Helping kids cope and feel safe during the COVID-19 pandemic

[MUSIC PLAYING] My name is Daniel Johnson. I'm a professor of pediatrics here at the University of Chicago and Comer Children's Hospital, and a pediatric infectious disease specialist. I'm here this morning to talk to you about COVID-19 and the way in which you can work to keep your children safe, and your family safe. Children are as likely to get COVID-19 as anybody else, but fortunately they don't get as sick. We need to work to protect them, in part, because some of them can't get sick, but mostly because we're worried about them transmitting the infection to our loved ones, those that live in a household such as parents and grandparents.

There are many ways in which we can help children get through the pandemic. And also, help you get through the pandemic, because all of us now are sheltering at home. And as a result, we're experiencing a new way of life. So first and foremost, it's critical that we help our children feel safe. We're battling two epidemics here, COVID-19 and the epidemic of anxiety about it. And so the way in which we can help children feel safe is we can give them the facts, but don't sugarcoat them, just give them to them in a way in which you feel most comfortable, and in which you think is best for them to hear it.

They don't need an overwhelming amount of information. They just need to know mostly that you think they're going to be fine, that adults are working to keep them safe, and that there is a team trying to approach the disease. You'd like to give them a sense of power and responsibility. All of us do best when we have that sense. And there are various things that you can give them power and responsibility over. And some of those things really relate to social distancing, and good-- and hygiene. So, for example, you can ask them what kind of soap they want to use when washing their hands, or you can ask them what kind of song they'd like to sing in order to get to that 20 seconds that they need to get to when they're washing their hands, or you could ask them if they want to use gel or soap.

All of those things are ways in which you give them power over what's going on. And as far as responsibility goes, you could ask them to help clean around the house. Give them a wipe. Let them wash something down. That gives them a sense of responsibility. Let them know what to expect. The kinds of things right now are you're going to be home, you're going to be spending more time together. But this goes a long way towards helping your own mental health, which is tell them what the normal routine is going to be in the house now. So that that way, again, they just know what to expect. Now, of course, empathy goes a long way. And what I mean by that is that this is scary, and acknowledging that it's scary, letting them know they can talk to you, letting them know that you're concerned about them, all shows ways in which you demonstrate empathy to them.

And then I suppose they need, certainly last but not least is you want to model the behavior you want to see. So voices down, don't holler, try and let them know how you're feeling, so that way they know that they can talk about how they're feeling. And I suppose I should add that distraction helps them and helps you. So giving them a schedule, as I said, but also giving them things to do as part of that schedule. So that if you're working at home, you can tell them, for the next hour, you're going to be doing this. And so they should be working on something else.

And that something else can be any of the kinds of things that relate to their normal day. If someone else in the house has COVID-19, that puts a little more pressure on the way in which you run your household, because it means that you want to keep other individuals away from them. Now, how do you do that? Well, it depends on your home. If you have large enough space, then you'd like to give the sick person a portion of the house that allows you to limit the through traffic through wherever they're at. So if they have their own bedroom, or you can create their own bedroom, then let them stay in their bedroom, so that way they're not walking around the house and running the risk of contaminating other areas. You want to limit who's going into that area. You'd like to designate movement of items in and out, so that way they get properly handled and cleaned down.

And, of course, what's most important is the 6 foot radius, the 6 foot distance that needs to be kept between that person and you, that if that person moves around the house, that there's a way to clean the space after they leave it, so that that way there's less likelihood of transmission from surfaces. And, of course, teaching that person to do a few things themselves will help with reducing risk of spread. So when that person leaves their area, or that person is around someone else, they should be wearing a mask in order to cut down risk of transmission. They should be coughing into their arm and elbow, or even better, into a Kleenex, so that way it just gets tossed away.

And, of course, they and you should be washing your hands frequently. We really estimate now that people should be washing their hands somewhere around hourly, which means about 15 times a day. That probably also means that your hands are going to get a little dried out, so having some hand lotion around the house is also going to make a difference. Fortunately, we don't think COVID-19 is terribly dangerous for newborns, but we really don't have a lot of data on that, and that's because so few newborns have gotten COVID-19. And the way in which we protect newborns is that we make sure that the person who's sick does as little of their care as is possible.

And if they do do care for that newborn, then they wash their hands before they handle the newborn, they put on a mask in order to keep down the number of respiratory droplets that are coming from them. We suggest that if they're breastfeeding that they not only clean their hands but also their arms, wear new clothing, not new in the sense that it was recently bought, but new clothing in terms of clothing that they haven't been wearing all day, so that they make a change of clothes, and that they make sure to wash the chest area, so that way when the baby latches on to the breast, that they're latching on to a clean surface. Now, these are things that we normally recommend for breastfeeding anyways. Of course, what would be even more ideal would be just to pump the milk and have someone else feed that newborn.

