Despite the schools’ efforts to prevent the spread of COVID-19, medical professionals agree that the risk of exposure is likely to increase as more children return to buildings in the fall.
“What we do know about children is that they are not as symptomatic and they can spread it without knowing it, and that can certainly be problematic in the school environment,” he says Dr. Courtney Sauls, a pediatrician at Ascension St. John Pediatric and Adolescent Medicine.
For example, suppose your young child has contacted someone who has a positive COVID-19 test. Your child has no symptoms. What to do?
To determine whether testing should be done, it’s important to determine the type of exposure first, medical professionals say. The Centers for Disease Control and Prevention define direct exposure as “contact within 6 feet for at least 15 minutes with someone who has a documented positive test”.
The timing of the exam is also important. If they test positive, most people do so four to ten days after exposure Stephanie Zumwalt, Quality Manager and COVID-19 Site Manager for OU Health Physicians Tulsa.
“If you’re exposed today, don’t come to me tomorrow because it won’t show up,” she says. “You have to wait at least four days to be tested. So you have to go into quarantine for these days until you can come in and be tested. “
How do you determine whether and for how long a child should be tested or just quarantined?
Talk to your child’s family doctor, says Sauls.
“We have many resources and connections to connect families to the test environment and for COVID,” she says. “And we advise families all day long about COVID. This is what we do for and this is what we are here for. That is why I would like to urge families to turn to their pediatrician first and foremost. “
Another reason to call the child’s doctor is because most healthcare systems, including Saint Francis, Ascension St. John, and Hillcrest, won’t run the test at any of their testing sites without a doctor’s advice.
“Your child’s pediatrician will direct you to the most suitable testing site for your child,” he says Sherry Fisher, clinical director of the Warren Clinic.
Meredreth MaynardAccording to the Utica Park Clinic Quality Director and Hillcrest’s COVID Response Incident Commander, parents should call their child’s Utica Park Clinic provider or schedule a telemedicine visit if they are a new patient to see if testing is prudent. A test is ordered if necessary.
“With COVID, we learned that every situation is slightly different depending on exposure, type of exposure, amount of exposure and type of symptoms,” Maynard says. “We think this clinical discretion is really important in the next steps.”
If children have symptoms of any kind, it’s especially important to call their doctor, as co-infection is common in children, Maynard says.
“Just because your child has an ear infection or strep throat doesn’t completely rule out the possibility that they don’t have COVID,” she explains. “We just don’t know enough about the virus to know how closely these things are related. Is this a symptom of a traditional ear infection due to another bacterial cause? Or could this really be a complication with COVID infection? “
Some test sites do not require a doctor’s prescription (see list below). For example, at OU-Tulsa’s Wayman Tisdale Clinic, parents can simply call the test hotline (918-619-4980) to schedule a drive-through test. In fact, the whole family can be tested at the same time.
There are some conflicting opinions about whether a negative test still needs to be quarantined in the correct testing period, even if the child has not developed symptoms. Maynard says tests can give a false negative and suggests those with confirmed exposure quarantine for 14 days regardless of the test results.
Sauls, on the other hand, says a false negative is highly unlikely.
“Fortunately, the sensitivity and specificity of these PCR swab tests are very, very trustworthy,” she explains. “You’re in your high 90s, so it’s very reassuring that you probably won’t have false negatives.”
At the start of the pandemic, some questioned the accuracy of rapid tests that are available in some urgent cases in the Tulsa area. Both the rapid test and the PCR test use nasal or throat swabs.
“The problem is that there aren’t that many available with these rapid tests,” Sauls says. “So most places don’t offer this as a testing method. But I would trust both equally. “
If parents prefer to quarantine their children rather than have them tested, Sauls supports that decision.
“If they can safely quarantine at home for 10 to 14 days and the family with working parents or missing school isn’t overly burdened and they don’t want to be tested, that’s fine too,” she says. “But testing will limit the time it would take you to do it. “
Parents should check with their district as to when they can send their child back to school without symptoms after exposure.
Should very young children be tested? That depends on the situation, says Zumwalt.
