COVID Testing & Return to School FAQ

Based on FDA guidance, accepting negative COVID-19 Home Test Kit results is different from Rapid Antigen or PCR test requirements. Acceptance of negative test results from COVID-19 Home Test Kits to return to school will require two negative test results at least 24 hours apart, per FDA guidance. Many home test kits include two tests per kit. In yesterday's message, we shared this guidance is for individuals who test positive for COVID-19. This guidance is not for individuals who test positive for COVID-19. This guidance is for symptomatic individuals who are testing in order to return to school before the standard 5 day isolation time. If parents/guardians use a COVID-19 Home Test Kit and their child tests negative, they must test their child again with a second test no sooner than 24 hours after the first test. If the second test is also negative, their child may return to school as long as they have been fever- free for at least 24 hours without using fever-reducing medication. The parent must provide the completed and signed COVID-19 Home Tests Results Form (https://campussuite-storage.s3.amazonaws.com/prod/33903/86de7fb0-3a18-11e6-b537-22000bd8490f/2383587/a34df1c6-9bb8-11ec-92a2-0afcddde3cd5/file/COVID-19_HomeTestResultsFormDirections.pdf)to school health staff in order for the child to return prior to the standard isolation time. *Parents/guardians still have the option to seek a Rapid Antigen or PCR test from FCHD, FHH, a pharmacy, or a health care provider rather than using a COVID-19 Home Test Kit.

Fever is defined as a temperature of 100.4 degrees or higher. Body temperature changes throughout the day and may be higher in the afternoon or evening. In older children, the most accurate way to measure temperature is with a thermometer under their tongue. For babies and younger children, taking a rectal temperature is the most accurate measurement. ​ Fever in general is not a medical emergency. Fever is a sign that one’s immune system is functioning well and responding to an illness process. A fever does not always require medication. ​ There are cases when a fever is more concerning: If your baby is less than 3 months old and has a fever over 100.4 (taken rectally), he or she needs to be examined. If an older child is listless, not drinking fluids, having trouble breathing, or has chronic medical concerns and has a fever, call our office for guidance. In most healthy children, fever can be a normal part of a viral infection. It can last 3 to 5 days. If a child does not have chronic medical concerns, is able to drink fluids normally, and is not having difficulty breathing, it is OK to monitor the fever at home for a few days. You may give children over 3 months of age Tylenol, and children over 6 months of age ibuprofen as needed. Please note: these medications may only reduce the fever and may not bring the temperature to normal. See our dosing chart for dosing levels. ​ If the fever persists, or for symptoms listed below, we will ask you to bring your child to be seen: Is your child not drinking fluids well? Are there symptoms of strep throat: sore throat, headache, abdominal pain, rash? Are there symptoms of a urinary tract infection, UTI: pain with urination, urinary frequency, vomiting, blood in urine? Symptoms of sinus infection: headache or sinus paid with 10-14 days of cough and congestion not improving? Symptoms of pneumonia: cough without nasal congestion, chest pain with cough, increased work of breathing? Symptoms of an ear infection: Ear pain, frequent waking at night with pain? Most importantly, always assess the child and not the number of their temperature. If a child looks concerning even if their fever is not high, please call our office.

What is strep throat? · Strep throat is an infection caused by bacteria. · It is most common in school-aged children during the winter and early spring. What are the symptoms? · Sore throat, fever, headache, stomach pain, nausea and/or vomiting · Some children also develop a fine, red, sandpaper-like rash. (Scarlet Fever) · Cough and runny nose are not seen with Strep throat – these are viral symptoms. How is Strep treated? · Your provider will prescribe an antibiotic. · Ensure that your child takes the antibiotic as directed, and for the full course to prevent the bacteria from coming back. What else can I do to help my child feel better? · Offer Tylenol or Ibuprofen as a fever-reducer or pain-reliever. · Keep your child well hydrated – Fluid intake is more important than eating solids. · Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Cold or frozen foods are good choices too. · If you haven’t replaced your child’s toothbrush in the past 3 months, now is a good time. What to Expect: · Strep throat responds quickly to antibiotics. · The fever is usually gone by 24 hours. · The sore throat starts to feel better by 48 hours. When can my child return to school? · Your child can return to school after the fever is gone, and they have been on the antibiotic for at least 24 hours. Call Your Doctor If: · Trouble breathing or drooling occurs. · Dehydration suspected. · Rash develops after starting antibiotic. · Fever lasts more than 2 days after starting antibiotics. · Sore throat lasts more than 3 days after starting antibiotics. · You think your child is worse or you think they need to be seen.

