COVID19 life

Viral Illnesses: Not the same as they used to be . . .

May 6, 2021

First of all, thank you for all of the kind and insightful comments and suggestions on Tuesday’s post. As usual, it was dashed off by me in a cloud of (pretty raw) emotion, and I could see many of you sensed that. I have written down a lot of things from those comments, so thank you.

I didn’t post yesterday because we are now dealing with a scourge that was always stressful but now has become a Bigger Thing. C developed a hoarse throat and a fever (plus bilateral conjunctivitis and an odd-looking facial rash). If I was a gambling pediatrician, my bet would be on adenovirus which (per my resident who just finished an EM rotation) is going around in our community again after a long hiatus.

I’m happy to see the is still alive and kicking! This little guy is rhinovirus. A much friendlier pathogen than the one currently causing our pandemic. Yet still a nuisance . . .

Normally, you’d keep your sick kid home, and they could go back when fever-free for 24 hours, right!?

Not anymore!

I mean, I totally get why!!! And I will of course follow any rules in place (I immediately notified the school about his fever, for example). And actually it’s pretty amazing that this is our first real rodeo in dealing with a febrile illness in a very long time. But I was a bit surprised/confused when someone at the private school office yesterday told me that we needed “a negative test and 7 days” for C AND G to return, or “10 days without a test.”

Those sound like travel or exposure guidelines so I am hoping she is just confused. Anyway, I contemplated bringing him to urgent care to get a respiratory pathogen panel, since an RPP2 contains both a COVID-19 PCR and adeno, and surely if he has an alternate diagnosis that is NOT COVID and gets better . . . he could go back when no longer sick?

But then he spiked another fever rendering today a wash so I’m going to wait for some policy clarifications. I also felt guilty because clinically he doesn’t need those tests (I mean, I know that, he appeared non-toxic to me!) and I don’t want to waste time/space in the urgent care.

ANYWAY. I am so glad I have full time (and now, vaccinated!) childcare at home. I had a full day of patients yesterday and moving them all would have been disastrous.

I am going to post an article that has some controversial aspects, but I still found it interesting: here.

Our county is ALMOST ORANGE! I recognize this should not be cause for celebration (orange = still bad) but . . . it’s better than red!


Oh! And all of the patients I saw yesterday were excited about the prospect of COVID-19 vaccines for their kids! (Obviously this does not apply to every patient in the region, but it was encouraging nonetheless as our area has a lot of hesitancy that I do not see dissipating any time soon.)


  • Reply Sarah K May 6, 2021 at 7:18 am

    I enjoyed the article from the Atlantic. Thank you for sharing. I live in Norway where there has not been such a political divide related to corona but we do still have some crazies. Notably, one of our biggest covid deniers recently passed away from corona.
    I think it is important that health care workers (I am one as well) keep urging people to get vaccinated in order that we can open up society and live normally again. If there is no promise of normalcy, then what is the point?
    I read your blog frequently but don’t usually comment. Good luck with the sick kiddos.

    • Reply Ana May 6, 2021 at 11:03 am

      Coming here to say that I, too, had the solo-parenting weekend from hell (lots of yelling, tears, bad behavior), and it was followed by all three of my kids coming down with a rough non-covid cold. Now I’m telling myself that maybe they already felt cruddy over the weekend even though they didn’t have visible symptoms and that future solo-parenting weekends won’t all be so terrible. Perhaps that silver lining applies to your kiddos as well?

      • Reply Ana May 6, 2021 at 11:09 am

        Sorry, not sure why this showed up as a reply!

  • Reply A. May 6, 2021 at 7:19 am

    Negative test + 7days is normal, because even if negative, they don’t want him spreading the non covid virus all around so that after, all the class+staff needs to test+isolate etc.etc. And maybe it is the new normal…

    • Reply Sarah Hart-Unger May 6, 2021 at 7:32 am

      Maybe . . .
      I think perhaps some CDC guidelines would be helpful here so that every school isn’t making up their own policies.

      • Reply Noemi May 11, 2021 at 12:12 pm

        Well, unfortunately, just because CDC guidelines exist does not mean individual state/county/local health authorities won’t make their own decisions that aren’t in line with CDC.

