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Healthwise Maui

Q: I’m confused — can kids get COVID-19?

Dr. Vijak Ayasanonda, vice chairman and co-medical director, Emergency Department, Maui Health: With so much talk about sending kids back to school, there’s been a lot of discussion about whether children are at risk from COVID-19. While scientists are still learning about the virus and how it works, here’s what we know so far.

Yes, children can get COVID-19, but based on the limited published studies it was initially thought that they’re less likely to be infected than adults. Early studies in the U.S., China and Italy found that children made up fewer than 2 percent of COVID-19 cases and were less likely than adults to be hospitalized. In most cases, kids who are infected seem to have a milder illness than adults, and some might not have any symptoms. This likely led to less testing in children. With the national discussions regarding reopening of schools, more testing is being done on children and the latest reports are starting to indicate that children are as likely to get infected and are as transmissible as adults.

People of all ages with certain medical conditions, including type 2 diabetes, heart problems and diseases affecting the nervous system, are at higher risk of serious illness if they become infected. And a small number of kids with COVID-19 have developed multisystem inflammatory syndrome, a rare but dangerous condition in which multiple organs or other parts of the body develop inflammation. This often includes swelling, redness and pain. A few children have died as a result of this condition.

Additionally, because many children who test positive for the virus are asymptomatic, meaning have no symptoms, they could be spreading COVID-19 to those around them without knowing it. This could be dangerous for those who have contact with individuals who are at higher risk for serious and life-threatening symptoms, including their grandparents or friends and family who may have other medical conditions.

You can help prevent your child from becoming infected with COVID-19 or spreading the virus to others by following CDC recommendations, including staying home and practicing social distancing. While it can be hard for children to stay 6 feet away from friends, you can reduce the risk by keeping playdates outdoors and avoiding close-contact sports and activities like football and basketball. Wash hands frequently and teach older children to wear a mask (do not place a face covering on children younger than 2) and avoid the new “plastic face shields” as they do not offer any benefit. The mask should cover both nose and mouth.

Finally, even as you protect your child from COVID-19, remember that there are other serious infectious diseases for which vaccinations already exist. So, do not postpone well-child visits and immunizations over COVID-19 fears.

Q: I keep reading about universal testing at Maui Memorial Medical Center. What is it and how will it help protect patients and employees?

Dr. Vijak Ayasanonda, vice chairman and co-medical director, Emergency Department, Maui Health: Universal testing means that all patients admitted to Maui Memorial Medical Center are being tested for COVID-19, regardless of symptoms. This includes patients admitted through the Emergency Department, laboring mothers, and direct admissions to the hospital (elective and other scheduled procedures). Rapid testing means that test results are available within about four hours.

Maui Memorial Medical Center began universal testing in June, to help identify people who may be carriers of COVID-19 but don’t have any symptoms. This helps prevent potential exposure to patients and staff, and it also helps the hospital manage PPE supplies by determining the appropriate level of care for each patient.

This COVID-19 test involves a nasal swab that is inserted in the back of the nose. Most testing is done in the Emergency Department, and patients wait in the Emergency Department for their results. Laboring mothers are tested in the labor and delivery unit once they’ve been admitted, and they wait for the results in their room where they are isolated until they are cleared as negative. If a patient tests positive or shows symptoms of COVID-19, they are immediately isolated in a “warm unit” which serves as an isolation area for COVID-19 patients or any suspected (PUI) cases. MMMC can expand warm units and capacity if necessary.

MMMC has enough tests to serve all our patients, as well as staff, when needed. We also recently received and are now using a larger testing machine that can now run tests in 4 hours and process more than 1,000 tests per day. However, at this time, MMMC does not serve as an outpatient testing facility for the general public. Maui County residents or visitors who want to be tested can visit the County of Maui COVID-19 website www.covid19mauinui.com/testing for a list of current testing sites.

Universal rapid testing helps protect patients and employees because it means the hospital can quickly identify and isolate patients who might be contagious, even if they aren’t showing symptoms.

This, along with the other safeguards in place at MMMC including universal masking, isolation and  enhanced disinfection protocols, appropriate PPE for all staff, no-visitor policy, and mandatory symptom/temperature screening for anyone entering the hospital, further minimizes the risk of potential exposure to patients and visitors, and employees and providers.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on the first and third Thursdays of the month. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

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