Parents in Pandemic: How to Help Children Embrace the New Normal?

Dr Rania Ayat Hawayek, a respected specialist pediatrician in Dubai, shares her view on the key question parents ask most frequently during Coronavirus pandemic: how to help them embrace the 'new normal'?. In addiiton, she warns against danger of wrongly overlooking critical pediatric risks while we are obsessed with coronavirus.

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Dr. Rania Michel Ayat Hawayek

Specialist Pediatrician
Circle Care Clinic

What pediatric concerns are wrongly overlooked during COVID-19?

First of all, Measles.

We all know that last year there was worldwide measles outbreak. So don’t delay your child’s MMR thinking that just because you’re at home you’re safe. Just like COVID-19 has come into a household, measles is another virus that could easily come in because everyone around that child is immune could carry, for instance, so it’s easy to catch.

Second, the infant vaccine, the ones done at 2, 4 and 6 months.

You leave an infant completely naked, their immune system completely vulnerable, if you don’t boost it, with those extremely important illnesses that are life-threatening.

And the other one, I would say would be meningitis.

Because, yes, it is a rare illness, but it is so detrimental and the vaccine is extremely protective so those would be the three.

When parents should take their child to hospital without delay?

Basic principles, they don’t change.

If a child has a fever that’s difficult to control, and runs more than day or so. It depends on the age. If an infant, less than 3 months had a fever, you know with no other obvious reasons, like no runny nose or no one around was sick, you would want that child to be seen because an infant with a fever, if it was bacterial, is very dangerous. Especially an infant in the first 2 to 6 months.

If a toddler who had a fever but had an associated runny nose, some loose stools and still had their energy, still had their appetite, you’re ok to sit on that. But, a relentless uncontrolled fever, breathlessness, breathing difficulty to the point of where the infant could not feed well or an older child was breathless on minimal activity, and of course the obvious things like seizures or like an accident with bleeding that you couldn’t stem, a potential broken leg.

The message here is COVID-19 or no COVID-19, if your child has a medical symptom, that doesn’t seem to be getting better with what you are doing now at home, or is effecting their ability to eat to breath to move, or is like a bleeding, like a hemorrhaging issue, you need to go to a hospital.

And yes, we are all worried about exposure if you go to a hospital, but hospitals have very good systems in place. They have divided their emergency rooms into potential COVID-19 and non-COVID-19, so for the bumps and lumps and the things that are obviously not infectious-related.

But, let’s bring COVID-19 back into the question.

For now, all our children are social distancing properly, they are not exposed to each other, which means, the likelihood of a runny nose or cough or all these things that happen now is very low. And if they do happen, we immediately assume it could be COVID-19. It’s correct to think that way. It doesn’t mean it is COVID-19 but when you think it could be, you behave in a more safe way, in a more safe approach.

So let’s assume your child does get exposed to COVID-19 and has a mild fever. If your child does not have breathing difficulty and are still doing what they are meant to be doing, like their energy levels are ok, they’re eating ok, they’re not breathless, you’re ok to continue to observe this child at home.

But, if your child had contact with a known case or a case you consider risky, even though your child is well, it is important to find out whether it’s COVID-19 or not, because it has an impact on you.

And there are so many at-home services. I got this app just this morning, that you can even call and get a check-up, get the test done at home. So don’t run away from finding out. No one’s going to take your child away from you.

The message, what they are doing now is very sound. If someone is an asymptomatic child or adult, they stay at home, but it’s important to know for the contact tracing.

So, don’t behave differently because of COVID-19. Keep it in mind, but don’t neglect something that could become life-threatening, like a bacterial infection that you think, 'oh the fever is because of just a virus'. It could be a strep throat that then becomes a scarlet fever. It could be a pneumonia that has nothing to do with COVID-19. So seek the help, don’t run away from it. We are keeping you safe, we are keeping ourselves safe.

How to prevent kid's health problems while staying at home?

Vitamin D, needs to be supplemented during this time because low levels of vitamin D have been linked to your immunity. So it needs to be supplemented at this time, because we all see less sun whether we live in a villa or an apartment.

When it comes to physical activity, parents need to find ways of being creative, especially for those people who live in apartments. You need to make the time to take your children out.

Yes, they may need to wear masks, but if you are in an outdoor space, very far away from others, you don’t necessarily need to. Be reasonable. You don’t need to have your mask on, if you are nowhere near anyone else. You know no one else is in sight, you’re ok.

Children need to run around, they need to run, go out, and run around in the park and we can do that now. So don’t keep yourself.

I know the easing of restrictions has been worrying for so many people, but do use them to your advantage. Because most people outdoors now are being safe. Most people are following the rules, some of them because they don’t want to pay the fines, but others because they understand they need to have the mask on. As long as you’re doing the same, you’ll keep them safe.

So try, buy a trampoline, try and create obstacle courses at home, try to be creative and playful as much as possible.

But also don’t get anxious. Do accept the fact that they will have more in the way of screen time nowadays.

They will be less active. Try to keep their diet healthy to balance that. They will need less calories if they’re not expending as much. I’m not saying make them go hungry, but keep in mind you know their intake, and just use the outdoors when you can, safely.

How can we prepare children to embrace the new normal?

Those especially the younger ones, with very important months in their lives, haven’t built the social skills. They might be very scared, very nervous. They understand that they haven’t been going out because of the big bad virus. They might assume that anyone not in their household or their circle can have the virus. So they might be additionally scared and averse to meeting other people, so what we can do as parents, as people who own the schools, as older people around them, in the run-up to the normalisation?

Climatize our children to the fact that when we go out, we need to do the distancing. When we go out, we need to wear the masks especially if you live in a place that wearing a mask is mandatory. Take them out for walk, take them out for the occasional trip to the places that you are allowed to go to, like outdoor places.

Children between 3 and 12, have them wear the mask, have them realize just like us. I was very nervous the first time I went into a supermarket during this time. I feel safe at my clinic, I feel safe at home, but you know how we feel when we go out. My husband told me the other day he was bit nervous the first time he took the car out after lockdown.

Children are the same, you do it once or twice and you realize actually, 'I can go out with a mask, everyone else has one, I feel safe'. And if they done it one, two, three times, and they don’t get sick, their perception changes, it feels better.

Over the summer, I think schools need to work a bit and not to leave students. Taking pictures of what they are doing at schools, getting students to virtually go through the school with the new changes on board, especially if they have colored segregated areas of where they need to stand, wash places, or what the security guard will look like.

It’s important for children to feel familiar with what they are going to see, because I feel that takes away a lot of the anxiety especially when what they’re going to see is different from what they remember. It would be a big mistake if we leave them for the 2 months of summer without any communication and without any preparation.

*Disclaimer: Please consider the information in this video/article most recent as per date and medical recommendations towards COVID-19 may change as the situation evolves.