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Coronavirus: Are children at risk and do they spread it? Coronavirus: Are children at risk and do they spread it?
(about 13 hours later)
Some children are set to go back to primary schools in England, but big questions remain about their role in the pandemic.Some children are set to go back to primary schools in England, but big questions remain about their role in the pandemic.
Children can catch coronavirus and sometimes - thankfully rarely - become seriously ill. Children can catch coronavirus but very rarely become seriously ill.
But it is unclear how much they might be spreading it to each other and to adults, including staff. But it is unclear how much they might be spreading it to each other and to adults.
Here is what experts understand so far about young people and coronavirus.Here is what experts understand so far about young people and coronavirus.
Do children get sick?Do children get sick?
It remains the case that, overall, older people are most at risk of complications from the virus.It remains the case that, overall, older people are most at risk of complications from the virus.
The average age of people being admitted to critical care units in England, Wales and Northern Ireland was 60 as of 24 April, an audit by a research charity suggested.The average age of people being admitted to critical care units in England, Wales and Northern Ireland was 60 as of 24 April, an audit by a research charity suggested.
"Children have so far accounted for between 1% and 5% of diagnosed Covid-19 cases, have often milder disease than adults and deaths have been extremely rare," according to Prof Adilia Warris, a paediatric infectious diseases specialist at the University of Exeter."Children have so far accounted for between 1% and 5% of diagnosed Covid-19 cases, have often milder disease than adults and deaths have been extremely rare," according to Prof Adilia Warris, a paediatric infectious diseases specialist at the University of Exeter.
Can children pass on coronavirus?Can children pass on coronavirus?
Young children are superspreaders of other diseases, such as flu. Children are considered a high risk group when it comes to flu, but so far appear to be at low risk of becoming very ill from coronavirus. So far they appear to be at low risk of becoming ill from the virus - but one of the missing pieces of the puzzle is how much children carry coronavirus and spread the disease to others.
One of the missing pieces of the puzzle is how much children carry coronavirus and spread the disease to others, even if they don't often become ill themselves. It is still not clear how infectious people are if they have very mild symptoms or no symptoms at all - of any age.
It is too soon to know how infectious people of any age with no symptoms, or only very mild ones, are to others. Coronavirus is transmitted in a similar way to the flu virus - through coughing or touching objects contaminated by droplets, such as pens and door handles.
Coronavirus is transmitted in a similar way to the flu virus - through coughing or touching contaminated objects, such as pens and door handles. Keeping 2m (6ft) away from other people at all times and washing your hands before touching your face or eating food helps stop the spread of coronavirus. These preventive measures are challenging even for adults to maintain.
Keeping 2m (6ft) away from other people at all times and washing your hands before touching your face or eating food helps stop the spread of coronavirus. But these preventive measures are challenging even for adults to maintain.
Whether children are spreaders or not remains "one of the many unknowns with the current coronavirus outbreak", says Prof Matthew Snape from the University of Oxford. He is beginning research into how many children and teenagers have been infected and developed immunity.Whether children are spreaders or not remains "one of the many unknowns with the current coronavirus outbreak", says Prof Matthew Snape from the University of Oxford. He is beginning research into how many children and teenagers have been infected and developed immunity.
"Understanding this is vital to understanding how to manage the outbreak response, including decisions about when to re-open schools," he says. "We know from the current data that children have fewer symptoms and appear to have different transmission dynamics to adults," says Prof Saul Faust, professor of paediatric immunology and infectious diseases, from the University of Southampton and University Hospital Southampton NHS Foundation Trust.
"Children may possibly have shorter/fewer viral excretions from coughing or speaking," he added.
Why send primary school children back to school first?Why send primary school children back to school first?
Government guidelines say they are starting with Reception, Year 1 and Year 6 children because:Government guidelines say they are starting with Reception, Year 1 and Year 6 children because:
World Health Organisation (WHO) chief scientist Dr Soumya Swaminathan says that children are "less capable" of spreading the virus, and are at "very low risk" of getting ill from the disease.World Health Organisation (WHO) chief scientist Dr Soumya Swaminathan says that children are "less capable" of spreading the virus, and are at "very low risk" of getting ill from the disease.
"What we have seen in countries where schools have remained open is that there have not been big outbreaks in schools," Dr Swaminathan said."What we have seen in countries where schools have remained open is that there have not been big outbreaks in schools," Dr Swaminathan said.