But so far, with newborns who have gotten COVID-19, they've had either asymptomatic, meaning no symptoms, or they've had mild, and at worst, moderate disease, but, of course, because the numbers are low, we know that that's going to change over time. And so we all want to do our best at preventing the likelihood of newborns getting COVID-19. Kids are no different in terms of how they stay safe than the way in which you stay safe. So first and foremost, when the child comes into the house, be it that they just were outside for whatever reason, they should immediately wash their hands. Before they eat, wash their hands. After eating, wash their hands, because they've probably shared items that other people have touched. So handwashing is the biggest key. The other thing is that they should be encouraged to limit the times they take their hands to their face.

Now, that's like asking a child not to breathe, so I wouldn't work too hard on that one, because it's so difficult, but let them know that that's something you're doing, so that way they're more likely to want to follow your routine. Of course, if they cough, or sneeze, then they should do that into their elbow rather than their hands in order to reduce risk of spread of any germs. But probably the biggest thing for kids is around social distancing. Children are very social creatures. They want to spend time with other people. So, of course, quarantining in the home is something that we're all trying to do, that's another way of saying social distancing, or sheltering in place. So how are you going to keep up with the social aspects of their life while also ensuring that they stay as safe as possible? And that's where technology comes into play.

So virtual play dates, not in-person play dates, but virtual play dates is one of the best things that you can do. And you can use some of the free now online systems that allow you to bring people together. You can use cell phone, something like the systems that are out there now to bring people together. There are some that have games associated with them. There are others that are just for talking to people, just depends on your phone as to what you have. But these are great ways to bring kids into contact with each other without doing it in person.

And then the other thing in terms of keeping kids safe, of course, is to give them things to do, because you want them distracted, so that way they're not constantly on top of you, or on top of each other. And another way to do that is to go for walks. You can still walk outside, not in groups, but the two of you, be it a parent and a child, or a parent and a few children can go for walks together as long as you live together. And that also gives a way for children to be able to spend time outside, getting some exercise, which is important for their global health and well-being. After all, remember, life isn't just about COVID-19.

With global efforts underway to stop the spread of the novel coronavirus disease (COVID-19), social distancing and sheltering at home are a new way of life for families and households around the world. For parents and caregivers, this means finding ways to help children feel safe and supported — in addition to balancing parents’ other responsibilities and concerns.

This can certainly be challenging. It’s important to accept that each family and household is unique. But, there are general suggestions we can consider as we think about what will work best in our homes.

How can we help kids cope through the coronavirus pandemic?

Recognize that we're battling two epidemics: COVID-19 and the anxiety we’re feeling about it. To help our children feel safe, we can:

  • Talk with them about COVID-19 and let them know the facts.
  • Explain that adults are working hard to keep them safe and to find treatments for this disease.
  • Get them involved in following safety practices at home.
  • Let them know what to expect while sheltering in place, including creating and following routines.
  • Empathize with their concerns and let them know they can talk to us.
  • Model the behavior we want to see from them.
  • Encourage the whole family to enjoy opportunities for distraction.

What if someone in the home has COVID-19?

If a member of the household has COVID-19, others in the home should avoid or limit contact with that person and any items and surfaces they use.

If possible:

  • Give the sick person a dedicated area of the home.
  • Limit the movement of items in and out that area, so they get properly handled and cleaned.
  • Keep at least 6 feet of distance between the sick person and others.
  • Clean any surfaces the sick person touches outside of their area.

The sick person should:

  • Wear a mask any time they leave their area.
  • Wear a mask any time they’re around someone else.
  • Cough into their arm and elbow, or even better, into a tissue.

Everyone in the house should wash their hands frequently — about 15 times a day. Using hand lotion should help relieve dryness from frequent handwashing.

How dangerous is COVID-19 for newborns and infants?

Fortunately, we don't think COVID-19 is particularly dangerous for most newborns and infants. However, we don't have a lot of data on this, because few babies have tested positive for COVID-19.

If someone in the home has COVID-19, it’s best to remove that person from the baby’s care and space as much as possible.

If the sick person must be involved in the baby’s care, it’s important that they:

  • Wash their hands before they handle the baby.
  • Wear a mask when they’re within 6 feet of the baby and items or spaces the baby uses.

If the sick person is breastfeeding, the ideal option would be to pump milk and have someone else feed the baby.

However, if this is not possible and breastfeeding is necessary, take extra precautions before nursing, including:

  • Cleaning hands, arms and chest before nursing.
  • Changing into freshly washed clothes.
  • Wearing a mask.

How can we keep kids safe and active while sheltering in place?

Social distancing is the most important way to help keep kids safe during the coronavirus pandemic.

Plan time for children to:

  • Connect with friends. Set up virtual play dates to keep in touch.
  • Get outdoors. It’s okay to take a walk around the neighborhood, as everyone in the family keeps at least 6 feet of distance between themselves and anyone who doesn’t live in the home.
  • Get exercise. It’s important to maintain healthy habits.
Daniel Johnson

Daniel Johnson, MD

Daniel Johnson, MD, is an expert in pediatric infectious diseases and in the care of HIV-infected children. Dr. Johnson is committed to the development of community-based pediatric care in underserved areas, accomplished through partnerships with federally qualified health clinics and community hospitals.

Learn more about Dr. Johnson