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Why the New Coronavirus (Mostly) Spares Children Why the New Coronavirus (Mostly) Spares Children
(about 4 hours later)
The new coronavirus has infected nearly 90,000 people, and more than 3,000 have died. But relatively few children appear to have developed severe symptoms so far, according to available data.The new coronavirus has infected nearly 90,000 people, and more than 3,000 have died. But relatively few children appear to have developed severe symptoms so far, according to available data.
“Disease in children appears to be relatively rare and mild,” with those under 19 years making up only 2.4 percent of the total cases, according to a report published Feb. 28 by the World Health Organization.“Disease in children appears to be relatively rare and mild,” with those under 19 years making up only 2.4 percent of the total cases, according to a report published Feb. 28 by the World Health Organization.
So why aren’t more children getting sick?So why aren’t more children getting sick?
“My strong, educated guess is that younger people are getting infected, but they get the relatively milder disease,” Dr. Malik Peiris, chief of virology at the University of Hong Kong, said last month. Dr. Peiris has developed a diagnostic test for the new coronavirus.“My strong, educated guess is that younger people are getting infected, but they get the relatively milder disease,” Dr. Malik Peiris, chief of virology at the University of Hong Kong, said last month. Dr. Peiris has developed a diagnostic test for the new coronavirus.
The numbers so far support that theory: According to the W.H.O., only 2.5 percent of those under 19 have developed severe disease and only 0.2 percent had critical disease. There have been no deaths recorded in children under 9.The numbers so far support that theory: According to the W.H.O., only 2.5 percent of those under 19 have developed severe disease and only 0.2 percent had critical disease. There have been no deaths recorded in children under 9.
Scientists may not be seeing more infected children because “we don’t have data on the milder cases,” Dr. Peiris said.Scientists may not be seeing more infected children because “we don’t have data on the milder cases,” Dr. Peiris said.
Without more information, it is also unclear whether children can transmit the disease to others. The W.H.O. report said that its team sent to China, the epicenter of the outbreak, “could not recall episodes in which transmission occurred from a child to an adult.”Without more information, it is also unclear whether children can transmit the disease to others. The W.H.O. report said that its team sent to China, the epicenter of the outbreak, “could not recall episodes in which transmission occurred from a child to an adult.”
Still, children who are detected as infected must be shedding some virus or they wouldn’t be detected, noted Dr. Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health. But whether their infectiousness is high is as yet unknown. “It’s a very high priority to do studies to find it out,” he said.Still, children who are detected as infected must be shedding some virus or they wouldn’t be detected, noted Dr. Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health. But whether their infectiousness is high is as yet unknown. “It’s a very high priority to do studies to find it out,” he said.
One way to find out, he said, is to look at outbreaks such as the one at the church in South Korea. “If there were children among those people,” he said, “that would be a goldmine of data.”One way to find out, he said, is to look at outbreaks such as the one at the church in South Korea. “If there were children among those people,” he said, “that would be a goldmine of data.”
The other approach is to conduct household studies, where multiple members of a family might be infected.The other approach is to conduct household studies, where multiple members of a family might be infected.
In one such published case study of a family, a 10-year-old traveled to Wuhan, China, with his family. Upon returning to Shenzhen, the other infected family members, ranging in age from 36 to 66, developed fever, sore throat, diarrhea and pneumonia.In one such published case study of a family, a 10-year-old traveled to Wuhan, China, with his family. Upon returning to Shenzhen, the other infected family members, ranging in age from 36 to 66, developed fever, sore throat, diarrhea and pneumonia.
The child, too, had signs of viral pneumonia in the lungs, doctors found — but no outward symptoms. Some scientists suspect that this is typical of coronavirus infection in children.The child, too, had signs of viral pneumonia in the lungs, doctors found — but no outward symptoms. Some scientists suspect that this is typical of coronavirus infection in children.
“It’s certainly true that children can be either asymptomatically infected or have very mild infection,” Dr. Raina MacIntyre said last month. Dr. MacIntyre is an epidemiologist at the University of New South Wales in Sydney, Australia, who has been studying the spread of the new coronavirus.“It’s certainly true that children can be either asymptomatically infected or have very mild infection,” Dr. Raina MacIntyre said last month. Dr. MacIntyre is an epidemiologist at the University of New South Wales in Sydney, Australia, who has been studying the spread of the new coronavirus.
In many ways, this pattern parallels that seen during outbreaks of SARS and MERS, also coronaviruses. The MERS epidemics in Saudi Arabia in 2012 and in South Korea in 2015 together claimed more than 800 lives. Most children who were infected never developed symptoms.In many ways, this pattern parallels that seen during outbreaks of SARS and MERS, also coronaviruses. The MERS epidemics in Saudi Arabia in 2012 and in South Korea in 2015 together claimed more than 800 lives. Most children who were infected never developed symptoms.
