Hey friends. Our phone lines are blowing up with exposure and quarantine questions. I love that you guys are calling – it’s the right thing to do! And we are here for ya.

But just wanted to spell out some common scenarios so that you have quick answers:

What does the CDC consider a “close exposure”?

• Being within six feet of someone indoors for more than 15 minutes in a day.
• This is common in classroom settings where kids aren’t masking.
• The CDC does not consider it a “close exposure” if both kids are masked (what a GREAT REASON to mask all kids in school!).

What should I do if my child had a close (classroom or otherwise) exposure to COVID-19?

• Keep your kiddo home for 10-14 days after exposure to the positive person.
• Make sure your child wears a mask in any indoor setting for 14 days, if over age 2.
• An infection could show itself anytime in those 14 days – but if you get to day 10 and the child has zero symptoms, most of the time it’s fine to end quarantine.
• Sometimes a negative test on Days 5-7 will allow return to school on Day 7 of quarantine if no symptoms appear.

What if my child has been vaccinated and then exposed? Does she have to quarantine?

• Nope. If she is symptom-free, she does not have to quarantine.
• The CDC does recommend a COVID-19 test on day 3-5 after exposure though, to be on the safe side.
• Your child should wear a mask indoors for a minimum of 14 days after the exposure, even if vaccinated.

What should I do if someone in my house tests positive for COVID-19?

• Try to keep them in their room as much as possible, and using their own bathroom.
• If they’re older than 2, have them wear a mask in shared spaces.
• Don’t share towels, cups, utensils or bathroom supplies.
• Wash your hands a lot.

What if someone in my home tests positive for COVID? Can my child go to school?

• If your child is VACCINATED and has no symptoms, yes. Get a COVID test 3-5 days after the last close exposure to that person.
• Regardless of vaccine status, have the child wear a mask in indoor spaces (if over age 2) for at least 14 days
• If unvaccinated, they need to quarantine for 10 days after their last exposure to that person. If the COVID+ person cannot isolate (say a parent who must help with childcare), the child must quarantine for 24 days (14 days they could potentially catch it, and 10 days to become non-infectious if they do have it). Again, these times could be shortened with negative testing and no symptoms, as discussed above.

My child has been in close contact with someone who was positive for COVID, and is starting to show symptoms. What do I do?

• Don’t panic. Remember that most of the time, COVID-19 is mild in kids.
• The child must isolate at home for at least 14 days from first symptoms, and must be 24 hours without fever and improving.
• Have the child mask indoors for at least 14 days, if over age 2
• Get your child a test for COVID
• If the test is negative, consider a repeat in 24 hours (or if it was a rapid, consider a PCR)
• COVID is a virus, and will need time to run its course. Typically, the only thing kids need is time.
• If your child is under 3 months old, call your pediatrician.
• Make sure he’s breathing comfortably.
• Make sure he’s drinking enough to urinate every 6-8 hours.
• Make sure he’s acting coherent and normal.
• He’ll probably be more tired, and may be dealing with coughing and congestion.
• Some kids have GI symptoms like vomiting or diarrhea.
• We are okay with fever for up to 5 days. We don’t want fevers trending higher over time.
• We don’t want breathing to become labored, wheezy, or faster.

My child tested positive for COVID-19, but has no symptoms. What do we do?

Your child is infected and needs to be in isolation from others even though they don't have any symptoms.

• You may end your child’s isolation if 10 days pass after the positive test with no symptoms.
• If over age 2, have them mask in indoor spaces for at least 14 days

What if my kid has symptoms of COVID-19, but I don’t know of any positive contacts. What do I do?

• Typically if a child is showing symptoms of COVID-19 (which, let’s face it, can look like a whole lot of other viruses), and they have no known exposures, I will perform a rapid or PCR test on them. If it is negative, they can go back to school as long as fever-free for 24 hours and symptoms are improving.
• If I am VERY suspicious for COVID (let’s say they’re having shortness of breath and have lost their sense of smell), I will ether get a PCR (more accurate than the rapid test), or I will repeat testing in 24 hours.

Quick reminder about RAPID versus PCR testing:

• Rapid testing (the kind we do in the office which is done in 15 minutes) is 80-85% sensitive. This means if it’s negative, and I really think a kid has COVID, I will re-test again in 1-2 days, or send them for a PCR
• PCR testing (often drive-thru or hospital testing that takes a day or two to come back): 99% sensitive! One test is sufficient to rule in/rule out COVID.

As COVID-19 continues to inundate our society, there arises the question of when to start the countdown clock of quarantine. Let’s say mom gets sick with COVID-19 and stays at home as she is supposed to. Centers for Disease Control and Prevention (CDC) guidelines state children should avoid physical contact with the sick parent.

For children staying in the home of a sick parent, the CDC recommends:

• Both parent and child (over age 2) should wear a mask while in the same room

• Wash your hands frequently for at least 20 seconds

• Try to stay six feet apart, if safe to do so

• Increase ventilation by opening a window

• Disinfect high touch surfaces (phones, remote controls, counters, table tops, doorknobs, bathroom fixtures, toilets, tablets, bedside tables, light switches) often

• Avoid sharing personal household items (dishes, cups, eating utensils, bedding, towels)

• Watch closely for any symptoms of COVID-19

Now let’s say dad has COVID-19, and his symptoms started seven days after mom became sick. What do you do about children returning to day care or school?

The CDC states anyone who has had close contact with someone with COVID-19 should stay home for 14 days after their last exposure to that person. What is not exactly specified is what to do if the COVID-19 positive parent and asymptomatic children are in constant contact in their own home. I recommend a safe watch and wait approach, practicing the above recommendations and if the child is still asymptomatic at the completion of 14 days after the parent’s 10 day isolation ended (which is a total of 24 days after the parent became ill or had a positive test), then they can resume day care and school attendance. The 14-day countdown would begin at the end of the most recent family member’s 10 day isolation period (in our scenario that would be dad’s). And as COVID-19 can slowly trickle through the household, this can be a month-long lockdown.

With any sick symptoms in your child following an exposure of COVID-19, they should see his or her pediatrician and get tested. If your child does test positive for COVID-19, they can be around others 10 days after symptoms first appeared, as long as their COVID-19 symptoms are improving and they have not had fever in 24 hours without the use of fever-reducing medications.