Coronavirus (COVID-19) Exposure

Is this your child's symptom?

  • Exposure (Close Contact) to a person with confirmed or suspected COVID-19. Confirmed patients have a positive COVID-19 lab test. Suspected patients are those whom a doctor suspects of having COVID-19, based on symptoms and exposure (CDC definition).
  • Exposure includes travel from other areas where there is major community spread.
  • If an exposed person has no symptoms of COVID-19, they need quarantine and monitoring at home to see if they develop any symptoms.
  • If an exposed person gets symptoms of COVID-19, they may need to be seen for testing. Reason: flu and other viruses can cause similar symptoms. Testing is the only way to tell what you have. Your doctor will decide if testing would be helpful.
  • Updated Guide version: 3/30/2020
  • Author: Bart Schmitt MD, FAAP

Exposure to COVID-19: Definition per CDC

  1. Criteria for COVID-19 Exposure: Close Contact
    • The risk for getting COVID-19 requires one of the following:
    • Close contact with a person who tested positive for COVID-19 AND contact occurred while they were ill.
    • Close contact with a person who is under investigation for COVID-19 AND contact occurred while they were ill.
    • You will not need COVID-19 testing unless you develop a fever or cough.
  2. Travel from or Living in High-Risk Area (Hot Spot) - as identified by CDC or your state health department
    • Living in or traveling from a city, country or other geographic area where there is documented community spread of COVID-19. This carries a lower risk compared to close contact.
    • However, it does increase the risk of having close contact with a COVID-19 sick patient without knowing it.
    • You will not need COVID-19 testing unless you develop a fever or cough.
  3. Exposure to COVID-19: Levels of Risk
    • Household Close Contact. Lives with a person who tested positive for COVID-19. This carries the highest risk of transmitting the infection.
    • Other Close Contact. The CDC defines 6 feet as how far coughing can spread the virus. How long the close contact lasts can also be important. Prolonged close contact is defined as more that 10 minutes. Close contact includes kissing, hugging or sharing eating and drinking utensils. It also includes close conversations. Direct contact with secretions with a person with COVID-19 is also close contact. Includes being in the same childcare room, classroom or carpool. These exposures are usually lower risk than living with an infected person.
    • In Same Building - Low Risk Exposure. Being in the same school, place or worship, workplace or building carries a small risk for exposure.
    • In Same City - Low Risk Exposure. Living in or traveling from a city or country where there is major community spread of COVID-19, also carries a small risk. These "hot spots" are identified by the CDC at Coronavirus. Outdoor contacts are much safer than indoor contacts.

COVID-19 Disease: Frequently Asked Questions

  1. Trusted Sources for Accurate Information: CDC and AAP
    • Nurse call centers and doctors' offices are overloaded with calls. They need to keep their lines open for sick patients.
    • To meet the extreme demand for COVID-19 information, when possible, find your answers online. Here are the most reliable websites:
    • Nurse advice lines and medical call centers are needed for sick patient calls.
  2. COVID-19 Outbreak:
    • An outbreak of this infection began in Wuhan, China in early December 2019.
    • The first COVID-19 patient in the United States was reported on January 21, 2020. During March 2020, cases were reported in all states.
    • The first COVID-19 patient in Canada was reported January 31, 2020.
    • The World Health Organization (WHO) declared COVID-19 a global pandemic.
  3. COVID-19 Symptoms:
    • This COVID-19 coronavirus causes a respiratory illness. The most common symptoms are fever, cough and shortness of breath.
    • Less common symptoms are body aches, chills, diarrhea, headache, runny nose and sore throat.
  4. COVID-19 - CDC Definition of Exposure (Close Contact):
    • You are at risk of getting COVID-19 if the following has occurred:
    • Close contact with a person who tested positive for COVID-19 AND contact occurred while they were ill.
    • Living in or traveling from a city, country or other geographic area where there is documented community spread of COVID-19. This carries a lower risk compared to close contact if one observes social distancing.
    • Community spread is occuring in most of the US, especially in cities.
    • The CDC has the most up-to-date list of where outbreaks are occurring: Coronavirus.
    • COVID-19 - How it is Spread:
      • COVID-19 is spread from person to person.
      • The virus spreads when respiratory droplets are produced when a person coughs or sneezes. The infected droplets can then be inhaled by a nearby person or land on the surface of their eyes.
      • Most infected people also have respiratory secretions on their hands. These secretions get transferred to healthy people on doorknobs, faucet handles, etc. The virus then gets transferred to healthy people when they touch their face or rub their eyes.
      • These are how most respiratory viruses spread.
      • Reports from China suggest that the initial coronavirus (COVID-19) cases were spread from animals (probably bats) to humans.
    • COVID-19 - Travel:
      • Avoid all non-essential travel.
      • If you must travel, go to the CDC website for updates on travel advisories: Travelers.
    • Other COVID-19 Facts:
      • Incubation period: average 5 days (range 2 to 14 days) after coming in contact with, or the secretions of, a person who has COVID-19.
      • Expected course of infection: 80% have a mild illness, much like normal flu or a bad cold. The symptoms usually last 2 weeks.
      • No symptom patients: an unknown percentage of infected patients have no symptoms.
      • Complications: 20% have a more severe illness with trouble breathing from viral pneumonia. Many of these need to be admitted to the hospital. People with complications generally recover in 3 to 6 weeks.
      • Death rate: currently estimated at 0.5 to 2% (CDC) of all infected patients. Children generally have a mild illness. Deaths in children or teens are very rare. Older adults, especially those with chronic lung disease or weak immune systems, have the highest death rates.
      • Vaccine: there is currently no vaccine to prevent COVID-19. Many labs are working on developing a vaccine, but that will take at least a year.
      • Treatment: currently, there is no effective anti-viral medicine for coronavirus. Treatment is supportive. Oxygen and IV fluids are used for hospitalized patients.
    • Concerns About Positive Lab Test for the Common Coronavirus that Causes Colds:
      • There are many strains of coronaviruses. Most of them cause the common cold.
      • Older viral respiratory panels only tested for the "common" coronavirus.
      • Common coronavirus strains usually don't cause serious illness in healthy children.

