Children and COVID-19: What to Know

There is no doubt the pandemic has been stressful for everyone. This is especially true for parents. The U.S. Food and Drug Administration has approved the first COVID-19 vaccine for children ages 5 – 11. This gives about 430,000 South Carolinians access to the vaccines. 

There are a lot of unknowns with this novel coronavirus, but Dr. Matt Bartels, our vice president and chief medical officer, provides some answers to common questions parents may have about the pandemic’s effect on children.

What is going on now with the pandemic?

The pandemic continues to march on. The declining case counts we are seeing currently are encouraging, but that doesn't mean COVID-19 is completely subsiding. In several areas of the world, case counts continue to rise, some at levels even higher than those at the beginning of the pandemic. There’s not enough population immunity. Variants continue to develop or reemerge. Those factors pose the greatest unknowns, making it a challenge to predict when there will be another surge in our country. 

What do we know about children and COVID-19? 

We are continually learning with this new virus. It does appear that healthy children are less seriously affected by it. There are exceptions for children with underlying medical conditions. 

You can find more information on children and COVID-19 from the Centers for Disease Control and Prevention* (CDC). 

What do experts think is most likely to happen next with the pandemic?

Most experts agree the pandemic is not over. They expect outbreaks with continued surges around the world. We need to be aware of significant health disparities around the globe especially affecting access to vaccines. Health care is not the same everywhere. Because of that, the ongoing spread of COVID-19 is certainly going to continue even within the United States. The virus will continue to spread especially through unvaccinated people and those who are not immune. 

How does it look in South Carolina?

Current data is positive in terms of declining case counts and hospitalizations. This doesn’t mean we are out of the woods. We don’t know what the next variant is going to look like. With continued spread, new mutations are likely to develop. Population immunity is critical to ending the pandemic.

Why is it important for children ages 5 – 11 to have access to the COVID-19 vaccine? 

Children are part of our communities. They can become infected or carry the COVID-19 virus, contributing to ongoing spread and the likelihood of variants developing. It’s fortunate that children are not as severely affected by acute infection. But there are many instances of admissions to hospitals — including intensive care units — of children and adolescents. The risk to children from COVID-19 can be severe in certain instances. The overall risk to children is much less than it is to the elderly and people with chronic conditions in terms of disease severity, but the risk is not zero. 

Children can easily become virus spreaders and cause illness in more people who are more vulnerable. It can be easy to focus only on the individual. With this virus, we also should consider the risk to our families and others in the community. 

Overall, why are childhood vaccines important? 

In the last 100 years, there have been two advances that have affected the health of the population more than any other medical developments: clean water and vaccinations. Despite the numerous things happening in health care, those two improvements have saved more lives than all other interventions. Vaccines have saved millions of lives and prevented numerous outbreaks of disease. Vaccines are critical for protecting both the individual and the population. 

What should parents consider when deciding to vaccinate their children against COVID-19?

If faced with the choice to vaccinate or take the chance of your child becoming infected, I would always encourage parents to choose vaccination. Vaccines are currently safer than ever. 

One challenge is significant misinformation in the public realm. People should always look at the facts. Find information from a reputable source, such as the Centers for Disease Control and Prevention. You can also check out the South Carolina Department of Health and Environmental Control website. Talk with a trusted medical adviser, such as your child’s pediatrician. 

If more than half of the population in South Carolina is vaccinated, why do children need to be vaccinated?

More than half is not enough to declare population immunity. Until children are vaccinated, they are potentially at risk of becoming ill or passing along the virus to others. While vaccines are not a guarantee, they are a remarkably effective way to add layers to our defense. To contain ongoing spread and prevent new variants, it is critical that children get immunity. The safest, quickest way for children to become immune is through vaccination. 

What can parents do to keep themselves and their children safe? 

Get themselves and their children vaccinated. There are breakthrough cases, but data shows these cases are almost always less severe. The vaccines are a safe and effective tool in the toolbox for preventing severe illness. Take other precautions, such as wearing a mask indoors and maintaining a safe distance from others. 

What about the multisystem inflammatory syndrome? 

