Are children less susceptible to coronavirus?

As countries look to ease school and play restrictions, what evidence is there that children react differently?

How many children are being infected with Covid-19?

Children represent just a small fraction of confirmed Covid-19 cases, with fewer than 2% of reported infections in China, Italy and the United States being in people under 18 years old and with under-18s accounted for fewer than 2% of hospital admissions with Covid-19 in the UK.

Does this mean children are less susceptible?

There is now a wealth of evidence that children generally experience milder symptoms when they are infected – although there have been rare cases of children becoming seriously ill or even dying. However, it is not yet clear whether they have a lower chance of catching Covid-19. Although fewer children have been picked up in national testing programmes, this could be due to fewer being tested. During the early phase of the epidemic in Europe, adult travellers played a dominant role in seeding infections, which also meant, purely for circumstantial reasons, that children would have played a less significant role in spreading infections.

Studies on this question give a mixed picture. One analysis, in the Lancet Infectious Diseases, of households with confirmed Covid-19 in Shenzhen, China, found that children younger than ten were just as likely as adults to get infected. However, there is other evidence from South Korea, Italy and Iceland suggesting lower infection rates among children. Some of the difference could also be down to differences in social mixing.

Why do children react differently to adults?

For many infectious diseases, there is a U-shaped risk curve, with the youngest and oldest in society being most vulnerable. Covid-19 does not follow this pattern – even toddlers and newborn babies typically only experience mild symptoms. One theory is that children’s lungs might contain fewer of the ACE2 receptors that the virus uses to enter cells. To confirm this, researchers would need to study tissue samples from children. Another possibility is that children’s immune systems respond in a more optimal way to the virus – mounting a strong enough response to get rid of the infection, but without going into overdrive and flooding the body with inflammatory proteins, which are known to sometimes cause problems in adult patients.

Are children invisible transmitters?

Asymptomatic transmission is known to play an important role in the spread of Covid-19 – studies have shown that in general people appear to be at their most infectious in the day or so before symptoms start. This raises the question of whether children are silent spreaders of the virus. A recent German study, which compared the viral load of nearly 4,000 people aged from one to 100 years old, added weight to this idea. It found that regardless of age, people appeared to shed a similar level of virus, suggesting they could be equally infectious. However, a caveat is that the study did not measure real-life transmission in children. As schools reopen and community transmission is tracked closely in some European countries, a clearer answer on this is likely to emerge in the coming months.

Source: https://www.theguardian.com/world/2020/may/13/are-children-less-susceptible-to-coronavirus

UN chief calls for greater protection for children caught up in COVID-19 crisis

The looming global recession resulting from the COVID-19 pandemic could cause hundreds of thousands of additional child deaths this year, effectively reversing recent gains in reducing infant mortality, a new UN report issued on Thursday has revealed.

In a statement on the new findings, UN Secretary-General António Guterres called for urgent action to support the world’s children amid the universal crisis.

“Thankfully, children have so far been largely spared from the most severe symptoms of the disease. But their lives are being totally upended”, he said.

“I appeal to families everywhere, and leaders at all levels: protect our children.”

The report finds that the socio-economic impact of the pandemic, together with measures to mitigate the spread of the new coronavirus, could potentially be catastrophic for millions of children worldwide.

It details how the crisis is putting young lives at risk in key areas that include education, food, safety and health.

Education on lockdown

Practically all students worldwide are now out of school because of the pandemic.

Nearly 190 countries have imposed school closures, affecting 1.5 billion children and young people.

The report stated that the losses in learning today, and in their future development, are hard to fathom.

“Some schools are offering distance learning, but this is not available to all”, the Secretary-General said, adding that children in countries with slow and expensive Internet services are severely disadvantaged.

Millions missing out on school meals

Child nutrition is another vital concern, according to the report.

The UN chief recalled that even before the pandemic, childhood malnutrition and stunting were at unacceptable levels.

With classrooms shuttered, the nearly 310 million children worldwide who rely on school meals are missing out on this daily dose of nutrition.

Meanwhile, hastily implemented lockdown measures risk disrupting food supply chains and local markets, posing a potentially grave threat to food access.

Safety at home and online

Sixty per cent of all children worldwide are living in countries that have implemented full or partial lockdowns, according to the report.

As the crisis deepens, family stress-levels also are rising, and children confined at home are both victims and witnesses of domestic violence and abuse.

School closures also mean the loss of what the UN chief called “an important early warning mechanism” for incidents.

“There is also a danger that girls will drop out of school, leading to an increase in teenage pregnancies”, he added.

Earlier this week, the UN Children’s Fund (UNICEF) and partners reported that with more children relying on technology for learning and socializing, the risk of online abuse and exploitation is rising.

The Secretary-General underlined the special responsibility social media companies have in ensuring child protection online.

Child health a casualty

Though coronavirus infection rates so far have been “far milder” among children, the report found the broader effects of the crisis on child health are significant.

Hospitals and health facilities overwhelmed with COVID-19 patients are making it difficult for children to access standard care.

Families out of work, or otherwise experiencing reduced incomes, are forced to cut back on essential health and food expenditures, which particularly affects children, women and breastfeeding mothers.

Polio vaccination campaigns have ceased, thus setting back progress in eradicating the disease in its last two strongholds: Afghanistan and Pakistan. Additionally, 23 countries have suspended measles immunization campaigns targeting nearly 80 million children.

“With the global recession gathering pace, there could be hundreds of thousands of additional child deaths in 2020”, the Secretary-General warned.

This scenario would effectively reverse progress made in reducing infant mortality over the past two to three years.

“And this alarming figure does not even take into account services disrupted due to the crisis – it only reflects the current relationship between economies and mortality, so is likely an under-estimate of the impact,” said the report.

Action for children

While the COVID-19 crisis is unprecedented, it is also an opportunity for “unprecedented international solidarity” for children and humanity.

Governments are urged to take steps to counter the unintended effects on children by rolling out or expanding social assistance to families, securing food supply chains and local food markets, and prioritizing the continuity of services such as schooling, nutrition programmes, and maternal and newborn care.

The report further recommends specific protections for the most vulnerable children, such as migrants, refugees, minorities, children with disabilities, and those living in slums.

Standard strategies for physical distancing and lockdowns should be adapted in places such as low-income settings in urban areas, refugee camps and conflict zones.

The report underlined that the UN is working across all settings and stands ready to support countries striving to invest in the world’s youngest generation.

Said the Secretary-General: “With the pandemic placing so many of the world’s children in jeopardy, I reiterate my urgent appeal: let us protect our children and safeguard their well-being.”

Source: https://news.un.org/en/story/2020/04/1061892

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