Covid-19 and children with spinal cord injury
We have worked collaboratively with Dr Allison Graham, Consultant Physician in spinal cord injury (with specialist interest in paediatric injury) to produce the following specific information on Covid-19 and children with spinal cord injury. Throughout this piece we link to the NHS and the Centers for Disease Control and Prevention.
In relation specifically to Covid-19 it is not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children.
Although the non-specific guidance is that children of any age with neurological conditions are more likely than other children to be affected, this does seem to be related to how their general health and breathing function is before illness. All families of children with spinal cord injury who have chest and breathing changes due to their level of injury should already have the knowledge and equipment to ensure they can clear their chest and use all breathing equipment prescribed to keep them as well as possible. These children should be considered in the vulnerable group as identified by UK government. Follow the UK.gov information on social isolation for this. Carers are an essential part of your team and need to use all elements of good infection control practice to reduce risk of infection.
Covid-19 symptoms may present slightly differently in children. Do seek medical advice if needed – the symptoms experienced with Covid-19 are often symptoms of other illnesses as well. Although there is a lot of coverage about how busy the NHS currently is, we would still encourage you to seek medical help if required through calling NHS 111 if in England, Scotland or Northern Ireland or through their website, and if in Wales use either NHS 111 if available in your area or call Wales Direct on 0845 4647. Call 999 if an emergency. Ensure you have up to date information about your child’s normal situation and medication use.
The National Spinal Injury Centre at Stoke Mandeville or your local unit can be contacted for further help and advice. Although they currently have a reduced service with outpatient appointments, they are still doing routine appointments by phone and email where possible and can support with any concerns you may have.
Information about health services
It is vital to remember that the health service is still open – it is just taking on a different form. If you have any concern about your child’s health that is not related to Covid-19 then contact your GP practice or the spinal units who can all offer advice and appointments by telephone.
What happens if you do need to be seen at a spinal centre or hospital?
If you do need to be seen then there are guidelines that will be explained and temperatures are taken of anyone who goes in. Most advice is that one adult only should accompany the child. Hospitals are currently working with green and red zones to keep areas where potentially positive patients are separate form those with other conditions.
It will take a long time for “normal service” to resume but it’s really important not to wait and worry at home. Seek medical advice when you need it.
Students returning to school
Some children in England will be returning to school on 1 June whereas Northern Ireland and Scotland will return later in the year. It can be really difficult determining whether it is safe for your child to return and what the best thing to do is. Each parent needs to consider the other members of the family, how the child will manage with learning support assistants (and whether their needs will be met in terms of health care such as personal protection equipment), and what the school is doing for social distancing such as hand washing. It also somewhat depends on how you feel your own child can understand the rules and regulations. Following the updated information from Royal College of Paediatrics and Child Health, Dr Graham advices that many children with spinal cord injury can stop shielding unless they are in group A (please see the link for categories that fall into this group).”
Hyperacute inflammatory presentation
The hyperacute inflammatory presentation is very rare. Any parent who sees their child become seriously unwell quickly need to seek urgent medical advice. There are a variety of possible signs which include any unusual rash on the mouth, hands and feet, and needs to be reviewed medically. Acute services are open and can safely see children. We do not yet know why some children respond this way.