As more and more Alaskans test positive for COVID-19, cases have been confirmed among an increasing number of children statewide as well. Now, with a new school year underway and the COVID-19 pandemic still in full force, more information is emerging about kids and the coronavirus.
Kids and young adults 19 or younger made up 15.3% of total COVID-19 cases in Alaska as of the end of August, or 813 cases of 5,298 total. In contrast, back in May, kids made up just 8.4% of total cases, with 31 cases confirmed among children of 368 cases statewide, according to data from the state’s health department.
Alaska also has a higher percentage of confirmed COVID-19 cases among children than most other states, according to data from the American Academy of Pediatrics and the Children’s Hospital Association.
But it’s hard to compare those percentages across states, said Liz Ohlsen, a staff physician at the state’s Division of Public Health who is working with state and public health officials to help prepare schools and districts for operations during the pandemic.
While it does look like there’s a higher percentage of COVID-19 cases detected among kids in Alaska, Ohlsen said that doesn’t necessarily mean that a child is more likely to get the illness in Alaska versus another state.
The state has more young people than other states, and testing availability looks different in Alaska, Ohlsen said. If a child has mild symptoms in Alaska, they might be better able to get a test than in other places, she said.
How kids can get it and spread it
“Don’t assume they can’t get it,” said Dr. Melinda Rathkopf, director of the Allergy, Asthma and Immunology Center of Alaska and leader within the Alaska chapter of the American Academy of Pediatrics. “That’s a myth — they can get it.”
Both adults and children can spread the virus with or without symptoms, said Ohlsen with the state public health division.
“We’re thinking that younger children seem to be a little less likely to get the virus and a little less likely to give it to other people,” Ohlsen said. “It doesn’t mean they’re immune, it doesn’t mean they can’t transmit it.”
According to a recent study out of South Korea, kids over the age of 10 appear to get and spread the coronavirus just as easily as adults can, Ohlsen said.
“And the tricky thing is because kids are less likely to have symptoms, they’re more likely to give it to other people without even knowing they’re sick,” Ohlsen said.
On top of that, Rathkopf noted another concern is kids spreading the illness to others in the household.
“Your kid could get it and bring it home to you, your elderly parent that you care for in the home, a sibling that may be higher risk,” she said.
And symptoms can be vague, so “it’s just going to require increased vigilance,” Rathkopf said, like taking temperatures and doing health check-ups before bed.
How are children getting COVID-19 in Alaska?
Dr. Bruce Chandler, medical officer at the Anchorage Health Department, said that while much of the data on COVID-19 is incomplete, his “impression is that most kids in Anchorage have acquired infection from adult family and household members,” he wrote in an email.
He pointed to research that shows it is common for kids to get COVID-19 from family members, which makes sense since that is who they spend the most time inside with.
While there have been some individual cases in staff and children at child care facilities and preschools, he’s not aware of clusters or spread in those places in Anchorage, he said.
Alaskans are increasingly getting the virus through community spread — giving the illness to people they work, socialize or live with, compared with earlier in the pandemic when people were picking it up during travel and spreading it to a couple of their close contacts. Earlier on, there were more cases among adults in their 40s and 50s, Ohlsen said.
“Now, as we’ve seen increasing community transmission, we’ve really seen more cases rising in younger Alaskans,” Ohlsen said.
The fastest-rising demographic is people in their 20s and 30s, but the state is also starting to see more cases involving people between the ages of 10 and 19, she said.
Symptoms and hospitalizations
Alaska hasn’t seen many kids severely affected by COVID-19, Ohlsen said. There have been no deaths among children with COVID-19 in the state, with just one reported hospitalization for someone between the ages of 10 and 19, she said.
COVID-19 symptoms listed by the federal Centers for Disease Control and Prevention include: fever or chills; cough; shortness of breath or difficulty breathing; fatigue; muscle or body aches; headache; new loss of taste or smell; sore throat; congestion or runny nose; nausea or vomiting and diarrhea.
Kids are more likely to have mild or no symptoms at all, Ohlsen said. And broadly speaking, children tend to have slightly more gastrointestinal symptoms like nausea, vomiting and diarrhea than adults, she said.
Nationally, kids are less likely to end up in the hospital or intensive care unit with a severe case of COVID-19, but it’s possible, even in healthy children and in all age groups, Ohlsen said.
Some kids nationwide have gotten multisystem inflammatory syndrome in children — a serious illness with inflammation throughout their bodies. There are no reported cases of the illness in Alaska, Ohlsen said.
“It’s rare but it can be severe,” Rathkopf said.
Of kids nationwide who require hospitalization, about a third end up needing critical care, Rathkopf said.
It’s too soon to say whether children who get COVID-19 will experience long-term effects from the illness and what that might look like, Ohlsen said.
Masks and social distancing
“I think it’s definitely a myth that kids can’t wear a mask,” Rathkopf said.
She said it’s important to “normalize mask wearing” and practice other health measures like washing hands for 20 seconds in order for kids to learn those skills.
At her office, Rathkopf takes the opportunity to show kids how to put on masks correctly — only touching the sides and then adjusting it, and pinching it around the nose and pulling it forward to keep glasses from fogging it up. Masks should cover the wearer’s nose and mouth, and fit close against the sides of their face with no gaps.
It’s important not to assume kids will know how to wear a mask or wash their hands properly, Rathkopf said. But that doesn’t mean they can’t learn. She sees children with cancer and said that kids can learn to wear masks. It just takes some practice.
“Kids learn to wear a seat belt,” Rathkopf said. “Kids learn to wear a bicycle helmet.”
When it comes to social distancing, some schools are “cohorting” the younger children who may have trouble remembering to stay 6 feet apart, keep a mask on and wash their hands, Ohlsen said. So, as an “added layer of protection,” they’re keeping younger kids in tighter, smaller groups in order to limit possible exposure, she said.
The CDC also lists the range of risk factors for playdates outside of school settings including whether they take place inside or out, whether children can stay 6 feet apart and how frequently they occur.