As a parent, I have been struggling with virtual learning, school-based in-person learning, or homeschooling for this next year. To be honest with you none of these are ideal for my children or me. I don’t like the idea of my children being tied to a computer from 7:45 am -2:15 pm schedule of virtual learning (yes, I know there are a few breaks in there), with the numbers of this virus increasing and MIS-C now on my radar school-based in-person learning is a little scary, and homeschooling, who am I kidding these children despised me after our eLearning experience and that only lasted weeks not a whole year!
What appeals to me with the last option though is the freedom of not being tied to the computer and with some creativity, lessons could be rather fun for both the children and myself—but pair all that with a toddler amid a 1st and 5th grader and fun doesn’t adequately describe the potential of that option. Decisions, decisions…. So back to MIS-C what in the world is this and what does this do to the decision-making process for school? How do I protect my children?
Today I learned that MIS-C is very similar to an immune response that has been around for a long time, Kawasaki Disease. Kawasaki is a syndrome of unknown origins, that is believed to be an excessive immune response to an infection, and that is exactly what MIS-C appears to be, an excessive multi-system immune response to the Coronavirus/COVID 19 exposure.
Symptoms to Look For
Like Kawasaki symptoms of MIS-C share these symptoms: persistent and high fever, rash, sore throat, red swollen lips, tongue, hands, feet, fatigue, weakness, a conjunctive component with redness in eyes, and some cardiac-related symptoms. What sets them apart is that with MIS-C there are increased gastrointestinal components: vomiting, diarrhea, and abdominal pain. In addition to that doctors are seeing hypotension in children as well. The heart seems to be having a harder time contracting in children with MIS-C, inducing lower blood pressures requiring added support to regain normal blood pressures. In addition to those symptoms electrolyte and platelet abnormalities being reported as well. Consequently, MIS-C is showing up in children typically a couple of weeks to up to a month after infection, and not immediately upon infection.
So that is really bad right?! Of course, it is because anytime a child is sick it is really bad. No one likes to see a little one suffering or ill. Especially on the heels of the sad news of the pediatric death in the midlands our hearts and thoughts go out to the family of the child, it reminds us that healthy children (and adults) are not any less immune to this viral monster sweeping our state and world. But there are some reassuring aspects to this we are now learning six months down the road from the onset.
Dr. LaCroix’s statement in our first article is still accurate today, that this thing is so scary because “we just don’t know a lot about this yet.” Though we still don’t know everything about this we are learning so much. Here are some things we have learned and you should know about MIS-C and what is ahead for schooling in the fall.
Here’s the Interview
1. How is this transmitted?
Unlike popular belief, Dr. LaCroix explained that children are not the agents of spreading this as once thought. We are seeing transmission from adults to children and not children to adults or child to child. Though there could be specific cases that this might occur, most cases have been adult to child transmission.
2. When do we seek medical care for a child who is ill?
If your child has several of the symptoms listed above, you should seek medical care. Certainly, if your child has a high fever that is persistent and is having vomiting and diarrhea you should consult your physician. Once a child has been determined to have MIS-C treatment is started immediately. We are seeing though that 50-60% of children that are presenting with COVID do not have a fever or cough. It can appear as mild as a typical upper respiratory infection with a runny nose, sore throat, headache, and congestion.
3. How long are children being hospitalized with MIS-C?
Children who are being hospitalized are staying an average of 5-8 days in the hospital. The length of the course varies on the severity of symptoms the child is dealing with. Most extended stays to the 8 days are due to excessive vomiting and diarrhea. Those children need to be able to eat and drink again and keep it down before being released.
4. Are certain children more susceptible to MIS-C?
There is no clear cut answer to this as healthy children can be affected, however, if you have a child that was born early or that struggles with heart and lung issues already, they may have a more difficult time with this due to their preexisting conditions.
5. Should I be worried about this with back to school right around the corner?
We should all be taking steps to protect our children and those around us. What is encouraging is that children are less likely to be infected and less likely to need hospitalization. Recovery is remarkable in children. We are seeing nearly all of the children make a complete recovery. We are following each case until there is a resolution for each system that is involved in the immune response. In our six months of following this virus in children, we have found most return to normal rather quickly. To ensure a child is healthy and recovering well echocardiograms may be redone and other system tests may be used to carefully monitor multisystem recovery.
6. So, what should I do about school for my children? Is virtual the way to go?
Dr. LaCroix was quick to point out that this is a very personal decision and one that needs to be made individually based on family situations. She also mentioned that the school systems are doing a tremendous job with taking steps to keep children healthy, and that school-based learning is important to the development of children not only academically, but mentally, socially, and emotionally. She also brought up the very real aspect of not all children having access to the internet and other resources if school-based learning is not an option.
So, what does she recommend we do to protect our children? The same things she has been telling us for the last 4 months—hand hygiene, mask up if you are in a situation where 6 ft of social distancing is not possible, and stay home if you are not feeling well. She did mention to avoid crowds which goes along with maintaining proper social distancing and of course following the CDC guidelines.
Zoom meeting and interview with Dr. LaCroix shared by Fox News can be found here.
For more information on the rate of pediatric patients and more info on MIS-C in SC please see the SC DHEC website or use this link.Dr. Robin LaCroix is the Prisma Health Upstate Children’s Hospital Medical Director as well as a Pediatric Infectious Disease Specialist as well as a mom of two young sons and a long time Greenville resident.