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Advice and information for children and adolescents
Children seem less likely to become infected or ill
The Norwegian Institute of Public Health monitors knowledge about the role of children in the spread of COVID-19. In December 2020, the European Centre for Disease Control (ECDC) published a summary and assessment of available knowledge:
The combined knowledge indicates that:
- Children of primary school age and younger are less likely to become sick from coronavirus. When they become ill, they usually have milder symptoms and a mild disease course.
- Children can be infected and have symptoms, but to a lesser degree than adults. Since they have fewer symptoms than adults, it is assumed that they are less contagious.
- It is rare that they infect other children or adults outside their household. This is supported by findings from the Norwegian Corona Child Study.
- Transmission in schools and childcare centres contributes only to a small extent in the spread of COVID-19 in the society. The start of the school year in August does not appear to be the cause of the second wave of COVID-19 seen from October 2020.
Adolescents (teenagers) are probably more contagious than children because they get more symptoms when infected with COVID-19. Adolescents may also have a lifestyle that increases the risk of transmission, such as a larger and more geographically dispersed network of contacts, the need for close contact with peers, as well as pandemic fatigue. Their ability to infect others appears to increase gradually until adulthood.
Some countries have reported an inflammatory condition after COVID-19 among children and adolescents, known as MIS-C (multi inflammatory syndrome in children) or PIMS (paediatric inflammatory multisystem syndrome temporarily associated with COVID-19). The condition is rare, but serious. The NIPH has been notified about 5-10 children in Norway with this condition (January 2021). When treated for this syndrome the prognosis is good.
For more information on COVID-19 symptoms in children and adolescents, see Facts about the virus and COVID-19 disease.
In December 2020, a new variant of the coronavirus was detected in the United Kingdom. Initially, questions were raised as to whether children and young people had a greater role in the spread of the English virus variant. Recent reports show, however, that the gender and age distribution of the new variant appears to be similar to other variants. Public Health England have reported that there seems to be a lower transmission among children than adults, about half as contagious in the age group under 10 years compared to adults.
Children with chronic diseases have a low risk of severe COVID-19 disease
Based on current knowledge, there appears to be a very low risk of severe COVID-19 disease among children and adolescents in general, but also among children and adolescents with chronic diseases or conditions. For more information about these groups, see:
- Norsk barnelegeforening - Norwegian Paediatric Society (in Norwegian)
Should children and adolescents be vaccinated with coronavirus vaccines?
The vaccines that are now available are approved for use from 18 years and older, with the exception of the BioNTech and Pfizer vaccine that is approved from 16 years.
For children and adolescents, the risk of severe COVID-19 disease is low, even with chronic underlying disease. However, vaccination of adolescents is possible with the BioNTech and Pfizer vaccine, which is approved from the age of 16 and can be used in adolescents with a high risk of serious illness.
If you are worried about your sick child or adolescent
In most cases, children / adolescents who are sick do not have COVID-19, but have another infection or condition that requires assessment and treatment. If you are worried about your child or adolescent, contact the health service to see if they should be assessed by a doctor. Do not delay seeking medical attention due to concerns about being infected with COVID-19.
In general, the younger the child is, the lower the threshold should be for contacting a doctor. As a general rule, this applies to children who are 2 years and younger, especially children aged 0–6 months. Other reasons to contact a doctor are when the child/ adolescent has:
- poor general condition (the child / adolescent is lethargic and feeling unwell)
- difficulty breathing and / or breathing faster than usual when resting
- fever combined with respiratory tract symptoms and / or poor general condition
When shall children with respiratory tract symptoms stay at home?
If the child has had symptoms of respiratory tract infection in the last 24 hours (newly arisen), the child should be kept at home, especially if the child has several symptoms at the same time or has a reduced general condition. Children with newly arisen symptoms of respiratory tract infection should be tested, in consultation with their parents. In order for children to experience the sampling as less uncomfortable, the sample can be taken in the front part of the nose or from the throat.
Children of primary school and childcare age who only have a runny nose and are otherwise in good form with no other signs of a new respiratory tract infection do not need to stay at home or be tested.
Although we recommend liberal testing of children as well, testing is not compulsory and must always be performed in consultation with parents. If the child is not tested and there is no strong suspicion of COVID-19 (for example, where there are no other people around the child who have tested positive for COVID-19), the same recommendations apply as for other respiratory tract infections - i.e., the child should be kept at home until they are back to normal and considered to be well.
When can the child return to childcare or school?
If the child has developed symptoms of respiratory tract infection during the last 24 hours and has been tested for COVID-19, the test result must be available before the child can return to childcare / school, regardless of whether the child no longer has symptoms. Everyone who is diagnosed with COVID-19 must be in isolation and will be followed up by the healthcare service in the municipality.
The child's general health condition determines when they can return to childcare/ school after recovery from a respiratory tract infection. This applies even if the child still has some residual symptoms such as a runny nose (regardless of the colour and consistency of the mucus/ snot) or a cough. Such symptoms are common after a respiratory tract infection among younger children.
As long as the residual symptoms can be linked to a completed infection, and are not newly arisen or increasing, the child can return to childcare / school when the general condition is good or back to normal. The child can return to childcare / school even if others in the family have respiratory tract symptoms. If others in the family have been diagnosed with COVID-19, the child must be quarantined and followed up by the healthcare service in the municipality.
Symptoms of COVID-19 can be difficult to distinguish from allergies. This applies, for example, to a stuffy / runny nose and sneezing. If you are in doubt about whether the symptoms are due to a recent respiratory tract infection or allergy, testing is recommended. Children with known allergies where the symptoms are recognised as allergy problems can go back to childcare / school.
