With the recent return to schools in the United Kingdom, and the overall success of the vaccination programs running up and down the country, much has been made of the risk of another wave in this next phase of re-opening. Children and young adults have been schooled where possible remotely, and a minority of pupils who could not work at home were permitted to visits schools throughout the lockdowns. In government narratives, much of the conversation around schools has not been around the risk to children themselves, but more in the ‘foundations’ of infection which can be facilitated through mass gatherings in school settings. Although the UK is improving and in a better place than early January, where hospitals met capacity – there is still a precarious situation. The government has installed 5-week periods of pause between reopening and restriction easing to assess the ongoing effect of these closures – with fears that rising infections rates in school could cause another surge.
As overwhelming percentages of at-risk populations are now vaccinated, there is less risk of high mortality where children may spread coronavirus to their elderly relatives or carers. Yet, although rare, there are numerous reports of significant impact to children’s health when they contract coronavirus, Long covid has been identified as a significant after effect of coronavirus, yet it is not known exactly what the incidence of this condition is. In a recent poll by the ONS in December, short term and long-term side effects were estimated as follows;
These statistics were likely taken from adults due to complexities in self-reporting of children, particularly younger children who may struggle to communicate nuance in their symptoms and overall health. It is likely, too, that children and adults will experience different manifestations if their conditions persist post-infection, due to physiological and immunological differences.
Coronavirus has brought to light a long-known area of medicine which struggles to make significant bounds and progress due to the complexity of the human body. Long-covid is one of many post-viral syndromes which can manifest with infections – people will be most common with glandular fever and the tiredness which can prevail for months and years post infection. Infection by other viral pathogens like cytomegalovirus, a particular bad strain of influenza and other viruses can all cause chronic fatigue, persistent malaise and conditions like ME (Myalgic Encephalomyelitis).
There have been a number of reports of children developing the serious auto-immune condition or a novel proxy now called “paediatric multisystem inflammatory syndrome'”. In children, where this condition does manifest, there is significant inflammation, multiple organ dysfunction and other main symptoms like fever and fatigue. These symptoms are managed conservatively to relieve symptoms and reduce the over-activation of the immune system which is often to blame in auto-immune disorder.
Although there can be serious complications from COVID-19, the prevalence of these for children is extremely low. However, the manifestations in those children who do develop an auto-immune response to COVID-19 should serve as a reason to remember that social distancing, restrictions and measures must stay in place until significant immunity of the population has been achieved. The common narrative is that coronavirus is only associated with mortality in elderly people, but there can be serious and wide-reaching consequences for any age of individual who contracts coronavirus.