Commentary: Should you be worried about your kids getting COVID-19? Let a San Diego doctor explain

The San Diego Union-Tribune, By Carolyn Barber on May 28, 2020

One problem with being bombarded by numbers, as we have been during this pandemic, is trying to make sense of — well, of any of them, to be frank. That goes double for the grim notion of fatality rates, a problem wildly compounded in the U.S., where we have tested only about 5% of the population. Without a good understanding of the prevalence of the new coronavirus, and without knowing how many people are walking around our streets positive with the virus but asymptomatic, we are at a huge disadvantage.

Still, most of the younger people I’ve spoken with would wade through a river of statistics if it meant answering one question: Will this thing kill me?

On that front, let me share good news. Per the Centers for Disease Control and Prevention (CDC), only 2% of confirmed cases in the U.S. occur in those under age 18. The numbers are even lower in Spain and Italy. If you’re young and don’t have pre-existing medical problems, the information gathered so far tells us that you have a pretty darned low chance of dying from COVID-19, the disease that the coronavirus can cause — and the numbers have been consistent in that regard.

Let’s take the example of New York City. The five boroughs have been a vector for infection and spread of the virus, with over 197,000 documented cases and more than 16,000 known deaths. Yet as of this week, New York City had reported just 10 deaths among those age 17 or younger, and only 19 deaths per 100,000 people for those aged 18 to 44.

As of mid-May, in fact, the number of confirmed pediatric deaths in the entire country for kids under age 19 was just 42, per COVKID, a national data dashboard. We haven’t tested many children in the U.S., but based on the total number of currently estimated pediatric cases, this correlates with a fatality rate of only 0.006%.

The pandemic instead may affect young people in a different way, albeit very rarely. An illness called pediatric multisystem inflammatory syndrome, potentially triggered by a virus, could be causing inflammation of the blood vessels, heart, skin, etc., of children. That’s worrisome, but it’s also extremely unusual with less than a few hundred reported cases. Young people have a much greater likelihood of simply experiencing a mild or moderate flu-like illness — or no illness at all. In fact, the largest pediatric study to date in China (more than 2,000 kids) found this to be the outcome 94% of the time.

In younger and older people alike, if you have no pre-existing medical conditions, the statistics are greatly in your favor. At one of New York’s largest hospital networks, New York City Health, only 0.7% of all COVID-19 deaths occurred in people under age 64 who had no known pre-existing medical conditions. Again: For patients with no medical issues previously, people under the age of 64 were beating the virus more than 99% of the time.

As a physician, let me offer this caveat: We are still early in the course of the novel coronavirus, and these numbers will change some. Still, the trend of an age-related mortality benefit has been consistent, and it bears pointing out.

Even if they become infected, most young people won’t be hospitalized or ever see an intensive care unit, either. Per the CDC, through mid-May, fewer than two of every 100,000 young adults between the ages of 5 and 17 were hospitalized, and just 37 of every 100,000 people aged 18 to 49 were admitted. Regarding ICU admissions, only 334 children under age 18 have been admitted to intensive care units across the U.S. since the pandemic’s beginning — just a handful of the estimated 760,000-plus pediatric coronavirus cases. A JAMA study published this month further reveals that more than 80% of children admitted to ICUs in their study also had prior medical problems. Being young and healthy wins.

This isn’t to say that danger doesn’t exist. It does — just not commonly, nor in the ways many young people might think about. The real risk is that younger folks may be asymptomatic carriers of coronavirus — they feel fine, but they might inadvertently pass the disease to older adults, who are at greater risk for infection and death.

The bottom line: If you’re young with an uncomplicated medical history, it’s highly unlikely that doom is knocking on your door. You still have a responsibility to practice social distancing, wash your hands often, wear a mask in public, avoid large gatherings, and adhere to state and local guidelines — and if you’re ever in doubt about what to do, think of your parents and grandparents, or perhaps a friend who is medically compromised.

But if what’s been keeping you up at night is the prospect of a terrible and early end, rest easier. I’m one of the people who does wade through the river of statistics — and they’re on your side.

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