COVID-19 information for parents/carers

What parents need to know about COVID-19

COVID-19 appears to generally cause mild illness in children. Very few children have to be admitted to hospital with COVID-19 in the UK and an even smaller number have a severe illness. 

For information and practical guidance to help your child's school life read the section below and visit the government website. 

For current advice on the COVID-19 vaccination for children please visit the government website. 

However, at this time, when everyone is preoccupied with COVID-19, it's really important to realise that not every illness your child has is due to COVID-19. All the 'normal' infections that can make children and babies really unwell still remain and there is a major risk that parents may delay bringing their child to the attention of a healthcare professionals even if they are unwell. If you are not sure if your child is unwell and whether they need to be seen by someone, click here to help you decide. GPs and hospitals are still providing the same safe care that they always do for children.

Your child is only likely to get infected if they come into close contact with someone with Covid-19. Close contact is defined as either face to face contact under 1 metre for less than a minute or 2 metres for less than 2 minutes. 

Many more children are being infected with Covid-19 especially in the teenage years but for most it remains a very mild illness. Most of the severe cases have been in elderly people with medical conditions such as heart problems or lung disease. Children with chronic health problesm such as asthma do not appear to be at more risk, however all teenagers are being offered vaccination as well as some other ages if a child has a medical problem. 

For specific information for children and young people with cancer undergoing cancer treatment, click here.

If you are worried about your child's breathing and are not sure if they need to be seen by a healthcare professional, click here to help you decide.

Our local and regional paediatric services are well set up and have detailed plans in place to treat and support all children who have severe a COVID-19 disease. There is a national plan in place for children that require intensive care support (PICU).

If a member of your family develops Covid-19, then they need to self-isolate for 10 days. It is no longer necessary for the whole family to self-isolate if they test negative and are double vaccinated or are under 18 years old. 

Social distancing and is the most effective way of minimising the spread of COVID-19. You may choose to limit the close contact you have with people you do not usually live with. These are personal choices and it is important to consider that others may wish to continue to take a more cautious approach. 

Previously the most vulnerable children had to shield but shielding has now paused. For more information on shielding click here.

It is extremely important to realise that not every child with a fever has COVID-19. All the other conditions that can make children unwell are still ongoing during the COVID-19 pandemic. If you are not sure if your child is unwell and whether they need to be seen by someone, take a look at the red / amber / green criteria below to help you decide.

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to the touch
  • Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
  • Severe breathing difficulty - to breathless to talk/ eat or drink
  • Is going blue round the lips
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  • Develops a rash that does not disappear with pressure (the ‘Glass test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 
  • Has testicular pain, especially in teenage boys

You need urgent help:

Go to the nearest A&E department or call 999

If your child has any of the following:

  • Is finding it hard to breathe including drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Infants 3-6 months of age with a temperature of 39°C / 102.2°F or above
  • For all infants and children with a fever of 38°C or above for more than 5 days
  • Has persistent vomiting and/or persistent severe abdominal pain
  • Has blood in their poo or wee
  • Any limb injury causing reduced movement, persistent pain or head injury causing persistent crying or drowsiness
  • Is getting worse or if you are worried

Immediately contact your GP and make an appointment for your child to be seen that day.

We recognise that during the current COVID-19 crisis, at peak times, access to a healthcare professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.

If none of the above features are present

  • You can continue to provide your child care at home. Information is also available on NHS Choices
  • Additional advice is available to families for coping with crying of well babies
  • Additional advice is available for children with complex health needs and disabilities

Self Care:

Continue providing your child's care at home. If you are still concerned about your child, call NHS 111 - dial 111.

The key messages from this guidance are:

  • Nationally, education and childcare settings are open, and attendance is mandatory (for schools) and strongly encouraged (at childminders, nurseries and colleges)
  • The Royal College of Paediatrics and Child Health has made it clear that the overwhelming majority of children and young people still have no symptoms or very mild illness only

  • Secondary school pupils in England and Wales are are being asked to start wearing masks in school again, to help slow the spread of the Omicron Covid variant. 

  • Continuing to take regular rapid tests will help you to identify infections early and reduce transmission - there is no need for primary age pupils (those in year 6 and below) to test
  • Your nursery, school or college will no longer trace close contacts - close contacts will still be identified via NHS Test and Trace
  • Children and young people aged under 18 years 6 months who usually attend school, and have been identified as a close contact should continue to attend school as normal as long as they are well
  • All children aged 12 and over are now eligible for a COVID-19 vaccination

If you have concerns about your child attending, you should discuss these with your school or college.

For more information please see the full guidance. 

What is PIMS?

PIMS TS was first reported in April 2020 and cases continue to be low in number but we need to remain vigilant.