No children died during the SARS epidemic in 2003, and the majority of the 800 deaths in the outbreak were in people over age 45, with men more at risk.No children died during the SARS epidemic in 2003, and the majority of the 800 deaths in the outbreak were in people over age 45, with men more at risk.
Among the more than 8,000 cases of SARS, researchers at the Centers for Disease Control and Prevention were able to identify 135 infected children in published reports.Among the more than 8,000 cases of SARS, researchers at the Centers for Disease Control and Prevention were able to identify 135 infected children in published reports.
Children under age 12 were much less likely to be admitted to a hospital or to need oxygen or other treatment, the researchers found. Children over age 12 had symptoms much like those of adults.Children under age 12 were much less likely to be admitted to a hospital or to need oxygen or other treatment, the researchers found. Children over age 12 had symptoms much like those of adults.
“We don’t fully understand the reason for this age-related increase of severity,” Dr. Peiris said. “But we see that now — and with SARS, you could see that much more clearly.”“We don’t fully understand the reason for this age-related increase of severity,” Dr. Peiris said. “But we see that now — and with SARS, you could see that much more clearly.”
It’s not unusual for viruses to trigger only mild infections in children and much more severe illnesses in adults. Chickenpox, for example, can be largely inconsequential in children, yet catastrophic in adults.It’s not unusual for viruses to trigger only mild infections in children and much more severe illnesses in adults. Chickenpox, for example, can be largely inconsequential in children, yet catastrophic in adults.
Influenza is unusual in that it has evolved with humans over thousands of years and infects millions worldwide each year. Still, even though thousands of young children end up in the hospital each year with influenza, just a small percentage of them die, said Dr. Krys Johnson, an epidemiologist at Temple University in Philadelphia.Influenza is unusual in that it has evolved with humans over thousands of years and infects millions worldwide each year. Still, even though thousands of young children end up in the hospital each year with influenza, just a small percentage of them die, said Dr. Krys Johnson, an epidemiologist at Temple University in Philadelphia.
This trend is generally true of respiratory illnesses because children tend to eat well, and to get plenty of exercise and rest — none of which may be true of adults. “The younger, most healthy segment of the population are able to fight it off,” she said. Adults may also be more susceptible because they are more likely to have other diseases, such as diabetes, high blood pressure or heart disease, that weaken their ability to stave off infections.This trend is generally true of respiratory illnesses because children tend to eat well, and to get plenty of exercise and rest — none of which may be true of adults. “The younger, most healthy segment of the population are able to fight it off,” she said. Adults may also be more susceptible because they are more likely to have other diseases, such as diabetes, high blood pressure or heart disease, that weaken their ability to stave off infections.
Updated June 16, 2020Updated June 16, 2020
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The body’s innate immunity, which is critical for fighting viruses, also deteriorates with age, and particularly after middle age.The body’s innate immunity, which is critical for fighting viruses, also deteriorates with age, and particularly after middle age.
“Something happens at age 50,” Dr. MacIntyre said. “It declines, and it declines exponentially, which is why for most infections we see the highest incidence in the elderly.”“Something happens at age 50,” Dr. MacIntyre said. “It declines, and it declines exponentially, which is why for most infections we see the highest incidence in the elderly.”
A key question about the new coronavirus is whether children who are infected and asymptomatic are able to pass the virus to others.A key question about the new coronavirus is whether children who are infected and asymptomatic are able to pass the virus to others.
“We know that young people in general — not just kids, but young adults and teenagers — have the most intense contact in society,” Dr. MacIntyre said. Young people who don’t realize they are sick may contribute to the epidemic’s momentum, she said.“We know that young people in general — not just kids, but young adults and teenagers — have the most intense contact in society,” Dr. MacIntyre said. Young people who don’t realize they are sick may contribute to the epidemic’s momentum, she said.
To understand the epidemic fully, she and other scientists said they need detailed data: when people were first exposed to the virus, when they first began to show symptoms, how many and which people have mild symptoms versus more severe disease.To understand the epidemic fully, she and other scientists said they need detailed data: when people were first exposed to the virus, when they first began to show symptoms, how many and which people have mild symptoms versus more severe disease.
With detailed data, some observations, such as the higher risk in men, may change. Still, Dr. Mark Denison, a pediatric infectious diseases specialist at Vanderbilt University in Nashville, said last month that he does not expect to see a sudden uptick in infected children.With detailed data, some observations, such as the higher risk in men, may change. Still, Dr. Mark Denison, a pediatric infectious diseases specialist at Vanderbilt University in Nashville, said last month that he does not expect to see a sudden uptick in infected children.
“It’s hard for me to imagine that there’s such a degree of underreporting of clinical illness in children that we’re only hearing about two or three cases,” he said.“It’s hard for me to imagine that there’s such a degree of underreporting of clinical illness in children that we’re only hearing about two or three cases,” he said.
“I think it means that there are many, many less children” who are infected in China, he said, “and that they’re not as much at risk.”“I think it means that there are many, many less children” who are infected in China, he said, “and that they’re not as much at risk.”