Transcription:
COVID-19: Information for Parents and Children

Melanie Cole (Host):  This is the Weill Cornell Medicine Podcast on the COVID-19 Coronavirus. This podcast is dated March 19^th, 2020.

There’s no handbook for your child’s health, but we do have a podcast featuring worldclass clinical and research physicians covering everything from your child’s allergies to zinc levels. This is Kids Health Cast by Weill Cornell Medicine. I’m Melanie Cole. And our topic today is the Coronavirus. Joining me is Dr. Carolyn Hiltebeitel. She’s the Associate Director for Pediatrics and Primary Care and an Assistant Professor of Clinical Pediatrics at Weill Cornell Medicine. Dr. Hiltebeitel, thank you for joining us today. Help us to understand this 2019 Novel Coronavirus. What’s the latest information that we have as of now on this and is if effecting children as much as adults?

Carolyn Hiltebeitel, MD (Guest):  So, COVID-19 is a new or novel Coronavirus meaning that it’s mutated so this is a strain of Coronavirus that we have never seen before. Nobody in the world has been infected with this virus before. And that’s why we are all susceptible so it’s more concerning because everybody may get this virus. Because none of us have immunity to it, we have never experienced it. Kids fortunately do seem to have less symptoms from this virus. Ninety percent of kids have mild or moderate symptoms meaning just cold symptoms or fever, don’t need to be hospitalized, don’t need any more supportive care other than being home and dealing with their symptoms at home.

So, fortunately, kids do seem to be less affected than adults.

Host:  That is encouraging to hear. So, for parents that are so worried; what are the first symptoms? What would we feel? Will this feel like the flu if the mom or the dad or the child gets it or anybody else in the family gets it? What will it feel like?

Dr. Hiltebeitel:  It could feel like the flu, certainly. It could also just feel like a cold. Or you may have no symptoms whatsoever. Children tend to have milder symptoms as I said. So, a lot of them will just have a little runny nose or cough, maybe some sore throat. And some will have fever.

Host:  Okay so, let’s talk about transmission because I think that that’s one of the things that people have the most questions about. Is it air borne? Tell us about surfaces. Tell us how this thing is transmitted please.

Dr. Hiltebeitel:  So, this virus is not what we would call an air borne virus. It doesn’t stay in the air for long periods of time. It’s not transmitted into air spaces. It is transmitted by respiratory droplets meaning if somebody coughs or sneezes, the virus is in the saliva from their mouth and those droplets can travel up to six feet in the air and then they fall on surfaces. So, that’s why the recommendations for people to stay at least six feet away from one another so if someone does cough or sneeze in the space that you are in; those droplets won’t reach you. They will land on surfaces as I said so, it’s important for people to clean surfaces frequently, to wash hands in case they touch a surface that might have viral droplets on it and then to be very careful not to touch their nose or their mouth or really any part of their face because those droplets may have viral particles in them and then if they get inside your nose or mouth, they can infect you.

Host:  Well Doctor, do antibacterial or alcohol wipes clean those surfaces and if so, how often should we be cleaning the surfaces around our house?

Dr. Hiltebeitel:  Fortunately, this virus is killed very easily by alcohol and antibacterial wipes and bleach. So, it is really important to clean surfaces frequently with cleaning products or wipes. Things like door knobs, things like the handle on your refrigerator or your sink, countertops, toys, anything that people are touching frequently can have viral particles on them if somebody is infectious. So, very helpful to clean surfaces several times a day especially if someone in the house has symptoms.

Host:  So, how do we talk to our children about this Dr. Hiltebeitel? What if we contract it? Do we have to stay away from our kids? How do we discuss this because it can be pretty scary for them, they are home from school, tell us what you want us to say to them.

