Kevin writes:

Wondering your thoughts about testing kids for covid.

Recently my 8 year old (had primary series plus booster, no med hx) had fever, sore throat, one episode of vomiting on a Sunday night / Monday.  Had covid antigen test lying around and tested him, he was positive.

Told school, out until next week (5 day quarantine and it was Monday).  Can’t get childcare as he is covid pos.  

Wife thinks it unethical to send his 5 yo brother (asymptomatic, primary series plus vax) to kindergarten in case he flips positive (has neg antigen test but could be antigen neg and infectious early on is my understanding.)

For all other febrile illnesses, it seems fever free for 24 hrs and feeling better is standard to go back to school, except covid.  Obviously we are not testing for RSV, flu, paraflu at home, but seems like fever free 24 hrs and back to school for those (don’t know infectivity of those after fever free 24 hrs … but do we really know infectivity of covid after fever free in vax kids x 24 hrs or just pcr positivity)?

Maybe I am thinking of this wrong (I “called in sick” today to take care of my well appearing, afebrile kids) but should I have even tested them?  I feel kinda dumb testing them (like a sent a ddimer on a PERC negative chest pain patient in the ER).  I’m guessing people just don’t test their febrile, vax kids (or even unvax’ed kids) because they thought through the apparent penalty of the knowledge.  

Thanks for any thoughts,

kevin

Carol writes:

Hi, Daniel and Vince:

Thanks for keeping us up to date with the latest in COVID treatment and prevention. I recently came across some studies suggesting that nitric oxide nasal spray was somewhat effective in reducing the duration of nasal viral shedding in patients with mild COVID, and the claim that an observational study suggested that it may prevent infection. Can you comment on these studies?

Thanks, Carol, MD, MSPH

Denver, CO

David writes:

I just tested positive and started Paxlovid. My wife was last boosted in October. When should she get another booster, she is over 65. I would expect to have good protection for several months after my infection.

Thanks,

David Shulan, MD

Russ writes:

Dr. Griffin,

Thank you for all you have done to help keep us informed. I have listened to most of your updates since midpart of 2000. Thank you as well to Vincent Racaniello for providing a platform for Dr. Griffin as well as for TWIV in general.

A situation I have been seeing more often recently is (symptomatic) patients refusing to be tested for COVID-19. It is also seemingly more common for medical providers in my area to not test for COVID-19 even in patients who are clearly symptomatic, early in the disease and not up to date on vaccinations.

I can think of a number of negative consequences of people not knowing if they have COVID-19.

Will you please address the reasons why you think that it is important to continue testing for COVID-19.

Thank you.

Russ Coash, PA-C

Geneva, Nebraska

Family Practice, Emergency and Hospital Medicine