Needham Pediatrics | COVID-19 Guidelines & FAQ

The following guidelines represent the most recent recommendations for managing individuals with a positive COVID test, as well as identified as close contacts of people with COVID. The following guidelines are comprehensive and should answer most of your questions about COVID infection and COVID exposure. If you still have further questions after reading the information below, then you may call our office for further guidance.

POSITIVE COVID TEST

This guideline applies if you have tested positive for COVID (either by rapid antigen test or PCR test) regardless of your vaccination status:

• A positive antigen test (whether taken at home or in a clinic) does NOT need to be confirmed with a PCR test.

Guidelines:

1. Stay home for 5 days
2. If you have no symptoms or your symptoms are resolving after 5 days, you may leave your house.
3. Continue wearing a mask around others for an additional 5 days (this includes wearing a mask at home as well as outside of the home).
   • If unable to wear a mask (ie. young children), they must isolate at home for a total of 10 days
4. If you have a fever, continue to stay home until your fever has resolved for 24 hours without fever-reducing medications.
5. Please send your doctor a MyChart message informing us of a positive COVID test, along with the date of the test or symptom development. This way it can be documented correctly in your child’s chart.

Please note: the Dept of Elementary and Secondary Education (DESE) agrees with the above isolation guidelines (5 days at home, 5 days masked) and does not require a negative test to return to school.

Reasons to call the office for guidance:

1. Chest pain
2. Increased work of breathing/labored breathing
3. Concern for dehydration
4. Fever (>101) for more than 72 hours in a child younger than 2 years of age
5. Fever (>101) for more than 120 hours (5 days) in a child 2 years of age or older
6. You have another acute concern for your child and feel they need to be evaluated.

Athletics/Sports Clearance

1. This applies only to children 12 years of age and older
2. An office visit is required 10 days after symptoms developed if:
   • Greater than 4 days of fever >100.4 degrees
   • Greater than 7 days of muscle aches , chills, or extreme fatigue
   • Child had concerning breathing difficulties
   • Child experienced palpitations (heart beating in an unusual way / irregular heart beats),  chest pains or syncope (passing out).
   • Child was hospitalized.
3. For all others with asymptomatic or mild disease, you may call the office once out of isolation (see above) and a nurse will assist you in determining if you need to have a visit with your doctor.
   • This visit may be a virtual visit or an in-person visit, depending on the child’s medical history. Please note! Sports clearance involves a gradual return to play over the course of a few days. This is for your child’s safety.
   • This applies if the child had less than 4 days of fever >100.4 and less than 7 days of muscle aches, chills or extreme fatigue.

CLOSE CONTACT OF INDIVIDUAL WITH COVID (FULLY VACCINATED)

 This guideline applies if you have been identified as a close contact of an individual with COVID and you have either:

• Received 3 doses of either Pfizer or Moderna vaccine
• Received 2 doses of the J&J vaccine (or 1 J&J and 1 Pfizer/Moderna) or
• Received 2 doses of either the Pfizer or Moderna vaccine within the last 6 months or
• Received the J&J vaccine within the last 2 months

Guidelines:

1. Wear a mask around others (including at home) for 10 days
   • If you cannot wear a mask, you must isolate at home for a total of 10 days
2. Test on day 5 (if possible): day zero is your last date of exposure
   • Negative rapid antigen tests should be confirmed with a PCR test
   • Positive rapid antigen tests are assumed to be positive and DO NOT need confirmation.
   • If you develop any symptoms, get a test and stay home.

CLOSE CONTACT OF INDIVIDUAL WITH COVID (NOT FULLY VACCINATED)

This guideline applies if you have been identified as a close contact of an individual with COVID and you have either:

• Received 2 doses of either Pfizer or Moderna vaccine over 6 months ago and have not been boosted
• Received 1 dose of the J&J vaccine over 2 months ago and are not boosted or
• Received 1 dose of either the Pfizer or Moderna vaccine or
• Have not received and Covid vaccines.

Guidelines:

1. Stay at home for 5 days. After that, continue to wear a mask around others for 5 additional days
   • If you are unable to wear a mask, you must isolate at home for a total of 10 days
2. Test on day 5 (if possible) with PCR as a preferred method of testing.
   • Negative rapid antigen tests should be confirmed with a PCR test
3. If you develop any symptoms, get a test and stay home.

CONTINUOUS EXPOSURE:

Please note that if your exposure is continuous and you are unable to separate from someone who has COVID, you are being exposed on a daily basis. This makes the quarantine period longer since your date of last exposure is constantly changing.

For example, if a parent tests positive and is unable to separate from a baby, the baby is therefore being exposed to COVID each day that the parent remains infectious (10 days, assuming mild symptoms). The baby needs an additional 10 days of quarantine starting when the parent is no longer assumed to be infectious. In this scenario, the baby should be tested 5 days after the parent is no longer infectious (day 15 after the parent’s diagnosis or symptom start) and the baby will need to be quarantined for a total of 20 days!