‘We’re all at risk’ for COVID-19, according to doctors, public health officials
STEAMBOAT SPRINGS — Many of the people who have been or will be infected with COVID-19 may never know they have it.
They may experience either very mild symptoms, or no symptoms at all.
In a COVID-19 outbreak on a cruise ship where nearly all passengers and staff were tested, about half of the 619 confirmed cases were asymptomatic at the time of diagnosis. About 18% of asymptomatic cases never developed any symptoms, while the rest developed some degree of symptoms after testing positive.
In the data available thus far — largely from China — the majority of kids are experiencing mild symptoms, with a significant percentage showing no symptoms.
That means your child — seemingly the picture of health — could be carrying the virus and actively spreading it without you ever knowing they are infected.
While it is good news this virus seems to be sparing the lives of children, that does not mean children are not equally capable of infecting a parent or grandparent or neighbor who falls into the high-risk category. And studies are finding kids can be “generous” spreaders and capable of carrying high virus loads.
“You should assume it is everywhere and act accordingly,” said Routt County Public Health Medical Officer Dr. Brian Harrington during a recent town hall panel. “We are all at risk.”
Those assumptions are especially necessary given the federal government’s failure to establish early and aggressive testing countrywide. South Korea did do mass testing — including of asymptomatic people — and as a result, their curve is remarkably flatter than that of the United States.
And new data shows total COVID-19 deaths are likely higher than what is being reported. Part of that is due to the lack of testing capacity, the cause of death not always being listed as COVID-19, and people dying before testing was available at all, with deaths being misattributed to causes like pneumonia.
But just because the data so far on children is a lot more hopeful than for people over 65, and especially for those over 80, it does not mean kids cannot get severely ill or die.
There was a report on March 28 of a 9-month-old baby in Illinois and a teenager in California dying after being diagnosed with COVID-19, but there is still some uncertainty about exact cause of death in both cases.
Last week Connecticut officials announced a 6-week-old infant tested positive for COVID-19 after being pronounced dead at the hospital. That death is also still under investigation.
On Monday, a one-day-old infant died in Baton Rouge, Lousiana, after the mother, who tested positive for COVID-19, went into labor at 22 weeks. The infant death is being attributed to COVID-19 complications.
As of Monday, the mother was still on a ventilator, and the infant’s test results had not been released. This would be the first reported case of a baby who died after being delivered prematurely because of coronavirus complications.
The only other infant death worldwide that has been reported came out of China, where researchers reported the death of a 10-month old with COVID-19. That baby had a bowel blockage and organ failure and died four weeks after being hospitalized.
Just like adults, children with underlying health conditions are more at risk, especially those with chronic lung disease, heart disease, neurologic conditions, immunodeficiency conditions, organ transplant, cancer treatment and treatment with medications that lower the immune system, according to the Children’s Hospital of Colorado.
In a separate study tracing more than 2,000 children in China testing positive for the virus, there was just one death — a 14-year-old. According to the study, 6% of the children were severe or critical, and 90% of cases were either mild or moderate. The study found 11% of COVID-19 cases in infants were severe or critical.
There are still far too many unknowns about the virus to assume anyone is safe. Healthy people of all ages are getting seriously ill and dying.
But because of their ability to spread the virus, “kids shouldn’t be going on play dates,” said Dr. Matthew Freeman of the Steamboat Emergency Center.
As to why the disease isn’t having as significant impact on kids, everything at this point is speculative, Freeman said.
“The disease hasn’t been around long enough for meaningful data,” he explained.
But only speculating, it likely has to do with differences in younger lungs, he said.
The virus enters cells through the ACE2 receptor. The differences in the numbers and development of those receptors may be part of the reason why kids are not getting as sick as elderly people.
“The virus just may not be able to utilize those receptor cells in kids in the same way,” said Dr. Dana Fitzgerald of Pediatrics of Steamboat.
But she wants parents to know that kids can get sick. And those younger than 1 can get sicker.
Fitzgerald emphasized the data is still very new, and there is still a lot doctors don’t know.
If a child is breathing fast, has a bad cough or has a fever above 101 for more than three days, parents should call their child’s doctor, and they may need to be seen to check oxygen levels, Fitzgerald advised.
If they have what seems like a cold or flu, and the fever goes down after a couple of days and the kids are back to their normal selves, they can stay home and don’t need to come in, she said.
Fitzgerald reminds people there are also cold and flu strains still going around.
“I really encourage parents to call if you aren’t sure,” she said.
Particularly because kids can carry higher viral loads and can be asymptomatic while shedding virus, Fitzgerald recommends not hanging out with grandparents and other high risk individuals.
“It’s a great time to video chat,” she said.
And as with every age, local doctors are limited in their ability to test. Until that changes, Fitzgerald doesn’t want parents to assume they can get their child tested.
But again, for parents with any concerns, the recommendation is to call their pediatrician.
To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.
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