There have been a lot of questions about how children are impacted by COVID-19 and the first thing to emphasize is that there are still a lot of unknowns. Ongoing research is attempting to answer our most pressing concerns around risk and children’s role in spreading the novel coronavirus. Although it was originally believed that children were less likely to be infected, we have since come to understand that children have the same viral loads upon infection and can spread the disease to others as easily as adults. This also means that even if their symptoms are mild or asymptomatic, they can spread the virus to others.

So, who is most at risk for severe illness from COVID-19 and how can you keep your children safe? We answered some of your most pressing questions. 

High-Risk Children

Children infected with the novel coronavirus are less likely to develop severe illness compared with adults, but they are still at risk of developing severe illness and complications from COVID-19. Some children living with underlying health conditions such as asthma, diabetes, heart disease, immunosuppression, obesity or any genetic, neurological or metabolic condition may be at higher risk for severe illness. This is not an exhaustive list, so if your child lives with any underlying condition, you should talk to your healthcare provider about your child’s situation.  

Infants under a year old are also considered high risk because their immune systems are not fully developed. The best way to protect babies is to keep them socially distanced from individuals outside their household. Reminder that it is recommended that children under age 2 should not wear a mask because of suffocation hazards. 

In addition, the Centers for Disease Control and Prevention (CDC) is investigating a rare but serious medical condition that can develop in children who contract COVID-19, even if they are asymptomatic or have mild symptoms, called Multisystem Inflammatory Syndrome in Children (MIS-C). If your child is experiencing any new or recurring symptoms we recommend discussing these with your child’s healthcare provider. 

Preventing COVID-19 for Children

The key to stopping the spread of the virus is to limit in-person contact with those outside the household, wearing a mask and maintain six feet apart distancing. Unfortunately, especially for small children, this can be extra challenging, The key is to explain safe practices to your child and then be a great role model of behavior. 

This starts with wearing a mask. It is recommended that all children 2 years of age and older should wear a face mask  whenever they are out of the house. This is especially important at school, childcare or any other group activity. In addition to protecting the child, masks significantly reduce the spread of COVID-19 to other children and adults. It is understandable that this may be a difficult or even scary task for some children. Parents can help their child by demonstrating on a stuffed animal or in the mirror while explaining to the child why they are important. Decorating the masks or buying ones that are more personalized and fun are also a great way to encourage wearing a mask.  

Besides mask wearing, make sure your child washes their hands frequently with soap and water or uses hand sanitizer before they touch their face. It may be helpful to explain to your child why it is important to wash their hands and to show them how you wash often to encourage them to copy your good habits. This also translates to touching your face. Just by showing and explaining to your child that it is something you shouldn’t do can help them mirror your habits. As a parent, frequently disinfecting any surfaces your child may touch and washing any items that may have come in contact with outside germs can also keep your child safe.  

It is important for children to maintain a six-foot distance from others outside their households. While adults can gauge that easily, children may struggle due to math skills that have not yet been learned on how to calculate that distance. Parents can assist by placing physical barriers – such as cones, blankets or sticks on the ground to remind children how close they are permitted to get to others. When walking in public, parents can demonstrate stepping aside so another can easily pass in order to maintain proper distance.

One thing that many parents may forget about, especially when we are all trying to stay distanced, is the importance of still receiving regular vaccines. In fact, the COVID-19 pandemic has resulted in a scary trend and a 40% drop in immunizations. This is particularly dangerous for children who receive a number of important shots before adulthood. Mayo Clinic pediatrician Dr. Robert Jacobson explains that this is truly troubling because “we’re developing pockets of reduced immunity for these vaccine-preventable diseases, so outbreaks are more likely to spread because of that decreases herd immunity.” The Lung Association encourages everyone to work with their healthcare provider to stay up-to-date on immunizations, including getting the flu shot for those 6 months of age and older.

Treating a Sick Child

Children can develop any of the symptoms associated with COVID-19, though most cases report that symptoms start with a fever and cough. If your child develops a fever, sore throat, MIS-C, fatigue, body aches, loss of taste or smell, nausea or vomiting you will want to monitor them closely and contact your healthcare provider. 

If you are concerned that your child may have been exposed to the virus you can take a few steps to keep them and others in your household safe. First, keep your child home and contact your healthcare provider to discuss testing. Notify your child’s school, playgroup or any other person that may have come in contact with them so they can be tested as well. 

Try to limit your child’s contact with other members of the household. This can be tricky, but the CDC offers tips for isolating your child away from the rest of the family as well as other ways parents can keep themselves safe while caring for their sick child. 

For more information about preventing, diagnosing and treating COVID-19 visit our COVID-19 hub

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