The children had serious inflammation throughout their body. Inflammation is a normal response of the body’s immune system to fight infection. But sometimes the immune system can go into overdrive and begin to attack the whole body and if this happens, it is important that children receive urgent medical attention.

Doctors are concerned that in severe cases of PIMS the inflammation can spread to blood vessels (vasculitis), particularly those around the heart. If untreated, the inflammation can cause tissue damage, organ failure or even death,

Some of the symptoms of PIMS can overlap with other rare conditions, such as Kawasaki disease and Toxic Shock Syndrome. Some people have referred to the condition as ‘Kawasaki-like disease’. Like PIMS, complications from Kawasaki can cause damage to the heart. Kawasaki tends to affect children under five whereas PIMS seems to affect older children and teenagers.

Can PIMS be treated?

Yes. Doctors know what to look out for and will do tests to diagnose what’s wrong and what treatment to give the child. Even where doctors aren’t 100% sure whether a child or teenager has PIMS, they know how to treat the symptoms associated with it. Doctors use the same type of treatments to ‘reset’ the immune system for both PIMS and Kawasaki disease.

Researchers hope to find out more about how to diagnose patients as quickly as possible and which are the most suitable treatments for each patient.

What symptoms should I look out for?

There’s a very wide range of symptoms and children with PIMS can be affected very differently. Some children may have a rash. Some, but not all, may have abdominal symptoms such as stomach ache, diarrhoea or being sick. All the children diagnosed with PIMS had a high temperature for more than three days, although this can be a symptom in many other illnesses and on its own is not a sign of PIMS.

While most won’t, some children may be severely affected by the syndrome. The most important thing is to remember that any child who is seriously unwell needs to be treated quickly – whatever the illness. The advice to parents remains the same: COVID-19 is extremely unlikely to make your child unwell; if you are worried about them, take a look at the red/amber/green symptom guide above and if required, contact NHS 111 or your family doctor for urgent advice, or 999 in an emergency, and if a professional tells you to go to hospital, please go to hospital.

If your child doesn’t have these signs of being seriously unwell but you are still concerned, talk to you GP.

How many children have been affected?

It’s difficult to say because doctors are still in the process of reporting back – and also because there isn’t a definitive test. We think around 75-100 children may have been seriously affected and admitted to an intensive care unit. Almost all these children have since recovered.

A survey has been sent to 2,500 paediatricians (doctors who treat children) to gain a more complete picture of the condition. It asked doctors for details of every potential case seen since the beginning of March so we expect it to report a lot more cases – e.g. around 200 cases in England. But many of these children will not have been seriously ill and almost all children diagnosed with PIMS are now well again. The survey is likely to pick up cases which later turn out to be a different illness, eg Kawasaki disease. Some doctors believe a much large number of children may have had the condition but were very mildly affected and recovered without seeing a doctor.

Doctors have reported seeing a big reduction in cases in recent weeks but this could rise if cases of COVID-19 go up again.

Have any children died from PIMS?

We don’t know for sure because there isn’t a test for this condition. Doctors think two children may have died but they can’t be certain that there weren’t other reasons why the children died. These deaths are very sad indeed but doctors believe deaths in children related to PIMS are very, very rare. Many more children die of other infections such as flu or even chicken pox every year.

Is PIMS caused by COVID-19?

PIMS seems to be linked to COVID-19 because most of the children either had the virus or tested positive for antibodies indicating they had been infected (even if they hadn’t seemed ill at the time). But a very small number of the children with PIMS symptoms didn’t test positive for either.

How can doctors tell if a child has PIMS?

There currently isn’t a test which will say whether a child definitely has the syndrome. A syndrome is a collection of many different symptoms which, together, can give doctors an indication of whether or not someone has a particular illness. Doctors will look for a pattern of symptoms relating to PIMS and then do more tests, such as blood pressure and blood analysis, to make a diagnosis. Researchers are currently trying to develop a blood test which can quickly indicate whether a child has PIMS.

Are black or Asian children more likely to be affected?

When the first few cases were identified in the UK there seemed to be a larger number of children from an Afro-Caribbean or Asian background. Doctors don’t yet know the reason for this and it may turn out that these children are not at a higher risk than other children – in some other countries where the syndrome has been written about the children were white. But it is important for families with these backgrounds to be aware of the signs and symptoms of the condition, however rare.

Doctors are learning more and more about this condition all the time and we hope to have more information over the next weeks and months. We will update our guidance regularly.

For more information, click here.

