Children and COVID-19

This week’s expert: Associate Professor Nigel Crawford, Paediatrician, the Royal Children’s Hospital, Melbourne

As outlined by Paediatrician, A/Prof Nigel Crawford from the Royal Children’s Hospital, Melbourne, in an interview with Dr Harry Nespolon on the Healthed podcast Going Viral.

It is the world-wide experience that children appear to be at low risk of experiencing symptomatic COVID-19. Because of the low numbers, there are still a number of unanswered questions with regard to the transmission and expression of the disease in this population. Many studies are currently underway, but Professor Crawford outlines the current understanding about COVID-19 in children:

• Fears that children are ‘super-spreaders’ appear unfounded. Global experience has children accounting for only 2% of the overall confirmed cases, but the concern has been that there is a large population of children who are asymptomatic but infectious. To date, none of the outbreaks here in Australia have a child as the index case. What’s more, in the investigation of contacts of confirmed cases, testing has shown very few children who tested positive were asymptomatic.

• is a good resource for GPs wanting the latest information on COVID-19 and children, as well as providing a range of other useful evidence-based guidelines and advice. Developed by the Murdoch Children’s Research Institute and funded as a Commonwealth Educational Resource, it is likely to prove worthwhile to Australian clinicians.

• With the broadening of the testing eligibility criteria, most children presenting with even mild URTI symptoms, in particular a fever and cough, should be considered for COVID-19 testing depending on their geographical location. Check with the Health Department authorities to determine if your area now has lowered the threshold of testing eligibility. Despite the low risk, it is important to recognise that children are not ‘bullet-proof.’

• All children should be considered for vaccination against the flu. It is currently available free for children aged between six month and five years, and for older children with a significant comorbidity.

• To date it appears vertical transmission from a mother to an unborn child does not appear to be a significant risk. Studies into this are ongoing.

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