COVID-19: What we have learned through 2020

Though 2020 brought unprecedented challenges with COVID-19, this new year holds great promise!   Despite the hope we have in the new COVID-19 vaccine, the virus cannot leave the forefront of our minds just yet.  This does not mean we have to live in fear.  We have learned much from 2020 and now have more knowledge and are more empowered to face COVID-19 in 2021.  Below you will find a summary of what we’ve learned through 2020. 

Children are not super-spreaders!

We now know that children contract the virus less often than adults and that they are about half as likely to transmit the virus as adults.  This is great news for our kids! This does not mean that we stop wearing masks, social distancing, and washing hands, but it is good news, nonetheless.

Illness in children is less likely to be severe

Thankfully, we have learned that though children can and do get COVID-19, they often have no symptoms or very mild symptoms.  Though those with chronic health conditions may have an increased risk of more severe illness, we are thankful to have not seen this in our pediatric population.

Schools and daycares are doing a great job

By and large schools and daycares have done a great job instituting protocols to keep our kids and teachers safe.  From offering the option to learn exclusively virtually, offering alternating days for school in-person and at home, and providing learning environments in smaller groups such as pods, schools have become very creative. We agree with the American Academy of Pediatrics who recently reiterated the importance of children returning to “in-school learning for their healthy development and well-being.”  Though in-school learning is never without risk, the added health and safety measures and minimal spread of illness between children are very helpful and are allowing our kids the benefits of in-person interactions with peers and teachers.

Exposure to COVID-19, now what?

Each scenario is different, but in general, an exposure occurs when someone is within 6 feet for 15 minutes or more with an “index case” (person who has COVID-19).  If masks were worn by both parties or the exposure occurred outdoors, the risk is lower, but is still counted as an exposure.   If the exposed person was a health care provider and was also wearing eye protection, this is not counted as an exposure.  Let’s go over a few more details.

An index case is a person with a known COVID-19 infection.  This person is considered contagious and able to spread the virus for the following duration:

The exposed person is a person who was within 6 feet for 15 or more minutes of an “index case.”

The exposed person with NO SYMPTOMS needs to quarantine and can choose to be tested. His/her 2 options are:

  1. Quarantine alone: An exposed person needs to quarantine and monitor for symptoms x 10 days.  Starting on day 10, as long as no symptoms have developed, he/she can return to usual activities.       BUT, until day 14, he/she should continue to monitor for symptoms, social distance, and wear a mask when around others outside his/her household. 
  2. Quarantine and test for COVID: An exposed person needs to quarantine for at least 7 days, but as soon as day 5 of the quarantine, he/she can be tested for COVID. The test done should be PCR, not rapid antigen.  If PCR testing is negative, starting on day 7, as long as no symptoms have developed, he/she can return to usual activities.  AND, until day 14, he/she should continue to monitor for symptoms, social distance, and wear a mask when around others outside his/her household

The exposed person WITH SYMPTOMS needs to quarantine and can choose to be tested. His/her 2 options are:

  1. Quarantine alone: An exposed person WITH SYMPTOMS needs to quarantine for 10 days after symptoms began.  After that point, he/she can leave quarantine as long as fever has been gone x 24 hours and all other symptoms are improved.
  2. Quarantine and test for COVID: An exposed person WITH SYMPTOMS can be tested for COVID-19 at any point.  Day 2-3 of symptoms is the ideal day to test.  If the test is positive, he/she should quarantine x 10 days since symptoms began and can leave quarantine after 10 days as long as fever has been gone x 24 hours and all other symptoms are improved.

 

Someone in our household has COVID, what should the rest of us do?  When should we be tested?

This is a frustrating situation! If one person at home is positive, the rest of the household will need to quarantine also. Timing of testing varies based on the ability of the household members to quarantine from the positive person.  There are 2 scenarios:

  1. When family members are unable to quarantine from the positive individual: testing for other household members can occur

The positive person can leave quarantine 10 days after his/her symptom onset (as long as fever free x 24 hours and symptoms are improved).  This typically means testing for other asymptomatic household members does not occur for about 15 days.

  1. When family members can quarantine from the positive individual: testing for other household members can occur as soon as 5 days since last close contact with the positive person (if asymptomatic) OR anytime, if symptoms are present

 

Do I need a repeat COVID-19 test to prove that the infection is gone and return to school or work?

No!  COVID-19 tests can be positive for as long as 3 months after the initial infection.  This does not mean that the person is still contagious.  Because of this, we do not repeat COVID-19 testing to allow return to school or work.  Return to school or work is based on the scenarios above, described under “An Index Case.”

 

I’ve had COVID-19 illness, can I get it again? 

This is a great question!  Research has led us to believe that a person will likely be unable to get COVID a second time in the 3 months following initial infection.  What we still do not know is if that immunity will last longer than 3 months and if having the virus previously means subsequent infections will be less severe. For those with previous COVID-19 illness who are exposed to COVID-19 again, the CDC states that there is no need to quarantine if: their infection was in the last 3 months, they recovered from that illness, AND they have no current symptoms of COVID-19. 

COVID-19 Vaccine

We love that people are calling this the “light at the end of the tunnel” vaccine!  The hope the vaccine brings is a bright light in 2021, indeed!   Almost every PAA staff member has been able to receive our first vaccine dose thus far and we are so thankful!   Next month, we will discuss the vaccine in more detail.  Until then, please watch Dr. Mirrop’s video where he explains how the vaccine works and answers our most frequently heard vaccine questions (COVID Vaccine Explained).

References

  1. https://www.nationalgeographic.com/science/2020/12/we-now-know-how-much-children-spread-coronavirus/
  2. https://www.health.harvard.edu/diseases-and-conditions/coronavirus-outbreak-and-kids
  3. https://covidpathway.com/you-have-covid/
  4. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/end-home-isolation.html

 

Author
PAA Advanced Practice Providers Our PAA APP's include: Annie Croft, Pam Dietrich, Amber Mercer, Erin Moore, Nikki Nutter, and Emily Woodard

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