As I was heading into work last week, my neighbour asked if I was worried to be working in the pediatric ER. I responded “I am not scared for myself but rather for all the children who are sick and are not coming to the ER because they are afraid of COVID-19.”
Children very rarely get sick from the coronavirus – fewer than 20 children in Montreal have been hospitalized with COVID-19. Half of these patients were admitted for reasons unrelated to the virus, such as ingestion of a foreign body or a urinary tract infection. They tested positive as they were screened during their admission, not because they had symptoms. In Canada, fewer than five per cent of the reported infections have been in people younger than 18 years old.
But children are being significantly affected by COVID-19, just not in a way that makes headlines. Their emotional and social development is being stunted and their intellectual growth curtailed from being in lockdown.
Many children lack supportive home environments and need the structure and social interaction that is provided by schools, clubs, sports and summer camps. They need social interaction with other children: playing sports together, doing creative art projects and exploring nature. These are all invaluable for healthy development.
Many parents are stressed from having lost their jobs, or not being able to go to work. Others are faced with the impossible task of working full time from home and being caregivers. The result? Many children are glued to screens for eight hours per day or more while parents work. Screens do not provide the cognitive and social stimulation that children need.
As we move towards the end of the school year, I believe we need to focus on opening summer camps and sports for children. Viruses are much more likely to spread indoors than outdoors. The vast majority of camps and sports programs during the summer take place outside and are led by young adults who are also at lower risk of infection.
Kids need exercise and social interaction – they need to get off their screens. Teenagers need jobs, a sense of purpose, and the opportunity to develop technology-free relationships. Summer sports programs, day camps and sleep away camps fill all these needs.
I’m not suggesting this be mandatory. No parent should feel pressured to enrol their child is any sports program or summer camp, but the option should be there for those who wish to benefit from them. Most studies show that children with COVID-19 were infected by an adult relative and it was not the child that had infected the adults.
We will be living with coronavirus for months and years to come. We likely won’t have a vaccine for 18 months. There is a good chance little will have changed come fall when school resumes, except that colder weather will force kids inside where the risk of spreading germs is higher and are volumes in the ER are much higher due to other respiratory viruses.
The children are not getting sick. We have seen two times as many cases of appendicitis in the emergency room than coronavirus since March. But the reality is that kids will be exposed to it sooner or later.
The recent deaths of three children from Kawasaki disease in New York is tragic. As pediatricians,we have seen Kawasaki cases since the 1970s. It is an inflammatory condition that we see with many types of infections. Most kids with Kawasaki Disease completely recover, especially with early diagnosis and treatment. We are not clear on the role, if any, that coronavirus played in these cases. I worry that the families of children will not seek needed medical treatment, for fear of coming to the hospital.
While there will be some children that get infected with COVID-19, their risk of getting sick is much less than with other viruses such as influenza or RSV (respiratory syncytial virus). These viruses have resulted in over 500 children being admitted to the hospital this year alone. COVID-19 is not dangerous for the vast majority of the youth population and pediatric hospitals are not overwhelmed.
As a pediatrician, my job is to advocate for children. It’s time to think about opening up summer camps and sports programs. Protect the vulnerable people from coronavirus but let the children out of lockdown. It’s better for their mental and physical health.