Vaccination rates across Australia continue to rise. Teenagers aged 12 to 15 have only had access to the vaccine since early September and, for now, there is no vaccine available for children under 12. This means many children and young people under 16 remain vulnerable to COVID infection, with cases likely to grow in coming weeks as schools reopen. There is a chance your child might know someone diagnosed with COVID or become infected themselves.
Authors
Margie Danchin
Paediatrician at the Royal Childrens Hospital and Associate Professor and Clinician Scientist, University of Melbourne and MCRI, Murdoch Children's Research Institute
Jessica Kaufman
Research Fellow, Vaccine Uptake Group, Murdoch Children's Research Institute
Tria Williams
Senior Research Nurse Coordinator, Murdoch Children's Research Institute
As we transition into the next phase of the pandemic, we encourage parents to talk with their children about what this means. Help children understand the important roles that COVID testing and vaccination play in returning to school and friends. Give them space to ask questions, and reassure them there is no shame in being diagnosed with COVID.
The COVID Wellbeing study and the COVID Schools study at the Royal Children's Hospital and the Murdoch Children's Research Institute explore the experiences of children tested for COVID. So far we've learned from the experiences of dozens of families of children who tested positive.
Here are some suggestions for how to navigate this challenging time:
Support kids through the testing process
Testing plays an important role in protection against COVID and children may need multiple tests over time. Supporting your child to have a calm testing experience can keep them from developing negative associations with testing or other medical procedures in the future.
To prepare your child for their test, explain what will happen, using language they understand. Practise some distraction or coping strategies, such as closing their eyes and focusing on their breath, cuddling a parent, counting or listening to music. You may want to show them a short video demonstrating the test. Or you can get tested first and model how you cope with it. Good preparation can help ease any anxiety your child may feel about the test and the possibility of having COVID and give them some control over the process.
Receiving a positive diagnosis
For most parents, the news their child has tested positive for COVID is distressing. But it's important to remember the majority of children infected with COVID have mild or asymptomatic illness.
It is estimated around 1% of children who test positive with COVID and have symptoms may get admitted to hospital. Some of these children might be managed through Hospital in the Home or be admitted solely because their parents are in hospital with COVID, rather than because they are very unwell.
Children who are admitted may only need one to two nights in hospital for some fluid or perhaps some oxygen. Very few children need admission to ICU. It can be helpful to explain this to children if they are worried about becoming seriously unwell.
When you receive your child's positive diagnosis, take down the details of who you're speaking with and who to call if you have concerns. Absorbing all the information you receive can be hard, especially if you're upset, stressed or trying to comfort a child.
Have a look at resources for families online and start a list of questions for your health care team. Knowing how to access information and support can provide you with comfort and control over what is happening. It's also a good idea to let your child's local doctor know so they can provide your family with additional support.
If your child is old enough to understand, you may wish to tell them about their diagnosis. Create a safe space for them to share their worries. Acknowledge your child's fears about getting sick, answer their questions, reassure them it's normal to feel anxious and be honest. You could say things like: "It's OK to feel worried that you have COVID, but most kids don't get very sick. It's just like having a regular cold."
Following a positive diagnosis, all or some of your family members will need to isolate. Your child will also need additional tests to come out of isolation, possibly done at home. This period can be challenging, especially if several people in your family are unwell. In addition to caring for your child's symptoms, check in with your child regularly and encourage them to share how they are feeling. If you are worried your child is distressed, reach out to your local doctor.
Telling other people
Many parents in our study were very open about their experiences, but some said they felt guilt or shame about their child's positive COVID diagnosis. They were reluctant to tell other people what was happening.
This fear of stigma was particularly apparent if their child may have been responsible for the closure of a school. Focus on surrounding your family with people who care about you and support you, both emotionally and practically.
Reassure your child this is not their fault and they should not feel ashamed of their diagnosis.
If your child does not want to share their diagnosis with others, it's important to respect their need for privacy. If your child would like to talk about their experience, assist them to communicate this sensitively and safely. Equipping them with standard responses to reply to questions from peers can also be helpful.
Closely monitor their online chat groups, social media posts and their mood and behaviour during this time. Some children who test positive might be teased or bullied. For example, some children have received unkind or hurtful messages, photos or emojis about having COVID.
Moving forward, looking back
For some children, transitioning back to school following illness can be smooth, but for others the psychological effects can linger. Some children may have trouble sleeping, complain of abdominal pain, lose their appetite or be a bit more withdrawn, or show other signs of anxiety about returning to school. They may be worried that other children might whisper, point at or tease them because they tested positive.
Working with your child's school during this time is crucial to your child's health and recovery. So too is early access to psychological support if you or your child's teachers are worried, either through a school counsellor or a psychologist via a referral from your GP.
The children and families who participated in our research demonstrated great courage in sharing their stories. Their experiences reinforce the importance of preparing all children and young people for the testing process and the potential impacts of a positive diagnosis, particularly raising awareness about potential stigma.
Encourage your children to be brave and kind as they transition back to school and friends. Help them to act with compassion, empathy and respect for privacy, should someone they know or care about be diagnosed with COVID.
Margie Danchin receives funding from the NHMRC, WHO, DFAT and the Victorian and Commonwealth Departments of Health. She is Chair, Collaboration on Social Science and Immunisation (COSSI).
Jessica Kaufman receives funding from the National Health and Medical Research Foundation and the Victorian Department of Health.
Tria Williams works for the Murdoch Children's Research Institute.