“If your (test) is positive, your husband is positive, little Johnny is positive and little Maria is 2 years old and only has the biggest seizure in the world – we have to tie her to test her – don’t test her. Because if the three of you are positive, guess what it is. So just quarantine at this point. “
Getting your minor child’s PCR test results typically takes anywhere from one to three days in the Tulsa area. Once the results are in, “the provider who ordered the test will notify the parents,” says Fisher of the Saint Francis / Warren Clinic. Rapid test results can be available within an hour of the test.
Maynard suggests parents link their electronic health records to their children’s EMRs to reduce the time and frustration involved in retrieving test results electronically. Most healthcare systems that use MyChart, including Hillcrest and Saint Francis, require you to fill out a form online or in person and wait up to several days for the connection to activate.
Ideally, this connection should be established before the COVID test.
“That way, you’re not trying to navigate through this entire process plus the stress of knowing you had exposure,” Maynard says. Whether or not to link the EMRs of parents and their college student children should also be done in advance, she adds. This process requires additional steps if the child is at least 18 years old.
Sauls of Ascension St. John confirms data showing COVID-19 does not affect children as much as it does adults. However, she warns that it can be fatal to certain children.
“In terms of major respiratory illnesses, we are seeing a small number of children with COVID in our hospital system, which is really great,” Sauls says. “The unfortunate thing about such severe cases of COVID and children is that there is no real rhyme or reason for it. It’s not just kids with asthma or diabetes or whatever that are chosen. We don’t really know why some kids get really bad, and then most kids don’t get any symptoms at all. So it’s definitely something to be taken seriously. “
Zumwalt advises parents of returning students to expect calls about potential exposures and says they should take those calls seriously.
“Don’t be angry with the teachers and nurses and everyone in the school for trying to protect the entire school population,” she says.
According to Sauls, pediatric testing for COVID-19 is not as accessible as it is for adults, possibly due to a lack of data. For example, adults can get a drive-through test at CVS or Walgreens, which does not test minors under the age of 12. The Tulsa Health Department also doesn’t test children under the age of 12.
“I think kids make people nervous and a lot of other testing facilities or urgent concerns don’t have much experience with children,” Sauls says.
But Sauls agrees that if we don’t test children, we won’t be able to fully understand how COVID-19 spreads among them, or how they might transmit the virus to adults.
“To fight this pandemic, we need more people we know – we need to know more,” she says. “And so (testing) only serves to improve our understanding of how this has spread and the role our children play in it.”
Accessible COVID-19 Tests for Children Under 12 Years
The following test sites test children for COVID-19 without medical advice. Children must be accompanied by a parent or legal guardian.
Due to the CARES law, most COVID-19 tests are provided free of charge or reimbursed by health insurance.
* If you know of a test page that should be added to this list, please email details to [email protected]
Access to medical care
Various locations on the Tulsa subway; Roadside tests may be available.
Appointment required at https://amc.nextcare.com/locations.
University of Tulsa Lorton Performance Center, 550 S. Gary Place
Internal tests for children from 12 months
Test from 10 a.m. to 3 p.m.: 55 p.m., Sunday through Thursday.
Appointment required at https://portal.immylabs.com/appointment.
MCI diagnostic center
7018 S. Utica Ave.
Online registration at https://mcicovid.com required.
Comprehensive Health Services from Morton
1334 N. Lansing Ave.
Appointment required: Call 918-295-9308.
OSU Center for Health Sciences parking lot on campus
1111 W. 17th St.
Tests possible from Monday to Friday from 8 a.m. to 5 p.m.
Appointment required: plan at https://medicine.okstate.edu/covid/covid-19-schedule-online.html or call 918-281-2750.
OU-Tulsa Wayman Tisdale Specialist Hospital
591 E. 36. St N.
Appointment required: Call 918-619-4980.
Appointments on Mondays and Thursdays from 8 a.m. to 4 p.m. (closed for lunch from 12 a.m. to 1 p.m.).
Tulsa Emergency Room and Hospital
717 W. 71. St. S.
Dedicated, separate area for patients who fear they have COVID-19
No appointments are made. Call from the car park: 918-517-6300.
Tests possible from Monday to Thursday from 10 a.m. to 6 p.m. Friday from 9 a.m. to 2 p.m. The tests on Saturday and Sunday are reserved for newly emerging symptomatic patients.