19 February 2021

One year into the COVID-19 pandemic, we’ve learnt a lot about the disease and the coronavirus (Sars-CoV-2) that causes it, but we’re still learning. At the same time as life-saving vaccines started to roll out, new strains of the virus emerged and have fuelled devastating second and third waves in countries around the world. These new strains are not a surprise, given that viruses constantly change and mutate (that’s why the flu vaccine changes each year), but the reported higher transmissibility (or rate of spread) of the new strains has sparked a new wave of fear and unease among families everywhere. Only time will tell what this means for the months ahead while we wait for the world to be vaccinated against COVID-19, but parents and carers can draw comfort in the fact that children still make up a small proportion of confirmed COVID-19 cases worldwide.

Here’s a breakdown of the current facts about COVID-19 and children, so you can remain informed but not alarmed as we face this next phase of the pandemic.

How many kids have been sick so far?

While children do catch the SARS-CoV-2 virus which causes COVID-19, the data internationally has consistently reported the lowest rates are in children (under 12 years) with only around five per cent of confirmed cases occurring in children (under 10 years) in Australia.

“Importantly, the published data also suggests that children tend to have less severe cases of COVID-19 than adults,” says Children’s Health Queensland Director of Infectious Diseases Julia Clark. “In most cases the virus causes mild or moderate symptoms, which can include fever and cough, but also milder cases of pneumonia sometimes requiring hospitalisation.”

“Severe complications in children are uncommon,” Dr Clark adds.

When it comes to those who get seriously unwell, the numbers are clear. About one half of all adults with critical illness (predominantly elderly people with chronic conditions) have died, whereas to date very few deaths in children have been reported worldwide.

Are infants more at risk?

“Being a young infant is not particularly associated with an increased risk of severe disease,” Dr Clark says. Infants appear to have similar respiratory symptoms to those caused by other winter viruses and influenza. Approximately 10% of babies appear to need admission to hospital to receive oxygen, in a similar way to other winter viruses. These are important and serious infections, but these babies almost all recover without needing support from intensive care. This is very different to the experience in the elderly, particularly those with existing health problems.

Are the newspaper reports that the new UK strain of COVID-19 is more likely to infect children true?

The new UK variant of COVID-19 virus (known as the B117 SARS-CoV-2 variant) is thought to be 50-70% more contagious than the original variant of the virus, but there is no evidence to date that it is more infectious to children specifically. Similarly, there is no evidence to suggest that this new variance causes more serious illness in children or adults. The president of the Royal College of Paediatrics and Child Health in the UK has stated that the overwhelming majority of children and young people have no symptoms or very mild illness only, even with the current UK variant. We do not yet know whether this new variant will spread more easily from child to child or from children to adults, but that is being carefully watched by researchers world-wide

What about children with complex and chronic conditions?

As COVID19 is less common in children, there is still limited information available about the impact it might have on children with complex and chronic medical conditions. “However, there are encouraging reports that even children with serious underlying conditions will mostly only experience a mild illness with COVID-19. This is reinforced by data from liver transplant units and from children’s cancer centres,” Dr Clark said.

“There is also no strong evidence that children with underlying respiratory conditions will be at increased risk of catching COVID-19 as is often the case with other viral infections.

That said, children who have experienced severe cases of COVID-19 in the past year have had underlying chronic conditions, with chronic pulmonary disease, obesity, neurological and developmental conditions, and cardiovascular conditions the most frequently reported internationally.

“It’s important to note that, so far, children with confirmed COVID-19 have contracted it from a family member or via close contact with a confirmed case. It is therefore crucial for every family member to take the recommended infection prevention precautions to reduce the risk of a child with a complex and/or chronic condition getting the disease.”

Parents and carers should contact their child’s specialist care team for tailored advice and information about their specific condition.

Visit our dedicated COVID-19 page for further health advice for children with complex and chronic conditions.

What about children who are immunocompromised?

Children whose immune systems have been compromised due to medical treatment (such as chemotherapy, organ transplants, current use of immunosuppressive medications etc) are more at risk from the common cold, the flu and other infections, and are potentially more at risk of developing a serious infection from COVID-19 . However, so far children with cancer or immunosuppression who have contracted COVID have generally experienced mild symptoms.

It is always important to take precautions to prevent the spread of infections for immunocompromised children (including basic hand and respiratory hygiene practices, and social distancing), however most immunosuppressed children are not any more at risk of severe COVID-19 disease than other kids their age.

