Understanding COVID-19 and its impact on children

Coronavirus
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Wednesday, Illinois health officials announce a child in the state tested positive for COVID-19.

When it comes to kids, data based on the experience in China has been informing pediatric doctors in the United States. The good news is there was a low infection rate among children in China.

Dr Larry Kociolek is part of what`s called the High Consequence Infectious diseases team at Lurie Children’s Hospital in Chicago.

“From the data in China, we know children have accounted for a very low proportion of overall infections,” he said. “Fewer than 1000 patients in a larger case series of 70,000 patients were pediatric and as far as I understand, there have been no pediatric deaths.”

There are still unknowns when it comes to children with underlying medical conditions.

“We’re certainly concerned that children with underlying medical illnesses – whether weakened immune system, underlying respiratory or cardiac issues,” he said. “So far, we have not seen that. But that is something we are very concerned about and keeping a close eye on.”

The H1N1 flu outbreak in 2009 hit the pediatric population much harder. So far with COVID-19, that has not been the case and much like the majority of adults infected, children also seem to present with mild illness.

Kociolek said it’s a phenomenon public health experts don`t understand just yet.

“It could be related to (the fact) their immune response is different that results in them having a more mild case,” he said. “It could be related to cross-reactive immunity. There are a lot of coronaviruses in our community that doesn’t make people very sick, causes the common cold. And whether or not the immunity from those viruses is allowing children to have a more benign course, we don`t know. But it is something we’ll figure out as we learn more about virus.”

Typically, children tend to spread sicknesses like the common cold quickly. Health experts call them a reservoir of viral illnesses simply by kids being kids.

“Children may not be the best with hand hygiene,” Kociolek said. “And those children then go and infect caregivers. … We have not seen that yet and it’s an interesting phenom. We don`t have a very good understanding of why that is case.”

Still, school districts across the state and city have announced a temporary shutdown.

“Typically the recommendation for prolonged school closures and widespread school closures would be based on the burden in the community which is currently low,” Kociolek said. “School closures, if taken unnecessarily, can have a significant impact on our society which will disproportionally affect low-income families and may not even have the desired impact, which is reduction of COVID burden.”

How long will the closures and other social distancing measures stay in effect? Kociolek said history has taught us longer is better.

“Duration of these outbreaks seem to be roughly 8 to 12 weeks. And they seem to make improvements after that duration,” he said. “However, if you don`t take those aggressive public health measures, the epidemic may actually be shorter duration of time. And that`s bad if we have all of our infections in a  few short weeks. That overwhelms the health system and could result in a lot more patient morbidity and mortality.”

Kociolek said as so far they have been able to test as needed. Lurie Children’s is actively working on its own test so they will not need to rely on outside sources.

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