The role children play in the coronavirus pandemic is the burning question of the summer, as children enjoy their free time while schools work on how to resume school.
The Trump administration says the science “is very clear,” but many doctors who specialize in pediatrics and infectious diseases say much of the evidence is inconclusive.
“There are still many unanswered questions. That’s the biggest challenge, “said Dr. Sonja Rasmussen, a professor of pediatrics at the University of Florida and a former scientist at the US Centers for Disease Control and Prevention.
Several studies suggest, but do not prove, that children are less likely to become infected than adults and more likely to have mild symptoms.
An early report from Wuhan, China, where the outbreak started last winter, found that less than 2% of cases were in children. Subsequent reports suggest that 5% to 8% of cases in the US are in children.
The CDC says that as of Friday, 175,374 cases had been confirmed in children 17 years of age and younger, representing about 6% of all confirmed cases. However, according to experts, the number of children who have been infected but not confirmed is undoubtedly much higher than that, because those with mild or no symptoms are less likely to be tested.
The CDC says that 228 children and teens through age 17 died from the disease in the US As of Thursday, about 0.2% of the more than 138,000 Americans who died in total.
An early study examining infections in children comes from a Wuhan hospital. Of 171 children treated there, most had a relatively mild illness. One child died and only three needed intensive care and ventilator treatment. Perhaps more concerning was that 12 had evidence of X-ray pneumonia, but no other symptoms.
A CDC study of 2,500 children released that same month in April echoed those findings. Approximately 1 in 5 infected children were hospitalized versus 1 in 3 adults; three children died. The study lacks complete data on all cases, but also suggests that many infected children have no symptoms.
“We are trying to find out who those children are,” said Rasmussen. “We need to determine the impact on the children and on the rest of the community, their parents and their grandparents. If they pass a lot on each other and then take it to their families. “
Not knowing if children are infected makes it safe to reopen schools, many experts say. The paucity of data on whether infected children, including those without symptoms, easily transmit the disease to others complicates the problem, said Jeffrey Shaman, an infectious disease specialist at Columbia University.
A study sponsored by the National Institutes of Health is being conducted that seeks to answer that question and others.
A May JAMA Pediatrics study, cited Thursday by White House press secretary Kayleigh McEnany, involved just 48 children treated in intensive care units in the US and Canada. As McEnany indicated, most were not seriously ill. Still, he did not mention that 18, or almost 40%, needed ventilator treatment and two died.
McEnany was right that children seem less likely to become seriously ill from COVID-19 than from the flu. But the CDC says that COVID-19 may be more contagious and has been linked to more “overcoming” events than the flu, which means it can spread quickly and infect many people.
Additionally, blood clots and organ damage have been found in children with COVID-19, including those who develop a related inflammatory disease. The most recent count shows that 342 American children and adolescents have developed that condition, called multi-system inflammatory syndrome in children.
The condition is rare but can occur in children with current or recent COVID-19 infections. Symptoms include fever and problems in at least two organs, which often include the heart. Digestive problems are common, and some cases have been confused with Kawasaki disease and toxic shock syndrome.
Perhaps the biggest unknown is whether it can result in permanent damage to the lungs and other organs. The virus is too new to know for sure.
