31 March 2020 (Updated 15 June 2020)

In a matter of weeks, COVID-19 and the coronavirus that causes it (now officially named SARS-CoV-2) has changed life as we know it. The rapid spread of the pandemic across the globe, together with regularly changing public health alerts and prevention advice, has left many parents confused and anxious about what they can or should be doing to protect their children.

While there’s still more to learn about this virus, it is comforting for families to know that children make up a small proportion of confirmed COVID-19 cases worldwide.

Here’s a breakdown of the current clinical facts you need to know, so you can be aware of and informed about COVID-19 but not alarmed.

How many kids have been sick so far?

While children can catch the SARS-CoV-2 virus which causes COVID-19, the data internationally has consistently reported only around one per cent of confirmed cases occurring in children (under 10 years).

“Importantly, the published data also suggests that children tend to have less severe cases of COVID-19 than adults,” says Children’s Health Queensland Infectious Diseases Senior Medical Officer Adam Irwin. “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 Irwin 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?

“Previous claims that infants are at similar risk to adults are not supported by the evidence we currently have,” Dr Irwin says. 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.

What about children with complex and chronic conditions?

As SARS-CoV-2 is a new strain of the coronavirus, there is little 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 Irwin said.

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

“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.

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 the SARS-CoV-2 coronavirus (COVID-19). Some asymptomatic (showing no signs or symptoms) infections have occurred 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.

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

Good hand and respiratory hygiene are the single most effective preventative weapons we have in the battle against COVID-19 and SARS-Cov-2.

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 the SARS-Cov-2 virus 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, 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 13 HEALTH (13 43 25 84) 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)