FCHIP's Year in Review

Answers for a year full of COVID-19 Questions

At the close of a tumultuous 2020, FCHIP is taking this opportunity to provide answers to many frequently- asked, health-related concerns to help guide families through the COVID-19 pandemic and beyond.

Download the .PDF version of this report. 

How do children differ from adults in terms of COVID-19 hospitalization and death?

Hospitalization rates for children are much lower than for adults, with 25 per 100,000 for ages 0-4, 15.3 per 100,000 for ages 5-17, and 17.9 per 100,000 for all children less than 18 years of age, compared to the total hospitalization rate of 307.7 per 100,000 for adults. (COVID-NET as of 11/21/20). The death rate for children is also low, with 45 children age 0-4 and 99 children 5-18 having died due to COVID-19, compared to 240,075 adults who have died (NCHS as of 11/25/20). Although children represent nearly 23% of the total United States population, they represent 10% of COVID-19 cases, less than 2% of hospitalizations and less than 1% of COVID deaths, so complications for children remain very low (Pediatrics, 2020).

What can parents do to prevent COVID-19 in children?

The CDC recommends the following steps:

• Monitor your child for COVID-19 symptoms every day
• Keep track of who your child comes into close contact with
• Take precautions to protect your child if you are sick with COVID-19
• Keep your child home and call their physician if your child gets sick
• In a medical emergency, call 911 or bring your child to the emergency department

COVID-19 in Children and Teens, CDC

Early on, children became sick due to family members being sick, but symptoms were mild and children were often asymptomatic. That is still the case, but we now also know that older kids are more likely to contract COVID-19, and that children of all ages can spread the disease to their family members.

What is MIS-C and should I be worried?

Some children have been found to develop a serious illness called the MIS-C (multisystem inflammatory syndrome) that is linked to COVID-19. The main symptoms are abdominal pain, vomiting, skin rash, diarrhea, hypotension (low blood pressure), and eye redness, and occur two-to-four weeks after symptoms of COVID-19 begin (MMWR, 2020). MIS-C is very rare, and research efforts are underway to increase understanding and develop treatments.

Will there be a vaccine for children? When?

A vaccine for children is not currently available. When the COVID-19 vaccines are made available, they may not be recommended for children, since testing is still underway to make sure they are safe for kids. Clinical trials with children for the COVID-19 vaccines are currently including only adolescents, while those for younger children are in development. That means it is especially important to keep your entire family protected. According to a recent survey by Ann & Robert H. Lurie Children’s Hospital of Chicago, most parents in Chicago are planning to get their children and themselves the COVID vaccine when it is available (Voices of Child Health in Chicago).

What are Chicago parents’ COVID-19 concerns?

Chicago parents are concerned about how COVID-19 will impact their family’s health at rates (95%) of concern higher than U.S. adults (80%) overall. According to a recent survey conducted by Lurie Children’s Hospital, parents who report poor health were even more likely (70%) to be concerned compared to parents with better health (60%). (Voices of Child Health in Chicago)

What are the mental health implications of COVID-19?

In a recent JAMA podcast, FCHIP founder Dr. Craig Garfield discussed how families are being challenged today, and the importance maintaining physical and mental health care for the entire family. Evidence shows that having depression and anxiety makes COVID-19 complications more likely, but that having COVID-19 can lead to depression and anxiety. Further, more children are visiting the emergency rooms due to mental health issues, with a 24% increase for children 5-11 and 31% for children 12-17, compared to 2019. Both adults and children are reporting worsening mental health since COVID-19 began for 27% of parents and 14% of children. Stress levels are up too, with parents reporting more stress compared to non-parents. Now is not the time to delay care; healthcare may look different these days, but the medical field is ever-evolving. Parents and caregivers can easily use telehealth for many appointments, or use in-car appointments to keep up to date on vaccines, so families should still see their doctor for ongoing care.

How can my family still celebrate the holidays during the pandemic?

As holiday season approaches, keep modifying, not canceling, plans. Plan low risk events, including virtual recipe sharing or meal hosting. Keep it safe, even in your household, washing hands, avoiding dry air. Wear a mask and social distance when socializing with anyone outside your home, and avoid non-essential travel, family gathering and indoor socializing. This holiday season, it will be more difficult to have safer, outdoor celebrations, but each family will have to figure out how they can best reduce risks for themselves and the health of the public. Consider the following before planning an in-person celebration:

• Community levels of COVID-19
• Exposure during travel
• Location of the gathering
• Duration of the gathering
• Number and crowding of people at the gathering
• Behaviors of attendees prior to the gathering
• Behaviors of attendees during the gathering
  (CDC, Holiday Celebrations and Small Gatherings)

Tips for Family Health in the COVID-19 Pandemic

COVID-19 has created challenges for families, but there are also opportunities to keep you and your family healthy during—and after— the pandemic

• Model healthy choices: During COVID-19, parenting means prioritizing flexibility and regularity. It is important to balance the unknowns outside of your family’s control with the schedules and supports needed to help your kids succeed, like healthy sleep habits. Parents and caregivers should model healthy behaviors, be honest about unknowns, and create a family unit focused on reducing risk for COVID-19. Families can work to establish and maintain healthy school-work-life balances for parents, children and your entire family unit. Work to co-parent effectively, whether together or apart, and promote positive sibling relationships, including getting older siblings involved in caring for and helping to care for younger children.
• Prioritize family health: Ensure that you are continuing regular care for your family, including flu shots and other vaccinations, appointments with your individual, marital or family counselors via telehealth, and also sharing your appropriate health concerns with children. A healthy parent is a better parent! Getting your kids involved in their own health, helping the family, and thinking about community health benefits your entire family.
• Optimize family time: Use your “family time” to share feelings and concerns, but also express appreciation for other family members. Creativity is your friend! Boredom can also be productive as a time to explore alternate goals. Now might be a good time to try new skills or family activities. Capture your family memories in pictures or video as you navigate the pandemic landscape together; record your children’s thoughts! Do crafts together, take walks, complete service projects, and do your best to reduce your risk for COVID-19 and other health conditions. You can still go outside, just dress appropriately for the weather, keep moving, keep snacks and water on hand, and focus on getting outside, even if it’s a short period of time.
• Public health is “everyday health”: Adopt COVID-19 safety measures as long-term measures to help reduce diseases in your family and your community: Even when COVID-19 rates decline, you can still avoid catching and transmitting flu, colds and other diseases. Washing your hands reduces the spread of diseases that causes diarrhea and dehydration, while wearing a mask can reduce the spread of respiratory viruses. Keeping your 6-foot distance may not be possible if you are treating a family member, but do your best! Children are now familiar with these measures, so wearing masks and regularly washing hands are part of everyone’s routine!