Doctors’ Notes


How to Handle Symptoms of Illness That Could Be COVID

Ah, the back-to-school-during-a-global pandemic season. New teachers, carefully packed backpacks, color coded folders for each class… runny noses, coughs, scratchy throats… OH NO. NOW WHAT??

As we’ve learned over the past 18 months, nothing is easy during a pandemic. Many of us are rejoicing that our kids are returning to a somewhat “normal” school situation, but the simple “cold symptoms” our kids inevitably develop after starting school can now turn into sick days, COVID testing, and waiting for results. So…

How should you handle it? When do you worry about the possibility of COVID? When is it just allergies? The guidance below can help you navigate this school year with a little less stress.

Is it Allergies?

Let’s start with allergies. Fall is a time when many children experience worsening allergy symptoms. Unfortunately, some of these symptoms overlap with symptoms of COVID-19.

Our advice is to make sure your child starts and continues their allergy medicine through the season. Typical allergic rhinitis causes sneezing, runny nose, and itching, but it can also cause mild cough and headache. Allergies do NOT cause fever.

Because we want to be sure we’re not sending ill children to school, if your child has 2 or more symptoms (congestion, headache, cough, sore throat, etc). we recommend keeping them home from school. See below for when to consider testing for COVID.

What About the Common Cold?

Lots of the usual viruses are circulating again, after taking a break last year. We’re also expecting influenza to make a comeback this year, as people are gathering in more ways than we did last year. (So be sure to get your flu vaccine as soon as it’s available! And stay tuned for COVID vaccines for ages 5-12, which are likely coming this fall!)

While it’s true that the majority of illnesses in kids are still going to be non-COVID-19, it’s also true that we can’t distinguish between them. Certain symptoms, like loss of taste or smell, are specific to COVID-19, but most symptoms are not.  (And remember: besides cold symptoms, COVID-19 can also cause gastrointestinal symptoms such as diarrhea.)

We can’t clear your child with symptoms that could be COVID-19 unless we test them and rule it out. So please keep your children home if they have any symptoms of illness. We know how disruptive that can be, especially now that many parents are back to in-person working, but it’s one of the best ways to stop the spread of COVID-19 — as well as all the other germs.  And, just a reminder: flu vaccines (coming soon!) don’t just help prevent infection; they help decrease transmission too.

What About Testing?

The best time to test for COVID-19 is at the start of symptoms that might be COVID – including fever, cough, difficulty breathing, nasal congestion, runny nose, loss of taste or smell, fatigue, nausea, vomiting, diarrhea, headache….*

…A lot of things we see commonly in kids! So give us a call if your child is having any of those symptoms, and we’ll work with you based on your details to get you scheduled for COVID testing right here in our Kids Plus offices.

*Note: This section was updated on 9.7.21, based on the latest guidance from public health officials.

When Can They Return to School?

This will vary depending on the situation, but generally, a child can return to school when they have been fever-free for at least 24 hours without fever-reducing medication, symptoms have resolved, and their COVID test is negative.

If your child has COVID-19, they must isolate at home for 10 days from the time their symptoms started, or if they don’t have any symptoms, 10 days from the date of their positive test.

If you have more than one child in the home, you can already tell this is going to get complicated as kids share germs, so please call us, and we can help you decide what’s best for your situation. Schools and child cares also have their own policies about returning to school, which may depend on their vaccination status, so make sure you consider that as well.

*Note: This section was updated on 9.7.21, based on the latest guidance from public health officials.

Is There Anything Else We Can Do?

Remember the very good mitigation strategies we have. First, we recommend COVID vaccination for everyone 12 years of age and older (available at our offices!).

Next: Masking works!

Wash hands frequently and please monitor your children for symptoms closely, keeping them home if they are sick.

As always, feel free to call us with any questions or concerns. Navigating this time of quarantine, exposures, and symptoms of illness is difficult. We’re so glad our kids are in school, but we know that comes with a lot of decision-making and can be stressful at times. We’re here to help!

Dr. Amy Maddalena, a Kids Plus Provider since 2006, is the Medical Director of our Breastfeeding Center of Pittsburgh.