the freezer,that trick is often used for kids with a specific illness called croup which is inflammation of the upper airways, specifically the trachea or breathing tube. The cold air from the freezer (or out the window on a cold night) will sometimes help improve that cough.
What if they don’t have an appetite? Should we be concerned if they skip a meal? Most commonly (and most likely) a child with a fever will have low appetite. Although good alimentation is helpful to improve an illness, do not panic if your child does not want to eat. It is normal, and they might start vomiting if you force feed them. Most importantly, keep them well hydrated by giving them lots of fluids such as Pedialyte, Gatorade, apple juice or water. The reason we often recommend “juices” instead of water is because a child not eating might become hypoglycemic and need sugar to help.
Try to prepare something your child loves but light on the stomach such as soup, toast or pasta.
If our kids get a cold (not a fever), what are your tips to help them get better faster? The cure for the common cold is purely supportive, meaning lots of rest. Keep your child hydrated, and keep the room cool and humidified. Other simple things to do areuse a saline mist, and bulb suction the mucus out for infants and young toddlers.
If you have a nebulizer machine (usually used by asthmatics), you can use it with saline ampules to provide extra humidification. I sometimes use an antihistamine (such as diphenhydramine) to dry up the mucus, but you should consult with your pediatrician before using any medications.
For children over 6 years old, over-the-counter cough and cold medications can potentially be used after being cleared by your child’s pediatrician.
Many of us are nervous to go into a doctor’s office now, even if we (or our kids) are sick. Can we get the same care via Telehealth visits? Telehealth has been very helpful for both doctors and patients. It has helped in minor illness, and even in some well visits not requiring vaccinations. Telehealth might be able to diagnose a common cold, but cannot differentiate between COVID and a common cold—so you still may be asked to come in.
Rashes are commonly examined via Telehealth, and I have personally done a few visits for developmental screenings.
Visits that will definitely require in-person care include the initial newborn visit, yearly well physical examination visits requiring office testing such as laboratory testing, hearing, vision and immunizations.
Related: 10 Immunity Boosting Foods
Anything else you’d like to add about this year’s cold and flu season that may make parents feel better and prepared? First of all, getting your flu shot should be at the top of everyone’s list, as well as catching up with any other pending immunizations. Continue to practice safe, universal precautions such washing your hands with soap and water or using alcohol-based hand sanitizers, and wearing your mask when out in public and enclosed spaces.
Just do your best to be safe, hug your little ones, and when in doubt…call your doctor.
SICK CHILD CHEAT SHEET
When to See a Doctor
Call and see your doctor right away if there’s a fever and the child:
- Looks very sick
- Is drowsy and lethargic
- Has a stiff neck, headache that is not improving, sore throat, ear pain, rash, vomiting, and diarrhea
- Looks dehydrated with dry lips, a sunken soft spot, few wet diapers, refuses to eat or drink
- Has a seizure