        Here is what CDC has to say:
        Scenario 1: Symptomatic student with no increased risk of exposure to the virus that causes COVID-19

        This student should stay home until his or her symptoms have improved according to existing school policies, typically, at least 24 hours after they no longer has a fever (temperature of 100.4 or higher) or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine (e.g., acetaminophen or ibuprofen).,14%20days%20after%20being%20exposed.

  • Reply A. May 6, 2021 at 7:35 am

    I think that with variants, it creates a lot of stress still. Cause children, youngs are sicker… So until all are vaccinated (or the famous 80% like they want), it is normal to act with caution. Public health guidelines change from place to place, but here, I can only send back my child symptom free. Covid times or not.

    • Reply Sarah Hart-Unger May 6, 2021 at 7:37 am

      Totally agree with symptom free! It is the seven days (and seven days for sibling) that I am not sure about.

    • Reply Sarah Hart-Unger May 6, 2021 at 7:38 am

      I mean, we have a full time nanny but most do not. I also worry that a policy like this could actually backfire as some people out of desperation stop being honest with schools.

      • Reply Gillian May 6, 2021 at 7:44 am

        Yes, I agree. I think the more stringent the policy the more people will medicate and send kids to school. Can totally backfire! There was a huge uproar in our community because sibs of quarantined kids (not sick just isolating after an exposure) were asked to stay home. The point was made that contacts of contacts are not required to isolate so those kids could be out in the world in all kinds of other ways, and because we know the guidelines for masking a social distancing are followed at school that school is a better place for the kids to be. The policy was changed.

        Also those who are vaccinated should not need to isolate and should only be testing if symptomatic as per the CDC.

        • Reply Sarah Hart-Unger May 6, 2021 at 7:45 am

          Sadly my kids not vaccinated yet obviously – cannot wait until they are!!

          • Gillian May 6, 2021 at 7:47 am

            Obviously mine aren’t either. I was thinking of the staff referenced above. but my 13 yo may be able to be vaccinated in the next couple of weeks and I can’t wait!!!

          • Irene May 6, 2021 at 9:32 am

            We had a positive case in our preschool and the state closed the classroom for 2 weeks. Not a single other person was positive but it did not matter. And guess what? Basically every kid aside from mine went to a babysitter or grandparents for the second week because it’s impossible to work with a toddler at home!

  • Reply Gillian May 6, 2021 at 7:39 am

    Here a negative test and fever free for 24-hours would get you back in school as would an alternative diagnosis. Siblings do NOT have to stay home (though if I really suspected covid I would keep my other kiddos home). No one else isolates or tests unless the index case is positive. We haven’t had ANY in school spread so these guidelines + masks and distancing are doing their job.

    In NY the government is encouraging lots of testing and no one would blame you for heading to urgent care to get tested. I have actually started keeping viral swabs at home (one of the benefits of being a physician) so I can swab anyone who needs it ASAP and bring it into my office. I have also been known to swab my own children in the back seat of the car while my au pair is double parked outside my office. My feeling is CAN do this and it means my kids aren’t out in the world spreading whatever germs they do have so better for everyone.

    • Reply Sarah Hart-Unger May 6, 2021 at 7:44 am

      Ok this is empowering and makes sense!!! I’m going to take him to urgent care or his Ped today.

    • Reply KGC May 6, 2021 at 10:21 am

      I second this. In Maryland, there is a nice flowchart of recommendations for school and daycares and symptom free + negative test OR symptom free + alternate diagnosis would allow back to daycare. There is less clear guidance on siblings; this seems to be more daycare-dependent on their policies.

      We recently kept my two kids out because the older one had a fever. For fear of having them both home for 1-2 weeks, we ended up at urgent care for COVID testing because they would do a rapid test on-site vs. pediatrician, who quoted us 4-7 day turnaround after sendout (uhhh, that doesn’t help). We were thrilled to have the (negative) answer quickly and they were only out for 2 days (for fever resolution + 24 hour symptom-free) rather than a week or more. As it turned out, a mild cold went around daycare, with a few other kids also getting runny nose and mild fever, so that’s all it was! (several other kids also got COVID-tested with negative results, so we are quite sure it was just a cold…that also spread to my husband and me…sigh).

      I agree that this is a totally new situation to navigate because kids get sick! In the past, we just all accepted that germs were around, but it’s so much harder now. We are lucky to use a small in-home daycare with a provider who is very non-alarmist – she follows all COVID protocols but fully recognizes that it is unrealistic to quarantine kids for two weeks if they get a runny nose or a cough. She ended up closing for one day for the above-described situation because several kids were out and getting tested and it was the first time she has shut down at all during the pandemic. Hope C feels better soon!

    • Reply Erin May 6, 2021 at 11:59 am

      Same here in NC. A cold just went through our whole house, coupled with our already-present seasonal allergies thanks to pollen (cough, runny nose, thankfully no fevers), so we all got PCR tests at our local testing site. As a rule, we parents have been testing ourselves (despite being vaccinated) anytime we need to test our kids. The testing site makes it so easy and we get results in 8-24 hours depending on whether it’s a weekday or not. This meant my preschool-aged daughter who was patient zero over a weekend didn’t miss any school, and my kindergartener son missed one day while we waited on a test.

  • Reply Irene May 6, 2021 at 7:57 am

    Oh I have so many thoughts and feelings about all of this. We live in an area that is very liberal and has been very careful about COVID. I was very supportive for a long time because we could manage. BUT it’s been so frustrating to see how people move the finish line. Our school situation has been similar to the Sommerville situation described in the article posted. I understand people being concerned really I do! But for those parents of kids for whom virtual school was AWFUL (not just me but definitely me!!) who have been SCREAMING about how this has affected our kids and their mental health it’s been really eye opening. We have met many of the metrics that would have allowed us to reopen even without vaccinated teachers and the refusal to do more for the kids is just bananas. It truly feels like some people won’t be willing to do anything until the disease is completely eradicated. The biggest thing for our family is our daughter’s long term therapist is still 100 percent virtual and is staying that way for the foreseeable future. This is despite her independently declaring that virtual therapy is not really working for our daughter and encouraging several long breaks. It’s been so hard to just call time and move on to some one else but my daughter really needs professional therapy and it’s not happening. I’m literally up at night about this but concurrently being judged by other families who are self righteously “waiting until it’s safe” for school. It’s just… hard. I am trying to do our part- we don’t need indoor dining or lots of other things but our kids do have some actual needs that are not being met.

    • Reply Sarah Hart-Unger May 6, 2021 at 7:59 am

      our therapist visits are in person – it may be time to try to find someone in your area willing to do that, if you are comfortable? Obviously everyone remains masked for the session.

      I wonder if perhaps some therapists might even be willing to conduct a session outdoors?

      • Reply Irene May 6, 2021 at 9:24 am

        We have asked and offered to pay for travel for an outdoor session for quite a while now! The answer is no. I think she wants to wait in they don’t have to wear masks and can do the regular routine. We are fully vaccinated and do what we can and yep it’s time to find some one else. It took a long time to build the relationship and my daughter will be sad to potentially never see this person who was SO important to her again but honestly I feel completely abandoned by her at this point.

        It is helpful to hear your therapy is in person. I have heard OT and PT are back but not actual therapy (people don’t talk about it much and the one other person I know with a kid this age in therapy is still virtual).

        • Reply Alyce May 6, 2021 at 1:16 pm

          You should look for a new therapist. Your current one isn’t able to meet your daughter’s needs and hasn’t been for a while. There are certainly therapists who are willing to meet in person at this point. Even if she was great before, it’s okay to switch therapists when your needs change.

          I went through this with my daughter’s speech and physical therapy appointments. We started last summer when it was virtual and it was a total joke so we quit. We started back later that fall with a place that would see us in person, well before vaccine availability.

    • Reply Grateful Kae May 6, 2021 at 10:49 am

      Ugh, I’m so sorry for you. I can feel your stress and frustration through the computer screen. 🙁 That all sounds soooo hard.

      • Reply Janelle May 6, 2021 at 11:43 am

        Any little sniffle or fever is so hard to manage now. And like you I understand why but it is still frustrating! Hope he feels better soon.
        Here in Ontario, CA siblings have to stay home too (and parents!) since the rules changed in January for our health unit. But only until neg test and then kid can go back when asymptomatic for 24 hours. However we aren’t even in in person school right now…

        I think you’d really enjoy the last podcast from The Girl Next Door if you haven’t listened already.

