COVID-19 update from infectious disease expert

Originally posted March 19, 2020
Updated April 6, 2020

News about COVID-19 is evolving daily. Our pediatric epidemiologist and infectious disease specialist, Emily Godbout, DO, MPH, sat down with us to provide updated information for parents and families.

Do we have any new information on COVID-19?

We have seen an increase in COVID-19 cases in the United States and we now have confirmed cases in the state of Virginia and in our Central Virginia community. We do anticipate seeing more positive cases. It’s important to note, however, that based on available evidence children do not appear to be at higher risk for COVID-19 than adults and they often have more mild infections. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date.

Are pregnant women at risk?

Pregnant women experience changes in their bodies that may increase their risk of some infections. To date, we have not seen that COVID-19 leads to adverse outcomes for pregnant women or their growing babies. That said, because we know that pregnant women may be more prone to viral respiratory infections, such as influenzas, it is very important for pregnant women to make sure they’re taking the appropriate precautions to protect themselves. This includes washing their hands, avoiding contact with people who are sick and practicing social distancing as best they can.

Should mom continue breastfeeding if she tests positive?

We are still learning about how COVID-19 is spread. Person-to-person spread is thought to happen mainly via respiratory droplets when an infected person coughs or sneezes. There has not been evidence to suggest that it is found in the breast milk of women with COVID-19, in the limited cases reported to date. A mother with confirmed COVID-19 should take precautions like washing her hands before touching her baby and wearing a face mask while feeding. You should continue to breastfeed your baby as your baby will gain antibodies and key nutrients from breast milk.

Do you have any tips for cleaning toys?

It’s important to remember to clean and disinfect all high-touch surfaces in the household – such as tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets and sinks – daily. This does also include hard, non-porous metal/plastic toys. Clean surfaces with soap and water to remove all visible debris and stains. Rinse surface with clean water and wipe with clean towel. Apply a disinfectant. Ideally let this sit for at least 10 minutes before wiping with a clean towel. Last, rinse with water and allow surface to air dry. I would also advise laundering plush toys and blankies on warm and dry completely.

How about smart phones and tablets?

These definitely need to be cleaned. We recommend unplugging and turning off your device and then you can use a disinfecting wipe to clean it.

For families with kids still attending daycare, what tips do you have for minimizing exposure?

We are really focusing on infection prevention measures. If your child is sick, they should not go to daycare. We want to emphasize with our children and our daycares that they need to be practicing good hand hygiene and cough etiquette, and ensure that they’re cleaning all their high-touch surfaces and toys.

The best tips for avoiding the spread of the coronavirus include:

• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
• Avoid touching your eyes, nose and mouth.
• Stay home when you are sick.
• Get plenty of rest.
• Drink plenty of fluids.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently-touched objects and surfaces.

What supplies should families have on hand at home?

It is a good idea for families to have some supplies on hand as they may find themselves at home for a period of time. I would recommend having a 30-day supply of prescription medicines as well as over-the-counter medicines and medical supplies (such as tissues, Tylenol or Motrin) to treat fever and other symptoms. Lastly, ensure you have enough household items and groceries on hand for about a two-week period.

Should families limit outings to areas with large numbers of people?

Yes, families should definitely limit gatherings with large numbers of people. In fact, Governor Northam just announced a ban on gatherings of 10 or more people. You’ve probably heard the term social distancing. Social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens your chances of acquiring COVID-19.

The hope with social distancing is to help stop or slow down the spread of disease and allow the health care system to more readily care for patients over time. Social distancing doesn’t mean social isolation. I know a lot of families who are doing virtual play dates or using FaceTime to connect with friends and family.

If one member of a family tests positive, what’s the best way to quarantine at home while still caring for the rest of the family?

As much as possible, the infected family member should stay in a specific room away from other people in the home and use a separate bathroom. They should also avoid sharing personal items such as cups, utensils and bedding. Always remember to use infection prevention measures - practice good hand hygiene, use good cough etiquette and clean high-touch surfaces.

If you have at-risk family members in the house, such as older adults (grandparents), we really want to try and protect them by keeping them away from infected people.

Should I be worried about contracting COVID-19 while at CHoR?

Absolutely not. In both our outpatient settings and at the hospital, we are taking multiple infection prevention measures to ensure the safety of our patients and their families. This includes things like a change in our visitor policy and the way we triage patients. We care for people with all types of infections, so we are well-equipped to safely care for patients with COVID-19 as well.

We had one mom ask about her child who uses an inhaler before and after heavy physical activity for coughing. Does that put her son at risk for developing complications from COVID-19?

All the evidence and data so far show that children typically have mild symptoms. There hasn’t been any data to suggest to us that children with co-morbidities, such as asthma for example, are at increased risk but I would recommend that parents reach out to their children’s primary care physicians to talk through previous diagnoses and how COVID-19 might affect them. Again though, I would reassure this mom that there isn’t any evidence at this time to suggest more significant disease in specific populations of children.

Do you have any tips for helping families stay calm during high-anxiety times like this? 

There is certainly a lot of anxiety right now. Although it’s a stressful situation, I want to remind everyone to remain calm. As parents, if we remain calm and confident we can provide the best for our children. It’s good for parents to remain informed using credible resources. Take the time to talk to your child or your teen about what they know about COVID-19. Answer their questions and share facts in a way that they can understand. You may want to limit your family’s exposure to news coverage of the event, including social media.

Try as much as possible to keep up a regular routine. Schools are closed, so create a schedule for learning activates and relaxing, fun activities. Be a good role model during this time. Let your children know they are safe and take good care of yourself. It is hard for us to take good care of others if we are not taking care of ourselves.

Our child and adolescent psychiatrists offer some additional tips for managing anxiety and talking with our kids about mental health during times like this.

Can you give us a reminder on the proper way to wash your hands?

Wash your hands often, especially after blowing your nose, coughing or sneezing; after going to the bathroom; and before eating or preparing food. Use soap and water and wash for at least 20 seconds. This is about the time it takes to sing the “happy birthday” song. Cover all surfaces of your hands, including front, back, between your fingers, under your nails and your thumbs. Rub your hands together until they feel dry. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol. Soap and water are necessary if your hands are visibly dirty.

Watch the full interview with Dr. Godbout: