As COVID-19 cases rise among children, parents wonder what’s safe: ‘No activity is risk-free’

Coronavirus vaccines are becoming more available and businesses are reopening, yet COVID-19 cases among children are on the rise, as people begin to socialize more and highly contagious new strains spread.

It’s a confusing combination of good news and bad news that has left parents unsure how to proceed, with summer just around the corner.

Children who contract COVID-19 generally experience milder illness and often are asymptomatic. Still, the rise in cases among kids is a reminder of the importance of keeping up with safety protocol and making sure that those who are eligible get vaccinated in order to protect those who are unable to be vaccinated and could spread the virus, doctors said.

Vaccine trials among children are underway — including locally — but it is unclear when they will be approved for use.

“It’s hard to be a parent these days,” said Mayssa Abuali, a pediatric infectious-disease specialist with Einstein Healthcare Network and St. Christopher’s Hospital for Children. “Parents have to look at the science and the data and talk to their pediatricians before making decisions, because no activity is risk-free these days.”

New cases of COVID-19 have been trending younger for weeks across the country and locally, as older adults gained access to the vaccines first. Younger adults, especially those with underlying conditions that make them vulnerable to the virus, have accounted for a growing portion of cases.

The few counties in the Philadelphia area that publish detailed age information show that cases have also risen significantly among children, even though they are less likely to contract the virus.

For instance, a year ago in Montgomery County, children under 19 accounted for just 3% of cases in the first two weeks of April. Now they make up a quarter of the county’s cases, with 806 children testing positive in the first two weeks of the month.

Meanwhile the percentage of cases among Montgomery County residents age 60 or older fell from 40% the first two weeks of April 2020 to 14% this year.

In Gloucester County, residents under age 20 similarly accounted for a small portion of known COVID-19 cases — just over 2% — during the first two weeks of April 2020 but now account for more than 20% of cases. The percentage of new cases among adults 60 or older dropped from 28% to 15%.

More readily available testing could be capturing a greater number of children with COVID-19 today. At the beginning of the pandemic, only people who experienced symptoms or were known to have had contact with an infected individual were tested. Children were rarely tested. But tests were hard to come by for all ages, so it’s unlikely this accounts for all of the rise in pediatric cases.

More social interaction and a general loosening of safety rules — namely, masking and social distancing — this spring have driven rising case numbers, especially as more transmissible variants spread, said Jeffrey Seiden, an attending physician in the emergency department at Children’s Hospital of Philadelphia and CHOP at Virtua Voorhees.

Youth sports programs, especially indoor contact sports, have been linked to outbreaks across the country in recent months.

“With more intermingling in the community, it was entirely predictable that we’d see the number of cases among adults and children go up,” he said. “The ‘prize’ we need to keep our eye on is not preventing all infections but preventing serious illness.”

Yet while case numbers are up, hospitalizations are not, he said, pointing to the fact that most cases are not severe.

More schools are resuming in-person class and the Philadelphia School District announced a multimillion-dollar plan to expand summer school offerings and open the program to all students. While indoor group gatherings are still considered risky, federal studies have shown that in-person school has not contributed to a rise in coronavirus cases. That’s because schools have been diligent in following safety protocols, including masks for teachers and students, social distancing, and requiring children to stay home if they show any symptoms, said Abuali, the pediatric infectious-disease specialist.

“When those measures are enforced, the rates of in-school transmission are low,” she said. “When we look at outbreaks in schools, it’s because the children were unmasked or exposed outside of school,” such as in their homes or group gatherings, like birthday parties.

Bonus: All kinds of illness, including flu, have dropped precipitously in both kids and adults because of pandemic precautions.

» READ MORE: Flu and other infections are down, likely due to COVID-19 social distancing

Social isolation during the pandemic has been especially hard on children. Parents are eager to give their children the interaction they’re craving, but wary of loosening the rules too quickly.

Marquita Burnett’s 7-year-old son, Jeremiah, would love to go to day camp this summer. His entire first-grade year has been virtual, and his favorite weekend activity, going to the movies, is out of the question.

“He misses being able to see his friends in person,” said Burnett, 33, of Philadelphia. Still, she is reluctant to send him to camp, even one outdoors, concerned that there could be an outbreak. Maybe she will feel comfortable enough to send him back to school in the fall, she said.

Edwin Mayorga, 44, of West Philadelphia, has tried to find new ways for his kids, ages 12 and 1, to have fun during the pandemic. Last summer, after binge-watching Avatar: The Last Airbender, Mayorga and his friend Sarah Rose Santiago created a virtual summer camp with the animated television series as the theme.

Mayorga said the camp was an opportunity for kids who are introverted — and may shy away from traditional in-person summer camps — to be part of a group on their own terms, by tuning in only for some sessions or participating with their camera off. About 20 children and adults tuned in, mostly family, friends, and acquaintances.

He isn’t sure whether they will bring back Camp Yip Yip this summer but says the family is still cautious about venturing out in public. Mayorga’s spouse, a teacher, is vaccinated, but he is still waiting on an appointment.

“We’re hopeful that me being vaccinated will help us feel more at ease,” he said. “Maybe we could join a swim club as an outdoor opportunity, but we’re trying to be cautious.”

As hard as it may be with summer approaching, rising case rates among children are a reminder of why parents must continue to be cautious, doctors said.

“We can balance giving our kids a normal life and caution — not letting our guard down too quickly,” Abuali said.

Abuali and Seiden said they think sending children to in-person school or outdoor summer camp is safe, so long as everyone is following masking and social distancing guidelines.

As for summer vacations, traveling by car with immediate family members is safer than flying, said Emily Souder, an attending physician of infectious diseases at St. Christopher’s Hospital for Children.

One of the most important things parents can do to protect their children from COVID-19 is get vaccinated.

“You really don’t know who has the virus, which is why the vaccine is so important — to protect not only yourself but those around you who are unable to get the vaccine,” Souder said. “It’s really about the greater population and protecting everyone, not just yourself.”

That’s why Burnett decided to get the shot.

She was hesitant, she said, “but I did because my son is asthmatic and I don’t know how that would affect him if he got sick.”

She’s hoping it will help get life back to normal a little sooner for her family.