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.
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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?
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.
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.
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).
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)
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.
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: