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Tuesday, February 20, 2024

How to Care for Kids if You're Sick With Covid-19

As a new parent, one of the first things you learn is that taking care of a baby is really, really hard. In normal times, my husband and I lean heavily on an extended network of caregivers—grandparents, friends, babysitters, and daycare—for help with the monumental, sometimes mind-numbing task of caring for young children.

But these are not normal times. Social distancing has stripped us of our caregiver network. It’s a necessary public health tactic to slow the fast and potentially deadly spread of Covid-19 (in viral form it's known as the novel coronavirus or SARS-CoV-2). But taking care of kids on your own is hard. It’s also scary when facing the specter of grave illness. What happens if one of you gets sick? What if both of you get sick?

We spoke to several infectious disease experts from Oregon Health & Science University, Stanford Children’s Health, and Cedars-Sinai Medical Center for advice. Be sure to check out the CDC's caregiving recommendations here, as well. Making plans in advance and wiping down your toilet can go a long way toward quelling your anxiety.

Designate a Caregiver

First, let’s plan for the worst-case scenario. If both you and your partner are incapacitated at the same time, or need to be hospitalized at the same time, you need to designate a caregiver. Unfortunately, if both you and your partner are sick, that means your children are also probably infected, which rules out Grandma Care.

“We know that SARS-CoV-2 disproportionately affects older individuals and risk of complications and mortality is highest in the elderly, so if feasible, it would be best to have the child stay with an aunt or uncle while the parents and child recover,” Dr. Priya Soni, assistant professor of pediatric infectious diseases at Cedars-Sinai Medical Center, told WIRED over email.

Before You Get Sick, Make a Crisis Plan:

  • Who is going to take care of your kids?
  • Your dog?
  • Identify nearby friends or family members who can help and are not in a high-risk population.
  • Post potential caregiver contact information prominently so that emergency responders can find it. If you have no one to ask, a hospital can usually advise you on community resources for families in crisis.

We have no family nearby, so I have asked several childless, low-risk friends to be emergency caregivers.

If your designated caregivers have children, that's OK too. The child may or may not develop it, but children typically don't struggle with the disease much unless they have underlying conditions. “We are shocked by how well children are doing with this infection,” said Dr. Dawn Nolt, an associate professor of pediatric infectious disease at OHSU’s Doernbecher Children’s Hospital. “What they’re showing is very mild.”

Isolate, but Stay in Your Home

Now for the good news: “Unless a family member is at higher risk for contracting a severe case of Covid-19 or any viral illness due to age and/or existing health complications, then the same measures are recommended for Covid-19 as would be for influenza or another viral respiratory infection,” said Dr. Roshni Mathew, pediatric infectious disease specialist at Stanford Children’s Health and clinical assistant professor of pediatric infectious diseases at Stanford School of Medicine.

That means if your partner isn't undergoing chemo or your children don't have asthma, you can stay at home—just with an extra dose of hand-washing, keeping your dishes separate, and sleeping in a separate bedroom if possible. Try to maintain these boundaries until your health care provider deems you to have a low risk of transmission, or around 14 days.

“This is a risk-balance issue,” said Dr. Nolt. “If you are mildly sick, who is going to take care of the kids in your home? The risk of transmitting an infection to a child is not going to result in a whole lot, because kids do well. But if you are sick and have an older household member, that might tip the issue of isolation differently.”

Another bonus? Infections within a family home are usually staggered, which can help, noted Dr. Mathew. Even if you do transmit the infection to your partner, it will come after yours has receded.

“The parent who is further along in the course of the illness could take on the primary caregiver role for the children to help minimize the chance of transmission,” said Dr. Mathew. “It’s important to remember that the risk of transmission is highest in the first few days of illness, when the symptoms are more pronounced.”

Not everyone has a second home if they get sick. But no matter how tempting, none of the experts we talked to recommended retreating to a hotel or an Airbnb. “Asking those that are SARS-CoV-2 positive … to be quarantined in an Airbnb or hotel is not up for debate right now, as our efforts are focused on social distancing and staying at home as much as possible,” said Dr. Soni. “Hotels and other venues like this are still considered public places and could significantly increase spread.”

Keep High-Traffic Areas Clean

There are plenty of smart ways to clean and disinfect your home, but you don’t need to go nuts. If your spouse is quarantining in the bedroom, you don’t need to wear gloves and dump his contaminated soup bowl into a vat of boiling bleach. “We don’t want you doing disposable trays or anything like that,” said Nolt. “We know this virus is very easily cleaned by household cleaners. You don’t have to mix your own detergents or buy anything super strong.”

The important exception is the bathroom. “Several studies have come out regarding the role of feco-oral transmission of this virus, in addition to respiratory droplets,” said Dr. Soni. In other words, when he uses the bathroom, your sick loved one is shedding virus in the form of gross flying poop particles.

If a separate bathroom isn’t possible, all the experts we consulted suggested to wipe down your bathroom every day, and especially after the sick person has used it—along with putting disinfectant in the toilet bowl, and wiping down high-touch surfaces like the faucet handles and toilet handles with disinfectant. And make sure your sick loved one closes the toilet bowl lid and washes his hands.

“When you flush the toilet, there’s an aerosol that’s generated, a splashing of water out of the toilet, and that may contain virus. So you know it’s important to keep toothbrushes and so forth away from the toilet. [Everyone should] close the lid when they flush the toilet,” said Dr. John M. Townes, the medical director of infection prevention and control at OHSU Healthcare. “And wash their hands after going to the bathroom, for sure.”

Take Care of Yourself

Nolt also made one last important point: The best way to prevent both parents from falling ill is to take care of themselves. Many of us are adjusting to new routines and new realities, of becoming full-time work-from-home employees as well as full-time caregivers.

It’s easy to let things like eating well, exercising, decreasing our stress, and getting enough sleep fall by the wayside when we’re coping with a dozen new and different demands on our time and energy. If you find yourself getting the urge to finish one last work assignment or do one more load of laundry … don't. It's now a public service to make sure that we stay healthy and able to take care of our kids and each other.

“It’s so important. We sacrifice so much for our kids … But you have to make sure you take care of yourself because if you don’t, you can’t take care of the people you’re responsible for,” said Nolt.

To help you out, we've compiled a roundup of our favorite tips for taking better care of yourself, from more comfortable work-from-home headphones and running gear. And if you need help keeping your kids busy so you can get a break, I also spoke to a pediatric anxiety expert on how to talk to your children about Covid-19 and how to keep them entertained. We put together a list of our favorite kids podcasts to keep them entertained, and our favorite Bluetooth speakers to play them on.

Putting your feet up for a half-hour may go against all your parental instincts, but the best way to make sure your kids stay safe and healthy is to make sure you stay healthy, too.

Updated March 24: Several readers have pointed out that this article doesn't acknowledge single parents. I did ask my sources for advice if you are a single parent and become incapacitated, but the advice is essentially the same: Identify people who can serve as emergency caregivers, and hospitals can also point parents towards community resources for families in crisis.

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