COVID-19 is spread by droplets. That means your child needs to be in extremely close contact with someone with COVID-19 (who is coughing) to become infected (within 1-2 metres of them). However, the droplets containing COVID-19 can survive for hours on hard surfaces (door handles, handrails etc). This means that your child is much more likely to get infected by picking up COVID-19 on their hands and then infecting themselves by touching their face (which allows the virus to enter via their mouth, nose or eyes).

This is why washing hands with soap and water is so important, especially after being in areas containing other people:

In addition, trying to stop your child touching their face (unless they have just washed their hands) will also reduce the risk of them getting infected:

For more information about reducing the risk of you or your child catching COVID-19, click here.

Previously specific groups of children had to shield but that has now paused for now. More information on shielding can be found here.

If the number of positive cases substantially increases in your nursery, school, or college, or if your nursery, school, or college is in an enhanced response area, you might be advised that face coverings should temporarily be worn in communal areas or classrooms (by pupils, staff and visitors, unless exempt).

However, face masks should NOT be used for babies and children under 2

Wearing a face mask in this age group can put babies and children at serious risk of harm or death:

  • Babies and young children have smaller airways so breathing through a mask is harder for them
  • Masks could increase the risk of suffocation because they are harder to breathe through
  • Babies are unable to remove the mask should they have trouble breathing
  • Infants could be at risk of becoming tangled, especially if they try to remove a mask, potentially causing serious injury
  • Older infants or young toddlers are not likely to keep the mask on and will touch their face more to try and remove it

Individuals are not required to self-isolate if they live in the same household as someone with COVID-19, or are a close contact of someone with COVID-19, and any of the following apply:

  • they are fully vaccinated
  • they are below the age of 18 years and 6 months
  • they have taken part in or are currently part of an approved COVID-19 vaccine trial
  • they are not able to get vaccinated for medical reasons

Children and young people aged under 18 years 6 months who usually attend school who have been identified as a close contact should continue to attend school as normal. They do not need to wear a face covering within the school, but it is expected and recommended that these are worn when travelling on public or dedicated transport. Further information is available in the stay at home: guidance for households.

Even if your child displays symptoms of infection (cough, breathing difficulty or fever) up to 10 days after a contact with someone with confirmed or suspected COVID-19, they are unlikely to become severely unwell. However, if your child has moderate breathing difficulty (see amber features), they will need to be reviewed by a healthcare professional. NHS 111 will arrange this (contact NHS 111 online or call NHS 111). If your child has features of severe breathing problems (see red features), call 999

There is no evidence showing that ibuprofen is associated with harm in children with COVID-19. If your child has symptoms of COVID-19 such as fever and headache, you can treat your child with either paracetamol or ibuprofen.

  • The most common signs of COVID-19 are cough and fever
  • As children can be asymptomatic education and childcare staff, secondary school pupils and college students should continue to test twice weekly at home, with lateral flow device (LFD) test kits, 3 to 4 days apart. Testing remains voluntary but is strongly encouraged. Here you can find the NHS guidance for households with possible or confirmed coronavirus (COVID-19) infection
  • To reduce the risk of spread to other household members, get them to cover their mouth and nose with a tissue or sleeve when coughing and sneezing and to throw used tissues in the bin immediately. They should also regularly wash their hands with soap and water (for at least 20 seconds each time)
  • In addition, keep shared spaces and surfaces visibly clean using household detergents, washing hands after cleaning. Household bleach using in accordance with the instructions can be used to disinfect surfaces. Use hot water and detergent or a dishwasher for crockery and cutlery
  • If your child develops moderate breathing difficulty (amber features) whilst your family are self-isolating, you will either need to contact NHS 111 online or call NHS 111. They will arrange for your child to be seen by a healthcare professional. If your child develops severe breathing problems (red features), call 999

Vaccinations

COVID-19 has shown how important it is to protect ourselves against infections. Vaccinations are by far the most effective way of achieving this. That’s why is so important that your child still receives their normal childhood vaccinations; to protect them not just during the COVID-pandemic but also for the rest of their lives. Make sure that your child doesn’t miss out - your GP practice is still open to administer them. Click here for more information.

All 16 and 17-year-olds can now book a second dose of the Pfizer jab - this should be given at least three months after their first.

All 12 to 15-year-olds in the UK are being currently offered a single Pfizer Covid jab and will be offered a second dose three months later.

The Government vaccination group JCVI has recently issued guidance for children aged 5 to 11 who are in specific clinical risk groups, or who live in households with adults who are also at clinical risk, to be offered the COVID vaccinations. We are currently looking at our records to identify those children who are eligible and we will be in touch directly to offer a vaccination. Please speak to your GP if you haven’t heard anything by the end of February.

The situation continues to change day by day. For the most up to date information on the situation, including advice about school attendance, need for testing or attendance to hospital for assessment, look at the updates provided by Public Health England.