The American Academy of Pediatrics (AAP) notes that while COVID-19 is contagious, it does not seem that children are at higher risk. However, while children are not typically manifesting severe symptoms from COVID-19, they are still contagious and able to spread the disease to others. (Some research has found that about 25% of infections are caused when people are pre-symptomatic.) Still, because the situation with COVID-19 continues to evolve, parents should take appropriate precautions, listen to their doctors and local health departments, and stay up to date on the latest Centers for Disease Control and Prevention (CDC) recommendations for children and families.
How Susceptible Are Children to COVID-19?
COVID-19 is a new virus in the coronavirus family. SARS and MERS are also coronaviruses. COVID-19 was first reported in December 2019 in Wuhan, China, and has since made its way across the world. While there is a lot we still need to learn about the virus, there is a lot we do know about children and COVID-19—much of which will come as a relief to worried parents. The CDC reports that COVID-19 acts similarly in children to both Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), where infections among children were relatively uncommon. Although infections of COVID-19 have occurred, children for the most part have been spared, or at least have experienced less severe symptoms.
What the Data Says
Again, because COVID-19 is a relatively new virus, the data and research we have on it is limited compared to other viruses. But after evaluating how the virus affected the people of China during the first wave of the outbreak, there is reason to believe that children became ill less frequently, or at least presented less severe symptoms. As the World Health Organization reports, regarding the initial outbreak in China:
Only 2.4% of people under the age of 19 became ill with COVID-192.5% developed severe disease0.2% developed critical disease
The CDC reports similar outcomes, with the virus affecting older adults more severely than children. The CDC reports that, of the 44,000+ cases reported in China up to February 11, 2020:
The majority of infections (77.8%) occurred in adults aged 30 to 69 years old2.1% of children under the age of 20 tested positive for the virusNo deaths were reported among children under the age of 10
As more data has been analyzed since the initial outbreak, our understanding of how COVID-19 can affect children is growing. A study of over 2000 children with the disease in China revealed the following:
About 4% had no symptomsAbout half of the children in the study had mild symptoms (fever, cough, fatigue)About 40% became moderately ill, including symptoms like pneumonia or lung problems in addition to the more common symptomsAbout 6% developed serious illness, with the majority of those cases being children aged 5 or younger
While, overall, it still appears that symptoms may generally be less severe for children, there is still risk of serious illness, and all necessary precautions should be taken to decrease the risk of infection for you and your loved ones. That includes vaccination for children 12 and older, as recommended by the CDC.
Why Fewer Kids Are Getting Sick
What’s the reason for these encouraging statistics, you might be wondering? Chad R. Sanborn, MD, a pediatric infectious diseases doctor at KIDZ Medical Services in Florida, explained a few theories in a March 2020 interview. “The first theory would be that kids aren’t getting the virus very much at all,” Dr. Sanborn said, referencing the studies from the World Health Organization (WHO), which found that only 2.4% of initial COVID-19 cases have been in children. “The other theory would be that many kids are getting the virus, the same as with every other virus, just not getting sick from it and therefore may not be tested as much,” explained Dr. Sanborn. Dr. Sanborn said that while it’s true that kids seem to get sick with everything (any parent can attest to this!), the fact that children are constantly fighting infections—some of which are similar to COVID-19—may offer them an added layer of protection. “This lack of ‘sickness’ could be because their immune systems are dealing with viruses similar to coronavirus all the time and therefore may have some protection, or that their immune system doesn’t go bananas when it fights infection, as adults’ immune systems sometimes do,” Dr. Sanborn added. However, other doctors note that adults are exposed to these same coronaviruses, so they would also have protection. Instead, they suggest, perhaps there is a mechanical explanation.
How Does COVID-19 Affect Children?
Just because most healthy children aren’t likely to deal with severe symptoms of COVID-19 doesn’t mean that they won’t contract it. If you suspect your child has symptoms of COVID-19, you should be diligent about keeping them safe and notifying their healthcare providers about any concerns, especially as they return to school and social activities.
Symptoms of COVID-19 in Children
Symptoms of COVID-19 in children resemble symptoms found in the general population, though they are often less severe. Some children only present with a mild cold or cough. Some children may be asymptomatic and still test positive for the virus. Here are some of the most common symptoms found in children:
Cold symptoms such as a runny noseFeverCoughShortness of breathFatigueSore throatHeadacheGastrointestinal symptoms such as vomiting or diarrhea
Less common, but extremely serious symptoms warranting immediate medical attention include:
Acute respiratory distress syndromeSeptic shock
Children With Underlying Health Conditions
Children who have chronic medical conditions or who experience immunosuppression are at higher risk of experiencing more severe symptoms of COVID-19. Parents of these children should be in close contact with their doctors to discuss what symptoms to watch out for and what precautions to take.