Cough – The “Cliff Notes” Version ​ Questions We Ask: Duration of the cough Any signs or symptoms of respiratory distress How ill appearing is your child? Any associated symptoms, such as fever? Who needs to be seen today: Patients with significant chronic medical concerns Patients with fever (over 100.4) for more than 72 hours Patients with fever over 105 Patients with signs or symptoms of respiratory distress Babies under 3 months old Patients with a known history of asthma, RAD or wheezing who have been using albuterol for more than 24 – 48 hour and are not getting better or are having additional symptoms Cough that is persisting 2 or 3 weeks or longer Comfort Measures at Home: Use a cool mist humidifier Honey: Do not give honey to babies under one year—it is not safe. For children ages 1 to 5 years: Try half a teaspoon of honey. For children ages 6 to 11: Try one teaspoon of honey. For children 12 or older: Try two teaspoons of honey. If honey is given at bedtime, make sure your child’s teeth are brushed afterward. Water. Encourage your child to drink plenty of water

Try to refrain from using baby wipes and use plain water with a cloth. Add some baking soda to a warm bath and allow to soak, especially after having a bowel movement. Apply a thick layer of diaper cream. Then apply layer of Aquaphor, A&D, or Vaseline on top. The bottom layer helps to heal the skin, the top layer helps to wick away moisture.

VOMITING- ​ Low-grade fever is normal with GI bug With vomiting start with fluids low and slow Try to wait 20-30 minutes after vomiting episode to begin fluids Offer 1 tsp clear fluids (water, Gatorade, pedialyte) every 5 minutes Do not offer solid foods during this time Can slowly progress to larger amounts of fluids as they tolerate this Begin process from beginning if vomiting returns again Can slowly introduce bland diet after period of 6 hours with NO vomiting Start with something small and high in carbs: crackers, plain dry toast Slowly progress as tolerated-stick with bland BRAT diet for at least a day or so (bananas, rice, applesauce, toast, crackers, plain pasta) Gradually return to normal diet-avoid fried foods, spicy foods, acidic foods, etc for at least several days Call the office if vomiting continues for more than 24 hours, has decreased alertness, or your child shows signs of dehydration (goes longer than 6-8 hours without urinating, has no tears with crying, or the inside of mouth feels sticky). ​ Diarrhea ​ Diarrhea normal with GI bug Can last 7-10 days but should taper off and improve-less frequent and begin to bulk up and become more firm Call the office if having more than 12 episodes of diarrhea per day, diarrhea does not start to taper off or improve toward the end of 7-10 day range, mucous in stool, or s/s of dehydration (see above)

What is Hand, Foot & Mouth, HFMD? Hand, foot and mouth disease (HFMD) is a common childhood illness and is caused by the coxsackie A-16 virus. Symptoms than may arise with HFMD include: Fever (100.4 or higher) Small, painful red spots (blisters) on hands, feet and mouth *Blisters may spread to arms, legs and faceThese symptoms typically arise 3 – 5 days after exposure to the virus. Fevers typically occur in the first few days, followed by blisters. Treatment Since HFMD is a viral disease, antibiotics are not needed. Symptoms of the virus that cause discomfort may be treated with over the counter medication, Tylenol or ibuprofen. See our dosing chart here. It is highly recommended that children drink lots of fluids; cold drinks soothe irritation in the mouth and help children stay hydrated. There is no special treatment for blisters; wash the skin per your normal routine with soap and mild water. Progression / What to Expect Fever may last 2 – 3 daysBlisters around the mouth may last up to 7 daysBlisters on the hands and feet can last up to 10 days. Peeling may occur during healing. Call our office if there are signs of dehydration, or if the fever (100.4 or higher) lasts more than 72 hours.Children can typically return to school or daycare after the fever has been gone for over 24 hours.

