The Coronavirus and Children
You’re probably very well aware of the coronavirus outbreak and know that it’s now made its way to the US. Concerns for the elderly and people with preexisting conditions are growing, but what about our kids?
Coronaviruses are actually a family of viruses – for the most part, they affect animals, but seven of them have proved capable of infecting humans. The name coronavirus is derived from the Latin and Greek words for crown and wreath – it’s named for its appearance: the ring around the surface of the virus appears crown-like (see below). (COVID-19 is technically the label for the illness the coronavirus causes in people, FYI.)
Before we get into anything about the coronavirus and children, we want to emphasize that the situation is rapidly evolving on a day-to-day basis. At the end of February, outlets like the CDC and the WHO, along with numerous experts, emphasized that the risks for families in the US are still very low, but with new cases emerging in more and more states across the nation, as well as speculation that the virus may have been present in some communities already for weeks, there’s no way to predict how the virus will spread moving forward or what it will mean for any given family.
Side Note: A “pandemic” refers to the spread of an epidemic across multiple countries and continents – it is not implicitly fearsome or deadly.
The majority of people (80+%) who have become infected with the coronavirus have suffered mild symptoms (very similar to a common cold) and fully recovered. The death rate among individuals who’ve contracted the virus is estimated at ~2-3%; by comparison, the death rate for MERS and SARS was 34% and 10%, respectively, and the death rate for the flu is 0.1%. It’s likely that the mortality statistics for COVID-19 thus far are an overestimate, by the way, because presumably we don’t have accurate/complete info on the number of people who have contracted it.
How Does the Coronavirus Affect Children?
Based on the evidence available thus far, children do not seem to be affected by the virus as much as adults. Terri Lynn Stillwell, a pediatric infectious disease expert at the University of Michigan, told NPR that out of a reported some 75,000 cases (as of February 20), there were only about 100 cases among children. In a more recent analysis accounting for cases outside mainland China, The Lancet reported that about 3% of cases occurred in children younger than 15 years old, assessing that there appears to be “a deficit of infections among children.”
Furthermore, as Vox.com reports, the coronavirus seems increasingly more deadly with advanced age, and the average age of death from the coronavirus is in the seventies (especially individuals with other health problems or smokers).
Experts aren’t 100% clear as to why children seem to be dodging the bullet here, and they’re quick to point out that they’re working with a limited pool of data, but they agree that children either aren’t getting infected at the same rates as adults or else aren’t exhibiting visible symptoms. IOW, children either don’t come down with COVID-19 at the same rate, or they are way more resilient to it if they do. Or both.
Similar patterns – few children evidently contracting the virus – were also observed with MERS and SARS, so it may be a feature of coronaviruses. Plus, viruses in general can sometimes lead to very mild symptoms of infection in children and be much more severe among adults.
Why are Children Protected?
There are a few ideas floating around in regards to why children seem somewhat protected from the coronavirus. First, the most susceptible people are individuals who are already suffering from medical conditions, and children are less likely to suffer from cardiovascular disease, high blood pressure, or lung disease. Another thought is simply that their immune systems are thriving – they’re just getting revved up, while those of adults are typically in decline. Because children are exposed to so many similar viruses on a daily basis (school, day care, etc.), they may actually have some immunity built up.
Pregnant Women
When swine flu (H1N1) broke out in 2009, it was a terrifying time to be pregnant. Pregnant women were especially vulnerable to this virus and were dying at a much higher rate.
The good news is that this doesn’t seem to be the case with COVID-19. While we don’t have a ton of data on how COVID-19 affects pregnant women and babies, one study published in The Lancet reported on a case series of 9 pregnant women with lab-confirmed diagnoses of COVID-19 pneumonia (all survived). The women’s symptoms were similar to symptoms among the general population, and though all nine women underwent cesarean sections for their deliveries, their babies were also born healthy and with high Apgar scores. Furthermore, samples of amniotic fluid, cord blood, neonatal throat swabs, and breastmilk all tested negative — scientists reported that “there is currently no evidence for intrauterine infection caused by vertical transmission.”
