NEWS | August 18, 2020

Advice about kids and COVID-19 from UC Davis Health expert

Coronavirus infections among children have grown, according to national studies

(SACRAMENTO)

Researchers are finding a growing number of coronavirus infections among kids, although younger children remain a small percentage of COVID-19 cases in Sacramento and throughout the country. But there is no guarantee that won’t change.

Cases of COVID-19 among children are growing, as are severe cases. Experts recommend masks for kids and adults alike.  Cases of COVID-19 among children are growing, as are severe cases. Experts recommend masks for kids and adults alike.

“COVID-19 is something we need to take seriously with children,” said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital. “We’ve heard a lot about how it’s milder in children than adults, but it’s important to know that kids get sick, too. Kids get pneumonia, too. Children have died from this, and we’ve had children in the ICU because of this. It can still be severe and scary for them.”

With some schools already starting classes, and new research coming out, both researchers and parents are focusing more and more on the impacts and risks of COVID-19 to children.

National data shows COVID-19 cases among children are increasing.

An August report from the Centers for Disease Control and Prevention that detailed hospitalization rates for children put it bluntly: “Children are at risk for severe COVID-19,” the CDC said.

The report said one in three kids hospitalized with the coronavirus end up in intensive care.

A recent report from the American Academy of Pediatrics and the Children’s Hospital Association said more than 97,000 U.S. children tested positive for the coronavirus in the last two weeks of July. That’s more than a quarter of all COVID-19 infections among U.S. kids since March.

"It's important not to open schools too early. Even if children are not the primary drivers of transmission, gathering them in classrooms is going to increase the number of cases among children, and they will spread COVID-19 to their families who could then bring it into the community."

Researchers say there may be a number of reasons for the spike – including the spike in COVID-19 cases throughout the U.S. population overall and the likelihood that children are spending more time playing together or in summer activities.

“We also think children may be getting infected from their families more,” Blumberg said. “Their parents are likely out in the community more, whether at work or somewhere else, and they’re bringing it home.”

Children under 10 appear to be less likely to transmit COVID-19 than older kids, teens and adults, partly because they often have less severe symptoms. That means they don’t do some of the things that spread the virus quickly, like cough and sneeze. But less risk doesn’t mean no risk.

“Children can certainly spread the virus to other people, including their families and older adults,” Blumberg said. “So, it’s important, even for parents of young children, not to bring COVID-19 into the household, and to help their children protect themselves with social distancing and with masks.”

Black and Latinx children are disproportionately getting COVID-19

Just as Black and Latinx adults have higher percentages of COVID-19 infections and more serious cases, their children are also disproportionately getting infected and battling more severe COVID-19 illnesses, according to the CDC report on children’s hospitalization rates.

“The differences are pretty dramatic and pretty frightening,” Blumberg said.

According to the report, Black children are five times more likely than white children to have serious cases of COVID-19 that require them to be hospitalized. Hispanic children are eight times more likely.

“Many of these children and their families have less access to care,” Blumberg said. “We think the parents of these kids are more likely to be essential workers in high-risk jobs. They could be working in the food industry, meat packing plants or agriculture where they’re often in crowded conditions with minimal airflow and may not have masks available.”

Where do we stand with back-to-school?

“It’s important not to open schools too early,” Blumberg said. “Even if children are not the primary drivers of transmission, gathering them in classrooms is going to increase the number of cases among children, and they will spread COVID-19 to their families who could then bring it into the community.”

He said before any communities consider in-person classes, the rates of COVID-19 must be low enough in the region to make the risks of getting back into schools manageable.

“California is not there, yet,” Blumberg said. “But it’s important to have these discussions, because if communities practice COVID-19 safety, we might get there in a couple months.”

He also said school officials should be aware of the danger to teachers.

“Those are adults who have a higher risk, in some cases a much higher risk, of both getting sick and having severe cases. Do we want to do that to teachers?” Blumberg said. “There is a danger to whole communities, because outbreaks may be amplified in schools, as we’re seeing in some states now.”

Advice for the time when in-person classes resume

“When the outbreaks are controlled, we need to do this in a rational manner,” Blumberg said. His advice:

  • Keep classes small. “This might mean having a morning session and a separate afternoon session,” Blumberg said.
  • Keep children isolated in small groups and have them stay in one classroom.
  • Prevent those small groups of students from mingling with other kids at recess or in the cafeteria. Each group should have separate recess and mealtimes or arrangements.
  • Be sure to instruct students, and everyone at the school, on the proper use of masks.
  • Be flexible and prepared to shut down if there is an outbreak.

“I would hope schools would be able to social distance and enforce universal masking for everyone – teachers, administrators, staff and children,” Blumberg said. “Once we can get schools open, that’s the only way they can stay open.”

Home schooling pods not likely to reduce risk

Some families have grouped together for at-home learning and other events with their kids. Blumberg warns they may be giving themselves a false sense of safety.

“I don’t think it’s possible for groups of parents to create their own bubbles. I don’t think it’s realistic,” he said. “Most of the time people are fooling themselves when they’re in a pod.”

"Children need to wear masks just as much as anyone else. Kids will wear a mask if they are told to wear a mask."

He said a group would have to be extremely strict about 6-foot-distancing and wearing masks in public, but it’s still very unlikely that everyone in a pod will have no interaction with anyone outside that group.

“Not everyone has the same values, so they will make exceptions for different reasons,” Blumberg said. “People will have contact with people outside the pod, and eventually, every pod will get connected to every other pod. In the real world, creating a bubble is just not possible.”

Kids and masks

“Children need to wear masks just as much as anyone else,” Blumberg said. “Kids will wear a mask if they are told to wear a mask.”

CDC guidelines say any child over age 2 should be wearing a mask in public, unless they have a health reason.

“Part of the issue is that some kids have been allowed to avoid masks for no real reason,” Blumberg said. “If a parent says, ‘Oh, my kid won’t wear a mask,’ then they won’t. If we expect them to wear masks, they’ll do it.”