Guidance from NHS England says that COVID-19 tends to be a mild, self-limiting illness in children - and that 'prolonged illness and/or severe symptoms should not be attributed to COVID-19 and should be evaluated as usual'.
An NHS England bulletin said that during the last year there had been a 'remarkable reduction' in respiratory viral infections other than COVID-19 as a result of social distancing measures. This meant an increasing number of young children have never been exposed to these viruses and 'unseasonable outbreaks' have been observed in other countries, it added.
The guidance says: 'We are asking that all children under five with respiratory symptoms are considered for face-to-face consultations and referred to secondary care as appropriate.
'While children with respiratory symptoms should follow government guidance, including on COVID-19 testing, this should not take precedence over clinical assessment.'
Child respiratory illness
The update comes after a warning from NHS England that a possible increase in childhood respiratory illness this year was on its 'radar'.
At an NHS England primary care webinar on 3 June Professor Keith Willett, NHS England's strategic incident director for COVID-19 said that while there were no signs of an increase in incidence of respiratory illness among young children in the UK at the moment, it 'may cause an issue going forwards'.
Professor Willett said evidence from the southern hemisphere, which has experienced two winters where children have had limited exposure to common respiratory illnesses as a result of the pandemic, had seen 'quite an uptick' in cases.
Guidance on face-to-face care for children comes as an update on COVID-19 vaccination in children from the Joint Committee on Vaccination and Immunisation is expected within weeks.
Health and social care secretary Matt Hancock said on 7 June that he had instructed the committee to draw up advice on vaccinating people aged 12-17.
Advice on face-to-face care for young children with respiratory illness comes after the BMA demanded a meeting with Mr Hancock over 'unreasonable demands' placed on general practice. The meeting came after NHS England guidance said all patients who wanted face-to-face appointments should be offered them.