COVID-19 information for children and young people

Last updated: 2 July 2020

The coronavirus crisis has been a worrying time, especially if you have a condition like arthritis.

The vast majority of COVID-19 cases among young people have not caused severe infections. This has also been true of young people with arthritis, regardless of what treatments they were on.

Below are some questions young people had. The answers were kindly provided by paediatric and adolescent rheumatology and ophthalmology healthcare professionals, with input from young people with arthritis.

This information is relevant to children and young people up to the age of 24.

How do I keep myself mentally and physically healthy in these uncertain times?

• Stay connected to your friends and family.
• Practice going out again and safely meeting friends, while following the advice about social distancing, good hygiene, and any other advice or instructions for the area you live. This is unless you have been advised to shield, but only a very small number of children and young people now need to shield.
• Try to maintain a daily routine. Having a good structure to your day and week can help reduce stress levels and give you a sense of control. Try to go to bed and get up at regular times as you would if you were going to school, college or work. Lie-ins are still fine at weekends!
• Regular exercise is so good for all of us both physically and mentally. Find something that you enjoy, such as walking, cycling or online exercise classes. Could you do this with a friend or relative? There are still lots of good ways to stay active.
• Try to achieve a set of goals in a day.

What do you know about how COVID-19 might affect young people with arthritis?

A lot is already known about how COVID-19 affects young people in general and we are continually learning more.

We know that being young is a good protection against this virus. The vast majority of young people who have had COVID-19 have recovered quickly without needing to go to hospital.

Less is known about young people who have a condition like arthritis. However, current evidence suggests there are still very few who get the serious complications that can occur in older people with COVID-19.

If you are interested in the research, papers can be found on the LitCovid website.

Could I have COVID-19 without realising it? And if so, could I pass it on to other people?

Yes, so it’s still very important to follow the guidance about social distancing and regularly washing your hands really well. There may be more specific advice or instructions for your local area.

What can I do to protect myself if someone in my household has COVID-19?

The person with COVID-19 will need to shield themselves from the rest of the household as much as possible.

Follow the advice that is being issued to the general public as much as possible, including:

• everyone in the house washing their hands regularly and well
• if you can use separate bathrooms and toilets from the person who is unwell
• keep toilets and bathrooms in the house as clean as possible.

There is more advice from Public Health England.

Is it safe to continue taking my immune-suppressing medication?

Yes, if you stop any medication you may be more at risk of a flare-up of your arthritis. And if this happens you may need to take steroids or increase your dose of steroids if you’re already taking them. This could put you at more risk of the virus.

People taking steroids of a certain dose have been advised to take special care. Talk to your rheumatology team if you’re not sure if this applies to you. It’s really important that you do not stop taking steroids or change the dose without talking to your healthcare professionals first, because this could be dangerous.

I’ve been told to have my medication as an injection, when I normally have it as an infusion. Is there any help I can have with this?

Your rheumatology team will let you know what support is available.

Many young people feel happy to give themselves injections once they have been shown how to do it. Another option is to have a family member give you the injection.

If you’re struggling, contact your rheumatology team for help.

My joint injections have been cancelled. How long will I have to wait for these to be rescheduled and what should I do in the meantime?

This is a difficult question to answer, as it may vary between hospitals.

If possible, you may be asked if you want a steroid injection without a general anaesthetic to put you to sleep. This won’t be possible at every hospital.

You might be asked if you’d like to take a short dose of steroid tablets to help treat your condition instead of an injection.

If I have steroid injections will I need to shield?

If that is the only change in your treatment and the rest of your condition is stable – no.

I am worried about going into hospital for appointments – will it be safe?

If you’re unwell and think you might need to be seen in a hospital, it’s important that you still go. People with COVID-19 are in different parts of hospitals to people who don’t have it.

However, many outpatient appointments are now being carried out over the phone or as video calls.

If someone from the hospital calls, make sure you have time to chat to them on your own – it’s still your appointment even if it’s on the phone or by a video call.

Have a think before-hand about what you want to say, how you’ve been feeling and any concerns you have. Make the most of the time you have and get the advice you need.

You could use the Arthritis Tracker before and during appointments as a reminder of what symptoms you’ve had. And you could show your healthcare team your summary.

Your rheumatology team will be able to decide if you need to go into hospital to see them, depending on how you’re feeling.

Please don’t go into hospital if you or anyone in your household has symptoms of COVID-19, or if you have had contact with someone who has symptoms. If this is the case get in touch with your rheumatology team before your appointment, so they can talk to you about what should happen. It’s likely they’ll offer you an appointment on a different day.

If you do go into hospital, you might be asked to have a swab test before-hand, have your temperature taken and wear a mask.

What should I do if I have a flare-up?

Contact your rheumatology team for advice, they will always be there to support you.

I am concerned about eye checks. How can I make sure my uveitis is well controlled?

You should be aware of any signs or symptoms of uveitis, especially now if you’re not having your eyes checked. Symptoms include:

• redness in the whites of your eyes near the coloured part of your eye, known as the iris
• difficulty looking at light
• changes to the appearance of your iris or your pupils
• blurry vision.

If you have any of those symptoms, get in touch with your rheumatology team.

Opticians are starting to open again and you may be able to ask them for advice – particularly if you have seen them before and they know your history. But, not all opticians are trained to monitor for uveitis.

It will be ok to postpone an upcoming eye check if all the following are true for you:

• you’ve had an eye check in the past
• you’ve never had uveitis
• you take methotrexate or adalimumab, or both together – as these drugs can treat uveitis.

If you have uveitis that’s being treated and is under control you will be able to have check-ups with your healthcare team on a phone or video call. By well controlled we mean:

• you haven’t had any signs or symptoms of uveitis or troubles with your eyes recently
• you don’t take more than one dose of eye drops a day
• you haven’t noticed any changes to or problems with your vision.

