The spread of the pathogen SARS-CoV-2, which causes the respiratory illness COVID-19, has brought many businesses, services, and households to their knees as customers and workers are encouraged, or ordered, to stay home. For some “key workers”, working from home isn’t an option, which is why in certain countries schools have tried to stay open for as long as possible without posing too great a risk to staff and students to support those still going to work. Deciding at what point to stop mass gatherings of young children is a complex issue, as while the still admittedly scant early evidence appears to indicate the virus doesn't affect children as badly as adults, they are famously good germ spreaders. So how safe are children from COVID-19?
Severity of disease
In adults, COVID-19 is strongly linked to a fever and persistent cough, but it can take up to five days for any evidence of symptoms to become apparent. There’s less information on the incubation period for children, but the US Centers for Disease Control and Prevention (CDC) states that though it's still early days in assessing the disease there’s no evidence to imply that children are at higher risk for COVID-19 than adults. There have been confirmed cases among babies and children, but adults make up the majority of recorded cases.
The CDC reports that while the symptoms for adults and children are the same, children are generally presenting with milder disease compared to adults. A study published in the journal Pediatrics reviewed 2,000 cases of confirmed COVID-19 in children in China. The researchers found that 90 percent of those cases experienced mild disease, while only 6 percent went on to develop more serious ailments such as shortness of breath and hypoxia, or low levels of oxygen in body tissues. It’s not yet known if children with pre-existing medical conditions such as asthma, diabetes or cardiovascular illness are at a greater risk of more severe symptoms. According to the CDC, the most commonly reported symptoms in children include:
- Cold-like symptoms, including a runny nose, cough, and fever
- Vomiting and diarrhea
Efficacy of spread
While having milder symptoms is more comfortable for the affected child, the danger is that they continue moving and interacting with others while individuals with more significant symptoms would just stay in bed. This leads to a greater spread of disease the longer the child isn’t suspected of having transmitted COVID-19.
We already know that SARS-CoV-2 can survive for a long time on surfaces. Since the main aim of affected countries is to slow the spike in cases, or "flatten the curve", it’s important to reduce the exposure of infected individuals, even if they have mild disease, to protect the most vulnerable people in the population. Children who are highly tactile and less concerned than most adults as to what goes in their mouths, or who and what they touch, pose a danger as super spreaders, even if they themselves remain mostly well.
Although Chinese and Japanese health authorities have reported cases of patients becoming reinfected with COVID-19, other health experts have explained that though it's possible for some people to catch viruses a second time, it's rare. Most people will have a healthy immune response, highlighting the importance of “herd immunity”.
If an entire school of children transmitted COVID-19 and then recovered, there may be a small number of students whose immune response doesn’t prepare them adequately for reinfection with the disease, meaning they will suffer the same illness. Despite this, those few students will be protected by the immunity of the majority of students as their chances of encountering the pathogen again become greatly reduced with fewer students getting sick. The same scenario explains why vaccinations are such a vital step for young children, enabling them to generate antibodies in a safe way so that their immune systems are prepared should they encounter the disease later on, while also protecting immunosuppressed individuals in their community – those who can't be vaccinated due to illness, medication, undergoing chemotherapy, etc – from the same illness.
While children, especially those still in school, may be circumstantially and behaviorally more likely to pick up COVID-19 compared to more germ-phobic adults, for the vast majority their symptoms will be mild. It’s important to note however that for a small minority this will not be the case, so if you’re a parent concerned about your child’s symptoms it’s important to follow the COVID-19 protocols in your local area to assess if they need further medical investigation. You can find out what to do if you or a loved one are sick with advice from the CDC here.
Run a business and concerned about COVID19? Find out how paid sick leave has been proven to dramatically reduce the spread of contagious diseases.