Children as Likely to Get Coronavirus as Adults, but Don’t Get Sick.

Screen Shot 2020-04-19 at 4.38.45 PM

Does Your Kid Have to Wear a Mask Outside?  The CDC is asking all adults to wear masks. But what about kids? By Tara Santora  Apr 10 2020, 8:25 AM

 

Why is this question so important?  If children were “immune” as suggested by Elon Musk, we could open up the schools and thus free the parents to return to work.  It might boost the sagging economy.  So goes the reasoning.

However, many experts disagree:

  1. Children get infected at the same rates as adults:

“At the beginning of the pandemic, it was thought that children are not getting infected with the coronavirus, but now it is clear that the amount of infection in children is the same as in adults,” explains Andrew Pollard, professor of pediatric infection and immunity at the University of Oxford. “It’s just that when they do get the infection they get much milder symptoms.

This opinion rests on research on people in Shenzhen, China, with confirmed SARS-CoV-2 infections and data from their close contacts:

In total, they looked at 391 people with confirmed COVID-19 and 1,286 individuals who were in close contact.

The researchers’ aim was to find out whether close contacts of people with COVID-19 would test positive for SARS-CoV-2 (the name of the virus that causes the disease COVID-19).  And would they transmit virus to their close contacts even when they presented no obvious symptoms?

The investigators found that children under 10 who were in close contact with people who had COVID-19 demonstrated a 7.4% infection rate — very similar to the 7.9% infection rate in adults.

However, the researchers also determined that children were less likely to develop symptoms, even though they seemed just as likely as adults to contract the virus.

“Kids are just as likely to get infected [as grownups] and they’re not getting sick,” notes co-author Justin Lessler, Ph.D., from the Johns Hopkins Bloomberg School of Public Health, in Baltimore, MD.

The researchers also report that people who lived with individuals who had diagnosed COVID-19 were more likely to develop the infection than other close contacts.

  1. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020

Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group. Social distancing and everyday preventive behaviors remain important for all age groups as patients with less serious illness and those without symptoms likely play an important role in disease transmission.

  1. A study from Wuhan in the New England Journal of Medicine: “Asymptomatic infections not uncommon” in children

The study describes 1391 children assessed and tested from January 28 through February 26, 2020, a total of 171 (12.3%) were confirmed to have SARS-CoV-2 infection. They conclude: “In contrast with infected adults, most infected children appear to have a milder clinical course. Asymptomatic infections were not uncommon.2 Determination of the transmission potential of these asymptomatic patients is important for guiding the development of measures to control the ongoing pandemic.”

  1. Notes from a pediatrician colleague at Weill Cornell Medicine, Dr. Seth Gordon:

I have found no antibody studies in children. (In case you need a primer on the different types of Coronavirus tests, check here). For the most part, children have been NEGLECTED from the beginning. This has been a tremendous oversight and continues to be a blindspot. Every parent knows children spread infection. They congregate in large groups and are the least hygienic among us. They don’t even make proper masks for children. Children have [likley] been a major vector of COVID-19 spread yet only about 1% of COVID-19 positive tests (RT-PCR swab tests which detect viral RNA) were performed on children.  But I believe they represent the vast majority of actual infections. Early on, when I advocated for the closure of schools it was because I was detecting asymptomatic children who were COVID-19 positive. Isn’t this why our schools are closed? I don’t see any evidence that we solved or addressed this issue at all and I see daily evidence of new COVID-19 cases in children. How are we supposed to reassimilate children in schools or camps when we have so little knowledge and testing.  It is not even known whether children will develop protective antibodies.  This is a HUGE problem in my estimation. While most children do well it is not a universal truth. I have taken care of many sick children during the last two months. As a physician, I feel helpless and frustrated when I can not treat or cure a patient. When Doctor Oz endorses a 2-3% child mortality rate upon returning to school, it really leaves me bewildered as a pediatrician and a parent. If a second wave of COVID-19 comes as predicted, it may be driven by non-immune children in Nov/Dec getting infected and spreading infections to adults again. So it is important to determine the immune status of children BEFORE we return them to school. This way we can make informed decisions.

  1. I would like to add a comment:

If we study the apparent natural resistance in children to the disease (COVID-19), we might gain important knowledge that will help those adults that don’t have that resistance, those that end up in the ICU and on the ventilators. The first step is to test all children, not only adults. Testing and contact tracing is key.  It is key to economic recovery too.

 

About D. Posnett MD

Emeritus Prof. of Medicine, Weill Cornell Medical College
This entry was posted in Coronavirus, Health Care, Uncategorized and tagged , , , , , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s