That’s good news — even if it’s preliminary.
Coronavirus and Children: Prevention
As a family, the coronaviruses tend to impact the respiratory system. The typical symptoms are cold/flu-like symptoms: a low-grade fever and cough, and sometimes fatigue or headaches.
As of yet, there isn’t a specific treatment for COVID-19; people who contract the disease are (ideally) treated for their symptoms, much like the flu. There is also no foolproof way to prevent COVID-19, but the CDC and the WHO stress that families should engage in the same kinds of preventative measures as they would for the flu:
- Wash your hands and your kids’ hands often
- Avoid people who are sick; stay home when you’re sick; keep your kids home when they’re sick.
- The WHO recommends “social distancing” — this means keeping 3 feet distance between others who are coughing or sneezing; similarly, many infectious disease experts say it’s “worth considering” limiting your exposure to crowded spaces or large groups, as much as you are able – especially if you are in a high risk category.
- Keep your hands away from your face (eyes, nose, mouth); keep your kids’ hands away from their faces – good luck with that!
- Consider taking a vitamin D supplement (you and your kids): recent research shows that vitamin D supplementation can help reduce the risk of respiratory infections, colds, and the flu — it won’t cure COVID-19 or guarantee protection from coronavirus, but it may help! These Vitamin D drops are easy enough to give to kids – and adults!
- Get a flu shot (this won’t do anything against the coronavirus but will help protect you from influenza and will also help “keep things straight” from a public health perspective).
- Cover your mouth when you cough (with your elbow, not your hand); teach your kids to cough and sneeze into their elbows.
On Face Masks:
There’s not any compelling evidence – on a population-level scale – to suggest that wearing a face mask has any ability to prevent illness. Masks can help prevent wearers from spreading illnesses, so if you are sick and want to reduce the chances of infecting others, by all means go right ahead. But wearing a mask yourself – or trying to get your kids to keep them on – isn’t going to protect your family.
On top of the fact that they don’t “work,” using masks unnecessarily has other costs — like creating a shortage for health care providers who really need them.
Check out the US Surgeon General’s recent tweet on the matter:
*Note: There’s lots of talk about vaccine development already being underway, and that’s great, but even if developers worked at breakneck speed it would be a long time – presumably ~18 months – before anything would be (safely) ready for the public.
Talking to Your Kids About the Coronavirus
Kids are talking about the coronavirus, and many of them are fearful of it. Even younger children are absorbing what they hear – one of Charlene’s friends heard children on the playground playing “tag” coronavirus style, calling out “you’ve got it” instead of “you’re it.” (Yikes.)
Experts recommend talking to your children about it – especially if they’re curious or worried – rather than trying to sweep the coronavirus under the rug. In fact, education experts are saying that this is a potential teachable moment – an opportunity to reinforce the real importance of things like tissues, soap, hand-washing, and personal hygiene in general. Talk to your kids about these things, and remind them that the risk is low.
You might also approach the situation by reading books with little children about hygiene, or encouraging older children to express their concerns through artwork or some other outlet. NPR published an incredibly informative comic designed specifically to inform kids about the coronavirus basics.
A CDC representative told NPR: “I told my children that while I didn’t think that they were at risk right now, we as a family, need to be preparing for significant disruption of our lives.”
If you have slightly older children, you can calmly include them in discussions about what that may mean – many health policy experts are suggesting families prepare their homes in the same way they might for a hurricane/nor’easter/storm/[insert geographically appropriate natural disaster here] – stocking up on food, water, household essentials, etc.
If you live away from family, it may also give you some peace of mind to talk with your elders, parents/aunts/uncles/etc., about plans for their care should they be exposed – especially if they fall into a high risk group.
If you’d like to learn more, or want to read more about preparedness for a pandemic, here are a few scattered resources we recommend:
- The Daily’s podcast episode on coronavirus
- “Preparing for Coronavirus to Strike the US,” by Zeynep Tufekci in Scientific American
- “It’s not overreacting to prepare for coronavirus. Here’s how,” by Kelsey Piper, at Vox.com or “How to Prepare for Coronavirus,” from The New York Times
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