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| U.S. Children With Coronavirus Are Less Hard Hit Than Adults, First Data Shows | U.S. Children With Coronavirus Are Less Hard Hit Than Adults, First Data Shows |
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| Children make up a very small proportion of American coronavirus cases so far and are significantly less likely to become seriously ill than American adults, according to a preliminary report on the first wave of coronavirus cases in the United States. But some have become very sick, and at least three have died. | Children make up a very small proportion of American coronavirus cases so far and are significantly less likely to become seriously ill than American adults, according to a preliminary report on the first wave of coronavirus cases in the United States. But some have become very sick, and at least three have died. |
| The study, published Monday by the Centers for Disease Control and Prevention, also reported that children appear less likely than adults to develop any of the major known coronavirus symptoms: fever, cough or shortness of breath. That could suggest that many children have mild or undetected cases of the disease and could be spreading the virus to others in their families and communities. | The study, published Monday by the Centers for Disease Control and Prevention, also reported that children appear less likely than adults to develop any of the major known coronavirus symptoms: fever, cough or shortness of breath. That could suggest that many children have mild or undetected cases of the disease and could be spreading the virus to others in their families and communities. |
| “We don’t think many kids get severe disease, so are kids transmitting the disease at a significant rate that’s going to propagate this outbreak?” asked Dr. Srinivas Murthy, an associate professor of pediatrics at the University of British Columbia, who was not involved in the study. The answer to that question, he said, will be important in deciding how to manage the pandemic, when to reopen schools and how to predict future waves of infection. | “We don’t think many kids get severe disease, so are kids transmitting the disease at a significant rate that’s going to propagate this outbreak?” asked Dr. Srinivas Murthy, an associate professor of pediatrics at the University of British Columbia, who was not involved in the study. The answer to that question, he said, will be important in deciding how to manage the pandemic, when to reopen schools and how to predict future waves of infection. |
| The C.D.C. study said that 2,572 of the nearly 150,000 confirmed coronavirus cases reported in the United States between Feb. 12 and April 2 were patients under 18. Their median age was 11. Those cases included 850 from New York City, the current epicenter of the outbreak in the United States, 584 from the rest of New York State and 393 from New Jersey. | The C.D.C. study said that 2,572 of the nearly 150,000 confirmed coronavirus cases reported in the United States between Feb. 12 and April 2 were patients under 18. Their median age was 11. Those cases included 850 from New York City, the current epicenter of the outbreak in the United States, 584 from the rest of New York State and 393 from New Jersey. |
| There were some significant gaps in the data. The researchers said that important information — like whether the patients went to the hospital or what, if any, symptoms they had — was not available for many of the cases in the study. State and local health departments, many of which have been overwhelmed by the fast-moving pandemic, may be able to provide more data in the future, the report said. | There were some significant gaps in the data. The researchers said that important information — like whether the patients went to the hospital or what, if any, symptoms they had — was not available for many of the cases in the study. State and local health departments, many of which have been overwhelmed by the fast-moving pandemic, may be able to provide more data in the future, the report said. |
| Of the 745 cases with data on whether the child was hospitalized, 147 children — about a fifth — were reported to have been hospitalized. Among adults that rate is about a third, the report said. | Of the 745 cases with data on whether the child was hospitalized, 147 children — about a fifth — were reported to have been hospitalized. Among adults that rate is about a third, the report said. |
| Forty percent of pediatric hospitalizations, or 59 cases, were for babies under 1. Five of the 15 children admitted to intensive care were babies. Children with underlying health conditions also appeared to have a greater risk of hospitalization, the report said. | Forty percent of pediatric hospitalizations, or 59 cases, were for babies under 1. Five of the 15 children admitted to intensive care were babies. Children with underlying health conditions also appeared to have a greater risk of hospitalization, the report said. |
| “Compared to other respiratory diseases, this is incredibly unique in the proportion of severely ill children,” Dr. Murthy said. “We would expect more hospitalization based on the number of kids that might get infected, and we’re not seeing that at all. And we still don’t know why.” | “Compared to other respiratory diseases, this is incredibly unique in the proportion of severely ill children,” Dr. Murthy said. “We would expect more hospitalization based on the number of kids that might get infected, and we’re not seeing that at all. And we still don’t know why.” |
| Although the C.D.C. report did not give details about the three deaths, Illinois has reported the death of an infant under 1 from the virus. | Although the C.D.C. report did not give details about the three deaths, Illinois has reported the death of an infant under 1 from the virus. |