We are still evolving in our understanding about this. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. 

The syndrome can be serious, even deadly, but most children who were diagnosed with this condition thus far have gotten better with medical care.

While concerning, there is no reason to panic, as it is a small number of children (300 worldwide) who have been affected by multisystem inflammatory syndrome. What we do know is that you should seek medical attention immediately if your child presents with unusual symptoms. 

Should children still be going to the doctor, even for non-emergency reasons? 

You should always consult with your health care provider if you have concerns. You may not need to bring them in to the office, however. During the pandemic, there have been many improvements including the way patients are triaged. Many doctors’ offices have embraced new technology, such as telehealth visits. However, if your child is sick, you should absolutely always consult your doctor. 

Should children go in for well checkups and vaccines? 

You should check with your doctor’s office. Some well checkups, especially for older children, may be able to be done virtually. The prioritization is on children under 2 years old, who should always be seen in person. We are observing that some patients are delaying getting necessary vaccines and screening tests, but with the right protocols these can all be completed safely. I would urge everyone to do their best to stay up to date on these visits.

As far as activities go for children, what should parents consider? 

Don’t travel too far from home and avoid large group play. It’s mentally and physically beneficial for kids to go out and play to get exercise, but it is important for them to maintain social distancing. Older children should wear masks. Stay outside and keep at least 6 feet from others.

Is there anyone who shouldn’t wear a mask? 

Children under 2 or anyone with trouble breathing shouldn’t wear a mask. Over the age of 2, children should wear masks with adult supervision. Children over the age of 2 should wear a mask when they are in public settings  especially indoor areas, when around people who are not in their household or when they are unable to maintain social distance. 

This is important because COVID-19 is spread person to person through respiratory droplets. We know that wearing a face covering is important in slowing the spread of the disease.  

What should parents of infants know about COVID-19? 

Thankfully, what we have seen with this pandemic is that it really does appear to be affecting children in much less severe ways than older people and people with chronic health conditions. That doesn’t mean children are completely immune. It simply means they tend to be very mildly affected, and in many cases, asymptomatic, including infants. That doesn’t mean they can’t get sick. It just means that their risk appears to be much less as an age group. 

At the beginning of the pandemic, there was worry that it would affect the younger infants more severely like the influenza virus often does. The good news is that unlike influenza, COVID-19 does not appear to be severely affecting infants in large numbers. 

Certainly, everyone is susceptible to getting this disease, and it appears that many can be carriers of the virus. However, infants shouldn’t be considered at higher risk than other children, and with the right precautions, families with infants can safely venture out of their homes. 

The same precautionary rules apply to parents of infants. Don’t overexpose your infants. Keep your distance. Non-household contacts should stay at least 6 feet apart. Wash your hands. Wear a mask if over age 2 years. 

What should you do if a parent gets COVID-19? 

Consult with your doctor and your pediatrician. Make sure you follow CDC guidance, and isolate from family if possible. Make sure that children and any other caregivers wear masks and minimize close contact to limit exposure. 

The CDC recommends having a sick room in your house if possible. Use it to keep anyone infected with the disease separate from others. If you can’t do that, wearing a mask in the house has been shown to limit the spread of the disease. 

Find more about what to do if you are sick

How should parents be talking with kids about the coronavirus? 

Keep the discussion factual. Minimize the fear. Let kids express themselves. And most importantly, keep the conversation going. 

Parents should watch for signs of withdrawal and depression in their children. Don’t let them worry in silence. Kids are intelligent and they are susceptible to the same fears and concerns as adults. Talk to them and provide ways for them to stay active and to do so safely. Communication is very important during these unprecedented times. 

Other ideas for practicing good mental health for your kids:

  • Take a break from the news and social media
  • Get outside
  • Maintain a healthy routine 
  • Find fun activities to do together so that kids have something to look forward to 
  • Focus on healthy eating and exercise 

It’s been undoubtedly stressful for everyone. This has forced everyone to slow down, and that’s not a bad thing. Hopefully this can be a healthy reset on all of our priorities.

*The Centers for Disease Control and Prevention is an independent organization that provides health information you may find helpful.

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