COVID-19 and Children: What You Should Know

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Research and scientific, reliable data show that COVID-19 has disproportionately affected seniors and the elderly. In fact, 80% of COVID-19 deaths have happened in those over the age of 65 and 95% of deaths have occurred in those over 50. The risk of a COVID-19 fatality continues to fall as patients get younger. However, that risk is never zero. 

Dr. Hassan Alzein of Alzein Pediatrics in southwest suburban Chicago says, “Unfortunately, COVID-19 numbers are rising exponentially among children 18 and younger.” 

The facts bear this out. By February of 2021, more than 3 million children had been diagnosed with COVID-19, with more than 1 million having been diagnosed just since mid-November. In April 2020, the CDC reported that just 1.7% of confirmed COVID-19 cases were in children under the age of 18 years of age. 

Now, Dr. Alzein notes, according to data from the American Academy of Pediatrics, children make up about 12.8% of the total cases in the U.S. Since states and local governments have loosened or ignored mitigation and social distancing regulations, cases of COVID-19 have continued to rise in children. 

How Does COVID-19 Affect Children?

“Yes,” says Dr. Alzein, “Children, including very young children and infants, can contract COVID.  Fortunately, many of them exhibit no symptoms at all, and some will experience mild symptoms like a low-grade fever, cough, and fatigue.” However, children may also have these symptoms of COVID-19:

• Fever or chills

• Cough

• Nasal congestion or runny nose

• New loss of taste or smell

• Sore throat

• Shortness of breath or difficulty breathing

• Diarrhea

• Nausea or vomiting

• Stomachache

• Tiredness

• Headache

• Muscle or body aches

• Poor appetite or poor feeding, especially in babies under 1-year-old

“While severe illness in children with COVID-19 is rare,” says Dr. Alzein, “some children have had severe complications, and while most of these children tend to have underlying health conditions, some were very healthy children, with no history of pre-existing health conditions at all.” 

According to the American Academy of Pediatrics, the mortality rate for children under 18 is about 0.23%

If you suspect your child has COVID-19, get them tested immediately. Positively identifying COVID-19 and isolating your child until the infection clears is vital to stopping the spread of infection within your family and the greater community. Watch for these signs that indicate your child may need to see their pediatrician or be taken to an urgent or emergency care facility:

• Fever (temperature 100.4 °F or higher)

• New uncontrolled cough that causes difficulty breathing (for a child with chronic allergic/asthmatic cough, see if there is a change from their usual cough)

• Diarrhea, vomiting, or stomachache

• New onset of severe headache, especially with a fever

A rare but serious COVID-19 complication that has occurred in children is Multisystem Inflammatory Syndrome (MIS-C). MIS-C can cause inflammation of the brain, heart, lungs, kidneys, eyes, gastrointestinal organs, and skin. This can result in permanent damage and impaired functioning of these vital organs. 

While research is ongoing, the CDC and its partners have not yet determined a cause or risk factors. If your child has trouble breathing, bluish lips or face, severe abdominal pain, is having difficulty staying awake or waking up, is suddenly confused, or has pain or pressure in the chest, call 911 or go to your nearest emergency room immediately. 

Symptoms of MIS-C can include:

• Fever lasting more than a couple of days

• Rash

• Conjunctivitis (redness of the white part of the eye)

• Stomachache

• Vomiting and/or diarrhea

• A large, swollen lymph node in the neck

• Red, cracked lips

• A tongue that is redder than usual and looks like a strawberry

• Swollen hands and/or feet

• Irritability and/or unusual sleepiness or weakness

How is COVID-19 in Children Treated?

As of this time, there are no drugs specifically approved by the U.S. Food and Drug Administration (FDA) for treating COVID-19 in children. Remdesivir, which has shown some benefits in adult clinical trials, is currently available only through Emergency Use Authorization for children. 

The CDC states that “the safety and effectiveness of Remdesivir for treatment has not yet been evaluated in children.” Most people with the illness, including children, will improve with rest, fluids, and fever-reducing medicine.

How Prone are Children to Contracting and Infecting Others?

COVID-19 is both swiftly evolving and highly contagious. Dr. Alzein says, “Early studies suggested that children were not significantly contributing to the spread of coronavirus, but more recent research raises concerns that children are “superspreaders,” easily contaminating others with the virus.” 

Studies now show that children are just as likely as adults to contract the virus. Since most children exhibit mild to no symptoms, that allows active infections to escape detection and contact spreads it to family and the larger community.  

Protect Your Kids From Getting COVID and From Infecting Others   

First and foremost, make sure your child thoroughly washes their hands for at least 20 seconds using soap and warm water. If soap and water are not available, use hand sanitizer with at least 60% alcohol content. Explain to your children that handwashing can keep them healthy and also makes them good friends. It will stop germs from spreading to others. 

The CDC states that when parents wash hands as recommended, children are more likely to do the same. Make handwashing a family activity and be a good role model. You can also teach your children to practice healthy cough and sneeze etiquette by covering your nose and mouth with a tissue when sneezing or coughing. Then by throwing the tissue in the closest garbage can, and washing your hands after you throw it away. 

Cleaning and disinfecting frequently touched surfaces daily such as tables, doorknobs, light switches, remotes, handles, desks, toilets, sinks, and toys with detergent or soap and water will prevent germs from spreading.

Children over two years of age should wear a mask that covers their nose and mouth whenever they are in public or with people that don’t live in your household. Limit close contact with strangers and out-of-household family and friends by helping your child maintain a distance of six feet and avoid anyone who is sick or is coughing or sneezing.  

Social distancing doesn’t have to mean social isolation. Outdoor playdates, where you can create more physical distance, are an option. Going for a bike ride or a hike allows you to be together without sharing germs. Bring that hand sanitizer along and use it frequently. Set ground rules, about distance and touching. If you think it’s unrealistic that your children will follow those rules, encourage Zoom or Facetime games with friends instead.

Helping Children Avoid COVID-19

At this time, none of the COVID-19 vaccines, either from Pfizer, BioNTech, or Moderna, have been approved for protecting children. “COVID-19 isn’t just the flu,” says Dr. Alzein. “While the vast majority of children who contract the illness might just suffer a runny nose, there are some children, for reasons that have not yet been identified, who get seriously ill and may suffer a lifetime of health issues as a result.”

“Children can also spread the virus quickly and without any indication of illness, endangering the lives of seniors and those who have compromised immune systems. Keeping our children masked when in public, staying at least six feet from anyone who doesn’t live in your home, and washing hands frequently and thoroughly is the best way to avoid COVID-19.”