Parents normalize children’s symptoms to discount COVID-19, study finds

Parents normalize children’s symptoms to discount COVID-19, study finds

By Angela Betsaida B. Laguipo, BSNNov 10 2020

The current coronavirus disease 2019 (COVID-19) pandemic continues to spread across the globe, with a resurgence in new cases being reported in many countries.

Overall, the COVID-19 case toll has surpassed 51.37 million, with more than 1.27 million deaths. These numbers are expected to rise further over the coming weeks as the Northern Hemisphere heads into winter. Though the elderly and those with underlying health problems are at a higher risk of developing severe illness, children and young adults are considered superspreaders since most of them experience mild to no symptoms of COVID-19.

A new study by researchers from King's College London explores parental perceptions of COVID-19-like symptoms in their children and attitudes towards isolating them from others in the household when they are feeling unwell.

The team has found that parents appeared to resort to finding the most likely reason for the experience of symptoms, discounting COVID-19 if a more likely explanation was apparent. This means that they tend to normalize symptoms to reduce the perceived risk and intention to isolate.

Study: Parental perceptions of COVID-19-like illness in their children. Image Credit: George Rudy / Shutterstock

The study

In the study, published as a pre-print on the medRxiv* server, the researchers used data from interviews that examined parents' perceptions of COVID-19-like symptoms in their children. Also, they were asked about what they think about isolating themselves when they are feeling sick.

Overall, there were 30 semi-structured telephone interviews with parents of children between 4 and 18 years old. The participants were either the parents or the primary caregiver to a child who did not attend school in England due to the pandemic.

During the interview, the recognized COVID-19 symptoms included persistent cough and fever. By May, other symptoms were added, like loss of taste and smell.

Normalizing symptoms

The study findings include four themes relating to symptom attribution – "normalizing symptoms," "err on the side of caution," "experience of temperature," and "symptoms not normal for us."

The team found that parents were more likely to attribute symptoms of COVID-19 if a temperature elevation was present or the symptoms were unusual for their family. Symptoms were also normalized to reduce the perceived risk and intention to isolate. When symptoms were mild, they tended to worry less.

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In terms of self-isolation, four themes were also observed, which included "difficult to prevent contact with children," isolation would be no different to lockdown life," "limited space," and "ability to get food and supplies."

The parents believe it would be hard to isolate themselves from others in the household, especially their children. They also expressed their concern for their small children, who do not understand the boundaries needed when isolation is in place.

Further, some parents said that it would be hard to isolate themselves since they need to get food and supplies for the family. Lastly, parents said that isolation is hard in small spaces like apartments, particularly if they share rooms with other family members. Plus, those with more family members living in the household may find it hard to implement isolation measures.

"Our findings also suggest that larger families and those living in smaller homes may find it particularly difficult to isolate. Indeed, research suggests that households with dependent children are less likely to adhere to self-isolation than those without children," the researchers wrote in the paper.

"Parents who reported that they could rely on someone for help with food shopping were more likely to think they could isolate. This is in line with previous research. We suggest that aiding families with grocery shopping may be a practical route to facilitating adherence to isolation," they added.

The research highlights complexities in symptom perception, attribution, and household isolation. The researchers suggest these challenges can be overcome by providing better guidance on what symptoms require action, how to prevent infection within the household, and assisting families with grocery shopping through future infection waves.

Surging cases

Many parts of the world are entering second waves of the pandemic,  reporting tens of thousands of cases each day. Like the United Kingdom, Italy, and Belgium, many parts of Europe have already reimposed nationwide lockdowns to try and control the spread of the virus, and others may follow.

The United States remains the country with the highest COVID-19 cases, topping 10.24 million cases. India and Brazil follow with more than 8.59 million and 5.69 million cases, respectively.

Globally, more than 51.37 million people have been infected with SARS-CoV-2, and more than 1.27 million have died.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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