Coronavirus in Children

SARS- CoV- 2 is the name of the virus that causes the illness COVID-19. To avoid any confusion with terminology, we generally refer to the illness COVID-19 rather than the virus.

Fewer than 5% of COVID-19 cases are amongst children and data continues to show that they appear to exhibit only mild symptoms or have no symptoms. A very small number of children have had more severe illness and these children usually have significant underlying medical conditions. The vast majority of children, even those with significant underlying medical conditions, have not been severely affected.

This does not mean that as parents we should relax and not follow guidance, as there are many vulnerable people in society that directly benefit from cooperation with lockdown rules, wearing masks, handwashing and social distancing measures that all reduce the spread of the virus.

Evidence suggests that the new variants are more transmissible in younger age groups including those under 20 years of age.

All viruses adapt and undergo change over time. They can mutate or undergo mutation.

As case numbers increase overall among the population, the small percentage of children affected also translates into larger case numbers.

However, parents and families can be reassured that to date there is no evidence of there being an increase in the severity of illness among children with COVID-19 caused by the new variants.

Statements from The Royal College of Paediatrics and Child Health (RCPCH) have all confirmed that children’s wards are not seeing any “significant pressure” from COVID-19 at this time.

Most children with COVID-19 have no symptoms or very mild symptoms. New continuous cough, high fever and loss of sense of taste or small remain the main symptoms in children as they are in adults, but gastrointestinal symptoms, abdominal pain and diarrhoea have also been described.

Cough
Fever
Sore throat
Runny nose
Sneezing
Fatigue
Aching muscles
Headache and dizziness have also all been reported.
Differentiating COVID-19 from other childhood infections and illnesses is very important. Always seek advice from your paediatrician if you’re worried about your child’s health.

It is absolutely the right thing to do and safe to attend hospital emergency departments when you are concerned about your child. The flow chart below is a very helpful guide to assist parents to decide how best to act. In an emergency situation always call 999.

Multi-system inflammatory syndrome has features in common with other well-recognised inflammatory conditions that affect children, such as Kawasaki disease.

This syndrome is known as paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS). Persisting fever, abdominal pain, diarrhoea, rashes have all been described, but these also occur with many illnesses and so a medical assessment is always needed.

There is published guidance on how this syndrome is managed and again reassuringly, numbers of children affected have been very small.

Expert medical bodies all now agree that it is fine to use ibuprofen or paracetamol to manage a child’s fever.

Please do follow the dosing instructions for each of these medications and most importantly seek medical advice if you are concerned about your child during an illness.

Children who take regular medication for any reason should continue to take these as usual and follow advice from their paediatrician or GP.

• In the UK children aged 5 to 11 years in a clinical risk group (for example, those living with respiratory diseases, chronic heart disease, immunosuppression, and/or chronic neurological disease) or who are a household contact of someone who is immunosuppressed, should be offered two 10 micrograms doses of the Pfizer-BioNTech COVID-19 vaccine. There should be 8 weeks between the two doses. 
• The booster vaccination should be offered to children aged between 12 and 17 years, no sooner than 3 months after completion of their first round of vaccinations. 
• The booster vaccination should also be made available to those children aged between 12 and 15 years, who are in a clinical risk group or who are a household contact of someone who is immunosuppressed. 
• Many countries internationally, including the US, are now offering vaccination against COVID-19 to all 5 to 12-year-olds. 
• The benefits and risks from COVID-19 vaccination in children and young people are finely balanced largely because the risks associated with SARS-CoV2 infection are very low. Those aged between 5 and 11 years are considered the least at risk of serious COVID-19.

Many parents have raised concerns regarding the risk of attending clinics versus missing or delaying vaccinations for their children.

The simple message here is that keeping up to date with health checks and vaccines is just as important now as before the disruption caused by the COVID-19 pandemic.

Short delays in the timing of vaccines are not a concern and parents shouldn’t feel anxious about this. However, please do keep scheduled vaccines in mind and if these are now due please contact our office or your GP practice to arrange an appointment.

Within the hospital clinics where our practice runs clinics, strict precautions have been introduced for the safety of families, children and staff.

The specific precautions are set by each hospital and may vary, but these are all reassuring and include the following:

• Screening of all parents and children attending clinic with questions regarding recent symptoms of illness and a temperature check before entering the clinic.
• Only one parent per child permitted entry into the clinic to reduce number of people within the waiting areas.
• All staff and hospital attenders are required to wear masks.
• The toughest compromise has been allowing only one parent to attend the clinic with their child. The hospitals have remained very firm on this policy and I am very grateful to parents for their understanding and recognising it is for everyone’s safety.

Remote consultations by video or telephone are now well established, still receiving great feedback and suitable for many consultations.

At Childhealthy we fully understand that this is a worrying time and we are here and available to support you with your child’s health.

The latest guidance on COVID 19 vaccines in pregnancy and during breastfeeding are reported by Royal Colleage of Obsetrics and Gynaecology.

The key messages reported by the RCOG are as follows:

• ‘The latest advice from the Joint Committee on Vaccination and Immunisation (JCVI) is that COVID-19 vaccines should be offered to pregnant women at the same time as the rest of the population, based on their age and clinical risk group. Women should discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances.

• You should not stop breastfeeding in order to be vaccinated against COVID-19.

• Women trying to become pregnant do not need to avoid pregnancy after vaccination and there is no evidence to suggest that COVID-19 vaccines will affect fertility.’

MRC Global Infectious disease analysis – transmission in under 20 year olds.

BBC News report – no increase in severe child cases

NHS latest Covid-19 updates.

Great Ormond Street Hospital Covid 19 summary.

NHS Coronavirus and children.