What Parents Need to Know About Coronavirus (COVID-19)

We want parents to have the most reliable information about COVID-19, so we will update this article with new information as it becomes available. 

Every day seems to bring another nerve-racking headline about coronavirus, so you could be forgiven for feeling like you are in a scary sci-fi film. With so much information about this new disease swirling around the internet, it can be hard to sort fact from fiction—which makes it a big challenge just to figure out how best to keep your family healthy. So, consider this a fact-checked, 'to our best knowledge' guide to coronavirus. 

What is coronavirus?

Coronavirus is actually the name for a whole family of related viruses. Most of them just cause mild colds (think: sniffling and sneezing). But this new outbreak is caused by a totally unknown coronavirus that was never seen before 2019. The official name for this unexpected addition to the world of pathogens is COVID-19 (from coronavirus disease 2019). 

How is COVID-19 spread?

Like colds, COVID-19 is usually spread in one of two ways: 1) touching something that an infected person touched, then putting your hand on your face (it enters through your eyes, nose, or mouth) or 2) from tiny droplets that burst out of a sick person's mouth when she or he coughs or sneezes (especially if you are within 2 metres).

A new study by the United States National Institute of Health reported that COVID-19 is gone from cardboard surfaces by 24 hours. On hard surfaces (like doorknobs and tables) 50% is gone in 6 hours, and there is no trace in 2 to 3 days. In the air, under very specific lab conditions (very tiny droplets in a closed container that is constantly rotating at 65% humidity), half of the virus was inactive within 1 hour and by 2 hours 75% was gone.

What does all that mean in the real world?

You should clean any hard surfaces that others have touched and wash hands after opening cardboard boxes or put them aside for a day or so to let any virus die (porous surfaces dry up moisture, causing the virus’ 'body' to break apart).

But what about in the air? Like with colds or the flu, tiny droplets from coughing and sneezing can carry illness, but the NIH study may overstate the length of time it lasts in the air. Virus sprayed in a closed, rotating drum of moist air is very different than walking through a store. In the real world, sneezes send out the most wet droplets—coughs quite a bit less—and most droplets are pulled to the ground by gravity and get dissipated and dry out by air flow much sooner.

So, the risk is still greatest from being in close contact with someone who is sick and hand to face exposure. 'Hand-washing trumps everything,' said Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease.

Use tissues to cover your mouth and nose when coughing or sneezing, throw the tissue away and then wash your hands to eliminate the germs. 

In addition, please stay at least 2 metres away from people and avoid congested public places as much as possible. And, if you are coughing or sneezing, please wear a mask…and, if you don’t have one, cough/sneeze into your shirt or a scarf or your elbow. 

How bad is coronavirus for children?

This is pretty interesting: Some viruses, like influenza, are hardest on both ends of our families—infants and elderly. Others, like RSV (the bronchiolitis virus) are much worse for younger children. Babies often take months to recover from RSV, but for adults it’s little more than a cold. Likewise, Zika may give adults fever, but cause brain damage to a developing fetus. On the other hand, other viruses are much worse for adults. Mononucleosis (caused by Epstein-Barr virus) often causes no symptoms in infected children, yet can lead to months of chronic fatigue in adults.

So, where does coronavirus fit in? 

It appears that COVID-19 is pretty minor for minors. Children may have no symptoms at all, while it can be life threatening to older adults. This means the elderly need to be protected from children, not vice versa. So, if your toddler is getting sick or has been exposed to the virus, you should definitely postpone that trip to Grandma’s!

I have read that COVID-19 is more dangerous for children than we first thought—is that true?

Scientists are still learning about COVID-19, but initial research has found that it tends to be less severe in children than adults. However, that doesn’t mean children are immune to the disease—the American Academy of Pediatrics recently reported that infants are more likely than older children to get severely ill.

In a study from China, out of 31,000 COVID-19 cases, only 9 infants (between 1 month and 1 year old) were found who were diagnosed and hospitalized. Each had a close family member with the virus. A study of 745 infants who had close contact with a family member with coronavirus reported that only 10 tested positive. 

A Chinese study out last month in the British medical journal Lancet on 9 pregnant women with COVID-19 pneumonia found no infection in the babies. The babies were kept in isolation from the mothers, except to breastfeed (to protect the babies, mums had to wash hands and put on masks while nursing). 

Are children with asthma at risk?

The World Health Organization says asthma is one of the pre-existing conditions that makes us more vulnerable to the virus. This makes sense because other viruses with cold- and flu-like symptoms also cause double-trouble for people with asthma. If your child has asthma, continue the treatment your doctor recommends and avoid asthma triggers, such as cigarette smoke, dairy, and stale indoor air. Makes sure you have a 30 to 60 day supply of your medications, in case it becomes hard for you to leave home or your pharmacy has to close for a while. If you have not already, ask your provider about getting an emergency supply of your inhaler or other prescription medications.

Is it safe to take my baby to a health visitor for vaccines and baby reviews?

