Sorry to hear that someone in your family tested positive for COVID. Information is available on the CDC website but please also see below for similar information.
COVID Positive Children
Covid positive test results require a quarantine. Vaccination status does not affect quarantine.
Children < 2 years of age:
Both symptomatic and asymptomatic positive children less than 2 years of age require a 10-day quarantine. Children at this age are not eligible for a shortened quarantine since they are not able to mask in the community. Quarantine will start on the day of the symptom onset for symptomatic children and on the day of the positive test for asymptomatic children. Subsequently testing negative does not substitute the need to quarantine. Please keep in mind the day of the positive test OR the day of the symptom onset is day 0. Therefore, if your child tested positive on July 1, the final day of their quarantine is July 11th, and July 12th is when the child may return to the community. Many people miscalculate this by not counting the 10th day as part of the quarantine.
Children > 2 years of age:
Both symptomatic and asymptomatic children over the age of 2 require at least a 5-day quarantine. Quarantine will start on the day of the symptom onset for symptomatic children and on the day of the positive test for asymptomatic children. Testing negative does not substitute the need to quarantine. Please keep in mind the day of the positive test OR the day of the symptom onset is day 0. If your child tests positive for Covid on July 1, they must isolate from others through and including July 6. The child then is eligible for return to the community between day 6-10 (in this scenario July 7-11) if they meet the criteria below. Please keep in mind, subsequently testing negative does not substitute the need to follow these quarantine rules.
Quarantine may be discontinued once the following criteria are met:
· Fever free for 24 hours without fever reducing medication
· Significant improvement to symptoms (other than loss of taste/smell)
· The ability to continue to wear a well-fitting mask at all times around others between day 6-10 of the quarantine
· Center City Pediatrics cannot overrule local school/daycare/camp criteria so please check in with your child’s institution
· Both Tylenol and Ibuprofen can be used to treat fever or discomfort in children who are Covid positive. Ibuprofen is for children 6 months of age and older. Fevers in infants <8 weeks of age are an emergency, and you need to contact the office right away. Please see CCP dosing guidelines for how much medication is safe and appropriate for your child – Tylenol, Motrin, and Advil Dosing Guide – Center City Pediatrics
· Cold Symptoms (runny nose, cough, congestion) can be treated by putting your child in a steam bathroom, using a warm or cool mist humidifier, or applying a saline nasal spray or drops to your child’s nostrils with bulb suction. ½ Tsp -1Tsp of honey may be used to alleviate cough or help with a sore throat in children over one year of age.
· OTC Cough and cold medication is allowed for children over the age of 4. Please follow all safety and dosing instructions. Keep in mind may OTC cough and cold medications already contain Tylenol (acetaminophen), so always check ingredient labels to avoid accidentally overdosing this medication.
· Lots of fluids: Pedialyte, Gatorade (in children over 3), soup broth, and popsicles are a great way to encourage your child to drink more fluids when sick.
When to be Concerned
Please call the office or seek emergent care for the following symptoms:
· Persistent fever (fever extending beyond 4-5 days)
· Fever in an infant 8 weeks of age or younger of 100.4 or higher
· Acute mood changes (inconsolable, lethargy, or much more ill appearing)
· Concern for dehydration (not drinking fluids, dark urine, dry mouth/not making tears, confusion, or not urinating at least once every 6-8 hours)
· Breathing concerns- fast or labored breathing, wheezing, breathless, or chest pain
Please see the list of local testing resources on the CCP website- COVID-19 Local Testing – Center City Pediatrics
· Rapid tests can be used for children at home. On the label it says not for children < 2 years of age, because it was not specifically tested on this target population. The modality of testing with a nasal swab can be used on infants even as little as the first day of life.
· Rapid antigen tests are a nice tool to have in your “tool belt” but are not perfect. Rapid tests report false negatives with approximately 15% of cases and potentially more with the omicron variant. If your child is ill and gets a false rapid test, it is recommended to repeat the rapid test again in 24-48 hours or you can obtain a more sensitive test (molecular/ PCR testing).
· Molecular/PCR testing is ideal if your child is asymptomatic but has had a known Covid-19 exposure given the higher sensitivity of the test.
· If your child is covid positive, rapid testing may continue to be positive between 2 days and 2 weeks. Molecular and PCR testing can stay positive for weeks/months after testing positive.
· Repeating the Covid test once you have a known positive is generally not recommended. Some schools and places of employment require a negative rapid test before return, but this is not currently evidenced based. However, CCP cannot overrule your local institution’s guidelines.
· A known positive test is needed to provide documentation of recovery for travel, event purposes in the next 90 days.
· If your child has been exposed to Covid-19 OR is symptomatic with a rapid positive test, do not continue to test your child. This is valid result and you do not need a PCR test to confirm.
Unvaccinated/Not Up to Date with Covid Vaccine
· Stay home and isolate for 5 days from your most recent Covid exposure
· Obtain a Covid test 5 days after your most recent Covid exposure, or sooner if you develop symptoms of illness
· *Mask around others for 10 days after your most recent covid-19 exposure
*If your child is < 2 years of age and cannot mask around others AND is not fully vaccinated, a 10-day quarantine is required after a Covid-19 exposure.
Vaccinated/Current with Covid Vaccines/Boosters
· No quarantine required after an exposure
· Obtain a post exposure Covid test 5 days after your most recent exposure to Covid-19
· Mask around others for 10 days after your most recent Covid-19 exposure
· Monitor for symptoms of Covid-19 and isolate if symptoms occur
Covid Positive Family Member
· Try to have the Covid positive family member isolate from other household members who do not have Covid-19 (this includes their own room and bathroom whenever possible). If the positive family member is unable to do so, they should wear a well-fitting mask (N-95 if possible) around other household individuals. Everyone who is over 2 years of age at home should mask whenever possible.
· Practice good handwashing
· Open windows to increase ventilation in the home
· Clean high touch household surfaces like doorknobs, faucets, remotes, cell phones and tablets
· For those household members who are continuously exposed to the Covid positive individual, their time to watch for symptoms and quarantine begins once the Covid positive individual’s 10-day period (from beginning of symptom onset/positive test result) ends. For example, if mom tested positive for Covid and cannot isolate, her unvaccinated/not up to date on Covid vaccine children should quarantine during her 10-day period and then start an additional 10-day quarantine period once mom’s 10-day period ends. Similarly, follow guidelines to test earliest 5 days after last exposure or at any time symptoms develop between last exposure and 10 days.