Should children wear masks at school?Should children wear masks at school?
While face coverings may help reduce the chance of spreading the disease when social distancing rules are difficult to follow, the government is not recommending their use in UK schools.While face coverings may help reduce the chance of spreading the disease when social distancing rules are difficult to follow, the government is not recommending their use in UK schools.
Guidance explains that young children may find it difficult to use them without assistance and that focus should be on washing hands and other good hygiene measures.Guidance explains that young children may find it difficult to use them without assistance and that focus should be on washing hands and other good hygiene measures.
Are children immune?Are children immune?
One theory for why children generally have no or milder symptoms is that their lungs might contain fewer of the receptors that coronavirus uses to infect cells. But experts say there is no good evidence to support this.One theory for why children generally have no or milder symptoms is that their lungs might contain fewer of the receptors that coronavirus uses to infect cells. But experts say there is no good evidence to support this.
And there have been reports of a very small number of children with coronavirus getting very sick and developing an overactive inflammatory immune response.And there have been reports of a very small number of children with coronavirus getting very sick and developing an overactive inflammatory immune response.
What about Kawasaki-like disease?What about Kawasaki-like disease?
Scores of UK and US children have been affected by a rare inflammatory disease linked to coronavirus. In a tiny number of children it can cause serious complications, with some needing intensive care. Scores of children in the UK, US and across Europe have been affected by a rare inflammatory disease linked to coronavirus. In a tiny number of children it can cause serious complications, with some needing intensive care.
Symptoms appear similar to Kawasaki disease - a potentially fatal syndrome that affects blood vessels - including a high temperature, low blood pressure, a rash and difficulty breathing.Symptoms appear similar to Kawasaki disease - a potentially fatal syndrome that affects blood vessels - including a high temperature, low blood pressure, a rash and difficulty breathing.
The syndrome appeared to be similar to the over-active immune response, known as a "cytokine storm", seen in some adults with Covid-19. In many cases, it seems it is the body's immune response rather than the virus itself that proves life-threatening.The syndrome appeared to be similar to the over-active immune response, known as a "cytokine storm", seen in some adults with Covid-19. In many cases, it seems it is the body's immune response rather than the virus itself that proves life-threatening.
But these symptoms identified in children are rare events - known to affect about 20 children so far - and not all of them tested positive for Covid-19. But these symptoms identified in children are very rare events - known to affect about up to 100 children in the UK so far - and not all of them tested positive for Covid-19.
Prof Rosalind Smyth, a consultant in paediatric respiratory medicine at Great Ormond Street Hospital, points out: "Our understanding of this condition in children is limited. The majority of children who have had the condition have responded to treatment and are getting better, said Prof Russell Viner, president of the Royal College of Paediatrics and Child Health.
"We should investigate fully these children, with Sars-CoV-2, who present with a multi-system inflammatory disease to assess whether this is a presentation of Covid-19," she says. "This shouldn't stop parents letting their children exit lockdown," Prof Viner added.
When to seek helpWhen to seek help
While children can catch coronavirus, it is rarely serious. If your child is unwell it is likely to be a non-coronavirus illness, rather than coronavirus itself.While children can catch coronavirus, it is rarely serious. If your child is unwell it is likely to be a non-coronavirus illness, rather than coronavirus itself.
The Royal College of Paediatrics and Child Health advises parents seek urgent help (call 999 or go to A&E) if their child is:The Royal College of Paediatrics and Child Health advises parents seek urgent help (call 999 or go to A&E) if their child is:
What about pre-existing conditions?What about pre-existing conditions?
Underlying health conditions also play a role, regardless of age.Underlying health conditions also play a role, regardless of age.
For example, there are about five-and-a-half million people in the UK of all ages who have asthma - and this puts you at higher risk of severe illness if you contract coronavirus.For example, there are about five-and-a-half million people in the UK of all ages who have asthma - and this puts you at higher risk of severe illness if you contract coronavirus.
Children with existing health conditions that put them at much higher risk of complications from coronavirus are being advised to stay at home - a protective precaution called shielding.Children with existing health conditions that put them at much higher risk of complications from coronavirus are being advised to stay at home - a protective precaution called shielding.
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What do I need to know about the coronavirus?What do I need to know about the coronavirus?