    When to Call for Coronavirus (COVID-19) Exposure

    Call 911 Now

    • Severe trouble breathing (struggling for each breath, can barely speak)
    • Bluish lips or face
    • You think your child has a life-threatening emergency

    Call Doctor or Seek Care Now

    • Trouble breathing occurs, but not severe (such as tight breathing, fast breathing or shortness of breath at rest)
    • You think your child is very sick and needs to be seen urgently

    Self Care at Home

    • Close contact with COVID-19 patient more than 14 days ago AND NO cough, fever or trouble breathing. You can stop quarantine.
    • COVID-19 exposure, but no symptoms: home care instructions
    • Questions about COVID-19 testing
    • Questions about COVID-19 prevention

    Seattle Children's Urgent Care Locations

    If your child’s illness or injury is life-threatening, call 911.

    Care Advice

    COVID-19 Exposure, but NO Symptoms

    1. Exposure and No Symptoms
      • Although you may have been exposed to COVID-19, you do not currently have any symptoms. COVID-19 symptoms start, on the average, 5 days after the last exposure. The onset can range from 2 to 14 days.
      • Since it's been less than 14 days, you are still at risk for coming down with COVID-19.
      • You need to watch for symptoms until 14 days have passed.
      • Stay at home and follow this medical advice.
    2. You Do Not Need to Contact Your Doctor
      • You do not have any symptoms.
      • You do not need to call your doctor unless you become sick.
      • Doctor's offices, health departments and nurse advice lines have become overwhelmed with calls about sick patients.
      • You can find the answers to most of your questions here or online.
    3. Measure Temperature
      • Measure your temperature 2 times each day. Do this for 14 days after your exposure to COVID-19.
      • Report any fevers or respiratory symptoms to your doctor.
      • Early detection of symptoms and quarantine is the only way to reduce spread of the disease.
    4. Home Quarantine: How to Do
      • Quarantine means restricting people who were exposed to a contagious disease from contact with others who are well.
      • The level of quarantine needed for an exposed person who has no symptoms, may depend on the degree of exposure. For now:
        • Stay at home.
        • Do Not allow any visitors (such as friends).
        • Do Not go to school or work.
        • Do Not go to stores, restaurants, places of worship or other public places.
        • Avoid public transportation or ride sharing.
        • Other family members are not on quarantine unless the exposed person becomes sick.
    5. Call Your Doctor If:
      • Fever occurs
      • Cough or trouble breathing occurs

