by Sanaz Cordes, MD
Pediatrician

As a pediatrician, it’s no surprise that friends and family are reaching out with questions and concerns about the risks and outcomes of coronavirus infection in children.  There are many confusing sources of information about coronavirus in the pediatric population, and parents that I’ve spoken to are becoming increasingly anxious as they receive outbreak education and protocols from their schools and daycares.

What is the coronavirus?

Coronaviruses are a family of RNA viruses that typically cause respiratory disease, with symptoms such as coughing, nasal congestion, runny nose, fever, and mild diarrhea.  The current virus responsible for the global outbreak is a coronavirus strain referred to as COVID-19.  Over 111,000 confirmed cases of COVID-19 have been documented.  Of these cases, 44,000 are in China, followed by Italy and Iran.  There have been over 3,400 reported deaths, representing a 3% mortality rate.  In the United States, there are 550 known cases of infected persons, and 22 deaths have been reported to date.  At last count, 34 states have confirmed cases of the virus, with Washington taking the lead (128 cases), followed by California (124 cases) and New York (105 cases).

Risks and Outcomes in Children

In China, only 416 of the 44,000 cases of COVID-19 occurred in children under the age of 10.  This represents less than 1% of the infected population.  No known cases of COVID-19 mortality has been documented among children, globally.  This is in comparison to the 15% mortality rate in people over the age of 80. 

Symptoms of COVID-19 in children

Children infected with COVD-19 display signs and symptoms of a cold: coughing, runny nose, headache, and low grade fever.  Some experience body aches and diarrhea.  Even infants display these mild symptoms, and most children recover within two weeks.

Why are children being spared by COVID-19?

Pediatric infectious disease experts are relieved and perplexed, in equal measure, at the mercy that COVID-19 has been showing children.  There are a handful of theories as to why children are spared from developing severe disease, and most are based on the fact that children’s immune systems are used to being constantly assaulted.  They are exposed to dozens of viruses on a regular basis.  This makes them experts at developing a rapid immune response to infection.

Community Exposure Prevention

Children are mobile little people that like to congregate in groups and have little understanding of personal space.  Additionally, they shed large volumes of any virus they carry.  The pediatric population is at the lowest risk of developing serious symptoms if infected by COVID-19.  However, children are a huge player in the potential spread of the disease to higher risk populations like grandparents and other seniors.  They are vessels for virus transmission, even though they are spared from serious disease themselves.  So the focus should be on preventing community exposure of the virus by children.

The Bottom Line

By the time I’m done reciting these facts to my friends and family seeking advice, they impatiently ask: “So, what’s the bottom line?  What should we do?”  And no one really likes the answer:  “Do all the things you normally do, but better.” 

Children should be encouraged to:

• Diligently wash their hands for at least 20 seconds

• Apply alcohol-based hand sanitizer frequently

• Keep their hands out of their mouths (everyone hates this one, I know)

• Cover their mouths when sneezing or coughing (with a tissue or their arm/elbow) and immediately wash or use hand sanitizer

• Avoid sharing utensils, cups, and other personal items with classmates

 
One of the best things you can do for your kids is to avoid creating anxiety about the COVID-19 outbreak. Also, be sure to keep them up to date on all recommended vaccines.  And most importantly, encourage them to practice the hygiene measures above to reduce the spread of the virus.