Coronavirus (COVID-19)

Coronavirus (COVID-19)

Coronaviruses are a family of viruses that can cause illnesses ranging from the common cold to more severe respiratory illnesses.

The novel coronavirus or COVID-19 was first identified in December 2019 in mainland China and has since spread to the United States and other parts of the world.

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What are symptoms of COVID-19?

The novel coronavirus, SARS-CoV-2, causes the disease known as COVID-19. COVID-19 symptoms are typically mild and begin gradually. These may include:

  • New onset or worsening cough
  • Shortness of breath
  • Sore throat
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Headache
  • Fever
  • Loss of taste or smell
  • Fatigue
  • Muscle aches
  • Congestion

    Symptoms may not show in everyone who has COVID-19 or they may not feel like they’re sick. While most children have mild cases of COVID-19, they are still at risk of passing the virus on to others. People over 60 years old and those with existing medical conditions like hypertension (high blood pressure), being overweight, heart problems or diabetes are at an increased risk for severe cases of COVID-19.

    How does COVID-19 spread?

    COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch. People who are closer than 6 feet from the infected person are most likely to get infected.

    COVID-19 is spread in three main ways:

    • Breathing in the air when close to an infected person who is exhaling small droplets and particles that contain the virus.
    • Having these small droplets and particles that contain the virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.
    • Touching eyes, nose, or mouth with hands that have the virus on them.

    Is there any way I can prevent getting COVID-19?

    The best way to prevent getting COVID-19 is to have your child:

    • Get vaccinated against COVID-19 if they are 5 years or older. The vaccine is safe and vaccination still remains the best protection for them against severe COVID-19 infection.
    • Have your child wear a well-fitting mask if they are 2 years old or older unless they are unconscious or unable to remove a face covering on their own. Children should not wear a mask if they are under 2 years old, however, because of suffocation risk.
    • Avoid large public gatherings for the time being – especially if your child is ill or starting to feel ill.
    • Practice proper hand hygiene by washing your hands often and for 20 seconds with warm water and soap as recommended by the CDC or using an alcohol-based hand sanitizer.
    • Avoid touching their face especially the eyes, mouth and nose.
    • Coughing or sneezing into their elbow or using tissue and throwing it away immediately after.
    • Keep a distance of at least 6 feet between themselves and anyone who is coughing or sneezing (sometimes called social isolation).

      The majority of household cleaners will be able to disinfect or ‘kill’ the virus and should be used to wipe down common surfaces at home if someone at home has COVID-19 (doorknobs, toys, bathrooms, TV remotes, etc.).

      These methods are also general best practices to prevent seasonal flu or other respiratory viruses.

      What do I do if my child or myself start showing symptoms of COVID-19?

      If your child, yourself, or someone else in your household start to show symptoms, the best thing to do is first call your child’s Primary Care Provider or your local/state health department. They will be able to direct you to the best resource or nearest testing site should testing be needed. Even if your child has a mild case of COVID-19 or other illness, you should have them:

      • Stay home from school or other public areas
      • Stay home from work (for adolescents/teenagers)
      • Avoid sports or other extracurriculars
      • Avoid taking public transportation, ride-sharing services or taxis
      • If your child or yourself have a medical appointment (doctor, dentist, physical therapy, etc.) that was scheduled before becoming ill, please call the office ahead of time and tell them your symptoms to see if it’s ok for you to still come in or if you will need to reschedule.

        Frequently Asked Questions

        What are the current visitor guidelines?

        Visitor guidelines are currently in place at all IU Health facilities to help minimize the spread of COVID-19 and other respiratory viruses. Updated visitor guidelines can be found at rileychildrens.org/covid-19-updates.

        Do patients and families need to wear a mask when at Riley?

        We continue to regularly learn more about the novel coronavirus and adapt our policies accordingly. Our masking procedures and requirements have been updated per CDC recommendations in all facilities to further prevent COVID-19 transmission from those who may be infected, whether or not they are showing symptoms.