Dr. Hiltebeitel:  It’s really important to talk to kids about this virus. Because obviously, they know there’s something going on. Our routines are all disrupted. Parents are working from home; kids are out of school. Babysitters may not be able to come. Daycares are closed. So, even small children realize that there’s something very unusual going on. And it’s important to ask your kids what they’ve heard, what do they know about what’s happening. Because I’m sure they’ve heard things from adults and from probably from other children which may or may not be accurate.

It's important to ask your kids what they are feeling, you don’t have to put words in their mouth but ask them are they scared, are they worried. What have they heard and what are their concerns. And then ask them what questions they have. Because kids often don’t have the kind of questions that we do about viruses. They may just want to know is mommy going to be home for the next three days. Is daddy going to home now during the day? Is the babysitter going to come? Are they going to get sick? You really want to just address the questions they have and try not to give them too much information. Because you don’t want to overwhelm them. And they may not developmentally be ready for the kind of information that you think they might be.

So, you really just want to answer the questions that they have and leave it at that. Don’t try to tell them everything’s going to be okay. Tell them that you are concerned. Tell them that you are doing everything you can to try to keep them safe and to try to help everybody keep from getting sick. And that’s why everyone is staying home and not having playdates and washing their hands a lot and not touching elevator buttons and doorknobs. Because you want them to understand why you are doing what you are doing but tell them that you’re going to do everything you can to keep them safe and to keep your family safe so that they know that you’re working hard and that they trust you.  

Host:  Well thank you for that great answer. Are video visits an option? If we’re worried about our children Doctor, as a way to speak to our pediatrician about our concerns, are video visits an option?

Dr. Hiltebeitel:  Yes, fortunately they are. So, we’re doing a lot of video visits right now for children that are ill, for children that – where parents have questions about them possibly being ill. We’re really doing our best to keep children out of the office as well as adults, but particularly children. So, we can connect with a video visit with the doctor for many different issues. You know pink eye, cold symptoms, fevers, thing that may be COVID virus and may not be COVID virus and we are doing our best to keep kids out of the office, to keep kids out of the ER. If a child is moderately ill for several days, we will bring them to the office, but we are trying to isolate those children as much as possible so that other people aren’t exposed to them. And so that they aren’t exposed to other viruses and things in the office.

Host:  So, for parents, what symptoms should we watch out for that would warrant a call to the pediatrician? If the temperature – if the child develops a fever of 101 or 2, is there a number that you doctors have come up with that says yes, call us right away?

Dr. Hiltebeitel:  There really isn’t a number. Kids in general tend to get higher fevers than adults do. We really are more concerned about how the child looks, and how long they’ve had a fever. If they’ve had a fever for more than two or three days, or they look poorly to you before that, if they are having trouble breathing, if they are very lethargic; they’re not drinking, they are not getting up to play a little bit; those are the things that we are more concerned about. If children have over 105 temperature; that can be a sign of a more serious infection so that would be a number that we would want to know about. But otherwise, it’s really how long has the fever been and what are the child’s other symptoms.

Host:  Thank you for clearing that up. That’s really an important point. So, now onto social distancing. And trying to prevent this spread. Teenagers specifically, are going to go crazy during isolation like this and quarantine; as a pediatrician, what can we be telling our teenagers and our tweens about the importance of social distancing, they want to hang out with their friends. Oh it’s just a friend coming to the house. What do we tell them?

Dr. Hiltebeitel:  So, this goes back to how the virus is transmitted and we talked about that earlier. It’s transmitted through droplets of saliva and viral particles in those droplets. So, you do really want to try to stay at least six feet away from everyone and those droplets can land on surfaces, so you don’t want to be touching surfaces that a lot of other people are touching. Things like doorknobs, things like elevator buttons. So, we have to tell our teenagers and our kids that the less contact you have with other people, the less likely you are to get sick and the less likely you are to get other people sick and so this virus will not spread as rapidly. Fortunately, now we have FaceTime, we have Zoom. There are ways that kids can connect over the internet so that they don’t have to be in physical contact with each other. And that’s really fortunate because we haven’t always had those options. So, it’s just really important to set an example for your kids and to stay home yourself and avoid crowds, avoid close contact with other people and tell them that it’s really important and why.

