What do we know about children and COVID-19?
Frankly, not much.
Conflicting studies the world over indicate varying levels of infection among minors, especially young children, and no conversation about children this time of year is likely to exclude the start of a new school year.
Medical professionals, much like the layfolk among us, have recently debated the various costs and benefits of opening school campuses for in-person classes.
One common argument is that children are significantly harmed by extended virtual classes. Slower academic development, as well as fewer social interactions, prove to be a real detriment to children learning remotely. Children with challenging home lives might be in greater physical danger, as well.
An oft-cited analysis published by the American Academy of Pediatrics makes just these points.
In it, the academy “strongly advocates that all policy considerations for the coming school year should start with a goal of having student physically present in school.”
The authors go on to say policymakers must consider the evolving body of evidence regarding virus transmission caused by children. They also urge schools to remain open unless forced closed by a local public health mandate.
“Finally, policymakers should acknowledge that COVID-19 policies are intended to mitigate, not eliminate, risk,” they write.
Denton County children and teens represent one of the fastest-growing age groups of locals confirmed to have the novel coronavirus. The number of people 19 and younger to test positive for the virus has increased more than 210% since July 1. Only county residents over the age of 80 outpace that growth, but they still account for the smallest age demographic of infected locals.
People ages 12-19 account for roughly two-thirds of positive virus tests among the youngest age group. Those 11 and younger make up just 32.9% of the group. Despite that, the infections are happening, and while rare, children can have a rough time battling COVID-19.
Melissa Winans, chief nursing officer with Texas Health Presbyterian Hospital Denton, said most children who come in with the disease can be sent back home before too long. Some of the children with more serious cases are stabilized before being transferred to a children’s hospital, such as Cook Children’s Medical Center, for long-term care.
Most of the children who are transferred have some sort of underlying health condition, Winans said via phone Friday afternoon.
“Most of the pediatric patients that have come into our emergency department ... are able to be sent home,” Winans said.
The hospital doesn’t handle inpatient pediatrics, she said. Regardless, any emergency room can help stabilize a child before sending them off to specialists.
“What we don’t want is people skipping care because they’re afraid of COVID,” she said.
She said the gut reaction whenever somebody comes in with a respiratory issue these days is to assume they have COVID-19. Overall, there are a lot of things medical professionals don’t know about the disease and the virus that causes it.
“I think that’s the challenge with this virus — being that it’s a novel virus,” she said. “We just don’t know enough. We are learning as we go.”
In Denton County, no one younger than 40 has been confirmed to have died from COVID-19, as of Friday evening.
A study published July 23 by the Centers for Disease Control and Prevention references international studies that show a low rate of virus transmission among children “when community transmission is low.”
“Further, the lack of in-person educational options disproportionately harms low-income and minority children and those living with disabilities,” the authors continued. “These students are less likely to have access to private instruction and care and far more likely to rely on key school-supported resources like food programs, special education services, counseling, and after-school programs to meet basic developmental needs.”
An Argyle ISD parent advocating for the opening of schools during a Monday school board meeting read several sections from the CDC report.
Matt Richardson, director of Denton County Public Health, took the lectern later and explained why the report isn’t the best guidance for Denton County. In particular, the CDC guidance in the report was targeted at communities with low virus transmission.
“When you look at our active case rate and our positivity rates, Denton County, as a whole, is not a community of low transmission,” Richardson said. “In fact, our transmission countywide is increasing.”
Richardson, along with DCPH Division Manger Marty Buchanan, released a recommendation Monday urging local school districts to postpone in-person classes until at least Sept. 8, among other guidelines.
Scientific articles published over the past few weeks often don’t show strong evidence of children transmitting the virus responsible for COVID-19. It’s hard to carry that understanding into conclusion that children do not or cannot transmit the virus. Because school campuses closed months ago in many parts of the world, children’s interactions outside the home have been limited. Additionally, children are less mobile than adults, at least in many parts of the United States.
An article published in the journal JAMA Pediatrics one week after the CDC guidance showed that young children had just as much if not more genetic material of the virus in their nasal cavities when compared to older children and adults: “Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population ... where children with high viral loads are more likely to transmit.”
That does not necessarily mean children would have a higher ability to transmit the virus to others, researchers pointed out.