        • Everyone entering a Riley Children’s Health or IU Health facility, both inpatient and outpatient, will be required to wear a medical-grade surgical or isolation mask. This includes visitors, patients and team members. Masks are available at public entrances from guest relations.
        • All patients should wear a mask while in our facilities except when in their room.
        • All new patients and visitors will continue to be screened for symptoms when entering our facilities, and will be provided a mask to wear. If symptomatic and a parent/guardian of a pediatric patient, the parent/guardian may be masked and continue to their destination, or asked to reschedule their visit, depending upon the urgency of the appointment and patient care required.
        • Please remember, children younger than 2 should NOT be masked. Learn more from Pediatric Hospitalist Dr. Emily Scott on alternative options.
        • Homemade cloth masks are no longer allowed.

        These mask updates reflect the latest information and the current status of supplies available to fight the virus. Additional updates are likely in the weeks ahead.

        How can I communicate with patients who are in the hospital?

        We understand that for many of our patients, their families and loved ones the recent visitor guidelines can be frustrating. We encourage those who would like to remain in contact with their loved ones while they're in the hospital to utilize virtual video resources such as Skype or FaceTime. We also offer patient postcards that can be sent to your loved ones in the hospital to let them know you're thinking of them and provide words of encouragement. Submit a patient postcard.

        Is my child able to receive a COVID-19 vaccination?

        Yes, COVID-19 vaccination is recommended for children 5 years and older. The vaccine is safe and vaccination still remains the best protection for them against severe COVID-19 infection and protects your family as well. Currently, only the Pfizer vaccine is approved for children ages 5-18 years old. If they are eligible to receive a booster dose, schedule that as well. Moderna and Johnson & Johnson are only able to be given to individuals over the age of 18. We are able to provide the vaccine to our patients here at Riley Hospital for Children during either their hospital stay or visit.

        At Riley Hospital for Children at IU Health, we have cared for more than 600 children hospitalized with COVID-19, including approximately 150 in the Intensive Care Unit (PICU). While many children have only mild symptoms from COVID-19, it has caused severe illness requiring hospitalization in thousands of children across the U.S. The best way to protect your child is through vaccination. The CDC has helpful information on possible side effects from the vaccine.

        Get more details on how to schedule a vaccine appointment for your child.

        But what about the reports of myocarditis (heart inflammation) in children who have received the COVID-19 vaccination?

        Myocarditis is a diagnosis that involves inflammation of the heart muscle, and pericarditis is inflammation of the thin outer lining of the heart. Some people do not experience any symptoms, while others may have chest pain, irregular heartbeat, or shortness of breath.

        Myocarditis is rare but can occur after a variety of infections, including SARS-CoV-2 (the cause of COVID-19).

        If any cases of myocarditis following vaccination occur, it is important to tell your child’s doctor. They will report the information to the CDC through the Vaccine Adverse Event Reporting System (VAERS) Program.

        Can the mRNA COVID-19 vaccine cause myocarditis?

        There is a very small risk of myocarditis and/or pericarditis in people who have received an mRNA COVID-19 vaccine. If it happens, it usually is experienced within one week of vaccination and after the second vaccine dose in adolescent males and young adults.

        Is it more likely that my child will develop myocarditis with the vaccine than due to COVID-19?

        Children are more likely to develop heart issues after COVID-19 infection than after the vaccine. Vaccinated individuals who develop myocarditis after vaccination often only have mild cases that resolve quickly. Longer-term follow up is ongoing

        Can my child receive the vaccine if they have a history of congenital heart disease?

        Congenital heart disease is NOT a risk factor for developing post-vaccine myocarditis, but it has been identified by the CDC as a risk factor for severe infection for COVID-19.

        Key Points to Remember

        • Vaccination is the best protection against severe disease! If your child is 5 years or older, they are eligible to get the vaccine, and should, as the vaccine is safe, effective, and the best way to protect themselves from severe infection.
        • While children have seemed to only have mild cases of COVID-19, they are at risk of spreading it to others who may be more vulnerable, such as older people, those who are immunocompromised or those with existing medical conditions.
        • Practice proper hand hygiene by washing your hands often and for 20 seconds with soap and warm water. Alcohol-based hand sanitizers may also be used.
        • Avoid going out in public if you or your child start to feel ill or begin showing symptoms.
        • Call your child’s doctor or local/state health department if they start to begin showing symptoms for next steps.

