What to Know About COVID-19 and Children

Let me start with introductions. My name is Rachel Bies, M.D. I am a pediatrician and medical director of Wayzata Children’s Clinic, and medical director of St. David’s Center for Child and Family Development. When I took on medical directorship with both organizations, I had no idea that I would be tasked with leadership in a pandemic. As pandemics go, I feel so fortunate that I get to care for children. Unlike pandemics of the past, the novel coronavirus (SARS CoV-2 or COVID-19) has affected children less often and less significantly than other viruses. At this time, we don’t have a good understanding of why this is. Can you imagine the level of anxiety in our families and communities if this virus impacted children similarly to adults? If we were discussing how to ration medical resources to keep our children alive?

Here is what we do know about COVID-19 and children:

Children are impacted by this virus in many ways, from primary infection to school closures.  Studies have shown us that children do test positive for this virus, and may have high levels of the virus in their system, but they are often asymptomatic (no symptoms) or minimally symptomatic. A recent study out of South Korea showed that children under the age of 10 were less likely to spread the virus child-to-child or child-to-adult. International data support that children who test positive for COVID-19 are most likely to acquire the virus from an ill household contact, rather than through community spread.

Not all age groups are equally affected. While most children who test positive are asymptomatic or minimally symptomatic, risk factors for COVID-19 in children include age < 1 year old, neurologic, metabolic, or genetic conditions, or congenital heart disease (per CDC). A small subset of children may experience a rare inflammatory response in their body, called Multisystem Inflammatory Syndrome Disorder in Children (MISC-C).  This condition often presents after the acute phase of the virus, and we don’t know why some children develop this reaction while other children don’t.

What can you do to keep your child healthy during COVID-19?

Remember, the best tools for virus mitigation include social distancing, use of cloth face coverings or masks for children over 2 years of age, and enhanced hand hygiene. While these interventions are imperfect, they are our best options for combatting this virus. Children with illness symptoms, fever (temperature over 100.4F), or a known exposure to COVID-19 should remain at home. Children should continue to see their physician for routine physical exams and recommended immunizations. Everyone is encouraged to get an annual Influenza vaccine this year.