In general, you want to avoid public places…but it is also important for your baby to get the vaccines. Ask your health visitor or GP if there is a time of day you can come to be exposed to the fewest people. Once you're there, find out if you can wait in your car until they call you to come in. Of course, you may choose to delay your baby’s shots, which is fine because your baby won’t be exposed to sick people…so your little one is essentially protected anyway!

Will normal vaccines make children more vulnerable to COVID-19?

Like a good police force, our bodies are built to fight off multiple attacks at the same time. We resist bacteria and viruses in our nose, mouth, eyes, stomachs, colon. Our immune system is constantly ridding our blood, body, and brain from allergens, infections, and even cancerous cells. This is why there is no problem in giving a baby several vaccines at the same time. So, I think it is very unlikely that getting a vaccine could weaken your child's ability to fight off COVID-19.

What do pregnant women need to know about coronavirus?

Read about pregnancy and COVID-19 here. 

Self-Isolation and COVID-19

Do I need to keep my family at home—and for how long?

This is such an important question, but unfortunately, we just don’t know the answer yet. It all depends on individuals and families staying home now, to reduce the spread of the virus. In reality, if everyone could stay home for the next 3 weeks, the spread in the world would be over. However, it is very possible that this highly contagious period will last at least 3 to 6 months.

What if children's centres are still open?

Unfortunately, that is not a good idea. Even though young children usually don’t get strong symptoms from COVID-19, they can still catch it and shed the virus for a week or two. And, keeping your distance is completely impossible in a child centre setting. So, you can imagine how easily this illness would spread through a community from children carrying the virus home to their families.

Is it okay if my nanny or au pair still comes?

Yes, but… Needless to say, it is impossible to practice 100% social isolation. However, the more people with whom you have close exposure, the higher the risk. 

How long do I need to keep my children at home? And does that mean we cannot go outside at all?

In most places, you can definitely take the kids outside and get fresh air and play, but you do not want to visit places where they will be touching surfaces that other children recently touched. Also, you will want to limit contact with other children. When they do plan to come over, make sure they are healthy, wash their hands and faces (faces get germs from hand touching)…and have a stack of fresh t-shirts they can put on, so they’re not carrying virus into your home on their shirts. Unfortunately, this is going to be a long several months.

When can we see grandparents?

The scary thing is that adults over 60—especially those with pre-existing medical problems—are at especially high risk from COVID-19. While the virus’ effect on children seems to be relatively mild, for the elderly it can be deadly. For the time being, it is clear that it is best to catch up with Grandma and Grandpa over FaceTime...which can still be a lot of fun!

I expect that—until we have a good vaccine—there will be lingering pockets of virus popping up in big and small communities across the country. So, even after Safer at Home orders are lifted, we will need to be really cautious about visiting Grandma or Grandpa…at least until we have a vaccine or effective treatment.

How does COVID-19 affect babies?

There is one glimmer of sunshine in this whole coronavirus crisis: Studies indicate that COVID-19 is less severe in children than adults. However, that does not mean children are immune to the virus. They can definitely get it, but most have mild symptoms…or none at all. We still have a lot to learn about COVID-19, but we do know that it takes newborns 4-5 months to develop a strong immune system. This is probably why the AAP recently reported that infants are more likely than older children to get severely ill.  

Bottom line: Be thankful that little kids seem less at risk, but do not let down your guard. Kids have been hospitalized with severe breathing difficulties and there have even been deaths. Take all the precautions you can to reduce their exposure.

Here are a few practical tips to help protect newborns and infants from COVID-19:  

• Wash your hands with lots of scrubbing and rubbing before holding or touching your baby (and make everyone else who comes into contact with your baby do the same.)
• Avoid crowds.
• Say no to visitors (especially child visitors).
• If you have a toddler or playgroup-aged child at home, make sure you’re washing his/her hands and face right when they get home to keep germs in check.
• Make visitors put on a clean shirt before holding the baby. Though COVID-19 doesn’t seem to live as long on soft surfaces, viruses can live on clothes.
• Breastfeed if you can. Breastmilk is filled with antibodies that can help boost a baby’s immune system.

What are the symptoms of coronavirus in children?

Reports from China suggest that when children do get sick, COVID-19 causes no symptoms at all, or merely mimics a common cold. However, some children are at risk for greater symptoms, including:

• Fever
• Cough
• Runny nose
• Shortness of breath
• Chest pain

When should I see a healthcare provider about coronavirus?

If your child has a history of asthma or other chest issues, the cough and wheezing may be particularly problematic. So, it’s a good idea to call your healthcare provider now to ask if your child should start breathing medicine if signs of COVID-19 begin.

Is ibuprofen safe for people with COVID-19 symptoms?

Initial reports from France said that ibuprofen wasn’t safe to use for COVID-19 symptoms, but now the WHO is saying it’s fine. So, for the time being, we don’t have any reason to avoid it. One reason I prefer ibuprofen over acetaminophen is because it lasts longer (6 hours vs only 3), which can be a blessing when having to give medicine to fussy kids.