The most common symptoms of the flu include fever (100.4 or higher), body aches, cough and congestion and malaise. While vomiting may occur, it is not a primary symptom. Symptoms usually appear quickly. ​ Treatment Treatment typically consists of comfort measures at home: lots of rest, lots of fluids, honey for cough and fever and paid reduction medications. What about Tamiflu? Tamiflu is an anti-viral medication and may be indicated if a child has flu or flu-like symptoms. Tamiflu does NOT kill the flu virus or cure flu symptoms. It has been shown to reduce duration of symptoms by about 24 hours. It stops the virus from making copies of itself; it is most effective when given within the first 48 hours of symptoms. The side effects can include significant vomiting and diarrhea.Tamiflu is a treatment option but is not a replacement for prevention with the flu vaccine. Prevention The flu vaccine is recommended every flu season, the earlier in the season the better. ALL children with egg allergy can safely receive the flu vaccine in any form.The American Academy of Pediatrics recommends the flu vaccine for all people ages 6 months and older, especially those with chronic medical concerns. The only people who should not receive the flu vaccine are those who have had an anaphylactic or serious allergic reaction to the flu vaccine in the past. Our office will offer the flu vaccine as early as it is available, usually mid-September. Please check with us for this year’s recommendations for type of vaccine.

What You Should Know About Common Shot Reactions: Immunizations (vaccines) protect your child against serious diseases. Pain, redness and swelling are normal where the shot was given. Most symptoms start within the first 12 hours after the shot was given. Redness and fever starting on day 1 of the shot is always normal. All of these reactions mean the vaccine is working. Your child's body is making new antibodies to protect against the real disease. Most of these symptoms will only last 2 or 3 days. There is no need to see your doctor for normal reactions, such as redness or fever. Here is some care advice that should help. This info is directly from healthychidren.org For more info regarding vaccine reactions, please visit https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Immunization%20Reactions&_ga=2.1082233.996443959.1641304519-899282263.1629122747&_gl=1*1bk8voi*_ga*ODk5MjgyMjYzLjE2MjkxMjI3NDc.*_ga_FD9D3XZVQQ*MTY0MTMwNDUxOS40LjAuMTY0MTMwNDUyMS4w

Possibly one of the most important developmental areas that parents can directly impact on is stimulating language and speech development through reading to your child. We now know that even in pre-verbal infants and toddlers, exposure to language plays a key role in learning, speech development and overall higher IQ. It also enhances bonding and attachment. Reading is the gift that keeps on giving - in so many ways!

Our changing lifestyles has made getting outside and connecting to nature less common and seemingly less important to us as a society. Kids that get outside are calmer, happier, healthier, less likely to develop long term medical problems (think anxiety and obesity) and are better students and learners. That’s not just me talking it up, that’s what the research shows. Not to mention the importance of appreciating the world around us and our responsibility to it. What are we waiting for?

Play, of all types and in different settings, is vital for overall child development. Play is more than just fun for children, it’s integral to every aspect of growth and development. Play needs to be integrated into the daily lives of all children and is a fundamental right (and necessity). It goes hand in hand with other current recommendations and concerns about media and screen time exposure and is linked directly to our next initiative promoting family engagement.

What links all of this together? Every child is part of a family. Families may come in different sizes and shapes but the fundamentals of family functioning are all the same. Building on the foundation of family function and promoting positive parenting practices is central and critical to healthy emotional child development and well being!

We recommend Frederick Health's PCR test. Hours and locations of testing sites can be found at here(https://www.frederickhealth.org/patients-visitors/coronavirus-covid-19-/curbside-testing/) We are not able to offer COVID testing for return to school or work.

We recommend Frederick Health's PCR test. Hours and locations of testing sites can be found at here(https://www.frederickhealth.org/patients-visitors/coronavirus-covid-19-/curbside-testing/) We are not able to offer COVID testing for return to school or work.