You’ll be asked to come into the eye clinic for an appointment if:

• your uveitis is still causing symptoms
• you’ve only recently been diagnosed with JIA
• you haven’t ever had an eye check
• you have recently stopped taking adalimumab or methotrexate.

If you have any questions or concerns about your eyes, get in touch with your rheumatology department.

I’ve been told I can wait longer before having blood tests again. Is this ok and how long is too long between blood tests?

If the results of your previous blood tests have been normal, they can now be done less often.

Once blood tests are stable, it’s usually safe for them to be carried out every three months.

If there have been problems with your blood tests before and you’re being monitored by your rheumatology team, they’ll be able to tell you how often you’ll need to have blood tests.

If your GP prescribes you methotrexate and does the blood tests, your rheumatology team can advise your GP how often blood tests need to be done.

What should I do if I get ill with COVID-19?

Get in touch with your rheumatology team to let them know you’re unwell. They will tell you what to do with your medication.

Your medication will be managed in the same way it would be if you become unwell at any other time. If you have a fever, it’s likely you’ll be told to stop your medicines (apart from steroids), until you’ve recovered.

It’s important you do not stop or change any medication before talking to a healthcare professional.

If you are concerned about yourself call for emergency help as you would do normally.

For the latest guidance about coronavirus, visit the Gov UK website.

I originally had a shielding letter – what do I do if I get another one?

As we’ve learned more about this virus throughout the pandemic, we now know that even fewer young people will need to be shielded. Many of the young people who were previously advised to shield, will not need a new shielding letter.

A few young people will still need to shield, so if you’re unsure or if you have any concerns, please get in touch with your rheumatology team.

You can check the shielding advice for children and young people on the Royal College of Paediatrics and Child Health website.

There is shielding advice for adults on the Gov UK website.

The risk to young adults is significantly less than it is for older adults so if in doubt, please discuss with your adult rheumatologist, specifically asking them about the risk for your age group.

I have got very stiff in my muscles and joints due to the limited exercise I have had in the lockdown. What can I do to help myself?

The first thing to do is chat with your rheumatology team in case it’s a flare in your condition. However, stiffness can be due to lack of exercise and movement, and some simple physio exercises can help with this. Your physio team can help direct you to suitable and specific exercises. We have some exercises you can do at home.

The NHS website has a video from a Pilates instructor showing how people with arthritis can do a work out.

For more inspiration on ways to get moving at home go to the We are Undefeatable website. They have ideas ranging from chair exercises, yoga to dancing in your kitchen.

I’m excited, but a bit nervous about going back to school, college or university. What would you advise?

You will not be alone in feeling nervous. 2020 is proving so very strange for us all. But it is great you are excited as physical attendance at schools and colleges is the best situation for the health and wellbeing of all young people like yourself. 

Maybe test the water by going out with a few friends practising safe social distancing as advised. The more you do it the easier it will be.

When you do go back, if you are still worried talk to a friend, teacher or a family member – don’t keep it to yourself.

At university be sure to get in touch with the disability student support services as they are likely to be particularly helpful.

When I go back to school, college or work, how can I prevent passing on coronavirus, if I happen to have it, but don’t have any symptoms?

The main things you can do is keep to social distancing guidance and regularly wash your hands thoroughly. There's more guidance on the Gov UK website. This was written by young people, for young people.

Also:

• When you get home take your shoes off and leave them by the front door.
• Leave anything like an ID badge or lanyard in a bag and don’t take them out at home.
• Keep your bag, or anything else that you take to school or college, away and out of anyone else’s reach.
• Change your clothes and if you can, put them in the wash.
• If you can, have a quick shower.
• And finally, wipe down your mobile phone case with anti-bacterial wipes and hand sanitiser.

If you have anyone else in the family who has to go out to work, it would help if they followed this advice too. For more information and advice on helping to stop the spread of coronavirus visit the Germ Defence website, which was put together by researchers in Southampton, Bath and Bristol.

Should I wear a mask?

Masks protect other people, rather than the people who are wearing them. But with that logic, if everyone wore a mask when out in public, this would lead to greater protection for everyone.

Face coverings of some kind like scarves are increasingly being recommended for everyone in places where social distancing is difficult, such as public transport and shops.

It’s important that any covering, such as a scarf or a face mask, is worn properly over the nose and mouth and that you do not touch the front of them – as it could have the virus there.

You need to wash your hands before and after taking off masks.

It’s important to dispose of single use masks carefully. Remember to wash scarves after each use.

Should I return to work? If not, what information will I need to give my employer?

This will depend on several things, such as what condition you have, what treatment you are on and what job you are doing. The best thing to do is to have a chat with your rheumatology team.

We would encourage people to return to work where possible if they’re not shielding as long as your workplace can encourage social distancing.

If you are in the very vulnerable shielding group and your work involves a risk of being in contact with people with coronavirus your healthcare team may be able to provide a letter to support working from home.

See our COVID-19 employment and work information.

If you’re feeling isolated from family and friends during these uncertain times, we’re here for you. 

• If you would like to talk to someone, you can call our free helpline on 0800 5200 520 (Monday to Friday, 9am to 8pm).
• If you’re over 18, you can join our young people’s forum on our online community to chat to others like you.
• Check out our Arthritis Tracker app to track your symptoms from pain, fatigue and emotional wellbeing. Download for free iPhone on the Apple App Store and for Android on Google Play. 
• Stay in touch and follow us on Twitter, Facebook and Instagram.
• Find out more about the support and events for young people and families available in your area.

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If you have a bit of time and want to get involved in some opportunities for young people with arthritis check out Your Rheum or check what's happening in your area for young people.