| Only a third of the cases studied had information on whether the child was hospitalized; only 13 percent had information on whether the child had other underlying medical conditions; and fewer than 10 percent of the cases had information about the child’s symptoms. | Only a third of the cases studied had information on whether the child was hospitalized; only 13 percent had information on whether the child had other underlying medical conditions; and fewer than 10 percent of the cases had information about the child’s symptoms. |
| Also, because many of the cases occurred very recently, shortly before the publication of the report, the researchers said their analysis “might underestimate severity of disease or symptoms that manifested later in the course of illness.” | Also, because many of the cases occurred very recently, shortly before the publication of the report, the researchers said their analysis “might underestimate severity of disease or symptoms that manifested later in the course of illness.” |
| Despite the gaps in the data, experts said the report, which is believed to be the largest study to date of confirmed cases of the coronavirus in children, could provide a useful early snapshot of general trends. | Despite the gaps in the data, experts said the report, which is believed to be the largest study to date of confirmed cases of the coronavirus in children, could provide a useful early snapshot of general trends. |
| Scientists are exploring several theories about why children seem relatively protected from severe disease. A leading idea is that a receptor in human cells that the viral particles bind to, called the ACE2 receptor, is not expressed as prominently in young children or might be a different shape. If so, in children, the virus might have more difficulty attaching to and entering cells, a step that is necessary for the virus to replicate and spread throughout the body. | Scientists are exploring several theories about why children seem relatively protected from severe disease. A leading idea is that a receptor in human cells that the viral particles bind to, called the ACE2 receptor, is not expressed as prominently in young children or might be a different shape. If so, in children, the virus might have more difficulty attaching to and entering cells, a step that is necessary for the virus to replicate and spread throughout the body. |
| Updated June 12, 2020 | Updated June 12, 2020 |
| 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. | |
| 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. |
| 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. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| 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. |
| Another theory is that children’s immune systems do not respond as aggressively to the virus as adult immune systems do, a process that can spiral out of control and cause as much damage as the infection. | Another theory is that children’s immune systems do not respond as aggressively to the virus as adult immune systems do, a process that can spiral out of control and cause as much damage as the infection. |
| “I’m getting more convinced that there’s a physiological age-based reason rather than children are just healthy,” Dr. Murthy said. | “I’m getting more convinced that there’s a physiological age-based reason rather than children are just healthy,” Dr. Murthy said. |
| The U.S. data echoes many of the findings in reports on pediatric cases in China, where the global outbreak began, but differences in China’s testing methodology make it difficult to compare results. One study of about 1,400 children under 16 in China found that fewer than half had coughs and only 42 percent had fevers, a much lower symptom rate than in adult patients. | The U.S. data echoes many of the findings in reports on pediatric cases in China, where the global outbreak began, but differences in China’s testing methodology make it difficult to compare results. One study of about 1,400 children under 16 in China found that fewer than half had coughs and only 42 percent had fevers, a much lower symptom rate than in adult patients. |
| In the American study, researchers had information about symptoms for 291 children. Of those, 73 percent had fever, cough or shortness of breath, compared with 93 percent of adult patients age 18 to 64. | In the American study, researchers had information about symptoms for 291 children. Of those, 73 percent had fever, cough or shortness of breath, compared with 93 percent of adult patients age 18 to 64. |
| The largest study to date of Chinese children, found that nearly 6 percent of the 2,143 confirmed or suspected cases of patients under 18 developed a severe or critical illness, and one 14-year-old boy with a confirmed diagnosis of coronavirus died. More than 60 percent of the 125 children who became severely or critically ill were age 5 or younger, the study reported. And 40 of those were infants less than 12 months old. | The largest study to date of Chinese children, found that nearly 6 percent of the 2,143 confirmed or suspected cases of patients under 18 developed a severe or critical illness, and one 14-year-old boy with a confirmed diagnosis of coronavirus died. More than 60 percent of the 125 children who became severely or critically ill were age 5 or younger, the study reported. And 40 of those were infants less than 12 months old. |
| The U.S. study also found that 57 percent of the reported cases were in boys, a gender pattern that has been seen in some adult studies. | The U.S. study also found that 57 percent of the reported cases were in boys, a gender pattern that has been seen in some adult studies. |
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