    Testing for COVID-19: Who, How, Where and When

    1. COVID-19 Testing: Who Needs It
      • Tests for COVID-19 are only done on people who are sick (have a fever OR cough) AND also have a health history that puts them at risk for having COVID-19. See the criteria for exposure to COVID-19 in the Causes section.
      • As community spread increases, who needs testing may change.
      • Testing requires a doctor's order (as with all medical tests).
      • Testing is performed on fluid collected on a throat swab and/or nasal swab.
      • Swab specimens are then sent to a lab.
      • The results become available in 24 to 72 hours.
      • Until the results are known, the person needs to stay at home in quarantine.
      • Caution: testing is not done on exposed people who don't have symptoms.
    2. Testing Sites for Specimen Collection
      • Swabs of the throat and/or nose will only be collected on people who have a doctor's order.
      • People cannot walk in and request a COVID-19 test.
      • Specimen collection sites vary from city to city. Your local health department may operate drive-through sites.
      • In general, they are not done in medical offices or clinics.
      • If you are sent to have a COVID-19 test done, go to the site recommended by your local health department, nurse advice line, or primary care provider.
      • Caution: don't go to an ER, other health facility or testing site without a doctor's order. If you do, you will not receive a test. And you may be exposed to patients who have COVID-19.
    3. Seeking Testing or Medical Care: How to Do It Safely
      • Your doctor or nurse will tell you where to go and when.
      • For trouble breathing or other serious symptoms, they will refer you to an ER or urgent care center.
      • For mild symptoms, they may refer you to a testing site. Testing is only available at special sites.
      • The best site for testing may depend on your local health resources.
      • Most doctor's offices and clinics do not provide testing.
    4. Call Ahead First, If Going to an ER or Other Medical Facility
      • Your doctor or nurse will do this, if they referred you.
      • If you are going to a medical facility without a referral, you must call ahead first.
      • Tell them you are bringing a person exposed to COVID-19 who now has symptoms (fever or cough). They may transfer your call to a doctor or triage nurse to help decide if you need testing. Often you will not.
      • Reason to call first: so healthcare workers can make plans to prevent the spread of COVID-19 to others. You don't want to be a "spreader."
      • They can also tell you the safest way to enter the medical facility.
    5. Announce Possible COVID Exposure When You Arrive:
      • Tell the first healthcare worker you meet that the patient may have been exposed to COVID-19.
      • Tell them the patient has been referred for COVID-19 testing because of symptoms. If you were referred to an ER, it will also be for a full medical exam.
    6. Cover Your Mouth and Nose - Wear a Mask
      • Cover the patient's mouth and nose with a disposable tissue (e.g., Kleenex or paper towel) or a washcloth.
      • Have the patient wear a disposable face mask if you have one.
      • Ask for a mask when you arrive.

    COVID-19 Prevention

    1. COVID-19: How to Protect Yourself and Family from Catching It:
      • Avoid any contact with people known to have COVID-19 infection. Avoid talking to or sitting close to them.
      • Social Distancing: try to stay at least 6 feet (2 meters) away from anyone who is sick, especially if they are coughing. Also called physical distancing. Avoid crowds, because you can’t tell who might be sick.
      • If COVID-19 becomes widespread in your community, try to stay 6 feet (2 meters) away from everyone outside your family unit.
      • Follow any stay at home (stay in place) orders in your community. Leave your home only for essential needs such as buying food or seeking medical care.
      • Wash hands often with soap and water (very important). Always do this before you eat.
      • Use an alcohol-based hand sanitizer if water is not available. Reason: soap and water work better.
      • Don't touch your eyes, nose or mouth unless your hands are clean. Germs on the hands can get into your body this way.
      • Do not share glasses, plates or eating utensils.
      • No longer shake hands. Greet others with a smile and a nod.
      • Avoid ERs and urgent care clinics if you don't need to go there. These are places where you are likely to be exposed to infections.
      • Masks: the CDC does not recommend wearing a face mask, unless you are sick.
    2. Keep Your Body Strong:
      • Get your body ready to fight the COVID-19 virus.
      • Get enough sleep (very important).
      • Keep your heart strong. Walk or exercise every day. Take the stairs. Caution: avoid physical exhaustion.
      • Stay well-hydrated.
      • Eat healthy meals. Avoid overeating to deal with your fears.
      • Avoid the over-use of anti-fever medicines. Fever fights infections and ramps up your immune system.
    3. Keep Your Mind Positive
      • Live in the present, not the future. The future is where your needless worries live. Stay positive.
      • Use a mantra to reduce your fears, such as "I am strong, like a bear."
      • Listen to peaceful, comforting music.
      • Go to a park if you live near one. Being in nature is good for your immune system.
      • Hug your family members frequently. Speak to them in a kind and loving voice. Love strengthens your immune system.
      • Use regular phone calls and video chats to stay in touch with those you love.
      • If community spread is very low where you live, the following normal social contacts can be considered:
        • Visits with family and close friends, as long as they are well and a small group.
        • Playdates with a few of your child’s close friends. Outdoor time is always best.
        • But if you worry about who might be coming down with illness, you will be choosing total isolation for your family, perhaps for months.
    4. How to Protect Others - Stay Home When Sick:
      • Stay home from school or work if you are sick. Your doctor or local health department will tell you when it is safe to return.
      • Cough and sneeze into your shirt sleeve or inner elbow. Don't cough into your hand or the air.
      • If available, sneeze into a tissue and throw it into a trash can.
      • Wash hands often with soap and water. After coughing or sneezing are important times.
      • Wear a face mask when around others.

    Online Resources

    1. Centers for Disease Control and Prevention (CDC): Coronavirus.
    2. World Health Organization (WHO): Coronavirus.
    3. American Academy of Pediatrics (AAP): at their parenting website

    And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

    Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

    Last Reviewed: 04/02/2020

    Last Revised: 04/02/2020

    Copyright 2000-2020 Schmitt Pediatric Guidelines LLC.