Host:  And what can we do to keep them occupied besides them sitting there staring at their phones?

Dr. Hiltebeitel:  So, there are lots of things that you can do with kids and I know it’s overwhelming when kids are suddenly out of school or not going to daycare and they are home all day and all of us feel a little cooped up. But it really is an opportunity to do things that we wouldn’t normally have time to do with our kids. Bake cupcakes or cookies or something healthier if you are a good cook and you are motivated. Do art projects. Arts and crafts, finger painting in the bathtub, big things, messy things that you wouldn’t normally do. Watch movies, that’s a great time to show kids movies from your childhood that you haven’t had time to do but you have fond memories of. Music, dancing, you can workout with your kids, you can put on a workout app and do yoga together or do a dance video together. It’s important to do things with your kids. I think that you shouldn’t worry about exposing them to more television or more iPad time than they would normally have. I think that that’s kind of the given and we all need a little break from each other at times. So, it’s a good way to kind of sit and be in your own space.

But we also should really try to take the opportunity to do more together and have fun so the kids feel that this is not such a punishment, that they get to do things with their families that they wouldn’t normally have time to do.

Host:  Well that’s definitely great advice. So, wrap it up for us Doctor, what you would tell parents that are concerned, they still may be want to order takeout or go shopping for some groceries. Their kids are going stir crazy. Give us your best advice on COVID-19 and what you want us to know as a pediatrician and if we have concerns where and when we should reach out.

Dr. Hiltebeitel:  So, obviously, the safest place for people is at home isolated with their families, not going outside, not touching door knobs, not being in elevators with other people. But we all do need to get out. We have things that we must do, maybe you can order groceries online and have them delivered. Or maybe you need to go to the grocery store and do that yourself. I think that it’s okay to do some of that. But obviously, you want to limit it as much as possible. The more surfaces you touch, the more people you are exposed to, the more likely you are to become ill.

In terms of things like takeout, there’s not much evidence that eating hot food from a takeout restaurant is a risky thing to do. So, especially in a place like New York City; I think it’s a fine thing to order food from a restaurant. So, in terms of protecting your family, the best things you can do are to wash your hands constantly with soap and water. Remember the 20 second rule. Sing happy birthday while you’re washing your hands or another song just so you get that 20 seconds in. Hand sanitizers are also good but obviously their availability is lower, so good old fashioned soap and water is just fine. Wash your hands whenever you come indoors. Wash your hands before you eat. Wash your hands if you think you are around somebody who is ill, and you are concerned. Clean surfaces frequently with alcohol or Clorox or any kind of disinfectant, Lysol, those sorts of things. And try to keep your distance from people. If you are around people, try to stay six feet away. Don’t have any large social gatherings. Resist having playdates and having friends over. And try to do things online just to stay connected with people. FaceTime with grandparents and elderly people who may feel isolated and try to normalize your life as much as possible but be careful. And be smart.

Host:  Thank you so much, to our guest Dr. Carolyn Hiltebeitel and to our listeners for listening to this special podcast on COVID-19 efforts for parents and children. I’d like to highlight that if you are in a lower risk age group, younger adults can help shape the course of this pandemic by taking social distancing seriously and staying home to the extent that this is possible. With these actions, they play a very important role in preventing the transmission of disease, protecting the health of our older or high risk individuals and keeping them out of the hospital. For information about COVID-19, including symptoms, prevention and travel advice; please visit www.weillcornell.org/coronavirus or call our hotline at 646-697-4000. This concludes today’s episode of Kids Health Cast. Please remember to subscribe, rate and review this podcast, share this podcast with people that you know. We’re learning from the experts at Weill Cornell Medicine together about this very serious situation that we find ourselves in. Thank you so much for listening. I’m Melanie Cole.