Protection of children and newborns during Covid-19 pandemic — Dr Chin and Dr Lee

MARCH 26 — We hope this write up will help create awareness for the protection of children and newborns against COVID-19.

DEFINITIONS

COVID-19 Patient

Person tested positive for COVID-19 by the relevant authorities.

Person under investigation (PUI)

Identified as Person Under Investigation (PUI) are person that have presented with

·         Fever OR acute respiratory infection (sudden onset of respiratory infection with at least one of: shortness of breath, cough or sore throat) AND

·         Travel to or reside in affected countries in the 14 days before the onset of illness OR, close contact in 14 days before illness onset with a confirmed case of COVID-19.

Close contact

Identified as close contact i.e. person who has been in contact with a confirmed COVID-19 patient that may involve the following:

·         Working together in close proximity or sharing the same classroom environment with a COVID-19 patient;

·         Travelling together with COVID-19 patient in any kind of conveyance including public transport;

·         Living in the same household as COVID-19 patient;

·         Health care associated exposure without appropriate Personal Protective Equipment (PPE) – including providing direct care for COVID-19 patients, working with health care workers infected with COVID-19, visiting patients or staying in the same close environment of a COVID-19 patient.

Quarantine order

Persons who has been asked to quarantine in accordance to the Laws of Malaysia, Prevention and Control of Infectious Disease Act 1988, Act 342

FREQUENTLY ASKED QUESTIONS

What is the risk of children getting infected by COVID-19?

Based on available evidence, children do not appear to be at higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date.

If my child’s school has a confirmed COVID-19 case or PUI, does she/ he need to be quarantined?

Contact tracing would be conducted to identify close contacts of the confirmed cases to determine if the nature of contact poses risk of virus transmission. Public health team will decide if there is a need for your child and/ or close contacts to be issued a home quarantine.

How can I protect my child from getting infected by COVID-19?

You can encourage your child to help breaking the chain of infection by:

  • Clean hands often using soap and water for at least 20 seconds (preferably) or alcohol-based hand rub
  • Avoid people who are sick
  • Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks, phones, etc.)
  • Launder items including washable plush toys according to manufacture instruction, at the warmest water setting possible

How should I perform hand hygiene?

Hand-washing is one of the best ways to protect yourself and your family from getting sick. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.

If your hands are not visibly dirty and soap and water are not readily available, then you may use alcohol-based hand rub that has a final concentration of 80 per cent Ethanol or 75 per cent Isopropyl alcohol, covering all surfaces of your hands, rubbing them together until they feel dry.

What are the symptoms of COVID-19 in children?

The symptoms of COVID-19 are similar in children and adults. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children.

Should children wear mask?

No. If your child is healthy, there is no need for them to wear a facemask. Only people who have symptoms of illness or who are providing care to those who are ill should wear masks.

What if my child is a Person Under Investigation (PUI)?

The health team will make an assessment to see if your child need an admission, or to be quarantined with a home surveillance order.

What should I do if someone at home is sick?

Use a separate room and bathroom from the rest of the family (if possible).

Clean hands regularly by hand-washing with soap and water or using an alcohol-based hand rub.

Provide your sick household member with clean disposable facemasks to wear at home (if available) to help prevent spreading COVID-19 to others.

Sharing bathroom with suspected/ confirmed to have COVID-19 people

If a separate bathroom is not available, the bathroom should be cleaned and disinfected after each use by an ill person. If this is not possible, the caregiver should wait as long as practical after use by an ill person to clean and disinfect the high-touch surfaces.

Cleaning and disinfecting of households

Cleaning refers to the removal of germs, dirt, and impurities from surfaces. Cleaning does not kill germs, but by removing them, it lowers their numbers and the risk of spreading infection.

Disinfecting refers to using chemicals to kill germs on surfaces. This process does not necessarily clean dirty surfaces or remove germs, but by killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

Clean and disinfect high-touch surfaces daily (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks, phones).

 

Dirty surfaces should be cleaned using a detergent or soap and water prior to disinfection.

For disinfection, use:

Unexpired diluted household bleach solutions, or alcohol solutions with at least 70% alcohol.

Prepare a bleach solution by mixing:

5 tablespoons (1/3rd cup) bleach for 3.8 litres (about 4 litres) of water, or

4 teaspoons bleach for 950ml (about 1 litre) of water

 

Breastfeeding

To date, much is unknown about COVID-19. Experts do not know whether mother with COVID-19 can transmit the virus via breast milk. However, whether and how to start or continue breastfeeding should be determined by the mother, the family and the healthcare provider.

A PUI or COVID-19 patient who decides to breastfeed should do it safely, with proper hand hygiene before touching the infant and before wearing the facemask.

If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well to feed the expressed breast milk to the infant.

Can COVID-19 be passed from a woman to her unborn or newborn baby?

We still do not know if a pregnant woman with COVID-19 can pass the virus to her fetus or baby during pregnancy or delivery.

Can I touch and hold my newborn baby if I am a suspected/ confirmed COVID-19 patient?

Close contact of skin-to-skin helps a baby to thrive. As we mentioned before, COVID-19 transmission is mostly droplets. If you are in doubt, do discuss this with the health team.

Why and how should I limit my child’s interaction with older adults, relatives and people with chronic medical conditions?

Older adults and people who have serious chronic medical conditions are at highest risk of getting sick from COVID-19.

If someone at higher risk for COVID-19 will be providing care (e.g., older adult, such as a grandparent or someone with a chronic medical condition), limit your children’s contact with those people.

Consider postponing visits or trip to see older family members and grandparents. Connect virtually or by writing letters and sending via mail.

*Dr. Chin Saw Sian MBChB, MRCPCH, is a General Pediatrician residing in Kuching, Sarawak; and is also a practising doctor in private sector.

Dr. Lee Yew Fong, MBBS, MHM, is a Doctoral candidate in Biomedicine (Global Health Track), at the Institute of Global Health, University of Geneva (UNIGE), Switzerland.

** This is the personal opinion of the writers and does not necessarily represent the views of Malay Mail.

 

References:

https://www.moe.gov.sg/faqs-covid-19-infection

https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding

https://www.rcog.org.uk/globalassets/documents/guidelines/coronavirus-covid-19-infection-in-pregnancy-v3-20-03-18.pdf

https://europeanmilkbanking.com/covid-19-emba-position-statement/

https://www.rcpch.ac.uk/resources/covid-19-guidance-paediatric-services#pregnancy

https://www.cdc.gov/coronavirus/2019-ncov/faq.html#anchor_1584387482747

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