A second local pediatric death and reopening of public playgrounds in Hamilton County this week serve as reminders that while children are less susceptible to serious COVID-19 infection, they're certainly not immune.
On Tuesday, the Hamilton County Health Department reported that a girl under age 10 with no underlying medical conditions had died due to the coronavirus — marking the first time that an otherwise healthy child in Hamilton County was known to have died in the global pandemic.
"The Health Department grieves with the family and the community for the loss of this child," Health Department Administrator Becky Barnes said in a news release. "We stress once again how important it is to wear a mask and practice social distancing to keep this virus from spreading. These are simple yet necessary acts of kindness that could save a life."
Since it's a new disease, much is still not well understood about COVID-19 — especially how and why it presents differently in children than adults, as well as the role that youngsters play in transmission.
Children are less likely to become seriously ill or die from the coronavirus. In Tennessee, COVID-19 has killed three children age 10 and under and one child between age 11 and 20 — out of 567 total fatalities.
A study published last week in the journal Nature found that people under 20 were about half as susceptible to COVID-19 infection as people over 20, and were also far more likely to never show symptoms compared to people over the age of 70.
"Age disparities in observed cases could be explained by children having lower susceptibility to infection, lower propensity to show clinical symptoms or both," study authors wrote.
School closures could also be another factor contributing to fewer COVID-19 infections in children.
Still, Dr. Charles Woods, a pediatric infectious disease specialist and chief medical officer at Erlanger Children's Hospital, said in an email that the biggest misconception about COVID-19 in children is that people assume children are safe.
"Children do get COVID-19 and can spread COVID-19. More children have mild infection than adults and require hospitalization less often than adults. Some will develop severe illness, and a few may die from the virus or complications," Woods said. "The risk is low but definitely not zero."
Although the vast majority of children fare well, infants and toddlers have slightly more risk for severe infections than older children, Woods said. Children with underlying health conditions are also at greater risk of symptomatic infection.
On June 24, Hamilton County Mayor Jim Coppinger allowed Hamilton County's outdoor playgrounds to reopen while still practicing COVID-19 preventive measures, such as proper distancing, and wearing masks when appropriate.
Operators of playground facilities are encouraged to implement cleaning and disinfecting procedures and also provide hygiene supplies, such as soap and paper towels or hand sanitizer where possible.
"You have to go about life, and risks are low, but avoiding infection if possible until we get an effective vaccine is worth trying — wear masks in public spaces with close contact with others as much as possible," Woods said. "And remember that if your child gets the virus, they can spread it to adults or other children who may be at high risk for severe infection or death from the virus."
Woods also worries about other effects of the pandemic on child health, such as the disruption it has caused in schooling and other routines, especially for kids who come from socially disadvantaged backgrounds.
A June article in the journal of the American Academy of Pediatrics says that the economic uncertainty, stress and anxiety of living through a pandemic has likely increased the already elevated risks for LGBTQ, maltreated and homeless youth, as well as youth with substance use disorders and those in foster care.
"Vulnerable youth cannot wait for the COVID-19 pandemic to subside to have their increased risks addressed and their needs for emotional and physical safety met," the authors said. "We should all be ready to assist them."
Contact Elizabeth Fite at email@example.com or follow her on Twitter @ecfite.