• Consequences: Inform parents in full about the short and long term consequences of rescheduled appointments regarding the health of their child and the future of their child;
• Alert: Inform when parents should alert healthcare professionals when the health of their child gets worse after a rescheduled appointment;
• Don’t Wait: Inform parents that they should not wait to contact a doctor if under normal circumstances they would. Healthcare professionals should be aware that continuing regular care is also of great importance;
• Resuming Regular Care: Resume regular healthcare as soon as possible with regard to the appropriate COVID-19 safety measures and offer alternative forms of consultations when possible like video calling. The level of 'child and family centred care' in the form of facilities, staff, family presence and participation and policies should not be affected by coronavirus and therefore return to at least the same level as before;
• Work Together: Work together on a national (or least a regional) level restarting regular paediatric care to ensure that all children have equality in waiting times to reduce the impact on the child and parents.

Considerations to support the decision making process: [*]

• Added Value: What will the added value of a test be? Will it change something in the treatment of the child when the test is positive? If not, then ask if a test is really necessary;
• Unpleasant: A COVID-19 test can be a bad experience for a child. Make sure you know how the test will be conducted. Imagine how the child will react;
• Protective Clothing: Test staff may be wearing protective clothing like a suit, face mask and splash goggles. This can make children feel unsafe or scared. This feeling could last until after the test;
• Previous Experiences: In children with previous negative experiences in healthcare it is extra important to consider the impact;
• Housemates: Do adult house/roommates have symptoms? Can you wait for their results?
• COVID-19 within the Family: Have other housemates/family members tested positive for COVID-19? Is it necessary to test or can you assume the child is also infected?
• Symptoms: Take the duration and severity of the symptoms into consideration.

To ensure that the best interests of the child are maintained

• Admission: Avoid admission to hospital if the care can be provided at home;
• Parental Visits: Consider allowing both parents to visit their sick child in hospital and other healthcare facilities (including overnight facilities);
• Rooming-in: Consider offering rooming-in (or living-in) for one of the parents if single rooms are available;
• Partner at Birth: Allow the father / partner to be present during labour and birth;
• No Separation: Do not separate a mother and new-born baby if they have to stay and allow the father to visit 24 hours a day;
• Siblings & Friends: Be aware of the effect of not being able to see their siblings has on both the sick child and the siblings. Be aware of the effect of not being able to see friends. Think of alternative ways of visual contact if visiting is not at all possible.

• Communication: Be aware that much of the information that children hear about COVID-19 is intended for adults. Because children don’t understand risk in the same way that adults do, many children are unsure of how worried they should be but many are very worried indeed – about themselves, their parents, grandparents, their pets, and their friends. Children are not small adults and their understanding depends on their developmental stage. This means that we need to talk to children about what is happening at a level that is developmentally right for them.
  Use play and stories with younger children to get to know the child’s emotions and to find out what the child understands. [ref] Part of good communication is also about listening to children and taking them seriously;
• Domestic Violence & Neglect: Be aware that in times of more isolation cases of domestic violence and sexual abuse against children are likely to go up. The same goes for neglect. Children who are already vulnerable are at even higher risk. Be aware that social networks like schools, sports and neighbourhood activities are not as much in place to help to identify cases. The same goes for primary care professionals. [ref] Be extra alert;
• Mental Health: Children experience more feelings of loneliness and anxiety which can, for example, result in depression in times of isolation.  [ref] Children with a history of mental health issues are more likely to regress at these times;
• Long Term Sick Children: Families who care for a long term sick child at home can experience extra difficulties in times of isolation. Their social network like grandparents, other family members and neighbours can’t help out. Stay in contact and support them in finding solutions;
• School: School is more than just education for children and young people. School provides a form of social interaction with other children and friends which is vital for their healthy development. Be aware that not going to school due to COVID-19 can have a big impact on children’s mental wellbeing. If schools have opened again and specific children still can’t attend due to health reasons interactive tools are available to follow lessons and interact with classmates remotely.
• Digital Care: A positive effect of coronavirus is the increase in the use of digital forms of communication between patients and doctors, like video consultations and training exercises. A positive effect is, for example, that digital consultations result in less travelling, less time out of school and work for children and parents, less issues with minding of other children, it minimizes parking issues and there are less safety issues regarding spreading of the virus. Do take into consideration that not every family will have access to a computer/phone with video set-up and/or internet connection. Be aware that extra policies have to be put into place to make staff familiar with digital consultations like video calling.
  Extra attention is needed to read body language and to keep the child involved and at the centre of care. Not every form of consultation is as suitable for a digital form such as a first consultation, discussing difficult subjects and when the child and or parents don’t feel comfortable with this form of consultation;
• Play: Still make play and other forms of distraction available in hospitals. Think outside of the box if play rooms or other facilities have to close. Like online activities and connectivity with other children and friends;
• Hygiene and Toys: Ensure that toys and other entertainment devices are thoroughly cleaned;
• Protective Materials: Offer enough safety protection materials to parents who give medical/ nursing care at home to their (seriously and/or chronically) sick child. The same goes for healthcare professionals who care for children with healthcare needs in schools, living facilities and children’s hospices;
• Research: Start research to register all children who have been tested positive for COVID-19 (because it was medically necessary to test them) and start follow-up studies to measure long-term effects of COVID-19 in children. Follow international protocols to minimize the impact of the studies on children.