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Coronavirus (COVID-19) and JM

What You Need to Know

Updated as of April 7, 2020

On behalf of our Juvenile Myositis community, the Cure JM Foundation Board of Directors and Staff have been monitoring the novel coronavirus (COVID-19) situation in the United States by monitoring reports from the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the National Institutes of Health (NIH), and JM experts. We are providing the following information to help you be informed and make the best possible decisions for you and your family. Please consult your healthcare provider regarding medical decisions. It is important to note that information about COVID-19 changes daily, if not more frequently, so please check-in with reputable sources such as the CDC, your state and local public health agencies and your physician.

What are the symptoms and the severity of Coronavirus?

According to the CDC, the following symptoms may appear 2-14 days after exposure: fever, cough, and shortness of breath. However, the complete clinical picture is not fully understood. Illnesses have ranged from mild (including with no reported symptoms) to severe, resulting in death. The CDC currently believes it’s possible for those with mild to no symptoms to still spread the virus and that someone could spread the virus prior to showing symptoms.

What can I do to protect my JM child?

An important course of action is to be aware, informed, and take practical steps to limit your child’s exposure.

According to the Centers for Disease Control and Prevention (CDC), the novel Coronavirus — COVID 19 — is transmitted principally by coming into contact with an individual carrier who transmits the virus either directly through sneezing or coughing, which releases the virus in droplets, potentially affecting others in close proximity (within approximately 6 feet). These droplets can possibly settle in the mouths or noses of people close by or potentially be inhaled into the lungs.

The CDC also states that “it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.”

Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at National Institutes of Health (NIH) and a world expert on communicable diseases says that families who should be most concerned are those with family members who have underlying conditions. One of those underlying conditions he mentions is anyone on immunosuppressive drugs.

Dr. Fauci further notes that if you have an underlying condition, you fall into a category where you may want to take extra precautions. “In general,” he says, “be careful and don’t put yourself at extra risk.”

Dr. Fauci says the most effective response right now is “social distancing” — separating yourself from groups or crowds, thereby lowering transmission risk.

Here’s a great checklist from the CDC on what you can do to protect you and your family.

Are there other precautions I should take?

The virus can live on surfaces for a period of time, so it is possible to contract the virus from surfaces such as airplane seats, on public transportation, or common desks or cafeteria tables at school. A JM doctor suggests the following, additional precautions: elbow bumps, instead of handshakes; pressing elevator buttons with your knuckle, not your fingertip; and minimizing contact with surfaces.

According to the CDC, the virus can be killed by cleaning with disinfectants, such as diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants. If someone in your household becomes ill, the CDC recommends the person who is ill avoid unnecessary contact with others in the household, wear a mask, and, if possible, use a separate bathroom. They should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in the home.

The CDC states the probability of indirect transmission can be reduced by frequent handwashing and to be careful about touching your mouth or nose as this is one way infections are transmitted from surfaces to humans. See video link at https://youtu.be/IisgnbMfKvI

To curb the spread of COVID-19, most states have instituted shelter-in-place orders. Check in with your state government website for more details and information specific to your geographic area.

According to the Yale School of Medicine, you should call your healthcare provider if you or child exhibit symptoms of COVID-19 such as a fever, cough, respiratory symptoms, diarrhea, vomiting, sore throat, and shortness of breath. But, it is recommended that you call your healthcare provider first and try to avoid the emergency room unless you or your child truly require emergency care.

According to the CDC, if you or your child have mild symptoms, it is best to recover at home. But, if you or your child have pronounced symptoms of COVID-19 and want to get tested, call your state or local health department or a medical provider. You can read CDC’s guidance on testing here.

Current guidance suggests staying home as much as possible, but if you must go out, the CDC suggests cloth face coverings to help slow the spread of the virus. According to the Cleveland Clinic, cloth face masks are recommended because those with COVID-19 that have mild or no symptoms can still spread the virus to others.

They make the following recommendations about a cloth face covering:

  • It should fit snugly but comfortably against the side of the face
  • It should be secured with ties or ear loops
  • It should include multiple layers of fabric
  • It should allow for breathing without restriction
  • It should be able to be laundered and machine dried without damage or change to shape

According to the CDC, cloth face coverings should not be placed on young children under age 2, or anyone who has trouble breathing.

Also note that the cloth face coverings recommended by the CDC are not surgical masks or N-95 respirators, which should be reserved for healthcare workers and first responders.

Make sure to call your healthcare provider for additional recommendations.

Are children less impacted than adults?

According to the CDC, children do not appear to be at higher risk for COVID-19 than adults. Although some children and infants have been become ill with COVID-19, adults make up most of the known cases. CDC data show that children under the age of 18 make up 1.7% of COVID-19 cases in the United States occurring during February 12 - April 2, 2020.

So, does that mean that children aren’t being infected? “The first, and most likely scenario, is that children are contracting COVID-19 but are getting a milder version of the disease,” says Thomas Murray, MD, PhD, a Yale Medicine pediatric infectious disease specialist. According to Yale Medicine, other possibilities could include that children aren’t exposed to the infection as often as adults, or they are exposed and don’t contract the infection, or contract the virus and just experience milder symptoms.

One study from China looked at 2,143 children with COVID-19 infections and 90% of the children had illness that was asymptomatic, mild, or moderate. According to a recent Harvard Medical School article, it is important to note that, according to this study, younger children are at higher risk of contracting the virus. Among children less than a year old, 10.6% had severe or critical disease. For children ages 1 to 5, that number was still high at 7.3%. It dropped to 4.2% for 6-to-10-year-olds, 4.1% for 11-to-15-year-olds, and 3% for those 16 and older.

For more information about COVID-19 and children, visit the CDC’s webpage dedicated to the subject.

Does my JM child have a greater health risk if he or she contracts the virus?

COVID-19 is a new disease and there is a lot we don’t know, including risk factors, but based on currently available information, people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. According to the CDC, those that are immunocompromised are considered to have an underlying condition.

For the immunocompromised, the CDC recommends following precautions outlined in “Are there other precautions I should take?”

Should my child be tested?

If you believe your child may have been exposed to someone affected with COVID-19 or is showing the typical symptoms of COVID-19, please contact your medical provider immediately. Again, symptoms include fever, cough, and shortness of breath.

Should I have a supply of drugs on hand?

Please talk to your physician or pharmacist to assure that you will have access to the drugs your child is taking in case there is an outbreak in your area and you need to stay home for an extended period of time. We recommend having several weeks supply on hand. Your pharmacist may be able to work with your insurance company to fulfill your next prescription early. Some prescriptions can be filled by mail order and some IV medications can be provided by home healthcare. Have over-the-counter pain relievers on hand as well.

Should I take my child off of any medications?

Experts recommend that you continue your child's medications as prescribed, and check with your physician before making any changes to your child’s medications.

Mental Health and Coping Skills

Concern over COVID-19 can make families anxious. This anxiety can be heightened for families with chronic health conditions like Juvenile Myositis.

This article from the National Association of School Psychologists presents some strategies to help cope with some of the feelings that your child may experience during this time. Please consult a physician if you have any concerns about your child, yourself, or anyone in your family.

Other helpful links:

Centers for Disease Control and Prevention (CDC)
www.cdc.gov/coronavirus/2019-ncov/index.html
www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html
www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

U.S. State and Local Health Departments
www.naccho.org/membership/lhd-directory

World Health Organization (WHO)
www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Cure JM Foundation Website Links
Hand Washing 101
Possible Drug Shortage Advocavy Letter for your Congressional Representatives
Keeping Your Family Safe