• Exposure (close contact) to a person with confirmed or suspected COVID-19 infection

  • Confirmed patients have a positive COVID-19 lab test

  • Suspected patients are diagnosed as probable COVID-19 by a doctor, based on symptoms

  • You or your child have NO symptoms of COVID-19 (fever, cough or trouble breathing)

  • Updated: December 4, 2020

  • Household Close Contact. Lives with a person who has positive test for COVID-19. This carries the highest risk of transmitting the infection.

  • Other Close Contact. The CDC defines 6 feet (2 meters) as how far coughing can spread the virus. How long the close contact lasts can also be important. Prolonged close contact is defined as a total of 15 minutes or more over a 24-hour period. Close contact includes kissing, hugging or sharing eating and drinking utensils. It also includes close conversations. Direct contact with secretions of a person with COVID-19 is also close contact. Includes being in the same childcare room, classroom or carpool. These exposures are usually lower risk than living with an infected person.

  • In Same Building - Low Risk Exposure. Being in the same school, place of worship, workplace or building carries a small risk for exposure. This risk increases if several people have the infection.

  • In Same City - Low Risk Exposure. Living in or travel from a city or country where there is major community spread of COVID-19, also carries a small risk. The CDC lists these "hot spots" . Outdoor contacts are much safer than indoor contacts.

  • COVID-19 Symptoms: The most common symptoms are cough and fever. Other common symptoms are chills, shivering (shaking), sore throat, muscle pain or body aches, headache, and loss of smell and taste. The CDC also includes the following less common symptoms: runny nose, fatigue (tiredness), nausea, vomiting and diarrhea.

  • Incubation Period: average 5 days (range 2 to 14 days) after coming in contact with the secretions of a person who has COVID-19.

  • No Symptoms but Infected: Over 20% of infected patients have no symptoms.

  • Mild Infections: 80% of those with symptoms have a mild illness, much like normal flu or a bad cold. The symptoms usually last 2 weeks.

  • Severe Infections: 30% of those with symptoms develop trouble breathing from viral pneumonia. Many of these need to be admitted to the hospital. People with complications generally recover in 3 to 6 weeks.

  • Deaths: Children generally have a mild illness and recover quickly. Pediatric deaths are very rare. Older adults, especially those with chronic lung disease, heart disease, diabetes or weak immune systems, have the highest death rates. The overall death rate is around 6 per 1000.

  • Vaccine: There currently is no vaccine to prevent COVID-19. Research is on the fast track in many labs. Safe and effective vaccines may be ready by early 2021. Most vaccines will be 2 doses, given 3-4 weeks apart. Similar to flu shots, they will probably provide protection for 6-9 months. The first widely available vaccines will only be offered to adults. Reason: Vaccine safety needed to be proven in adults first and vaccine trials on teens are just starting. (November 2020)

  • Treatment: New treatments for severe COVID-19 are becoming available. They are only used on hospitalized patients and are given in a vein (IV).

  • To meet the high demand for COVID-19 information, when possible, find your answers online. Here are the most reliable websites:

  • CDC website: https://www.cdc.gov/coronavirus

  • American Academy of Pediatrics parent website: www.healthychildren.org

  • Always follow the most current CDC recommendations if they are different than those in this document.

  • Exposure but No Symptoms - Overview:

    • Although you may have been or were exposed to COVID-19, you do not currently have any symptoms of that infection. COVID-19 infections start within 14 days following the last exposure.

    • Since it's been less than 14 days, the exposed person is still at risk for getting sick with COVID-19.

    • You need to watch for symptoms until 14 days have passed.

    • Stay at home and follow this medical advice.

  • You Do Not Need to Contact Your Doctor:

    • The exposed person does not have any symptoms.

    • You do not need to call your doctor unless the exposed person becomes sick.

    • You can find the answers to most of your questions here or online.

  • COVID-19 Testing - Talk with your Health Care Provider:

    • For questions about testing, call your doctor during office hours.

    • The availability of testing and where to get it can be different for every community.

    • Doctors may order a test about a week after known exposure if your child continues to be without symptoms. (CDC). Testing done during the first 5 days after exposure will usually be negative.

  • Measure Temperature:

    • Measure the exposed person's temperature 2 times each day. Do this until 14 days after exposure to COVID-19.

    • Report any fevers or respiratory symptoms to your family's doctor.

    • Early detection of symptoms and quarantine is the only way to reduce spread of the disease.

  • Home Quarantine - How to do:

    • Quarantine means restricting people who were exposed to a contagious disease from contact with others who are well. They are monitored closely to see if they stay well or become sick (CDC).

    • The quarantine period is usually 14 days. The CDC may shorten the timeframe of quarantine. Follow the most current recommendations of the CDC or your local public health department. If unsure, call your doctor.

    • The level of quarantine needed for an exposed person who has no symptoms, may depend on the degree of exposure.

    • For now, the exposed person will need to stay at home.

    • Do Not allow any visitors. (such as friends)

    • Do Not go to school or work.

    • Do Not go to stores, restaurants, places of worship or other public places.

    • Avoid public transportation or ride sharing.

    • Other family members are not on quarantine unless the exposed person becomes sick. Even then there are exceptions, such as exposed health care workers or first responders who do not have any symptoms.

    • Isolation Questions for Your PCP: Home isolation can be complicated. A parent may need to return to work. Someone in the household may be elderly or have a serious medical problem. If you have additional questions, call your doctor during office hours. Your doctor is the best resource for up-to-date information on COVID-19.

  • Day 15 or Later After Close Contact and No Symptoms - Quarantine Over:

    • The COVID-19 infection starts within 14 days of an exposure.

    • The exposed person has no symptoms of respiratory infection (such as fever or cough) during the 14 days after an exposure.

    • They should be safe from getting COVID-19.

    • If the exposed person has been on home isolation, it can be stopped.

  • Fever occurs

  • Cough or trouble breathing occur

  • Other symptoms of COVID-19 occur

  • You think you or your child needs to be seen

  • You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.