Navigating COVID-19 Testing for Kids Under 5 is a Parent's Nightmare

Parents of children under 5 are finding it difficult to get testing appointments—on top of the stress of having unvaccinated children during a major surge, watching child hospitalizations rise, and stressing about quarantines and daycare closures.

Young boy wearing a mask at a doctors appointment

Jacqui DiNardo, a Western Pennsylvania high school teacher and blogger, gave birth to her son in January 2020, right before the pandemic hit. Since then, her life as a mom has been dominated by COVID-19 in one way or another. She's had to worry about her child getting infected, deal with one daycare quarantine after another, and manage COVID testing chaos with a toddler in tow multiple times.

"In his short 2-year lifespan, my child has had to be tested for COVID nine times," DiNardo says. "All aspects of COVID have been challenging for me, but the pressure and implications of testing for my young child have been particularly daunting over the last two years."

COVID-19 Tests Are Hard to Come By for the Under 5 Crowd

Part of the problem parents of children under 5 face is that it can be difficult to get testing appointments for younger children, says Allison Edwards, M.D., medical director at the telehealth firm Sesame.

"Many public or retail test settings only test adults, due to the age policies they have in place," Dr. Edwards explains. "Those that do test children sometimes don't test children younger than 3."

So you are left trying to secure an appointment with your pediatrician, Dr. Edwards notes, which isn't always easy, especially during a surge like we are going through now, as Omicron rages throughout the country, infecting a record number of people—including children—at once.

DiNardo had to get her son tested right before Christmas, as COVID cases were surging, and she describes a stressful, chaotic experience.

"We couldn't get into our pediatrician's office so we went to an after-hours children's urgent care," says DiNardo. "We had to wait 30 minutes in a waiting room with other sick children, and then over two hours in the actual exam room waiting to be seen and swabbed."

Then there's the added cost that comes with COVID-19 testing for younger kids. For DiNardo, that means a $35 co-pay for each visit. But many parents report being charged out-of-pocket for tests, and some private practices and urgent care centers also require pre-test evaluations, which can easily skyrocket the cost of each visit into the $100-range. Older kids and adults, meanwhile, can get access to free or low-cost, often government-covered tests.

Parents of Kids Under 5 Are Stressed Enough As It Is

Children under 5 still aren't eligible for COVID-19 vaccination, and there have been some worrying headlines lately about unvaccinated children being hospitalized for COVID during the omicron surge. In fact, in early January, the number of kids hospitalized with COVID rose to the highest it's been since the pandemic began, with a notable increase in cases among children from newborn to 4-years-old.

All of this makes the process of getting kids under 5 tested even more stressful for parents because getting tested often means potentially exposing your child to COVID. This has been especially true over the past few weeks, as parents have sometimes described waiting in packed lines for many hours, or in overcrowded pediatrician offices.

On top of all that is the unrelenting stress of getting multiple exposure notifications from daycare and preschool, rearranging your work schedule to stay home with your child, and waiting to find out if your child is sick.

Daycares, which are filled with children too young to be vaccinated, have to be extra careful when it comes to identifying potential COVID-19 cases and quarantining children.

Every time DiNardo's son is identified as a close contact at daycare, he must be quarantined for 10 days per daycare requirements. If she wants to end the quarantine early, she must find her son a COVID test. Then comes the waiting period.

"Every time a COVID test is required (even just for a persistent case of sniffles), my husband and I have to commit to three to five days off work to wait for the PCR results to come in," DiNardo shares.

During the current surge, testing turnaround has taken longer than usual, says Leah Alexander, M.D., pediatrician and consultant for Mom Loves Best. This has created extra stress, especially for parents of the under-5 crowd.

"Since mid-December last year, results of PCR tests may not be available for three to five days," says Dr. Alexander. "A few locations offer 'rapid PCR' tests, but supply is often limited. In rural and more remote areas, I would anticipate more difficulty accessing COVID tests than in more populated areas."

At-home COVID tests may be an option—if you can get your hands on one—but those have their limitations, says Dr. Alexander. Rapid tests need to be performed correctly, and are most accurate when symptoms are present, she explains. It's best to do two tests, two to three days apart for best results, she adds.

Additionally, not all daycares or schools "count" rapid tests as a means to end quarantines or isolations, so parents should keep that in mind and contact their childcare provider to find out their particular guidelines.

Advice on How to Navigate It All

The stress of getting your child under 5 tested is real, and you aren't alone if you are finding the whole thing completely overwhelming. After all, many parents of young children have been doing this for almost two years now, with no end in sight.

But that doesn't mean you should forgo testing for your little one at this time. Even if you haven't been asked to test due to a daycare or school exposure, you should test your child anytime they've been exposed to COVID-19, or anytime they show symptoms, says Dr. Alexander.

It's really not possible to know whether your child has COVID without a test, because the symptoms of COVID resemble so many viruses that young children bring home.

"They may simply have a runny nose with fever or present with wheezing, diarrhea, or body aches," Dr. Alexander says. "A test is the only way to distinguish the normal causes of these symptoms from COVID-19."

In terms of keeping your child safe during this current surge, especially as you impatiently wait for a vaccine for young kids?

Suellen Hopfer, Ph.D., assistant professor in the program of public health at the University of California, Irvine, recommends surrounding your child with a wall of protection to decrease the risk of contracting COVID. This is similar to what the CDC recommends for protecting unvaccinated children.

"The best protective measure is to have caregivers, parents, and family members who are eligible to be fully vaccinated, including boosters," Dr. Hopfer says. "Couple this with other protective measures, to avoid crowds, defer travel, implement the routine protective measures, like mask- wearing (especially inside), hand hygiene, and physical distancing."

DiNardo's advice is to find parents of young kids who are going through the same thing as you. For her, that has meant finding other working parents with kids in full-time daycare to commiserate with.

"Unless you have faced these very difficult decisions as a parent, it is impossible to know what it is like," she says. "Navigating all of these obstacles is extremely lonely when you feel the weight of the world on your shoulders that others do not."

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