Should Kids and Babies Get Tested for COVID-19?

The coronavirus has taken a massive toll around the world. And children, like adults, can get COVID-19. As scary as the facts may be, babies and kids who have been diagnosed with COVID-19 often don't experience severe cases. "Children with COVID-19 have generally presented mild symptoms and have improved quickly," says Bessey Geevarghese, D.O., pediatric infectious disease expert at Ann & Robert H Lurie Children's Hospital of Chicago. But that is not to say that serious illness and complications aren't possible.

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But as we all know now, even if symptoms are mild for some, COVID-19 is easily spread and symptoms could be far more serious for others. So as many places lift mask requirements and move toward normalcy, should your child be tested for the coronavirus?

There are several situations in which the Centers for Disease Control and Prevention (CDC) suggests getting tested including after known or possible exposure to COVID-19 and when experiencing symptoms. These recommendations apply to children and adults alike.

Here's everything parents should know right now when it comes to keeping their loved ones—and other families—safe.

When to Get Kids Tested for COVID-19

Early in the pandemic, experts only recommended testing kids for COVID-19 when they had symptoms. But with greater availability and accessibility of testing and the knowledge that people can have asymptomatic infections (i.e., infections with no symptoms) that they can then spread to others, the CDC now recommends getting tested in several situations.

If your child has symptoms of COVID-19

The CDC recommends that anyone experiencing symptoms of COVID-19 gets tested immediately and quarantines while waiting for results—kids included. Symptoms include:

• Fever or chills
• Cough
• Shortness of breath
• Fatigue
• Muscle aches
• Headache
• Loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

The tricky part is that many of the symptoms of COVID-19 overlap with other common conditions, including seasonal allergies, colds, and the flu. And since kids tend to experience more mild symptoms of COVID-19, they may only exhibit one or two of the long list of possible symptoms. This is even truer for kids who have been vaccinated.

In general, it's better to be safe than sorry. Experts say that the only way to confirm whether that runny nose or fever is COVID-19 or another respiratory infection is to get tested.

If your child has been exposed to COVID-19

The CDC also recommends getting tested after close contact with a person with COVID-19, whether or not your child shows symptoms. Close contact is defined as being less than 6 feet away from the person for a cumulative total of 15 minutes or more, regardless of mask use.

If your child was exposed to COVID-19 and isn't showing symptoms, they should get tested at least five full days after they last had contact with the person with COVID-19. So if they were exposed on Monday, for example, you should wait until at least Saturday to test.

If your child is up to date on their vaccines, the CDC says that they don't have to quarantine during this five-day waiting period. But if your child isn't vaccinated, they should stay home and quarantine while they wait to get tested.

Of course, if your child develops symptoms during those five days, they should be tested immediately.

What if my child just had COVID-19?

With the possibility of reinfection, many parents are understandably confused about what to do in the event that their child has already recovered from a confirmed case of COVID-19 but has been exposed again. Experts say that it's possible to continue to test positive for COVID-19 long after symptoms have improved and the person is no longer contagious. So what to do?

The CDC says that if you have been exposed to COVID-19 and had confirmed COVID-19 in the past 90 days, you don't necessarily need to get tested. Watch for symptoms and take precautions (such as wearing a mask any time you are around others in public) for 10 days following your last contact with the person with COVID-19. You will only need to isolate if you develop symptoms during that time.

Other times your child may need to be tested

Kids may also be tested for COVID-19 in other circumstances. For example, kids without the characteristic signs and symptoms of COVID-19 may be tested prior to surgery or prior to hospital admission, says Gary Procop, M.D., CEO of the American Board of Pathology and former director of Molecular Microbiology, Mycology, Parasitology, and Virology Laboratories at Cleveland Clinic.

Additionally, testing might be required for travel such as before an international flight or boarding a cruise, or as part of a screening requirement for school or daycare attendance. Some families are also opting to get tested as a precaution before an indoor gathering with high-risk friends or family members.

