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Pediatrician Dr. Mona Amin on Winter Illness, Holiday Travel & Assessing COVID Risk

In case you missed Meg’s IG Live conversation with Dr. Mona Amin of PedsDocTalk in December about winter illness and assessing COVID risk, here are some key takeaways.

Skip ahead to:

1. There is A LOT going around — and it’s not just COVID. 

Pediatrics offices around the country are super busy right now, and they’re seeing a lot of sick kids. There’s a ton of COVID (obviously)!!! There’s also are a TON of other (non-COVID) viruses out there — ranging from RSV and the flu to unnamed viral crud — and they are wreaking all kinds of havoc. 

My daughter was home for 4 out of 7 weeks for illness this fall (complete with four PCR exams to match…), and I thought this was “special” somehow. Not so. *This is happening to parents in every region — unfortunately, kids are getting slammed with all the illnesses they “missed” last year, and this back-to-back-to-back cycling through illnesses is very common right now. 

When to Call the Doctor

Though many pediatric illnesses actually don’t require a visit to the doctor, it’s always unbelievably nerve-wracking to have a sick child. All of the more so in the midst of the pandemic… Here are some tips from Dr. Mona on when to call your pediatrician’s office and what to look out for: 

  • Any child over 3 months with fever persistence for 5+ days absolutely needs to be seen. (“Ninety-nine is not a fever,” Dr. Mona says…) 
  • Watch for signs of dehydration (such as no wet diapers/not going to the bathroom, crying without tears, sunken eyes, very pale skin).
  • If you’re concerned about your child’s breathing — even if you’re unsure — it’s always worth a call. 

Note that pediatric COVID presents with a very wide array of symptoms — there aren’t really hallmarks, and there are also a lot of asymptomatic infections among children. More on this below…

2. When to test for COVID: 

Dr. Mona recommends that anyone who has a fever and a cough pursue a test, because these are the top two COVID-19 symptoms (yes, there are all kinds of other symptoms, including separate symptomatology for children, but these are leading the pack). 

For other symptoms, Dr. Mona suggests thinking not only about the symptom but also what’s happening in your local area. How are case rates? What’s happening with COVID transmission where you live? Edit to update: This article was written just before the huge COVID spikes in the East and south…. so community transmission is an even bigger consideration now.

At-home tests are really good at picking up COVID *if you are symptomatic, but they still aren’t perfect. PCR tests remain the gold standard, but in many places these are still difficult to come by and expensive (note: in most places, PCR tests are covered by insurance). At-home tests are an easy and affordable first step for symptomatic illness. If you’re asymptomatic and needing to test (as in, after a known exposure, before/after travel, etc.), the PCR test is your best bet. 

Deciding when to test is a balancing act between symptoms and local transmission.

Note: It is imperative to check and follow local/school rules and policies for testing and return to school. Absent those, Dr. Mona says that a sick child is generally considered “cleared” for return to school after having been fever-free and med-free for 24 hours. 

There are basic layering steps you can take to reduce exposure: 

  1. Keep sick kids (or anyone!) home. 
  2. Consider vaccination status (your end and others). 
  3. Mask (for the 2+ crowd). 
  4. Practice hand hygiene. 
  5. Get outside. 

Some things are “more” or “less” risky than others (think: an outside playdate or walk with a mom friend vs. a crowded indoor venue), but there’s no clear right or wrong when it comes to decisions, personal comfort and risk assessment.

You can do things and be smart about it. 

Or you can sit them out and be okay with that. 

Can we all just cut the effing judgement? (Please?)

Re: #1 above, “keep sick kids home”: 

The sad/infuriating/embarrassing reality is that this is not something every family can manage. 

That’s because our work culture does not adequately or equally support parents (and especially mothers) who need to provide care for sick children. Many parents have to choose between earning a paycheck and staying home with sick kids, a decision that really sucks.  #facts

There are enormous discrepancies in access to resources, child care support, and PTO for this, and especially with the large numbers of children coming down with any-and-every virus one after another after another this year, it’s tough. 

We don’t have a solution… but feel strongly that it’s important to recognize that there are barriers standing in the way of this basic courtesy (which not only prevents the spread of germs but also affords sick children much-needed time and space to recover).

4. COVID is not going anywhere — we all need to respect that, but also think about how to build a sustainable approach to move forward. 

COVID is part of our new reality — we need to understand that it presents a risk but also accept that it is here to stay. Variants will keep emerging; the pandemic will not suddenly “end;” we can’t predict what will happen next or when. 

We have to learn to adapt. 

Adapting has to be about sustainability, but it’s also subjective — everyone (and every family) is different, and everyone’s idea of what is or isn’t sustainable varies. For some, activities and events are truly missed, and the idea of continuing to miss out on them is devastating in itself. There are ways to enjoy these things with precaution! For others, the newfound stress those same activities and events now present simply isn’t worth it. Think about what feels right to you and your family. Whenever you’re asking yourself about doing X, consider not only how to approach it with precaution but also: are you going to enjoy it? Or is it just going to be a source of stress? 

Generally, Dr. Mona suggests thinking about: How can you make decisions such that everyone in your family can live their lives, but with caution?  

Every family is going to have different ways of thinking through and answering this question, because “living your life” is highly subjective, but how refreshing is it to hear that by making some minor adjustments and taking precautions, we can continue to help protect our kids? 

For more, check out our favorite COVID resources for parents.


  1. Can you write a post on how to teach a two year old how to wear a mask? My little just turned two and won’t even keep a hat on :/

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