Neither in-office rapid tests nor the new home test kits use PCR technology. PCR tests are the most accurate, and therefore, our practice recommends the PCR tests available through Frederick Health. To find testing sites, please visit frederickhealth.org(https://www.frederickhealth.org/patients-visitors/coronavirus-covid-19-/curbside-testing/)

Neither in-office rapid tests nor the new home test kits use PCR technology. PCR tests are the most accurate, and therefore, our practice recommends the PCR tests available through Frederick Health. To find testing sites, please visit frederickhealth.org(https://www.frederickhealth.org/patients-visitors/coronavirus-covid-19-/curbside-testing/)

If your child was tested at Frederick Health, you will receive results directly from Frederick Health. If results are sent to our office, we will publish them to their patient portal. Please login to your child's portal rather than calling for results. If there are no results, that means we have not received them. Frederick County Pediatrics Portal login.(https://13814.portal.athenahealth.com/?deeplink=section%3Dappointments%26athenareferrer%3DREMINDERCALL%5FCONFIRMATION%5FCTA%26utm%255Fcampaign%3Dcommunicator%26utm%255Fmedium%3Demail%26utm%255Fsource%3DAppt%255FReminder%255FVisual%255FForms) If you do not have a patient portal, you can register at this link(https://13814.portal.athenahealth.com/?section=landing&sub=registration_wizard&CSRFPROTECT=NONE) .

If your child was tested at Frederick Health, you will receive results directly from Frederick Health. If results are sent to our office, we will publish them to their patient portal. Please login to your child's portal rather than calling for results. If there are no results, that means we have not received them. Frederick County Pediatrics Portal login.(https://13814.portal.athenahealth.com/?deeplink=section%3Dappointments%26athenareferrer%3DREMINDERCALL%5FCONFIRMATION%5FCTA%26utm%255Fcampaign%3Dcommunicator%26utm%255Fmedium%3Demail%26utm%255Fsource%3DAppt%255FReminder%255FVisual%255FForms) If you do not have a patient portal, you can register at this link(https://13814.portal.athenahealth.com/?section=landing&sub=registration_wizard&CSRFPROTECT=NONE) .

Please note that it is possible to receive a false negative, especially if the test was performed too soon. The CDC recommends testing be done day 4 or 5 after exposure. If your child is "negative" but has symptoms, a repeat test may be recommended. Individual schools and daycares have their own return protocols. Please consult their guidance.

Please note that it is possible to receive a false negative, especially if the test was performed too soon. The CDC recommends testing be done day 4 or 5 after exposure. If your child is "negative" but has symptoms, a repeat test may be recommended. Individual schools and daycares have their own return protocols. Please consult their guidance.

-If your child's COVID test is pending, a return to school note will not be issued. -We are not issuing return to school / daycare / work notes for rapid nor at home test results -Our Return To School notes states that Frederick County Pediatrics does not provide COVID testing. If a negative COVID test is required per facility protocol, the patient will need to obtain COVID testing.

-If your child's COVID test is pending, a return to school note will not be issued. -We are not issuing return to school / daycare / work notes for rapid nor at home test results -Our Return To School notes states that Frederick County Pediatrics does not provide COVID testing. If a negative COVID test is required per facility protocol, the patient will need to obtain COVID testing.

Yes! We are pleased to offer the Pfizer vaccine, which is a 2 dose series given 3 weeks apart. For ages 12-15 it has EUA, Emergency Use Authorization. For ages 16 and older, it now has full FDA approval. As soon as authorized for younger ages we will be prepared to offer the vaccine.

Yes! We are pleased to offer the Pfizer vaccine, which is a 2 dose series given 3 weeks apart. For ages 12-15 it has EUA, Emergency Use Authorization. For ages 16 and older, it now has full FDA approval. As soon as authorized for younger ages we will be prepared to offer the vaccine.

The best way to help your children become more comfortable wearing a mask is to model wearing one yourself and to talk about it with your child. Read more tips from Healthy Children.org(https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx)

The best way to help your children become more comfortable wearing a mask is to model wearing one yourself and to talk about it with your child. Read more tips from Healthy Children.org(https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx)

Newborn visit info

Info for 11 to 13 years

Info for 5 to 10 year olds