        Condition Specific Guidance for COVID-19

        Riley Children’s Health offers guidance and information for specific conditions & services and how they may be impacted by COVID-19. Remember to always contact your child's care team if you have additional questions and concerns.

        Having asthma or allergic disease does not make it more likely for a child to contract COVID-19. From the information we have right now, from places around the world, COVID-19 affects the lungs quite differently than asthma.

        Some viruses cause asthma attacks, but this one seems to act differently. Therefore, at this time, we are recommending the same precautions for people with asthma as the general population, including:

        • Practice social distancing as recommended by public health officials
        • Frequent hand washing/sanitizing, particularly if you have to go out of the house
        • If you do go out of the house, make sure to wash your hands thoroughly when you come back home. Change your clothes when you come home, if you can.
        • Make sure you have an adequate supply of your asthma medications, and stay on them as prescribed

        The one exception is if your child is on chronic oral steroids, or a biologic agent for asthma.

        I work in the medical field. Shouldn’t I stay away from taking care of COVID-19 patients because my child has asthma?

        • At this time, because children with asthma do not seem to be overall at higher risk of COVID-19 complications, it is not necessary for you to take additional precautions (exception: if the child is on chronic oral steroids or a biologic agent). However, do be diligent about protecting yourself by using all appropriate personal protective equipment (PPE) as recommended, to protect yourself. Remember, since adults seem to get sicker than children, you actually may be at higher risk than your child
        • If you work in the medical field, avoid bringing COVID-19 home by changing your clothes, taking off your shoes, washing your hands and face when you get home. Also, avoid taking objects back and forth to work.

        I heard that people shouldn’t use steroids with COVID-19. Should I stop my child’s steroid inhaler?

        • No, keeping your child’s asthma under control is one of the best ways you have to keep them well through this. We want to avoid you having to go to Emergency department (ED) or need steroids due to an asthma flare, and be exposed there, or have to take oral steroids.
        • The concern with steroids and COVID-19 is that when people have tried to use oral or IV steroids as a way to treat the inflammation from COVID-19 itself it doesn’t help and can make the lung injury worse. However, the lung injury caused by COVID-19 is quite different, and oral/IV steroids are a much higher dose than inhaled steroids. We strongly recommend that your child stay on his or her inhaled steroid.

        My child has fever and cough; does that mean they have COVID-19?

        • Not necessarily. There are other viruses circulating in the community that also cause fever and cough. So, if you see those signs, don’t panic or assume it is COVID-19, but do pay attention closely to symptoms
        • If you are concerned that you or your child may have COVID-19, we recommend you contact the IU Health Virtual Hub through the IU Health Virtual Visit app.

        What do I watch for in my child with asthma?

        • You will watch for the same types of signs that you do for asthma. You will watch for bad cough, breathing fast or hard, retractions (skin sucking in when taking a breath), or chest tightness or shortness of breath.
        • If you start to see respiratory problems, take your child’s temperature a few times a day to check for fever.
        • You will still give albuterol to see if it helps the symptoms. If it does, then follow your Asthma Action Plan.
        • If albuterol does NOT help, then contact the IU Health Virtual Hub for screening, or your asthma provider.
        • If you are seeing significant respiratory distress, then go ahead and go to the ED, but know that ED procedures are different now so they may have you wait in the car and come out to you.

        COVID-19 is a new virus that has spread across the world, including here in Indiana. We know that this can be a worrisome time for everyone, especially for families caring for children and young adults with blood disorders or cancer. Individuals with bone marrow failure syndromes, cancer, or sickle cell disease have weaker immune systems that may put them at higher risk for becoming infected with COVID-19.

        It is important to know there are extra precautions that you can take in order to protect your family member with a blood disorder or cancer.

