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Covid-19: Interim Guidance on Medically Vulnerable Children

Trainee performing check up.

Guidelines published by the Faculty of Paediatrics and the National Clinical Programme for Paediatrics and Neonatology

Do children with underlying health problems need to cocoon during the COVID-19 pandemic?

The Faculty of Paediatrics at RCPI and the National Clinical Programme for Paediatrics and Neonatology have published interim guidance on medically vulnerable children during the COVID-19 pandemic. The guidelines are aimed at parents and healthcare professionals.

Many children have underlying health problems which may make them prone to more severe illness with any infection, so the question arises as to whether these children should be cocooned from SARS-CoV-2 infection. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the strain of coronavirus that causes coronavirus disease 2019 (COVID-19).

It is clear now that fortunately the vast majority of children who get SARS-CoV-2 infection do not develop severe illness. This also appears to be the case for children with underlying health problems.

Given current knowledge about COVID-19 disease in children, it is now difficult to justify cocooning in most children with underlying conditions. Long-term cocooning of children with complex medical needs is likely to adversely affect them and may outweigh the potential risk of infection.

However, the guidelines advise that for children with profound immunodeficiency (e.g. a very recent transplant) it is best that individual risk (including the possible necessity of avoiding school) should be discussed with the child's specialist team.

This document has been developed by Consultant Paediatricians across a variety of specialties to provide guidance and reassurance for parents and healthcare professionals caring for medically vulnerable children. Knowledge of COVID-19 disease in children continues to expand and as information comes to light, this guidance will be updated.

Interim Guidance on Medically Vulnerable Children

Published July 2020

Read advice and recommendations provided by the Faculty of Paediatrics and the National Clinical Programme for Paediatrics and Neonatology.