When should adolescents with respiratory tract symptoms stay at home?
For adolescents with COVID-19 the symptoms resemble those in adults, especially for older adolescents. Adolescents who have developed symptoms of respiratory tract infection in the past 24 hours should stay home from school and contact the local testing centre to be tested for COVID-19. This also applies to adolescents with mild symptoms.
Adolescents with known allergies where symptoms are recognised as allergy problems can go to school as normal
Children staying in several homes
Many children have several homes. Most often, these are children with guardians who have two different households after a break-up, but they can also be children and adolescents who have different forms of relief families or have part-time stays in care homes.
The main rule is that planned meetings can be maintained as agreed. This also applies where the UK virus variant has been detected in the local community.
Care for children when several people in the household are ill
It is important that the child's need for care is taken care of, even if the guardian has COVID-19. Similarly, if the child has COVID-19, they must receive adequate care and attention from parents or others, even though this may mean that it is not possible to keep a distance. If caregivers are ill and unable to care for children for whom they are responsible, the municipal health services must be informed to implement relief from child welfare or others, as in other situations where caregivers are ill.
Follow-up at public health clinics and school health service
The municipalities should ensure that health services offered to children and adolescents are adequate. It is recommended that the health station and school health services maintain normal activity in line with national professional guidelines and necessary infection control measures.
For more information about the public health clinics and school health services, see the Norwegian Directorate of Health's website Helsestasjon, svangerskapsomsorg og skolehelsetjeneste and your municipality's website or contact the municipality for updated information.
Childcare centres, schools and after-school programmes
The Norwegian Institute of Public Health and the Directorate of Education and Training have prepared infection control guidelines for childcare centres, schools and after-school programmes. The guidelines describe measures to reduce transmission and provide advice and support to ensure good infection control for staff, children and adolescents.
For information about infection control measures in childcare centres and schools, as well as advice on end-of-term activities and events, see:
Play, social contact and events
Limit the number of guests that are present at the same time. This applies to both indoor and outdoor gatherings for both children and adults. The risk of transmission is lower outdoors than indoors, and when playing in small groups.
The general infection control measures apply when children, adolescents and adults are together in leisure time:
- Sick people should stay at home, or go home if they develop symptoms
- Good hand hygiene and cough etiquette
- Limit contact between individuals that do not live in the same household
The current recommendations and guidelines for the number of people who can gather in private gatherings and at public events (for example when the school arranges a gathering) can be found on NIPH's page about Events, gatherings and activities. The municipalities can also introduce stricter measures locally due to the infection situation both for private gatherings and for events. See your municipality's website for information on local measures.
Play and social contact in their leisure time should first and foremost be with children who are in the same group in childcare centres / school / organised leisure activities. Outside these groups, children can also play with a few close friends, preferably from the same local environment.
- Children who play together do not have to keep a distance. This applies to children who are already together at school and in sports, or others who are considered the child's close friends.
- Children should keep their distance from other children who are not in these groups.
- Adults who accompany children to activities and play should keep their distance from other children and adults.
- If an adult is responsible for a child outside their own household, the recommendation to keep a distance must be weighed up against whether the child needs to be comforted or helped.
- Children can have friends for sleepovers if everyone is well and the guests are among the same close contacts as in school and leisure time. Other members of the family should try to keep a distance from the guests.
Adolescents can also have a few friends / contacts that they do not need to keep their distance from, and who are considered to be their close contacts. They should be the same over time. They should keep at least one metre away from others who are not close contacts.
Birthday parties and other celebrations
For birthdays and other celebrations in or outside the home, limit the number according to th current advice and guidelines for events. Both children and adults are included. It may be necessary to split a class in two to ensure that not too many children and adults are present at the same time.
If possible, guardians of invited children should not go inside. If this is necessary for some children, the guardian should keep a safe distance from other children and adults and follow normal infection control advice.
Remember clean hands for everyone, especially when food is served.
Organised leisure activities and importance for children and adolescents
Leisure activities are important for the physical and mental well-being of children and adolescents. The outbreak has lasted for a long time and it is uncertain how long it is necessary to have strict infection control measures. It is therefore of great importance that children and adolescents can engage in leisure activities in a safe way that will reduce the risk of infection.
Where there is a need for strict infection control measures, try to maintain some activity as long as possible.
For many children and adolescents, participation in leisure activities can be of great importance, because the setting is a safe and familiar arena that can be an important point in a difficult everyday life. It is especially important to be aware of vulnerable children and adolescents, including those who under normal circumstances would not have been exposed, but who have become so as a consequence of the pandemic.
The pandemic may have changed participation in leisure activities. Instructors / leaders should be aware of dropouts from organised leisure activities, and if there are some children who have not participated in the activity for a while, the association can contact parents to look at possible solutions for participation.
Activities of longer duration
For more information and recommendations regarding activities of longer duration for children and adolescents, such as summer schools, camps etc., see:
Information for the general public
Information helpline for questions about coronavirus: 815 55 015 (weekdays 08-15.30)
The Norwegian Directorate of Immigration has answers to many frequently asked questions about travelling to Norway, and a helpline 23351600 that is open on weekdays from 10:00-14:00.
The Ministry of Foreign Affairs also has answers to many frequently asked questions.
If you need acute medical attention, contact your doctor. If you cannot reach your doctor, contact the emergency out-of-hours clinic on 116117. If life is in danger, call 113.
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SARS-CoV-2 is the name of the virus that is causing the outbreak of COVID-19 disease.
The virus is related to another coronavirus that caused the SARS outbreak in 2002/2003 but is not the same virus.