But, whichever you use, you want to give the correct dose: 10-15mg/kg or 4-7mg/pound every 4-6 hours for acetaminophen and 5-10mg/kg or 2.5-4.5mg/pound every 6-8 hours for ibuprofen. Always check with your healthcare provider, but many children seem to need the higher dose when their fever is high.

Are we close to a COVID-19 treatment or vaccine?

It seems today’s news is a constant flow of scary news, but there are some bright spots on the horizon. Hundreds of scientists are scrambling to discover new drugs to fight the infection, and there are several that may have promise. 

Also, in an exciting advance, scientists in Israel have developed a COVID-19 vaccine! The next steps will require 6 to 12 months of extensive testing to make sure it is safe and effective for children and adults of all ages. 

I heard a drug was just approved by FDA to treat COVID-19. Is that true?

Yay, science! We all have to stand up and salute all the incredibly dedicated scientists who have been diligently searching for a treatment to this terrible infection. And, it looks like their hard work has yielded a very solid advance. Preliminary evidence shows that hydroxychloroquine can be very helpful in fighting the virus in people before they have symptoms and in those who are very ill!

Hydroxychloroquine is a very well known and safe drug, used for decades to fight malaria. It has minimal side effects. Several early studies have been done showing its benefit—both killing the virus in the lab and helping sick, hospitalized people.

The benefit of the hydroxychloroquine was first noticed by Chinese doctors. In a study of 100 patients, a related drug, chloroquine, was effective in the treatment of COVID-19. Soon after, the NIH recommended chloroquine tablet, 500mg twice per day for 10 days for patients with any level of illness.

French doctors reported a study using hydroxychloroquine to treat COVID-19. Thirty-nine patients were in the study (23 were treated and 16 were not). Six of these patients were asymptomatic, 22 had upper respiratory tract infection symptoms, and eight had lower respiratory tract infection symptoms. People were treated with hydroxychloroquine (and 6 were also given azithromycin, a well-known antibiotic). After six days, 70 percent of the treated patients were considered cured (no virus detected) compared to 12.5 percent of those who did not receive the drug! Research on other drug treatments are underway and may offer up some helpful results.

Bottom Line: This is very promising news! However, since the study is not a published study—meaning that the findings have not yet been vetted by independent reviewers—we need to stay focused and smart. Also, if everyone were given the medicine, it might lead to rapid emergence of viral resistance. So, we next have to duplicate the studies and only use this medicine for those who truly need it.

Tips for preventing the coronavirus:

To reduce your risk of catching—or spreading—the coronavirus, follow these tips:

• Teach toddlers how to wash hands the right way! That means scrubbing with soap and water for at least 20 seconds. (That’s about as long as it takes to sing 'Happy Birthday'…twice!)
• No soap and water around? Use an alcohol-based hand sanitizer that contains at least 60% alcohol. Or, at the very least, wipe your hands vigorously with a tissue or paper towel, then throw it away.
• Sit more than 2 metres from people.
• Avoid people who are sneezing or coughing.
• Stay up to date with other vaccines, including the flu shot.
• If you have asthma, make sure you’re taking your medication.
• Try not to touch your nose, mouth, and eyes.
• Wash your hands, lots. (I know I said that already, but it’s super important!)
• If you are sick, wear a mask to protect others.
• Clean/disinfect frequently touched objects, like doorknobs and toys.
• Cough into a tissue or into your elbow instead of into your hand (this is a great habit to pass on to your toddler!)
• Stay home if you are sick and keep your children home when they are sick.
• Get lots of sleep to keep your immune system strong. 

If you are worried about the coronavirus…you are not alone! But I hope you can breathe a little easier knowing that by reducing your little ones’ exposure to the virus and teaching your toddlers some basic hygiene habits, you are doing your best to keep your family healthy…and to help other families stay healthy too. (Note: Want more information? Visit the World Health Organization website.)

More COVID-19 Resources:

• Pregnancy and COVID-19: What Expecting Parents Need to Know
• 23 Easy Indoor Activities for Kids—That Don't Require a Craft-Store Run
• 20+ Virtual Resources to Entertain Cooped-Up Kids
• 20+ Simple At-Home Stress-Relievers for Parents

UPDATED 4/15/2020: Updated/added information about asthma, coronavirus and babies, and visiting grandparents.

UPDATED 3/27/2020: We added new research about hydroxychloroquine.

UPDATED 20/03/20:  We added information about well visits and vaccines, the severity of COVID-19 in children compared to adults, and ibuprofen for COVID symptoms.

UPDATED 19/03/20: We added information about research on potential COVID-19 treatments.

UPDATED 19/03/20: We added information about how long the virus lives on different surfaces, self-isolating, updated our advice for pregnant woman, added information about conception, and added advice for parents of newborns and infants.

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider. Breastmilk is the best source of nutrition for babies. It is important that, in preparation for and during breastfeeding, mothers eat a healthy, balanced diet. Combined breast- and bottle-feeding in the first weeks of life may reduce the supply of a mother's breastmilk and reversing the decision not to breastfeed is difficult. If you do decide to use infant formula, you should follow instructions carefully.