Kids and coronavirus: What Guam parents need to know

Dr. Amanda Del Rosario, pediatrician at AMC, talks to PNC News about how Coronavirus affects children

Island pediatricians are assuring parents on Guam that children, so far, do not appear to be in the high-risk category when it comes to COVID-19.

Dr. Amanda Del Rosario, a pediatrician at the American Medical Center, said she’s been hearing from worried parents with children exhibiting any symptom remotely close to what they hear about the coronavirus.

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But with such limited tests on island, the doctor assures parents that it seems COVID-19 cases in pediatrics are quite mild and she said that’s good news.

“Even if your child truly does have coronavirus, most likely they will just show up as having minor cold symptoms, and recover just fine. But the larger and more concerning issue is that during the time that they are sick, they are contagious and able to spread the virus to other people, particularly those who are a lot more vulnerable in our community,” she said.

The doctor said unless symptoms are severe, it’s best to self-quarantine any children, over the age of one, with cold-like symptoms.

“There may be a low-grade fever, maybe there’s a little bit of a cough, and some runny nose or a sore throat. But if there’s no difficulty breathing and there are no problems with drinking and taking in fluids, and just a little bit under the weather, we really recommend that you just stay home,” said Del Rosario, adding that the current recommendation is to do so for at least 14 days “from day one of the symptoms.”

Del Rosario said parents should begin to worry only if those mild, cold-like symptoms turn into a high-grade fever or if the child looks like they’re having trouble breathing.

“If the cough turns into something a little more serious such that there seem to be signs of shortness of breath, and it looks like they’re [kids] working harder to breathe, then I’d want to speak to the parents about the child’s conditions,” said the doctor.

But, she said parents should be on the lookout for multiple symptoms in their children.

“I always like to say ‘what else is present besides the fever?’ So, is it high fever, but they’re still running around and active, not having any other symptoms? For that, you don’t need to come in, you can just monitor at home,” the doctor said.

“But if there’s high fever and we’re having a bad cough, or vomiting and not able to keep any liquids down, then that would make me a little more concerned, and I would want to talk to that parent over the phone or have the child brought in for an evaluation,” she said.

Del Rosario, who also chairs the Department of Pediatrics at the Guam Memorial Hospital, said with confirmed cases at GMH, parents should really venture out only if it’s a critical situation. 

“As pediatricians, our big, huge goal is to try our best to keep all the kids out of the ER, and out of the hospital, at all costs.”

Children fall into the same adult-criteria guidelines, established by the CDC and Guam Public Health to be considered PUI or surveillance cases.

However, Del Rosario said, Guam is not really seeing many pediatric cases that meet the criteria.

She said that since there are no confirmed child cases of COVID-19, Guam pediatricians are turning to medical literature from around the world to gather pertinent information on how coronavirus affects children.

As for pregnant women, the Doctor said being pregnant technically puts you in an immune-compromised state, much like people with diabetes or high blood pressure.
She said pregnant women are at a higher risk, generally. And, because of that, doctors are asking expectant mothers, to take added precautions to avoid contracting Coronavirus.
“Especially for my patients, whose moms are pregnant, we’ve been saying home-isolation, 14-day quarantine but even within the home, there has to be separation between the people who are sick and the ones who are not,” said Del Rosario.
“So it’s a lot of needing to be extra careful and practicing meticulous hand hygiene, and doing everything possible to separate those who are sick at home, from those who are healthy but also at risk of being sick from Coronavirus, if they were to get the disease.”
As for newborns and young infants, Del Rosario said they too, should be carefully protected from the virus.
The Doctor said so far, studies have shown that amongst the pediatric cases of coronavirus, infants under the age of one, have higher rates of serious illness compared to older children.
“Newborns and young infants are a unique population in that they are vulnerable to infections particularly in the first few months of life, as their immune systems are still developing.”

With regards to testing on Island, the Doctor said it’s been made clear that there are a limited testing kits available. Health officials are only testing patients who meet the PUI and surveillance criteria, in addition to having symptoms of COVID-19.

She said for that reason, she hasn’t tested a lot of children on Guam.

“I know there is a lot of frustration in the community about wanting to be tested, but those tests are reserved for people who are really sick and vulnerable [elderly or immuno-compromised],” said Del Rosario.

She’s adding her voice to the echoing chorus of officials and health care providers on Guam, emphatically asking residents to just stay home.

The doctor says she, and all island pediatricians, strongly support the Governor’s order to close schools, daycares, and mandate social isolation.

In terms of speaking to children about COVID-19, Del Rosario says the best way to deal with children around this time is to lead by example, “by teaching them good hand hygiene and also explaining to them, why we have to be careful and stay away from our grandparents.”

AMC clinics are still open and you can schedule a visit, if necessary. Del Rosario said doctors will also talk to you over the phone to see what appropriate next steps could be.