COVID-19 refers to the disease caused by the novel Coronavirus. It is an acronym for COrona VIrus Disease 2019 as named by the WHO. The full name of the corona virus is SARS-CoV-2 or Severe Acute Respiratory Syndrome Coronavirus type2. It is a new virus (novel) and therefore there are many unanswered questions about it and the disease that it causes. But everyday there are new discoveries and better understanding that will enable us to deal with it.
How does COVID-19 affect children differently?
Fortunately, the data from China so far shows that children under 15 years of age generally get mild disease, some of them even showing no symptoms (asymptomatic) at all but still testing positive for the coronavirus. Out of 72,000 cases reported by the Chinese CDC (Center for Disease Control ), less than 1 percent of the cases were in children younger than 10 years of age. Further evaluation of 1400 cases of children in a Wuhan Hospital showed that only 42% had FEVER with the other 2 common clinical features being COUGH (49%) and a RED THROAT (46%). Only 3 children required Intensive Care: one had an underlying kidney condition (hydronephrosis), one had a blood cancer (leukemia) and one had a surgical complication (intussusception), which was the only reported death. Thus in contrast with infected adults, most infected children appear to have a milder clinical course. As to why children have milder disease is unknown and several theories have been proposed . The great concern with children is their transmission potential, passing the disease unto other children, parents and most importantly their grandparents.
Which children are more at risk?
Even though the majority of children are expected to cope well with COVID-19, there are certain groups which can be a concern. These are children with underlying medical conditions such as Asthma, Heart conditions, Cerebral Palsy, Cancer cases receiving treatment and any condition that weakens the body’s ability to fight disease. It is important that these children avoid contact with other children and practice good personal hygiene. Stay home and frequent hand washing.
When is it a cold, influenzer or COVID-19?
Respiratory illnesses are very common in children and therefore it is difficult to know which one has the common cold, the “flu” (influenza) or COVID-19. Generally, a cold case has more runny nose and sneezing symptoms while Influenza is characterized by high fever and body aches and pains. As stated previously, COVID- 19 can cause a FEVER, COUGH and a RED THROAT. However, because of milder disease, it is difficult to know for sure. But as the disease becomes more common in the population, it would be wise to assume the possibility of COVID-19 infection in all children with respiratory symptoms and take the necessary precautions.
So when should sick children visit the doctor?
It is wise to avoid unnecessary exposure to hospitals, doctor’s offices, health centers during these uncertain times. But if your child is unwell and parents are concerned, then it may be necessary. Some examples of necessary visits include: All babies less than three months with poor feeding and high fever, vomiting and /or diarrhea with dehydration manifesting as decreased urine production, wheezing that leads to decreased feeding or affects sleep, Fever lasting for more than three days. If unsure, consult your Doctor.
My child has asthma, allergies. What can I do?
This is not a good time for your allergies to start acting up with symptoms of low grade fever, sniffles, sore throat etc or for your child to start wheezing, which may be due to the Sahara dust but of course, it is a cause for great concern and possible visits to the Doctor. Thus, please control your allergies with your regular antihistamine medications and religiously take your preventative asthma medication. Keep your allergies and Asthma under control.
Children as carriers- stop the spread
As mentioned previously, the biggest concern with children and this disease is their role of acting as reservoirs and transmitters of the disease. Children are good at sharing their coughs and cold to other children but most importantly to the vulnerable older age group, grandparents. From very young, they need to be taught to practice good personal hygiene ( washing hands, covering their coughs and sneezes etc) and this is something that the new generation will have to adopt for the future.
Talking to your child about COVID-19
The CDC.GOV has issued general principles for talking to children about COVID-19. These include being calm and reassuring, and making yourself readily available to answer all their questions in an honest and accurate way. However, we do not have all the answers as yet. Try to avoid overload with information from TV, online etc. This can lead to anxiety and stress. This is also a great opportunity to teach children on how to reduce the spread of germs with proper covering of coughs and sneezes, hand-washing habits etc.
The future is not all doom and gloom and the younger generation is relatively protected from the severe effects of this disease. Also, every day or week there is new research and discoveries that may make this disease more manageable and treatable. For example, it is possible that new treatments will be available soon that can limit the severity of the disease, not a cure but treatable. Also rapid test kits are being developed where one can test oneself and find out early on whether you are infected or not and therefore self isolate or not. Vaccine testing has already started but it will take many months before it becomes widely available.
Meanwhile STAY HOME, practice social isolation, avoid congregating , frequent hand-washing (or use gel if no water is readily available) and avoid touching your faces. Keep the children busy at home and enjoy the Family time together.
Dr Jose Nunez,
MBBS (UWI), MRCPCH (UK)
Head of Paediatric Department,
San FernandoTeaching Hospital