        1. Wash your hands with soap and water for 20 seconds (don’t stop until you finish singing the “Alphabet song”) or use hand sanitizer with at least 60% alcohol.
        2. Avoid touching your eyes, nose, mouth, and face.
        3. Avoid being close to people who are visibly sick, coughing, or sneezing.
        4. Disinfect frequently touched objects and surfaces. The virus can live on these surfaces and get transmitted this way.
        5. If you feel sick, call your medical provider FIRST.

        Additional resources are linked below with information regarding COVID-19 and how it may impact your family.

        COVID-19 and Cancer Survivors: What Do I Need to Know? (Source: Children’s Oncology Group) [Español] [Français]

        COVID-19 and Your Child, Teen, or Young Adult with Cancer (Source: Children’s Oncology Group) [Español] [Français]

        COVID-19 and Your Child with Sickle Cell Disease (Source: Sickle Cell Disease Association of America)

        Please contact your child’s primary treatment team with any questions or concerns you may have.

        It’s important to note that the vast majority (80%) of COVID-19 infections are mild, but in some cases it can cause severe lung infection, sepsis, and heart muscle involvement. Due to their congenital heart condition, children and adults with congenital heart disease (CHD) are at risk of getting sicker with COVID-19 than people without CHD. It’s important to try not to panic. The community is well-equipped to handle this. Because of the focus on infection control and prevention for years, we are well-versed in many of the procedures recommended by the CDC at this time.

        This includes:

        • Supplies and medications. While many of you may not be able to get 90-day supplies of specialty medications, we would recommend refilling as many of your medications as you can to have extra supply on hand. Please answer every phone call that comes in. You don’t want to miss phone calls from pharmacies or your care team. If you have questions about getting additional medication supplies, please contact our team.
        • Take precautions to limit droplet and contact acquisition of COVID-19:
          • Indiana is now in a state of lockdown, so you should try to leave your house as little as possible and only to go to essential places, like grocery stores.
          • Maintain a distance of at least 6 feet away from people.
          • Clean your hands as soon as possible after touching unknown surfaces.
          • Avoid touching your nose and face as much as possible, especially after contact with an unknown surface.

        We recommend you stick with trusted sources of information, including:

        It’s important to note that the vast majority (80%) of COVID-19 infections are mild, but in some cases it can cause severe lung infection. Due to their chronic lung condition, children with cystic fibrosis (CF) are at risk of getting sicker with COVID-19 than people without cystic fibrosis. It’s important to try not to panic. The CF community is well-equipped to handle this. Because of the focus on infection control and prevention for years, we are well-versed in many of the procedures recommended by the CDC at this time.

        This includes:

        • Supplies and medications. While many of you may not be able to get 90-day supplies of specialty medications, we would recommend refilling as many of your medications as you can to have extra supply on hand. Please answer every phone call that comes in. You don’t want to miss phone calls from pharmacies. If you have questions about getting additional medication supplies, please contact our CF team.
        • Take precautions to limit droplet and contact acquisition of COVID-19:
          • Indiana is now in a state of lockdown, so you should try to leave your house as little as possible and only to go to essential places, like grocery stores.
          • Maintain a distance of at least 6 feet away from people.
          • Clean your hands as soon as possible after touching unknown surfaces.
          • Avoid touching your nose and face as much as possible, especially after contact with an unknown surface.

        We recommend you stick with trusted sources of information, including:

        Cystic Fibrosis Foundation: COVID-19 Community Questions and Answers
        CDC: Coronavirus (COVID-19) Resources

        See more information from our Cystic Fibrosis Program, including what to expect at upcoming office visits and hospitalizations.

        It’s important to note that the vast majority (80%) of COVID-19 infections are mild, but in some cases it can cause severe lung infection, G.I. symptoms or liver disease. Patients with suppressed immune systems may be at higher risk for infections. There are steps you can take to protect your child:

        This includes:

        • Supplies and medications. While many of you may not be able to get 90-day supplies of specialty medications, we would recommend refilling as many of your medications as you can to have extra supply on hand. Please answer every phone call that comes in. You don’t want to miss phone calls from pharmacies. If you have questions about getting additional medication supplies, please contact our team.
        • Take precautions to limit droplet and contact acquisition of COVID-19:
          • Indiana is now in a state of "shelter in place", so you should try to leave your house as little as possible and only to go to essential places, like grocery stores (wearing a mask).
          • Maintain a distance of at least 6 feet away from people.
          • Clean your hands as soon as possible after touching unknown surfaces.
          • Avoid touching your nose and face as much as possible, especially after contact with an unknown surface.
          • Frequently clean surfaces with a disinfectant containing bleach. However, household disinfectants are also effective

        Call your child's Riley physician or nurse if you think your child has symptoms of COVID-19.

        We recommend you stick with trusted sources of information, including:

        It’s important to remember that most people (80%) with COVID-19 infections have mild symptoms, and children overall do much better than adults with this infection. That said, patients with neuromuscular disease, which are diseases of the nerves, muscle or neuromuscular junction, may be at higher risk to contract COVID-19. Talk to your physician to help you understand the risk for you or your child.

        To protect yourself and/or your child, it is important to follow the precautions:

        • Children with neuromuscular disease should ideally stay at home. Adults, leave your house only for essential places, like the grocery store.
        • Maintain a distance of at least 6 feet away from people.
        • Clean your hands as soon as possible after touching unknown surfaces.
        • Avoid touching your nose and face as much as possible, especially after contact with an unknown surface.
        • Wear a cloth mask when around other people, as recommended by the CDC.

        We recommend these additional resources for the latest information:

        We recognize this is an especially concerning time for transplant recipients, candidates, and household members. Information regarding COVID-19 is changing rapidly, and it is important to stay informed and be prepared. If your child is doing well at home, routine follow-up visits to your child’s doctor should be rescheduled. If your child is having any type of symptoms, you should call your primary healthcare professional before leaving your home to determine if your child needs to be seen. Our team has the following recommendations for patients and their families.

        Transplant recipients or candidates:

        • Maintain a minimum two-week supply of all medication, keeping in mind any dosage changes
        • Contact your transplant coordinator, if you are experiencing a cough or fever prior to any visit to the hospital for clinic, labs or rehab
        • Watch for calls or emails from IU Health team members regarding any change in your scheduled appointments
        • Use the IU Health Virtual Clinic for free screening/triage for COVID-19 for anyone in Indiana

        Transplant candidates on waitlist:

        • All patients on the waitlist are encouraged to follow the same recommendations below for post-transplant patients and their household members.

        Transplant recipients and household members:

        • Postpone all non-essential travel and encourage household members to do the same
        • Minimize exposures in public and avoid crowded environments
        • Minimize close contact with people (6 feet or more)
        • No handshaking
        • Cough or sneeze into a tissue or your elbow, dispose of your tissue in trash can immediately and wash your hands
        • Wash your hands frequently with soap and water for at least 20 seconds
        • Avoid touching your face
        • Disinfect frequently touched surfaces often (TV remote controls, light switches, cell phones, etc.)
        • Increase ventilation in household by opening windows (if feasible)
        • Work from home (if feasible)
        • Avoid sick people at home and in public
        • If a household member is infected with COVID-19, the infected person and transplant recipient should wear a simple surgical/dust mask and closely follow all of the above. If feasible, alternative accommodations may need to be considered for the transplant recipient while a household member is ill or the ill person should stay in one room with one caregiver to reduce contact with transplant recipient.

        Following the recommendations above are crucial to minimize exposure and spread of the COVID-19 among transplant patients and the general population.

        We recommend these additional resources for the latest information:

        Support Services & Resources

        Centers for Disease Control and Prevention (CDC)

        The CDC website provides up-to-date information about COVID-19.

        Indiana State Health Department

        Get updated information about COVID-19 in Indiana.

        American Academy of Pediatrics COVID-19 Information

        Get helpful information about COVID-19 in children from the American Academy of Pediatrics.

        Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults

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