The purpose of a Self-care Guide

Your home is your primary care centre.

The purpose of this guide is to help you in taking the best decisions for your children during the coronavirus COVID‑19 pandemic.

This guide will enable you to:

  • Learn the best ways to protect yourself
  • Take care of your children
  • Learn the basic care to provide to your family
  • Learn when and whom to consult when you require care and services

Keep this guide at hand!

This guide is also available in French at: Québec.ca/coronavirus.

How can I stay informed?

Visit the government coronavirus website at: Québec.ca/coronavirus.

Pay attention to government notices and instructions as relayed by the media (television, newspapers, radio, Internet).

The information provided in this document is based on a situation that evolves rapidly. Changes could possibly occur.

The COVID-19 pandemic

Definition

COVID‑19 is a disease caused by the highly contagious coronavirus that affects the respiratory tract. It is transmitted from one person to another.

A pandemic occurs when a new virus spreads throughout the world. Since humans are not protected against the new virus, a greater number of people become sick.

Transmission of the virus

The coronavirus (COVID‑19) is very easily transmitted by tiny droplets that are expelled into the air when an infected person coughs or sneezes.

If the person covers their nose and mouth, the droplets will land in the crook of their elbow or on their upper arm, mask or homemade face covering, handkerchief or facial tissue.

We can become infected by the coronavirus (COVID‑19) when:

  • Our eyes, nose or mouth contact droplets from an infected person who coughs or sneezes
  • We touch a contaminated object or surface with our hands then touch our face

Symptoms develop on average from 5 to 7 days after contamination, but may appear over a 2-to-12-day period of time. To be prudent, at least 14 days of isolation is recommended (see, “Prevention, protection and health advice”).

Some people with no apparent symptoms or whose symptoms have not yet developed may unknowingly spread the virus. Children who have COVID‑19 often present few or no symptoms but can nevertheless transmit the disease. While observations lead us to believe that transmission occurs less frequently in children under the age of 10, precautions must still be taken to reduce the risk of the virus spreading.

Coronavirus propagates during close interpersonal contact.

Close contact can occur in a variety of circumstances, including:

  • Living in the same home as an infected person
  • Providing care to an infected person
  • Gathering in public places and attending meetings

Symptoms

If your child has a symptom from the following list, it is recommended that you keep him/her at home and have the symptoms assessed at Québec.ca/decisioncovid19, or call 1‑877‑644‑4545.

The following symptoms need to be monitored:

Fever

  • In children 0-5 years old: rectal temperature of at least 38.5°C (101.3 °F)
  • In children 6 years and older: oral temperature of at least 38.1°C (100.6 °F)

General

  • Sudden loss of sense of smell without nasal congestion, with or without loss of taste
  • Sore throat
  • Major fatigue
  • Major loss of appetite
  • Generalized muscle ache unrelated to physical effort

Respiratory

  • Cough (onset or worsening)
  • Stuffy or runny nose
  • Out of breath, difficulty breathing

Gastrointestinal

  • Vomiting
  • Diarrhea
  • Stomach aches and nausea

What should be done when your child has these symptoms?

Do not send the child to educational childcare services, school or daycare if:

  • You have been directed by your local public health authority to self-isolate at home (applies to your child and anyone with whom the child has been in contact)
  • There is a danger that in your view your child may be infected or has been in contact with a COVID‑19 case
  • You are quarantined after a trip outside Canada

If in doubt, evaluate the symptoms on Québec.ca/decisioncovid19 or call 1‑877‑644‑4545 right away and comply with the directives that you are given. Any sick child must remain in isolation at home until appropriates directives have been received.

For all other condition, that is in the absence of COVID‑19, the usual health criteria for attending educational childcare services, school and daycare apply. This means that children whose general state of health is good and who can carry out their usual activities can attend school or daycare centres and specifically, no child should be excluded because of a cold.

Prevention, protection and health advice

How to prevent and protect against a coronavirus (COVID‑19) infection

No vaccine for coronavirus (COVID‑19) or medicine to treat the disease, currently exist.

Prevention is the only way to protect yourself and protect others.

Avoid contact

Ensure physical distancing of two metres at all time—it’s the main way for you to protect your family and friends. However, for children under the age of 16, physical distancing of one metre applies. Physical distancing directives are different for school settings and only apply there.

It is also important to avoid hugging, shaking hands and kissing. Your child should avoid hugging visitors, particularly when they are deemed vulnerable to the virus.

