Children with special care needs in quarantine -instructions for parents/guardians

 It has been difficult for many of us to be separated from friends and relatives while in quarantine. It is possibly even more difficult for children, particularly young children, who do not really understand why we need these measures.

You can use the suggestions below as a basis, adapting the wording to what you think your children will understand. Please remember that children who usually move between homes should not do so while they or somebody in the home is in quarantine, as this increases the risk of infection. Circumstances differ from family to family, meaning that it may in practice be impossible to avoid this. However, every effort should be made to ensure that your child remains in one location and comes into contact with the bare minimum of people during quarantine. Quarantine does not last forever, and it will hopefully be possible to rebalance interaction and workload between homes once it is over.

Households with some people in quarantine and others not

  • If your children are not mature enough or are unable to comply with the measures required to ensure that certain members of the household can observe their quarantine, then the entire household must go into quarantine. Alternatively, those not in quarantine should remove themselves and stay elsewhere as soon as quarantine is imposed. For instance, one parent may be in quarantine with the child while the other parent is staying elsewhere. A parent with a child in quarantine does not need to be registered as being in quarantine and does not need to be tested in order to shorten their quarantine from 14 days to seven. Only the child needs to be registered as being in quarantine and be tested.
  • Children who are mature enough and able to take care of their own hygiene (e.g. separate bathroom facilities) and keep the appropriate distance from their quarantined parents (or other quarantined persons) and from their classmates may continue to attend school.
  • Parents of older children in quarantine after exposure at school or during leisure activities who are able to keep the appropriate distance from their children during quarantine may continue to work at their workplace if teleworking is not an option.

Some tips for explaining quarantine to children

• There are a lot of people who are ill right now (in the world/in Iceland).
• Some of the following, as appropriate:

    • Because we were abroad, we may have met somebody who was ill, and we need to take especially good care of ourselves and make sure that nobody falls ill after being with us.
    • Because we met ____________ just before (s)he fell ill, we need to take especially good care of ourselves and make sure that nobody falls ill after being with us.
    1. Because ____________ must not fall ill, we need to take especially good care of ourselves and make sure that nobody in our home meets anyone who is ill (protective quarantine).
  • If appropriate:
    • Everybody in our home is healthy/well. If we fall ill, we may need to take medicine to make us feel better (antipyretic painkillers such as paracetamol/ibuprofen), sneeze and cough into our elbows, immediately throw tissues that we use to blow our noses into the bin and wash our hands properly. We should not hug anybody who is ill. We should only hug ___________ while we are ill. Then we will get better and everything will be fine again soon.
    • OR Not everybody in our home is as healthy/well as the rest of us. If we fall ill, we have to take extra care not to go into ___________’s room, sneeze and cough into our elbows, immediately throw tissues that we use to blow our nose into the bin and wash our hands properly. We cannot hug anybody who is ill, and we should only hug ___________ while we are ill. Also, we may need to take medicine to make us feel better (antipyretic painkillers). If ___________ becomes very ill, (s)he/you may need help from a doctor or go to hospital to feel better.
    • There are lots of strange things going on at the moment because nobody wants to fall ill. That is why we cannot go to nursery school/school/sports/work as we usually do. Even though we are all together at home, we cannot do everything we want to do when we are on holiday. But there are still lots of fun things we can do, and things will soon be back to normal.

The following suggestions for spending time together at home were submitted to the Chief Epidemiologist by an imaginative mother in quarantine. Do not hesitate to add your own ideas to the list and share them with others:

  • Consider time together as a gift rather than an imposition.
  • Eat well. It is easy to order food online and have it delivered to your front door. However, if this is not possible, you may need help with shopping from friends and relatives.
  • Ask somebody to go to the library for you and borrow books and comics for the children. Remember to wipe down books and comics and put them into a bag 24 hours before returning them.
  • Ask somebody to go shopping for you and buy puzzles and/or other games appropriate for the age of your children or that can be played by the whole family. It makes a nice change from screen time.
  • Find time to exercise together at home. Children find it very funny to see adults doing gymnastics. Icelandic television (RÚV), various internet providers and some school PE teachers have given suggestions for exercises to do at home.
  • Change the beds and use your favourite bedclothes.
  • Let your children choose their parents’ clothes in the morning.
  • Build a tent in the living room using tables, blankets, etc. Make a packed lunch, dig out head lights and torches and other similar equipment and let your children sleep there overnight.
  • Take refreshing walks to have a change of surroundings and get out of the house.
  • If possible, spend time in the garden or on your balcony to play and get some fresh air.

