Any outbreak of a new illness raises lots of questions. Coronavirus is no different. This novel virus, which has been named SARS-CoV-2, and the disease it causes, named coronavirus disease 2019 and abbreviated as COVID-19, has been on the public health radar for only a few months. First appearing in China in late 2019, the virus has now spread to every continent except Antarctica, and the World Health Organization has declared it a pandemic.
To date, more than 120,000 cases of COVID-19 have been confirmed around the globe, according to WHO. In the U.S., as of March 11, here are the most recent numbers from the U.S. Centers for Disease Control and Prevention:
- Total cases: 938.
- Total deaths: 29.
- States reporting cases: 39.
As cases and data multiply, infectious disease experts are starting to be able to draw some fairly solid conclusions about the virus and the coronavirus disease. High on the list of questions that parents have about coronavirus is how it may affect their children. Fortunately, the answer is somewhat reassuring.
Danger Increases With Age
According to numbers provided by the China Center for Disease Control and Prevention, almost 90% of the more than 72,000 coronavirus cases reported in February occurred in people between the ages of 30 and 79.
Only 8.1% of the coronavirus cases were teens, and 0.9% were 9 or younger. Similarly, the World Health Organization Mission to China found that just under 80% of the cases reported as of Feb. 20 were in people ages 30 to 69.
Children infected by the virus also typically have milder symptoms – or none at all – and the death rate among younger patients is much lower than middle-aged and older populations.
The CDC says that reports out of China suggest that children with confirmed COVID-19, “may present with mild symptoms and though severe complications (acute respiratory distress syndrome, septic shock) have been reported, they appear to be uncommon.” Kids typically suffered cold-like symptoms, such as fever, runny nose and cough. As with all respiratory illnesses, certain populations of children may be at increased risk of severe infection, including those with underlying health conditions such as asthma or compromised immune systems.
“As age goes up, mortality rate goes up,” says Dr. Robert Murphy, executive director of the Institute for Global Health at the Feinberg School of Medicine at Northwestern University. Globally, “The highest (mortality) rates are in those age 80-plus. From age 10 to 40, it’s about 0.2%,” he says.
In addition, the more underlying medical issues the person has, such as cardiovascular disease, lung disease and diabetes – known medically as comorbidities – the higher the mortality rate, Murphy says. “That’s why, when this thing gets into a nursing home, like it did in Washington (state) recently, it’s really a catastrophe.”
Why Are Kids at Lower Risk?
Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at the University of California—Berkeley School of Public Health, adds a note of caution. Yes, he says, “the preliminary epidemiological data suggest that children don’t seem to get as sick as adults, but I want to emphasize that this is very preliminary data out of China.”
However, the CDC reports that this is consistent with data from past coronavirus outbreaks, such as severe acute respiratory syndrome coronavirus, or SARS-CoV, and Middle East respiratory syndrome coronavirus, or MERS-CoV, where infection among children was “relatively uncommon” in those outbreaks.
The reasons for this remain a mystery. “Nobody understands why,” Murphy says. “It just appears not to be impacting them to any significant degree compared to teens and adults.” Swartzberg is willing to speculate, though he says, “these are only guesses. There is no science to support it.” One guess is that the virus first entered adults and has mostly spread from adult to adult, so it may be genetically predisposed somehow to affect older people. Another guess is based on the fact that other forms of the coronavirus are very common in children. “About one-third of all coronavirus infections are in children, so the idea is that maybe children are getting these other coronaviruses and that may be some protection. But again, this is all conjecture.”
Swartzberg also stresses: “We don’t even know for certain that (children) are getting less disease. There are less than two months of data. We don’t know, in children and adults, how many are infected and don’t even have any symptoms. There could be a lot of us walking around with (what seems like) colds who have this, or they may be asymptomatic.” That, of course, would make the disease and death rates even lower than already thought.
Pregnant Women and Infants
The data for pregnant and nursing women are even more limited, according to the CDC. There have been reports of preterm birth and other “adverse outcomes” in women who tested positive for COVID-19, but it is not conclusive if the virus caused the outcome. In truth, other respiratory infections, such as the flu and even the common cold with fever, can affect birth weight and lead to preterm delivery.
There has been no evidence that the virus can be transmitted to infants through the breast milk of women with COVID-19. The SARS-CoV virus was not transferred through breast milk, the CDC says, and in fact antibodies against SARS-CoV were detected in at least one sample.
As with adults, children should be encouraged to wash their hands often, stay home when they’re sick and avoid places that may be what Murphy calls “hot zones” for infection, such as the recently quarantined area around New Rochelle, New York. “Standard public health precautions are probably going to control this more than anything else in the next year, before we can get some drugs or a vaccine,” he says.
And, Murphy tells parents, you can relax. “If you are under 50, with no preexisting conditions, the mortality is less than 0.2%. Kids under 10, they seem to tolerate it or don’t get it at all,” he says. “That’s not the group to worry about.”