Coronavirus in children: What experts say on keeping safe

Kakamega Seventh Day Adventist church children washing their hands. [Benjamin Sakwa/Standard]

As coronavirus outbreak takes a toll worldwide, it seems to have largely spared children, leaving some thinking that the young ones are immune to the virus.

But this narrative has been disproved after Kenya reported the death of a six-year-old boy at the Kenyatta National Hospital (KNH). The boy, who had chronic anemia, succumbed to the disease on April 3, 2020.

The youngest person in Kenya to be infected with the Covid-19 disease is a two-year-old, according to Dr Patrick Amoth, the director-general of health.

Ruth Nduati, a pediatrician at the KNH, says children are also vulnerable to the coronavirus.

“Children of all ages can be infected with the virus. It is not clear if the amount of infection in children is the same as in adults, but when they get infected, they show milder symptoms,” Prof Nduati says.

The most common presentation of symptoms of coronavirus in adults is elevated temperature. This is not what children will get, according to the peditrician.

Only half of infected children will have high temperatures while others will show milder symptoms like a cough and sore throat. Not all infected children present respiratory symptoms as some even get diarrhea.

Nduati says children who have tested positive for the virus also show cases of severe pneumonia.

Data from a Chinese study of Covid-19 in children confirmed that slightly more than half of the infected children showed mild symptoms of fever, cough, sore throat, runny nose, body aches and sneezing.

Around a third showed signs of pneumonia, with frequent fever, a productive cough and wheeze but without shortness of breath and difficulty breathing seen in more severe cases.

The study also shows that 90 per cent of children had illnesses that were asymptomatic, mild or moderate as opposed to severe or critical. That means out of children who had a fever and a cough, 90 per cent did not have trouble breathing or needed oxygen.

Bigger risk

“Children with chronic conditions are at a bigger risk of getting infected especially if the adults in the house are infected,” Nduati says.

The coronavirus is transmitted through direct contact with respiratory droplets of the infected person, and touching surfaces contaminated with the virus. This means children infected with the coronavirus, with very mild or no illness, can transmit the infection to others, especially family members and elderly relatives.

“Children have milder symptoms but since the disease is highly infectious, they will surely transmit it to the other person,” the peditrician says.

But does Covid-19 affect children of different ages differently?

Data from the Chinese suggest that young children, particularly infants, are more vulnerable to Covid-19 than other age groups. While severe or critical illness was reported in one in 10 infants, these rates decreased dramatically as children grew older so that in children aged five years or older, only three or four in 100 developed severe or critical illness.

“The very youngest children are at more risk especially those with respiratory and cardiac conditions,” says Nduati.

Nduati says mothers should be keen in breast feeding their young children to ensure they are well nourished and able to fight the disease and avoid crowding in hospitals.

Though the virus is still new and not much is known about it, Nduati says the immune system of a child differs from that of an adult as it is still very much a work in progress.

Can Covid-19 affect newborns?

While the pandemic is still unfolding in many parts of the world, there are at least two cases of confirmed infections in newborns: one in Wuhan, China, and the other in London, UK. 

According to Nduati, newborns contract the disease from their mothers who have the virus already.

However, an infected pregnant mother will still deliver a healthy baby. Immediately after birth, the baby should be isolated from the mother to help it from contracting the disease. The mother can wear an N95 mask while breastfeeding the baby. 

Common cold

“It’s just like a mother having other respiratory diseases like flu or tuberculosis. It rarely affects children in the womb,” says Nduati.

Parents should not panic during this period as it is common for children to have coughs and common colds, she says. They should however check on how severe the cough is. 

“Most children get infected through adults and it’s their responsibility to protect them by following guidelines that have been given,” she said.

Good hand washing practice, social distancing and disinfecting surfaces and objects which may harbour germs is key in protecting children from the disease.  

Parents who have young children should carefully choose caregivers and limit the number of people who have contact with or hold them. 

“One thing parents should do is reassure their children that they are not going to die from Covid-19. It is really important that we get this message out. Children can be very compliant when they understand the risks at hand and they can be the ones reminding us to wash hands,” she said.