COVID-19 Exposure and Testing

The CDC considers a COVID-19 exposure as someone who has been within 6 feet of a COVID-19 positive patients for at least 15 minutes while they have symptoms, or 2 days prior to them having symptoms. This can include a family member or someone in the community (school or elsewhere).

There are four reasons to keep a child in home isolation.

1. If they have COVID-19 symptoms and are awaiting testing results.
2. They have COVID-19 symptoms and are not going to be tested.
3. They are considered a COVID-19 exposure (see the question above).
4. The local or state public health department asks them to be kept in home isolation.

Consistent with CDC guidelines, if one member of a family is positive for COVID-19, all members of the household should consider being quarantined for 14 days. If any other children or member of the family develop COVID-19 symptoms, they should be tested at that time. They should not go to school until cleared from quarantine.

The local health department or your school will provide you with specific guidance for your child. Generally speaking, the CDC recommends that children who have a direct exposure, defined as being within six feet of a student with COVID-19 for 15 minutes or more, need to be kept in home isolation for 14 days. The exposure could have occurred up to two days before the student with COVID-19 developed symptoms.

It is generally not currently recommended to have exposed patients without any COVID-19 symptoms be tested. A single test does not mean your child will not still develop symptoms later during the home isolation period. If your child has chronic medical problems, please consult your child’s health care professional as to the need for closer monitoring.

If a child does not develop any symptoms, CDC recommends home isolation for 14 days. If your child does develop symptoms, contact your health care provider for information on testing.

As much as possible, your child should stay in a specific room and away from other people in your home. Also, your child should use a separate bathroom if possible. People who do not have a need to be in your home should not visit.

Try to let your child stay in places in the home that have good airflow. Allow getting fresh air when possible.

Remind your child that it is very important to cover their mouth and nose with a tissue when coughing or sneezing.

Avoid the child sharing personal household items such as dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After your child uses these items, they should be washed with soap and water.

If they are old enough (over 2 years old) have them wear a mask whenever they leave their room.

If a family member has COVID-19 symptoms all household members should isolate at home until either tests results are known for the person with symptoms (and further guidance provided based on the result) or 14 days have elapsed without the development of symptoms for the exposed household members. Any time a new household member gets sick with COVID-19, the 14 day quarantine needs to begin again. See the CDC’s guidance on when to start and end home isolation for additional information https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html.

Home isolation is recommended for anyone who has been exposed to COVID-19. If you develop symptoms of COVID-19 you should contact your health care provider to determine if testing is needed at that time. Testing supplies, as well as the laboratory capacity needed to process COVID tests, are currently in short supply across the region and country. Like other health care institutions across the region and the state, UH will prioritize testing for those who need it most. We can’t test everyone, so we need to use our resources wisely. Patients with COVID-19 symptoms will be tested before those who are not showing any symptoms. We will only test asymptomatic patients if they meet criteria for a COVID-19 test before a surgery or procedure. The Ohio Department of Health does have a listing of testing sites that may be able to accommodate asymptomatic testing needs and can be found at https://coronavirus.ohio.gov/wps/portal/gov/covid-19/testing-ch-centers/.

A contact of an exposed individual is considered an exposure if you or your child was within six feet of a person with COVID-19 for 15 minutes or more. A contact for less time not considered an exposure by the CDC, even though it may still have some risk of transmission. Also remember, a COVID-19 positive patient is recommended to home isolate by the CDC for 2 days prior to symptoms begin, and then for 10 days after developing symptoms AND when fever is gone for at least 24 hours without fever reducing medications.

Consistent with current CDC guidelines, if your child develops any of these symptoms you should call their health care provider:

• Fever of at least 100 degrees F
• Chills
• New onset or worsening congestion or runny nose not associated with allergy symptoms
• New onset Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Nausea or vomiting
• Diarrhea
• Sore throat

Testing supplies, as well as the laboratory capacity needed to process COVID tests, are currently in short supply across the region and country. Like other health care institutions across the region and the state, UH will prioritize testing for those who need it most. We can’t test everyone, so we need to use our resources wisely. Patients with COVID-19 symptoms will be tested before those who are not showing any symptoms. We will only test asymptomatic patients if they meet criteria for a COVID-19 test before a surgery or procedure. The Ohio Department of Health does have a listing of testing sites that may be able to accommodate asymptomatic testing needs and can be found at https://coronavirus.ohio.gov/wps/portal/gov/covid-19/testing-ch-centers/.

You should contact your child’s health care provider and discuss the need for COVID-19 testing if your child has any of the symptoms of COVID-19 (see question 1).

If a family member has COVID-19 symptoms, current CDC guidelines recommend ALL household members should isolate at home until either tests results are known for the person with symptoms (and further guidance provided based on the result) or 14 days have passed without the development of symptoms for the exposed household members.

At this time, all COVID-19 tests should be ordered and managed by either a health care provider or the public health department. If you think your child should be tested, call their health care provider.

To determine the presence of the COVID-19 virus a swab (stick with a collection material on the tip, like a long Q-tip) is placed in the patient’s nose just inside the nostril. The specimen is obtained very quickly by rubbing for 10 seconds in the first nostril, then using the same swab in the second nostril.

The timing of test results varies based on when and where the test is obtained and how many other specimens are being processed at that time. Test results are usually available within 24 to 48 hours.

The COVID-19 PCR test (the most common but not the only type of COVID-19 test used) is very reliable if the result is positive. If the result is negative, it is usually reliable but the ordering health care provider might still believe the child has COVID-19 based on the symptoms and level of exposure. The child still may be asked to isolate at home even with a negative test.

At this time doctors are still studying the use and reliability of COVID-19 antibody testing to demonstrate previous COVID-19 infection that has resolved. Currently, antibody testing is available at University Hospitals under the direction of an Infectious Disease specialist.