Is it COVID or a cold?

In the age of the COVID-19 pandemic, we can no longer say easily that your child with cold symptoms has a simple cold. Pre-pandemic, it was so easy to say, “Of course they can go to school with a cold. Most kids can participate and be perfectly happy despite their stuffy nose or mild cough.” We pediatricians often spent time reassuring parents about colds.

SARS-CoV-2, the virus that causes COVID-19 (COVID) infections, is one of many viruses that mainly attack the airways. Most of the viruses cause similar initial symptoms, making it difficult to distinguish one from another. COVID, just like other illnesses, can appear like an innocent-seeming cough, runny nose and a mild fever. Determining if your child has COVID or a cold is trickier than knowing how to tell the difference between a cold and the flu.

“COVID in children can look just like a simple cold.”

Because it is so difficult to tell the difference between COVID or a “regular” cold, your pediatrician may ask you to assume that your child has SARS-CoV-2 and advise them to undergo testing and/or to keep them home. Since they might have COVID, you don’t want your child to pass it along to someone else. A child with COVID could pass it to a child with underlying health conditions. Or their teacher. Or another kid who is otherwise healthy, but then passes it to their own parent who has diabetes. Or to their grandparent who lives with them. 

A negative COVID test in your sick child is reassuring. Then you know that their cold may be from another virus, such as rhinovirus or RSV. In this case, after taking into account all factors, your pediatrician might say that your child may go back to school or daycare if their symptoms are improving. However, even if your pediatrician gives the green light, whenever practical, try to keep your children home until that last booger has dried and any cough is gone. If some other child gets a cold, their family will be in the same quandary as yours over the need to test for COVID or isolate/quarantine. (See CDC guidelines here) Besides, even “common colds” can lead to complications, and no one needs more complications in 2020.

The good news 

• Masking, distancing, and keeping your child home when sick should limit the spread of even simple colds. These practices can decrease the number of times your family members will need to stay home and quarantine. 
• Vaccine studies to prevent covid are happening right now. 
• Research into medicine to mitigates the effects of COVID illness is happening right now. 

While we cannot rush the science, at least the scientific research that will advance our understanding of COVID is well underway. 

In the meantime, please continue to laugh and have fun with your children. We have always said “Don’t get sick,” NOT “Don’t have fun.” Hopefully our new temporary disease-preventing habits of wearing masks and distancing will prevent ALL illness this year, whether COVID or not.