Sharing toys by children is tolerated, even though avoiding this is preferable, especially since children often put toys in their mouth. Toys should be disinfected both before after use by a child. This means that using toys that are easily cleaned is recommended. Moreover, children should wash their hands before and after sharing toys.

If a close friend or family member presents COVID‑19 symptoms, contact with their personal objects (glass, dishes, etc.) must be avoided and they must be asked to observe hygiene etiquette and wash their hands after coughing or sneezing. As much as possible, maintain safe distancing.

Wash your hands OFTEN

Frequent hand washing is the best way to protect yourself and others from coronavirus (COVID‑19). Teach your children and close friends and family the right way to wash their hands (see page 16).

WHEN should I wash my hands?

As often as possible, but especially:

  • Before I touch my face (eyes, mouth, nose)
  • After I cough, sneeze or blow my nose
  • Before and after I provide care to a close friend or family member
  • When my hands are visibly dirty or after I touch a dirty object
  • Before and after I prepare meals
  • Before and after I eat
  • After I use the toilet
  • Before and after I go to a public place
  • Before and after I put on a mask or homemade face covering and after removing it

WHAT DO I USE to wash my hands?

It is recommended to wash hands with soap and lukewarm water or with at least 60% alcohol-based gel, foam or liquid sanitizer.

Wear a mask or homemade face covering

Children of 10 years of age and higher must wear a mask or face covering over the nose and mouth in the following situations:

  • When someone else is in the same room, less than two metres away
  • When going to a care facility such as a hospital, clinic, doctor’s office or family medicine group office
  • In schools during movements outside classrooms and in common areas (from grade 5 elementary)
  • When on public transit and school transportation vehicles
  • In closed or partially covered public places where masks are mandatory*
  • In public settings whenever proper physical distancing is not possible

Masks and face coverings are recommended for children between 2 and 9 years of age but NOT for children under the age of two.

Wearing a mask or face covering along with other protective measures such as proper hygiene is mandatory.

Self-isolation

Self-isolation is required for 14 days after returning from a trip outside the country and for 10 days from the onset of symptoms. Self-isolation may be ended after the 10-day minimum expires and the following is true:

  • The person has had no fever for at least 48 hours
  • The person has a significant improvement for at least 24 hours (except for coughs and loss of smell, which may continue for a longer time)

The virus can be transmitted even if you have no symptoms.

Precautions and care when your child is sick

See that the child is comfortable

Ensure the following:

  • Your child is dressed in light clothing
  • Your child rests a lot
  • Your child drinks enough and shows no signs of dehydration, especially in case of vomiting and/or diarrhea

Watch for the following signs of dehydration:

  • No urination for six hours in the case of babies and eight hours for older children
  • Depressed fontanelles (soft spots on the top of a baby’s head)
  • Skin cold to the touch that does not regain normal shape after pinching
  • Irritability, somnolence
  • Extreme thirst
  • Dry mouth and tongue
  • Infrequent and/or dark urine
  • Dizziness, confusion and headaches

If your child shows signs of dehydration, over-the-counter hydrating solutions such as Pedialyte® are available in pharmacies. Your pharmacist will be happy to advise you.

Keep the room temperature at around 20 °C (68 °F).

Rest

Feeling weak and fatigued when you have coronavirus disease symptoms (see page 5) is common. Rest will help fight the disease. Your child can resume normal activities when their state of health permits.

Frequent drinking

Frequent drinking is important, since fever causes perspiration and major loss of liquids.

It is recommended to drink at least 1.5 litres of water a day.

Liquids may be consumed cold or warm, according to taste preferences. Beverages that contain sugar (such as juice) or caffeine (such as coffee, tea and soft drinks) must be avoided. Caffeine cause urination and increased loss of liquids.

Watch for the following signs of dehydration:

  • No urination for six hours in the case of babies and eight hours for older children
  • Depressed fontanelles (soft spots on the top of a baby’s head)
  • Skin cold to the touch that does not regain normal shape after pinching
  • Irritability, somnolence
  • Extreme thirst
  • Dry mouth and tongue
  • Infrequent and/or dark urine
  • Dizziness, confusion and headaches

Consult your child’s doctor/pediatrician

If your child is followed on a regular basis for a physical or mental health problem, keep all planned appointments. If you need a new appointment for a health issue, contact your child’s health professional.

