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For parents, this must be a trying time grappling with the pandemic and worrying about how it may affect your kids. We ran a story on Feb 8 2020 “Coronavirus is Uncommon in Children, Why aren’t More Children Getting Sick?” At that time, it appears that children are relatively less affected by COVID-19 than the adults. But are they?
Now, with more data gathered from the pandemic two months later, here are the interesting focal points regarding Covid-19 in children. The observations are gathered from a China study of more than 2000 cases of COVID-19 in children as well as from reported cases in the US so far.
Covid-19 in Children: What do the Latest Evidence tell us?
Looking at the data of Covid-19 in children, the good news is it appears that Covid-19 infects a smaller proportion of children, an interpretation from both the US and China data. Even when infected, the disease appears to be milder in children as compared to adults.
For the first part, in the US, only 1.7% are among children out of all the reported cases, in spite of the fact that children make up 22% of the population. A similar scenario appears to be the case in China, too.
Secondly, from the China study, 90% of the infected children’s symptoms are either asymptomatic, mild or moderate. Only 6% develop very severe to critical symptoms and only one 14 year old died.
Outside of the study data, in recent reports, COVID-19 claimed 2 young victims – a 12-year-old girl from Belgium and a 13-year-old boy from London, UK.
Compared to 90% of Covid-19 in children, 80% of adult patients on the other hand, have mild or moderate symptoms.
Furthermore, a higher 20% of adult patients progress on to a more severe or critical stage of the disease. In children, only 6% of cases become severe to critical.
Are Children Really More Immune to COVID-19?
Globally, in general it appears that children are less affected compared to adults. However we need to be cautious about drawing conclusions too early.
“It could be that the virus has preferentially affected adults at the moment because there has been workplace transmission and transmission during travel,” says Sanjay Patel, a paediatric infectious diseases consultant at Southampton Children’s Hospital. “Now that adults are spending more time with their children we might see a rise in infection in children, but we might not.”
Also we must bear in mind that children generally stay at home more than adults. Therefore there is less exposure and transmission risk of Covid-19 in children. In addition, fewer tests have been conducted among children compared to adults, so less cases may be detected.
Main Observations of Studies on COVID-19 in Children
What do we learn and what are the main takeaways from these studies?
–Fewer children get infected vs adults. However this lower rate might be due to higher transmission among adults whilst children are shielded relatively speaking.
–Lower percentage of children suffer from severe to critical stage of disease, compared to adults. This study shows that around 90% of infected children did not have trouble breathing, need oxygen or land in the ICU.
It is also possible the 4.4% percentage of asymptomatic but infected kids could be higher, as not all children are tested.
Of >2000 paediatric COVID-19 cases in the China study, the percentages of asymptomatic, mild and moderate and severe cases are relatively lower compared to adults:
- Asymptomatic 4%
- Mild 50%
- Moderate 39%
- Severe–Critical 6%
-Infants are more vulnerable: A higher proportion of severe cases in China are seen among the youngest children. Percentage of severe & critical illness by age group among cases of COVID-19 in children:
- Infants: over 10%
- 1-5 years: 7%
- 6-10 years: 4%
- 11-15 years: 4%
- Teenagers: 3%
–It is noteworthy that children play a role in spreading the virus – those who are either asymptomatic or have very mild COVID-19 symptoms can spread the virus, as do the silent hidden adult carriers. Hence the reason why it is so important to be serious about social distancing.
How can we use this information to help us?
On top of all the often repeated precautions about hand washing, social distancing, and maintaining healthy habits, parents should also take special care:
A – Be especially careful about who has contact with your young children
- Caregiver must be trustworthy, taking all COVID-19 precautions and hygiene practices
- Limit number of caregivers preferably to those with limited contacts with others especially other young children
- Emphasize to the caregiver about COVID-19 precautions and safe practices. In particular to STAY AWAY at the first sign of being unwell
- If you need to take your child out, keep them inside strollers or otherwise limit what they touch.
- Wash their hands frequently as children can’t touching things and touching their face
B – Be especially alert should young children get sick
- First contact your doctor for advice. Avoid bringing your child into the clinic for mild moderate illness to the clinic without consulting your doctor first. In some cases there’s nothing your doctor can do at the clinic, and you might just risk exposing your child.
- However, treat these symptoms seriously and you must seek medical care if your child has any of these symptoms:
- breathing problems whether fast, noisy or forceful breathing,
- shows a pale or blue color to skin
- trouble feeding or talking,
- a high fever that persists (caution, if you use anti-fever medication, best to use acetaminophen instead of ibuprofen)
- sleepiness and lethargy, or no interest about usual activities
- sustained crying or pain or irritability
- trouble drinking, and is passing less urine.
The key to fight COVID-19 is to break the transmission. Worldwide, everybody has a role and part to play, to unite together to fight the virus by taking all the necessary precautions to break transmission. That includes all parents playing an important additional role here too. By recognising that some asymptomatic children can spread the virus too, so keep your children safe at home.
References
What one study from China tells us about COVID-19 and children
Find a Pediatrician in Malaysia, on GetDoc
Find a Pediatrician in Singapore, on GetDoc
by Wong Mei Chan
View all articles by Wong Mei Chan.
