Amid the coronavirus pandemic, Rady Children’s Hospital is ready for an influx of patients. Not kids, though. While Rady is prepared to take young adults up to the age of 26 to take the load off local hospitals, it’s not expecting to treat high numbers of infected children.
Why? Because the virus is making few children sick for reasons that are unclear yet critically important to understanding the disease. According to county statistics  released Thursday, only six people under the age of 20 have tested positive for the coronavirus, and none of those has been hospitalized. (The county total for all ages stands at 341.)
Earlier this week, the county announced that two babies – a 6-week-old boy and a 4-month-old girl – had tested positive . Neither has shown symptoms and both are at home, KPBS reported. It’s not clear how they became infected or why they were tested. News about the cases made it onto CNN on Thursday.
With some exceptions, like the Spanish Flu in 1918, the youngest and oldest among us are most vulnerable to many infectious diseases. But coronavirus seems to largely leave children alone: Research  suggests that it’s less likely to make kids sick than adults, and it rarely kills them.
In an interview with VOSD, Rady Children’s Hospital pediatric infectious disease specialist Dr. Mark Sawyer explored the mysteries of coronavirus risk in kids and offered advice about how parents can protect their children.
Why are children less susceptible to the ravages of this disease?
I don’t think anybody knows why children are not being severely affected by this infection. But there are a number of theories that have been put forward.
Although it certainly doesn’t explain everything, one theory is that children in general are more robust, recover faster and do better with many infections than adults do, especially compared to adults who have other health conditions that make them more vulnerable.
What are some of the other theories?
As we grow and mature, our body changes, and the cells in our body change. The coronavirus binds to specific receptors on cell surfaces, and it’s possible that the density or number of those receptors is different between adults and children. That might explain why children are being protected: Because the virus just can’t get in, or at least can’t cause severe illness.
Another theory has to do with immune response. For some infections, it’s not a good thing if you’ve had exposure either to the same virus or to a related virus. When you get it again, or you get something that’s related to it later, your immune system overreacts and you get basically symptoms that come from the immune response rather than from the affecting bacteria or virus. There is some suggestion that that’s part of what’s going on with coronavirus: The immune system is reacting and may be overreacting in the lungs. In contrast, it may be that children have not had any prior exposure to related to this virus or related viruses.
But kids like these two babies are still getting infected. Just without symptoms, right?
Yes, and once they’re infected, they have the potential to transmit the virus to other people. It’s very important that parents include their children in social isolation. You don’t want children visiting their grandparents right now.
What about newborns?
We do worry about children in the first two months of life being more susceptible in general to infections. Their organ systems are just beginning to mature and are not fully developed. That’s particularly true in the lungs. So in general, young babies do have more problems with many respiratory viruses.
But so far, that hasn’t really been seen with this virus. It’s not clear why that is, if it’s due to the factors I’ve already talked about or some protection they’ve gotten from their mothers before they were born. All of these things are going to be investigated over the next few months. [New research  suggests it may be possible for babies to become infected in the womb.]
What should parents of babies watch out for?
They should look out for this in the same way that they would look out for any other respiratory infection. Seek medical care if a child is having trouble breathing or – in the case of young babies – having trouble eating because they can’t breathe well while they’re nursing or taking milk from a bottle. High fevers would be a potential concern as would any change in behavior, especially looking lethargic or having a weak cry.
What is Rady Children’s Hospital doing to get ready for a worsening of coronavirus here?
We’re prepared to take young adult patients up to age 26 as needed. It’s not completely unusual for us to take care of a young adult at Rady Children’s, and in this case, we will potentially have extra bed capacity to provide care if it’s needed.
We’ve also just begun to offer in-house coronavirus tests with a turnaround of just a few hours. The highest priority will be children with symptoms and children with high-risk conditions who may have been exposed to somebody in their household.
Fortunately, parents can be reassured their kids are not going to end up in the hospital with this infection.