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Should Babies Get Tested for COVID-19?

According to the CDC, current evidence suggests that the chance of a newborn getting COVID-19 from their birth parent is low, especially if the parent takes precautions like wearing a mask and washing their hands.

That said, testing is recommended for all babies born to parents with confirmed cases of COVID-19. According to the American Academy of Pediatrics (AAP), this is because a newborn is at the highest risk of infection when their birth parent gets COVID-19 near the time of delivery.

The testing should happen at about 24 hours of age, and potentially again at 48 hours of age, even if the baby doesn't show any symptoms. Otherwise, COVID-19 testing for babies should happen on a case-by-case basis—the same way it is recommended for older children.

How Do They Test for Coronavirus in Kids and Babies?

Currently, there are no child-specific coronavirus tests; rather there are two main types of viral tests available for both kids and adults, known as molecular tests and antigen tests. Both test for the presence of the coronavirus in samples taken from the nose or mouth.

Molecular tests

Molecular tests like polymerase chain reaction (PCR) tests typically use nasal or throat swabs to detect active COVID-19 infection but can also be done on a saliva sample. PCR tests most commonly require a nasopharyngeal swab (essentially a long Q-tip), says Dr. Geevarghese. "This swab is placed deeply into both nostrils to allow the swab to collect secretions."

These tests are considered the "gold standard" for COVID-19 testing as they are the most sensitive and accurate but they require a lab to process the results, usually within a couple of days depending on the lab's capacity.

Antigen tests

Antigen tests, on the other hand, typically provide results in 30 minutes after a less invasive nasal swab sample. These are the tests commonly referred to as "rapid tests." They are less accurate—particularly in pre-symptomatic or asymptomatic infections—but provide a quick, easy, and accessible testing option. Some rapid test kits contain two tests the second of which is intended for use as a follow-up test 24–36 hours after the initial test.

And keep in mind: Getting tested doesn't necessarily guarantee a definite answer if your child has COVID-19. "COVID-19 tests can have false-positive or false-negative results, so these tests are only one piece of data available to your doctor. Exposure history and the timing and character of symptoms are also important in making a clinical diagnosis and coming up with a treatment plan," says Mike Patrick, M.D., an emergency medicine physician and general pediatrician at Nationwide Children's Hospital in Columbus, Ohio. "Therefore, it is important for parents to partner with their child's doctor as together they look at the big picture and decide what is going on."

Where to Get Children Tested for COVID-19

While the decision to get your child tested may be made with the help of your child's pediatrician, the test itself may not happen in their office. This is because most pediatric offices are not equipped to do molecular testing. "Currently, most pediatric offices do not have the available resources to run tests for COVID-19. However, many can obtain swabs and send them to an appropriate lab," says Dr. Patrick. "Other offices may refer families to local facilities that can obtain and run the various tests."

COVID-19 testing locations vary by city and state but can include doctor's offices, urgent care facilities, drug stores, pharmacies, laboratories, and even private and public pop-up testing sites. Most sites will test both adults and children and some may offer both molecular (PCR) and antigen (rapid) tests, so be sure to check with the site beforehand if you're looking for a specific type of test.

Families also have access to rapid tests that they can do themselves at home, which are available by mail through the Department of Health and Human Services and over-the-counter at many retail locations and online. These rapid tests are authorized for use in people 2 years old and above.

What to Do If Your Child Tests Positive

If your child tests positive, you should follow the CDC's rules for isolation, which involve staying home for at least five days and isolating them from other members of the household as much as possible. If your child is experiencing mild symptoms, they generally can be managed at home with supportive care such as ensuring they stay hydrated, offering fever-reducing medicine, and encouraging rest.

If you're concerned about your child's symptoms, however, don't hesitate to consult their pediatrician. And seek emergency medical care if your child has difficulty breathing, changes in alertness, or chest pain or pressure.