  • Reply Becky May 6, 2021 at 8:01 am

    We have similar rules in the UK but one thing I hadn’t anticipated the impact of was this week when *I* came down with tonsillitis and had a fever and I had to take my perfectly healthy 6 year old and 1 year old out of school/nursery until I got the all clear via a covid PCR test. So I was feeling really really unwell and just wanted to go to bed but then I ended up with two energetic kids to entertain!! I mean, I understand the rules, I followed the procedure, but my goodness it has been a tough week!!

  • Reply Lisa of Lisa's Yarns May 6, 2021 at 9:34 am

    Rules are so different from state to state and then even within the state. We had a gasto virus here this week, but it didn’t require a covid test since my son and I only had one less common symptom. If we had a fever, I would have gotten us tested. I have heard from other parents that the gastro virus is moving through the school. So much for our long healthy stretch. My son and I also both got sick with colds in early April but that time I did get him tested because he had 2 common symptoms. He could go back to school with a negative test and no fever. Luckily the fever was short lived so he only missed 1 day of school. I asked in the parent slack channel and it turned out most kids had had similar symptoms but most parents did not get their kids tested for covid and just assumed it was a cold – but I assume their kids didn’t have fevers. It was the fever that prompted me to get our son tested. I got sick after him but didn’t get tested because I knew that if he didn’t have it, I likely didn’t either – and I’m vaccinated. But there is a lot of decision making that goes into when to test and how long to keep a kid home. I will say that urgent care was EMPTY. We went on a Sunday and were the only family there are first and then one other family came in. I had heard that urgent cares are empty these days so that will likely be the case for you if you take C in?

    I’ll have to check out that Atlantic article. As a country we are certainly learning a lot about how to manage a pandemic and how to communicate policies and such. I feel that Minnesota is doing a pretty good job. Our governor is a democrat but I don’t think he falls into the issue described in the article (didn’t read it yet but the gist I get is liberal states are being too careful). Our case counts had increased here but the governor said we didn’t need to tighten restrictions because of our vaccine progress – so I think he is doing a good job of sending a message that getting more people vaccinated is key. I think they are going to loosen restrictions further. Schools have been back in person here since Jan or Feb I think? So I feel like restrictions make sense and our governor is trying to give us hope of a return to “normalcy.” I would not want his job or anyone in public health, though!

  • Reply Amy May 6, 2021 at 10:08 am

    That article was interesting and lines up with a lot of what I’m seeing and hearing. I’ve seen tweets from liberals (who I normally agree with on just about everything!) saying that even being fully vaccinated they have no intention of dropping the mask outdoors lest they be confused as an anti-mask Republican. I know the “end” of a pandemic can be fuzzy, but this attitude is obnoxious.

  • Reply Sophia May 6, 2021 at 11:39 am

    Our kids’ school requires kids to be symptom free for 24h. Once sx free for 24h no testing required unless there is a known COVID+ close contact. Everyone masks in the school, teachers are vaccinated and much learning is done outside so risk of transmission is low. It’s a private school and the regulation is science-based IMO

    Thanks for that article. We are in MA and certain people want school to remain virtual until the risk is reduced to zero. We were having active shooter drills pre-covid so clearly this was not the benchmark of the past. It’s frustrating and I’ve become disappointed and disheartened that our kids are being used as a political football in a power struggle between the local politicians and teachers union. We had every intention of using the public schools when we moved here but are keeping our kids in private school for the foreseeable future as I do not have faith in the teachers union

    100% of local private schools were open all year and 100% of public schools here were either fully remote or hybrid until recently when the governor demanded they re-open M-F. There have been no outbreaks here in private schools, day cares etc and there does not seen to be a correlation with community spread as kids are not driving infections.

  • Reply Tyra May 6, 2021 at 6:52 pm

    It’s kinda fascinating to me that these other viruses are coming back with a vengeance now. There’s a lot of RSV around here (my little niece was hospitalised from it when she was just 4 weeks old) and my two kids are generally getting sniffles more often than they did last year. We don’t have any Covid in the community right now, so life is normal. But we also have 3 day full lockdowns if there’s any community transmission at all from hotel quarantine, which has happened twice so far this year.

    We bought my husband (ID physician) a TB virus plushie for his birthday a couple of years ago and it’s now one of the kids favourite toys!

  • Reply AnnaM May 6, 2021 at 8:12 pm

    So happy to see you share that Atlantic article. Yes. Let’s move on folks. I’m liberal as ever and the attitude we’re seeing from some is absolutely confounding.

    I hope the kids get to go back soon! 🙁

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