If you have concerns about your child, we recommend discussing their current level of immunosuppression with their specialist to form the best plan for your child.

Visit our dedicated COVID-19 page for further health advice for children who are immunocompromised or immunosuppressed.

What about the multi-inflammatory syndrome?

You may have heard news reports of children developing a type of hyperinflammatory syndrome after being infected by SARS-CoV-2. This syndrome is called Paediatric Multisystem Inflammatory Syndrome – Temporally Associated with SARS-CoV-2 (or PIMS-TS), and it has some features that are similar to other rare auto-inflammation diseases, such as Kawasaki disease. Doctors from around the world don’t know why a very small number of children develop this condition when most other children are not affected. This is an extremely uncommon disease and most children who have developed the condition, including critically ill children, have all made a good recovery.

Are children ‘super-spreaders’ of the coronavirus?

While we all know kids, especially younger ones, are not great at keeping their hands and bodily fluids to themselves at the best of times, there is so far no evidence to suggest they are so-called super-spreaders of coronavirus (COVID-19). Asymptomatic (showing no signs or symptoms) infections occur in children but it’s too early to say how often this occurs. However, almost all the reported infections in children have been traced to an adult in the same household. This suggests that children have been infected by close prolonged contact with adults and not by contact with other children.

All the evidence that we have seen so far suggests that children, with mild or asymptomatic infections are not very effective spreaders of the virus. Of course, this risk can be reduced even further with careful attention to hand hygiene and cleaning, particularly in children who may have symptoms.

Can my child have the COVID 19 vaccine?

There is currently no COVID-19 vaccine approved for people under the age of 16. Further information about COVID-19 vaccines and the national rollout is available on the Australian Government Department of Health and Queensland Health websites.

How can I help prevent my child getting COVID-19?

Physical distancing, good hand and respiratory hygiene are the most effective preventative weapons we have in the battle against COVID-19.

Teach your children to:

  • Wash their hands with soap and water often and thoroughly (for at least 20 seconds) to prevent viruses entering their body. This includes after being out in public, before eating, and after going to the toilet.
  • Cough or sneeze into a tissue or their elbow (and wash their hands, and put the tissue in the bin afterwards).
  • Try not to touch their face.
  • Try to stay at least 1.5 metres away from people who are coughing or sneezing. (Even if they don’t have COVID-19, they might have germs you don’t want any way!)

For more information, see the blog, How does novel coronavirus (COVID-19) spread and how can I stop myself from catching it.

Don’t let fear put your child’s health at risk

If your child is feeling unwell and you think they need to be seen by a doctor, especially in an emergency, there is no need to be concerned about the risk of them picking up COVID-19 in a hospital, practice or other healthcare facility. Strict infection control measures (including personal protective equipment like masks and gowns, intensive cleaning routines and isolation procedures) are in place to protect everyone – children, families and staff. If your child requires urgent care or has an important procedure or treatment due, do not delay bringing them to hospital. Similarly, if your child is on prescribed medication as part of their treatment or homecare, it is important that they continue taking their medication.

Be assured, the paediatric medical community is working tirelessly to ensure that all children with acute and/or chronic conditions are treated effectively and safely.

What should I do if my child develops symptoms of COVID-19?

If your child develops any COVID-19 symptoms, particularly fever, cough, sore throat or shortness of breath, loss of smell or taste, they should be tested.

Children may also experience other symptoms, such as runny nose, headache, loss of smell, loss of taste, nausea or vomiting, muscle pain, joint pain, fatigue, diarrhoea or a loss of appetite. Symptoms can vary depending on each case.

If your child has any symptoms, you can visit your nearest COVID-19 testing centre or ‘fever clinic’.

If you are unsure, or if your child has a sudden onset of any COVID-19 symptoms, you should contact your local doctor or
call 134 COVID (134 268) for health advice.

You should also keep your child isolated until their symptoms have cleared up.

If you think they need to see a doctor, you should go to the GP or local emergency department. Remember to phone ahead so the practice or emergency department can make appropriate safety preparations and protect other patients.

It’s important that you don’t delay taking your child to hospital if they are sick.

Stay informed

Children’s Health Queensland: COVID-19
Queensland Health: Novel coronavirus (COVID-19)
Australian Department of Health COVID-19
World Health Organization: Coronavirus disease (COVID-19)