Guardians also need to think about their own needs and spend quality time together or alone in these unusual and possibly frightening circumstances. This might be the opportunity to learn to cook your favourite meal, do some paintings from photographs, sort out your photo albums or watch that TV series that everybody has been raving about.

 Measures for quarantine in homes with special circumstances, such as illness or disability.

  • If at all possible and if another solution can be found, a person who is in quarantine should not be in the same home as an individual who has an illness or disability and does not need to be in quarantine. See also Instructions for persons at risk. Families may make the decision to keep the family together but should take every precaution to reduce the risk of infection in the event that their quarantine changes to isolation due to illness.
  • How should the quarantine of children who need the daily care of both parents/other guardians, such as due to illness or disability, be arranged?
    • It is not realistic in all cases that one parent undertake all care of a child in quarantine if others in the household need not be in quarantine. In such cases, both parents may need to be quarantined with the child.
    • If there are other children in the home who do not need as much care and have not been exposed, each family must assess whether it is realistic for such children to remain in the home (in quarantine or distanced from parents/guardians in quarantine) or whether it is possible for them to stay with relatives or friends while the home is under quarantine.
    • Parents with a child in quarantine do not need to be registered as being in quarantine and do not need to be tested in order to shorten their quarantine from 14 days to seven. Only the child needs to be registered as being in quarantine and be screened.
  • Hygiene in all care is important to minimise the risk of others in the home becoming infected. Children who need considerable care can be placed at great risk if a parent/guardian becomes seriously ill.
  • The virus can be transmitted with mucous/fluids from the airway/mouth by coughing or touch. It has been found in stools and urine although there are no recorded instances of infections by such means.
  • Use proper hand-cleaning measures before and after seeing to all the needs of the child. Soap and water are just as good as disinfectant.
  • When changing diapers, toilet assistance or bathing you should use disposable gloves and clean your hands before and after using the gloves. After toilet assistance and after changing diapers you should use soap and water to clean your hands and not only sanitiser.
  • Change neck cloths/handkerchiefs/wipes used to soak up saliva/mucous from airways. Collect such cloths into a container that is easy to empty into a washing machine and dispose of disposable wipes into a rubbish bag that is easy to close.
  • Minimise unnecessary touching of the child’s face and clean hands before and after touching the child’s face.
  • Try to avoid touching your own face, clean your hands first if you need to adjust your spectacles, scratch your nose (use a wipe) or otherwise touching your face. If the child touches you often, particularly your face, try to help your child to clean their hands regularly as well.
  • Remember to use the crook of your arm when sneezing/coughing rather than a handkerchief/paper towel.
  • Remember to clean your hands before preparing food, giving your child food or eating yourself.
  • Remember to clean your hands before taking care of other members of the household, including yourself.
  • Change clothes (take a shower if possible) if bodily fluids such as mucous/fluids from airways, vomit, urine or stools contaminate them. If this is not done as soon as possible after contamination, there is a risk of forgetting to do so.
  • Collect together the child’s clothes, towels and linen used for the child into a container that can be easily emptied into a washing machine or use (disposable) gloves to transfer such materials into the washing machine. Regular washing machine detergents destroy the virus even if the water used for washing is rather cold, there is no reason to change the normal wash cycle that you usually use for such materials.
  • What will happen to home assistance (medication administration, home nursing) if the service user is in quarantine?
    • While contact with persons in quarantine should be minimised it is vitally important that basic needs are met and that the safety of the child in question is ensured. A good idea is to examine how to reduce the number of people involved in the care of the child as much as possible without reducing the child’s safety. At the same time, carers must be able to rotate watches in order to rest. If a necessary carer enters the home, every effort must be made to ensure that such carer interact as little as possible with as few people in the home as possible and that the carer follows the same rules of conduct as household members.
    • Service providers have received instructions from the welfare department and the Chief Epidemiologist as regards how to protect themselves from infection while caring for individuals in quarantine or isolation due to illnesses caused by COVID-19. By employing the appropriate measures, such as hand-cleaning and, as appropriate, personal protection equipment, such services should continue.
    • Support families and others who assist the home but have not received the requisite training or who do not have access to personal protection equipment should suspend their involvement with the home or family members for the time being.
    • Under the present circumstances, it is a good idea to see if the home can be divided into independent sections, particularly if someone in the household needs to be in quarantine and cannot do so elsewhere. This ensures that fewer persons come into contact with the child. Try to turn the situation into a game and use smart devices to talk together if necessary.
    • Respite admissions and other multi-modal measures must take account of the greater good and may possibly be unable to accept persons in quarantine although solutions should always be discussed with the management of such organisations.

Fyrst birt 20.10.2020

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