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Everything you need to know about children and COVID

By DR. ARNEL NUGUID, The Philippine STAR Published Apr 13, 2021 5:00 am

COVID-19 is taking a terrible toll on families worldwide.  Many senior members of the household come down with it and don’t know where they got the infection.  One source they may not even consider is the most junior members of the home:  the children.

As a pediatrician and a COVID survivor myself, let me answer some commonly asked questions about COVID-19 and how it affects children.

How can one acquire this virus?

Similar to flu, COVID-19 is spread mainly through respiratory droplets. These are tiny blobs of liquid that an infected person can release when he coughs, sneezes or talks.

The viruses in these droplets can infect another person through the eyes, nose or mouth, when they land on your face or get transferred there when you touch your face with contaminated hands. Respiratory droplets are too heavy to stay suspended in the air; hence the virus is transmitted when people are in close contact — within six feet of each other. 

Children are usually called the 'silent spreaders.' So yes, infected and asymptomatic children are more likely to bring the infection home to their parents and grandparents.

This is the main reason why we should observe physical distancing and avoid gatherings in enclosed spaces and places where it is hard to keep a reasonable distance from others.

Since coronavirus is often found in people’s mouths and noses, frequent gargling with commercially available oral antiseptics could potentially decrease the risk of transmission and provide an additional level of protection.

When can a person start spreading the infection?

The time from exposure to COVID-19 to the appearance of symptoms, known as the incubation period, is believed to be two to 14 days with an average of six days.

We know that a person with COVID-19 can be contagious 48 hours before starting to experience symptoms. We should take note of this fact, especially now that we have a surge in cases.

People without symptoms may be more likely to spread the infection because they are most likely not isolating or adopting behaviors designed to prevent spread. This is why we should make it a habit to wear facemasks and observe physical distancing. Both measures will decrease the risk that a person who is asymptomatic will infect others. 

Are children any more or less likely than adults to spread the infection?

Most children who are infected typically don’t become as sick as often as adults and some might not show symptoms at all.

Children are usually called the “silent spreaders.” So yes, infected and asymptomatic children are more likely to bring the infection home to their parents and grandparents.

What are the usual symptoms in children?

Most children infected with the virus have no symptoms. When it does cause symptoms, common ones include fever, fatigue, dry cough, colds, sore throat and diarrhea.

Children who are usually admitted in the hospitals have underlying medical conditions. This may include obesity, asthma or chronic lung disease, sickle cell disease or any form of immunosuppression.

However, some children can get very ill from COVID-19. There is a rare but serious condition associated with COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C), which involves inflammation of the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes.

Can babies be infected with the virus?

Yes. Babies less than one year old might be at higher risk of severe illness with the virus because of their immature immune system and smaller airways. 

Unless herd immunity is achieved, there will always be a risk when sending kids back to school.

Will there be a vaccine available for children?

Yes, and everyone is encouraged to get their vaccines once available. To date, only the Pfizer-BioNTech COVID-19 vaccine has been authorized for use in persons 16 years of age and older.

I know a lot of parents will be interested to know that there are ongoing trials on vaccines for the younger age groups. 

Pfizer/BioNTech recently announced promising results for a trial testing its vaccine in children aged 12 to 15 years. The vaccine has been found to be 100 percent effective and triggered a stronger antibody response among these children compared to that in vaccinated 16- to 25-year-olds enrolled in an earlier study. The company recently started testing the vaccine in children younger than 12. 

Moderna is conducting two vaccine studies: one in children ages 12 to 17, the other in children aged six months to 12 years. These are very promising trials.

Hopefully, the results and vaccines will be made available to our younger kids soon.

Can schools safely open anytime soon?

Unless herd immunity is achieved, there will always be a risk when sending kids back to school.

There are several actions and requirements that should be put in place to prevent the spread of COVID-19 in schools and to ensure the safety of children and school staff while at school.

Five key mitigation strategies should be followed to minimize the spread of COVID-19 in schools: correct use of mask and face shield, frequent hand washing, cleaning surfaces, physical distancing and contact tracing.

Are play dates not allowed for now?

I know that this pandemic has negative psychological effects, especially on children. Besides experiencing worry and anxiety, the absence of social interactions with their friends has a negative effect on their mental wellbeing.

However, with the current surge that we are experiencing now, all social gatherings are better avoided temporarily.

As mentioned above, children are “ silent spreaders.” They can be infectious but still remain very active and playful. When exposed, they might end up bringing home the virus and eventually infect their respective families. 

Outdoor play dates may be a better option since proper social distancing can be observed. This may include a bike ride or a hike. Make sure parents impose strict ground rules about distance and touching.

If you don’t think it’s possible for your child to follow these rules, it’s safer not to do the play date, even if it’s outdoors. You can also do virtual play dates so that your child can interact with other kids and play through platforms like FaceTime, Zoom or Skype.

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