Take your child to the doctor in the following circumstances:

  • Your child is less than three months old has a rectal fever of more than 38.5°C (101.3 °F)— call 1-877-644-4545 or 811 to learn where to go
  • Your child is a carrier of a chronic disease or has a weakened or deficient immune system and has a rectal fever of more than 38.5 °C (101.3 °F)—go to the closest emergency room
  • You child appears to be very sick, listless and has difficulty waking up—go to the closest emergency room

Protect your family circle

Ensure the following when symptoms are observed:

  • Self-isolation in one bedroom to avoid contaminating other members of the family
  • Sleeps and eats alone in the bedroom (if the child is sufficiently independent)
  • Uses only one bathroom, which is cleaned after each use
  • Covers the nose and mouth when coughing or sneezing, ideally with a paper tissue (see page 17). Washes hands afterward
  • If no paper tissue is available, coughs or sneezes into the crook of the elbow or forearm since these are not in contact with people or objects (see page 17)
  • Spits into a paper tissue
  • Throws away facial tissues into a garbage bag placed in a trash can with a lid

Keep used tissues away from children and do not allow visitors in the home.

Continue with these measures for 10 days after the onset of symptoms. If your child has had no fever for at least 48 hours (without fever medicine) and no other symptoms for at least 24 hours except for coughs and loss of smell, which can last longer, normal activities may be resumed.

Keep the child’s environment clean

Generally speaking, coronavirus does not survive very long on objects. It can survive on surfaces from a few hours to several days depending on the type of surface (copper, cardboard, stainless steel, plastic are examples) and the ambient temperature and humidity.

Therefore, it is important to clean counters, sinks, door handles, toys and all other surfaces frequently touched by hands. Cleaning and disinfecting are very efficient ways of eliminating the virus.

Use soap and water or household cleaners on surfaces.

To disinfect, use a 1/9 bleach-water solution (1 part bleach to 9 parts water—i.e., 10 ml bleach and 90 ml water) or store-bought disinfectants.

The towels, clothes and dishware of a sick person can be washed with those of others in the home, using regular detergents.

Plan for help

Many people have the necessary personal resources to deal with the current situation. If you are worried, do not hesitate ask for and accept help. Talking about it with your close family members and friends is important. For more information, go to Québec.ca/allermieux.

You can also dial 211 for help or ask your local CLSC to connect you with their home care and services resource.

Stay informed

For up-to-date information, listen to the radio, watch TV, read the newspaper and/or go to the following government website often: Québec.ca/coronavirus.

The Ministère de la Santé et des Services sociaux provides instructions to the population on health matters and on how to obtain care.

The Act respecting labour standards provides information about your rights when you need to be away from your job to take care of your child. Go to www.cnt.gouv.qc.ca/en/leaves-and-absences/sickness-an-organ-or-tissue-donation-for-transplant-accident-and-family-obligations/index.html.

Always follow the government’s current notices and instructions, which can change as the situation evolves.

Provide your children with basic information

Show them:

  • The right way to wash their hands with soap and water (see page 16)
  • How to sneeze and wipe their nose with disposable facial tissues (see page 17)
  • How to sneeze and cough into their elbow and onto their upper arm (see page 17)

Frequently remind them to stay away from other sick people and those who do not live with you.

Keep the Reminder document close at hand (see page 5). It contains advice on what to do in different symptom situations.

Important:

  • Always take your child’s temperature with a thermometer, preferably rectally if 5 years and under and orally if 6 years and older.
  • Whenever your child has consumed cold or hot food or beverages, wait 30 minutes before taking the temperature orally.
  • Do not use rubbing alcohol on your child to try and reduce a fever. Alcohol can be absorbed through the skin or lungs and may be toxic to the child.
  • Do not administer ibuprofen products such as Advil®, Motrin®, etc. to children under the age of six months.
  • Do not give acetylsalicylic acid products such as Aspirin®, etc. to children under 18 years of age.
  • Do not put a mask or home-made face covering on children who are under two years of age.

Medication for relieving symptoms

Use medication intelligently

If there are no complications, coronavirus (COVID‑19) treatment does not require special medication.

Over-the-counter medication

Over-the-counter medication can be used to relieve coronavirus (COVID‑19) symptoms. Before administering medication, read the label carefully and only administer the recommended dose. If there is fever, use a cap of acetaminophen such as Tylenol®. It is strongly suggested to ask your pharmacist for instructions before administering over-the-counter medication when symptoms are present.

Avoid administering more than one product with the same ingredients at the same time (e.g., Tylenol® and Tylenol Sinus®). Also avoid using nasal decongestants and nasal washes for loss of smell. If your child has particular health problems, ask your pharmacist for advice or call Info‑Santé 811 before administering over-the-counter medications.