Are There Special Precautions to Take?
As more and more people are vaccinated and the spread of the virus slows, it’s still important to stay updated with information from your state and local health departments about what you need to do to keep your family safe. “Working parents can be prepared by having alternative childcare plans or talking with their employers about work from home options during school closings,” explains the AAP. “If your child attends a college or university, encourage them to learn about the school’s plan for a COVID-19 outbreak.” While many school districts are returning to in-person instruction, positive cases among students or staff may lead to temporary school closings. For the most part, though, taking common-sense precautions to protect your family from COVID-19 are still a good idea. These include:
Wash hands frequently, with soap and water, for at least 20 seconds.When soap and water are not available, a hand sanitizer (60% higher alcohol based) will work—unless the hands are grimy with mucus, food grease or other dirt. In those cases, if running water is not available, wipe hands with a wet wipe, and then follow with hand sanitizer.Keep kids home from school and away from public places if they are sick.Teach children to cough into their elbow, not directly into their hands.Teach children not to touch their face and urge them not to put their fingers in their mouth (very hard with little ones, of course!).Regularly disinfect your home, especially doorknobs, light switches, and other frequently touched surfaces.Keep up to date on your child’s vaccines, including their flu shot.
Why Flu Shots Matter
Kids and younger adults are much more likely to require hospitalization or die from seasonal flu than COVID-19, and the flu vaccine prevents about 50% of flu cases this year. It is not too late to get a flu vaccine. There simply aren’t enough ICU beds, ventilators, and hospital staff to handle a large influx of patients with COVID-19. So getting a flu shot (and practicing good hand hygiene) are the best ways to keep ourselves from taxing our healthcare system again with a new wave of cases.
Stop the Spread
In addition to good hand hygiene, we all need to take additional measures to continue to stop the spread of COVID-19. Everyone should practice social distancing, self-quarantine, and avoid crowded places if they have any symptoms. The CDC recommends COVID-19 vaccines for people ages 12 and above (except for individuals with certain allergies including those allergic to polyethylene glycol (PEG) or polysorbate). All vaccines currently available are safe, effective, and shown to reduce the risk of severe illness.
Special Precautions for High-Risk Children
If your child is in a high-risk group, such as someone who has a chronic medical condition or is immune suppressed, Dr. Sanborn recommends “carrying a list of medications they might be on, phone numbers of their specialists from their home cities, and possibly an immunization record (especially if traveling internationally).” He also urges parents of vulnerable children to make sure their vaccines are up-to-date and that they make sure they have at least two weeks of medications stocked up in case they become quarantined. Dr. Sanborn recommends caution in terms of traveling with a medically at-risk child. “For someone who is immune-compromised, it may not be a bad idea to not get on a plane/go to an airport unless it’s truly necessary,” says Dr. Sanborn. “Young children who may be immune-suppressed or with chronic illness, in particular, may not be good travel candidates because they don’t wash their hands as well, touch their face more often, not cover their cough and sneezes as well and pick their noses/wipe their nasal secretions more often.” Older at-risk children may be better equipped to handle travel, says Dr. Sanborn. “But I’d still be cautious if they have weakened immune systems,” he adds. In general, it’s best to avoid non-essential travel, even if everyone in your family has a healthy immune system, as this will help flatten the curve.
What Should You Do If You Suspect Your Child Has COVID-19?
On the heels of a disconcerting year, it can be easy to become panicked at the first sign of any type of illness. However, don’t be quick to assume your child has COVID-19 just because they have the sniffles.
If your child has concerning symptoms, such as a severe cough or high fever—or if you have reason to believe that your child has been exposed to COVID-19—you should call your pediatrician right away for guidance.
Since spreading the virus is still a concern, your doctor may or may not want you to come into the office. You can discuss the best option here with your doctor. Your local board of health may also give you advice about the best place to go for the diagnosis and treatment of a suspected COVID-19 infection.
However, if your child is experiencing severe symptoms, such as shortness of breath, rapid heart rate, extremely high or low temperature, confusion, or severe dehydration, you should visit your local emergency room right away. If possible, call ahead to the ER to tell them you are coming, so that they can prepare.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
Besides taking a few deep breaths and contacting a mental health professional if your anxiety feels out of control, it’s important that you get good, up-to-date information about COVID-19 as it pertains to your children.
Make sure that whatever sources you are reading include information from trusted medical and health organizations such as the Centers for Disease Control and Prevention, the World Health Organization, and the Academy of American Pediatrics.
And it goes without saying that if you have any concerns about your child’s specific needs, or their current state of health, you should never hesitate to reach out to their pediatrician. That’s what they’re there for.
Pregnancy and COVID-19
