COVID-19 Testing in children

By Nancy Kellogg, MD, Child Abuse Specialist, and the team at the Center for Miracles

Parents and child advocates are questioning how and when children should be tested for COVID-19. There is also particular concern for children living in foster care and community shelters. At this time, there are insufficient numbers of tests available so public health authorities have prioritized testing protocols. 

The population who is at greatest risk for the infection and for serious illness are older than age 65, immunocompromised individuals, and those who have recently traveled from areas where there is widespread community transmission of the disease.  The protocols may change as more test kits become available and the regional epidemiology changes.  Please remember this is a virus that scientists knew nothing about until it appeared four months ago in China, so we continue to learn more about it each day.

We are just beginning to learn what effect COVID-19 has on children.  A recent research article from China indicates that out of 2,143 confirmed or infected children, more than 90% were asymptomatic, mild, or moderate cases. 

Although we may not be able to test and confirm whether an infant or child has COVID-19, please consider the following precautions:

1. If a child has fever please keep them at home or in the shelter; anyone with trouble breathing should seek immediate medical care.

2. Try to minimize contact with other caregivers or children when possible; caregivers should practice social distancing, good handwashing and if a child becomes symptomatic, wear masks, if available.

3. The virus is transmitted through close contact but can also survive on surfaces such as door handles and counter tops.  Whenever a caregiver has a sick child in the home, they should wash their hands each time they contact the child or surfaces.  Keep hands away from the face.

4.  Foster parents and shelter personnel may be caring for children infected with COVID-19, now or in the future.  Even though testing may not be available to confirm the presence of the virus in sick children, caregivers should employ universal precautions as if the child is infected and can transmit the disease to others in the home or facility.  While the infection is not likely to be serious and may not require medical attention, transmission to an adult is still possible and adults may have more serious symptoms.

5. If a child in protective custody has fever and symptoms of COVID-19 (cough, runny nose, sore throat, and/or gastrointestinal issues such as vomiting, diarrhea, nausea, stomach pain), foster parents and shelter officials are advised to call the San Antonio Metro Health hotline: 210-207-5779 and notify your manager or supervisor with Child Protective Services.

The Children’s Hospital of San Antonio and CHRISTUS Health have set up a hotline to answer any questions you may have about COVID-19. The number is 1-800-458-4559. We have also launched a the CHRISTUS COVID Chatbox on our website at The Chatbox allows you to confidentially evaluate your own or your child’s symptoms regarding COVID-19. The best way to avoid the virus is to stay home and practice social distancing.

Keep calm and parent on

By Nancy Kellogg, MD, Child Abuse Specialist, and the team at the Center for Miracles at The Children’s Hospital of San Antonio

The COVID-19 pandemic has created a new work force: stay-at-home parents who are faced with the 24/7 job of child care.   The additional stresses of isolation, buying food, and keeping children happy and safe can be exhausting and frustrating.  Here are a few tips:

1. Try to keep a routine for mealtimes and activities so children are engaged and less likely to get bored and irritable. 

2. Invent some new activity/game. For example, older children may enjoy a different scavenger hunt each day for a favorite toy. There are plenty of websites to explore ideas:

3. Limit screen time for yourself and your children.  Social media content is more stressful now and children need to stay healthy and balanced with physical and interpersonal activity. Play outside whenever possible.

4. If you use a babysitter, be sure you speak to references first and ask for frequent updates when you are away. Make sure your children know to call you if they ever feel uncomfortable or scared.

4. Know your triggers.

*A baby who won’t stop crying. Put him in the crib, walk away, and take a few minutes of “time out” for yourself in another room

*A toddler with tantrums. Distract her, redirect attention, and use time out so everyone can calm down.

*Potty training.  Have lots of patience and if it is too stressful for you or your child, stop.

5. Be kind to yourself and others.  Everyone has been affected by COVID-19.           

6. Video chat with friends and family or try a hotline: Counselors are available 24 hours a day at Childhelp’s National Child Abuse Hotline: 1-809.4.A.CHILD

To report suspected child abuse: 1-800-252-5400