If your child is under the age of three months and has a rectal fever above 38.5 °C (101.3 °F), you can administer acetaminophen (Tylenol®, Tempra® or similar) in accordance with instructions on the label and your child’s weight.

Precautions relating to anti-inflammatories

Anti-inflammatories may aggravate coronavirus infections (COVID‑19). However, this information comes from clinical observations and has not been confirmed one way or the other. Some recommendations include avoiding taking ibuprofen such as Advil® and Motrin® to reduce fever from a coronavirus infection. If you are already taking anti-inflammatories and test positive for coronavirus, speak with your pharmacist, doctor or specialized nurse practitioner.

Relieving symptoms?

Fever

Fever is one of the body’s defence mechanisms that help fight infection. If you want to lower a fever to make your child more comfortable, acetaminophen is recommended unless your health professional advises against it or the child is allergic to this product.

Fever is defined as follows:

  • In children 0-5 years old: rectal temperature of at least 38.5°C (101.3 °F)
  • In children 6 years and older: oral temperature of at least 38.1°C (100.6 °F)

Sore throat

If your child is able, try gargling with a glass of salty water: 2.5 ml (1/2 tsp.) of salt in 250 ml (1 cup) of lukewarm water (no swallowing). Younger children (under the age of six years) often have difficulty avoiding swallowing liquid in the mouth. In this case, sugar-free hard candy or lozenges may also relieve a sore throat.

If you are directed to a health professional, be sure to take a complete current list of all your child’s medications with you.

If new medications are prescribed for your child:

  • Be sure to administer them based on the instructions on the label
  • Reach out to your pharmacist or doctor if a problem arises when your child takes the medication
  • Always keep medications in a dry location out of the reach of all children

Caring for children with a disability or autism spectre disorder

Handicapped children, including those with physical or mental disabilities or autism spectre disorder, are among the most vulne­rable members of society since they may experience problems related to mobility, communication, situational understanding and self-protection. Moreover, their medical and/ or behavioural condition means that they have a higher risk of developing complications from COVID‑19 contamination. As such, providing them with acute or intensive care can be more complex.

For children who have problems with understanding and/or communicating, prevention, precaution and care measures are the same as for adults. However, support from a parent, family caregiver or other provider is of prime importance for ensuring that preventive measures are applied when problems are encountered.

With this in mind, it is important to anticipate communication methods that are adapted to the needs and characteristics of the child and to ensure that they understand the current pandemic situation, how to protect themselves, why measures such as remaining at home have been implemented and the importance of screening.

Particular attention should be given to care that is related to tube‑fed medication and access to home support when required.

Making your child comfortable

Persons with physical or mental disabilities or who have autism spectre disorder especially risk developing the following problems:

  • Bedsores
    • Vary the position often.
  • Loss of autonomy
    • Get the child up and moving around and performing personal care activities such as hygiene and dressing as soon as feasible. Encourage the child to perform daily activities in accordance with capabilities. This will considerably lessen the risk of complication.
  • Dehydration
    • Children who need help with feeding have a higher risk of dehydration. As such, ensuring they drink regularly is very importan.
  • Lack of organization in children with behavioural or autism spectre disorders
    • Make certain that you put in place strategies for minimizing behavioural disorders and facilitating transitions to new daily routines.

Parents and/or family caregivers must also apply contamination prevention measures when using equipment and/or devices that are required to see to the patient’s needs. People who are not capable of removing their mask or face covering should not wear one.

Hygiene and prevention

Hand washing

  1. WET HANDS
  2. APPLY SOAP
  3. RUBS FOR 15-20 seconds
  4. SCRUB nails
  5. RINSE
  6. DRY
  7. USE PAPER to shut the tap

Wash hands often, especially:

  • When they are visibly dirty
  • After sneezing or coughing
  • After you blow your nose
  • After using the toilet
  • After changing a diaper
  • Before preparing, touching or serving food
  • Before eating
  • Before putting in or taking out your contact lenses
  • After moving garbage
  • Before putting on a mask or homemade face covering and after removing it

Wash your hands with soap and water. Antibacterial soap is not required.

If soap and water are not available you can use an alcohol-based gel, foam or liquid sanitizer (at least 60% alcohol).

Take a little gel, foam or liquid sanitizer with your fingertips and rub both sides of your hands, fingers and in between your fingers. Continue to rub until your hands are dry without having used paper towels.

Alert:

Sanitizers must be stored out of reach of young children. They can only be used occasionally and with supervision.

