Those Most At-Risk In School Reopening

"We shouldn't be complacent and think that if a child contracts coronavirus all will be fine. Chances are all will be fine, but we just don't know. This is particularly true for children who have underlying conditions, such as obesity or lung disease.”

– Elizabeth Cohen, CNN's senior medical correspondent

The Centers For Disease Control and Prevention (CDC) reports that while children have been less affected by COVID-19 compared to adults, children with certain conditions may be at increased risk for severe illness. Children who are medically complex, who have serious genetic, neurologic, metabolic disorders, and with congenital (since birth) heart disease might be at increased risk for severe illness from the virus.

Similar to adults, children with obesity, diabetes, asthma and chronic lung disease, or immunosuppression might be at increased risk for severe illness from COVID-19. The CDC is investigating a rare but serious complication associated with COVID-19 in children called Multisystem Inflammatory Syndrome in Children (MIS-C). At this time, they do not know what causes MIS-C and who is at increased risk for developing it.

(“People with Certain Medical Conditions.” Centers For Disease Control and Prevention.

July 17, 2020.)

The CDC addresses the problem of school reopening and children at increased risk of severe illness from COVID-19. According to guidelines set by the CDC …

“Some children may be at increased risk of getting COVID-19 or may be at increased risk for severe illness from COVID-19. For these children, parents and caregivers may need to take additional precautions with regard to school re-entry.

“There are more COVID-19 cases reported among children with intellectual and developmental disabilities than those without. People of any age, including children, with certain underlying medical conditions are at increased risk for severe illness from COVID-19.

“Additionally, children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease might be at increased risk for severe illness from COVID-19, compared to other children. Severe illness means that they may require hospitalization, intensive care, or a ventilator to help them breathe, or may even die.”

(“School Decision-Making Tool for Parents, Caregivers, and Guardians.” Centers For Disease Control and Prevention. July 23, 2020.)

(M.A. Turk, et al. “Intellectual and developmental disability and COVID-19 case-fatality trends: TriNetX analysis. Disability and Health Journal. 2020.)

The CDC says the list of underlying conditions is meant to inform clinicians to help them provide the best care possible for patients, and to inform individuals as to what their level of risk may be so they can make individual decisions about illness prevention. They are learning more about COVID-19 every day. This list is a living document that may be updated at any time, subject to potentially rapid change as the science evolves.

The CDC encourages these actions:

• Give medicines as prescribed for your child’s underlying conditions.
• Make sure that you have at least a 30-day supply of your child’s medicines.
• Call your child’s healthcare provider if you have concerns and to discuss your child’s specific conditions and risk for severe illness from COVID-19.
• Well-child visits and vaccines are still important during the COVID-19 pandemic. Stay in contact with your child’s healthcare provider and make sure your child is up to date with vaccines to prevent other diseases. Learn more about how to protect yourself and your family during the COVID-19 pandemic.
• If you don’t have a healthcare provider, contact your nearest community health center or health department.

Some officials say the risk of opening schools is actually less to the children themselves than it is to the adults working at the schools, like the teachers, the staff and actually the parents of the students. One new report says roughly one out of every four teachers in the United States, amounting to nearly 1.5 million instructors, have a condition that puts them at a higher risk of developing serious illness from the coronavirus.

Gary Claxton, et al. “How Many Teachers Are at Risk of Serious Illness If Infected with Coronavirus?” Kaiser Family Foundation. July 10, 2020.)

The children have been known to get a whole set of different symptoms. In the United States and the United Kingdom, hospitalized children between ages 2 and 15 had a condition doctors called “multisystem inflammatory syndrome.” The symptoms are similar to toxic shock syndrome and Kawasaki disease, which cause inflammation in the walls of blood vessels. In rare cases, it can lead to deadly limitations in blood flow.

Many of the children tested positive for Covid-19 or had its antibodies but they didn't necessarily have typical coronavirus symptoms such as respiratory distress. Their symptoms included a high temperature along with a rash, swollen neck glands, hands and feet, dry cracked lips and redness in both eyes.

Coronavirus causes a wide variety of symptoms in children, according to a study published in an American Academy of Pediatrics journal.

In that study, Dr. Rabia Agha and colleagues from Maimonides Children's General Hospital in Brooklyn studied 22 children with coronavirus. They found most did not have classic symptoms. Fifteen patients had a fever and nine had respiratory symptoms. Two had seizures and two were entirely asymptomatic.

(Faith Karimi. “What we know about coronavirus risks to school age children.”

CNN. July 10, 2020.)