Respiratory hygiene

  1. COVER your mouth and nose with a tissue when coughing or sneezing
  2. THROW the tissue in the garbage
  3. IF NO TISSUE IS AVAILABLE, cough or sneeze into your elbow or on your upper arm
  4. WASH your hands often. If soap and water are unavailable, use a hand sanitizer

Masks and homemade face coverings

Wearing a mask or face covering that covers the nose and mouth is mandatory on public transit and school transportation vehicles, in school during movements outside classrooms and in common areas (from grade 5 elementary) and in enclosed or partially enclosed public places for people age 10 and over. Go to Québec.ca/masque for details on locations where wearing a face covering is mandatory.

In all other public places which are not subject to the obligation to wear a mask or face covering but where physical distancing of 2 metres is not possible, wearing a face covering is strongly recommended. When you wear a mask or a face covering in public, you must also follow other safety measures, such as hygiene.

Children under the age of 2, people whose particular medical condition prevents them from wearing a mask or face covering and people who are unable to put it on or take it off by themselves due to a physical disability, are exempt from this requirement.

If you are sick, stay at home. If you need to go to the hospital or a medical clinic, wear a mask or face covering until you are provided with a procedure mask.

If you have no symptoms but need to be in close contact with someone who has a fever or is coughing or sneezing, for example to provide care, you should wear a mask or face covering.

Wash your hands before and after using a mask or face covering. Remove the mask by grasping the elastic or string loops without touching the front of the mask or homemade face covering. Fold up the inside of the mask and place it in a sealable garbage bag. If you wear a homemade face covering, place it in a clean bag. You may wash the face covering with the rest of your laundry after removing it.

A cotton or similar fabric scarf can also be used but you will need to wash it every day.

  1. PLACE the mask or face covering on your nose and mouth with one hand. Use your other hand to attach the elastic or string loops of the mask behind your ears.
  2. MOLD the mask or face covering to your nose.
  3. POSITION the bottom edge of the mask under your chin.

Change your mask or face covering whenever it becomes wet, dirty or damaged.

YOU MUST AVOID WEARING IT LIKE THIS:

Never touch your eyes, nose and mouth with your hands.

Decision Fact Sheet for parents

If your child has COVID‑19 symptoms

Follow the instructions on this poster to help you take the optimal decision for you and your close friends and family. Always use proper hygienic and preventive measures to avoid contamination:

  • Wash your hands frequently
  • Cough or sneeze into the crook of your elbow, onto your upper arm or into a paper facial tissue, not your hands
  • Keep your environment clean

Children

If your child has a symptom from this list:

  • Fever (with the temperatures currently listed according to age)
  • Cough (new or worsening)
  • Shortness of breath, difficulty in breathing
  • Loss of taste or smell
  • Sore throat
  • Nausea
  • Diarrhea
  • Vomiting
  • Stomach aches
  • Congestion
  • Runny nose
  • Major fatigue
  • Severe loss of appetite
  • Muscle pain

Decision for children

I stay at home and have my symptoms assessed at Québec.ca/decisioncovid19 or by calling 1‑877‑644‑4545.

Adults

I have a fever (temperature 38 °C (100.4 °F) and higher OR any of the following symptoms:

  • Onset or worsening of cough
  • Difficulty breathing
  • Extreme fatigue
  • Sudden loss of sense of smell without nasal congestion, with or without loss of taste
  • Muscular pain
  • Headache
  • Major loss of appetite
  • Sore throat
  • Diarrhea

Decision for adults

I stay at home and have my symptoms assessed at Québec.ca/decisioncovid19 or by calling 1‑877‑644‑4545.

Adults & children

I have a fever of 38 °C (100.4 °F) or higher (adult) or 38.1 °C (100.6 °F) and higher (child) AND one or more of the following:

  • Persistent and/or increasing difficulty in breathing
  • Blue lips
  • Difficulty moving
  • Fever (baby less than three months of age)
  • Somnolence, confusion, disorientation, difficulty staying awake
  • No urine for 12 hours

Decision for adults and children

Go to the emergency room immediately. If help is needed, call 911.

General information

Services Québec

Coronavirus hotline

1-877-644-4545 (toll free)

Deaf or hard-of-hearing persons

1-800-361-9596 (toll free)

Important phone numbers:

Your pharmacist:

Your doctor:

Your CLSC:

Keep informed. The Québec.ca/coronavirus website has up-to-date news.

Preventing infections: It’s a collectivity responsibility

  • Cough into your sleeve
  • Wash your hands
  • Keep your distance
  • Cover your face

Québec.ca/coronavirus

Toll free: 1-877-644-4545