Navigating Pandemic Life With a Toddler: Assessing the Risks

Raising a toddler is hard enough without having to factor COVID-19 into the picture. As a first-time mom and a bona fide worry wart, I would be anxious about my son’s safety and health under normal circumstances. So, pandemic concerns and all of the unknowns take that anxiety to a whole new level! 

While the CDC says that children are less likely than adults to develop severe illness from COVID-19, they also say that children are still at risk. And so of course my mind goes to the worst case scenario… what if my child becomes a part of that very small percentage of kids that gets really sick or has long term complications, or even worse…

So as I try and navigate pandemic life with a toddler and decide what risks I’m willing to take, a number of questions have come up for me. 

My Questions about Covid-19 and Risks to My Child

• When will a vaccine for kids be available?
• What kinds of precautions can we take to minimize risk of exposure while traveling?
• What percentage of confirmed COVID-19 cases are in toddlers?
• What percentage of toddlers with COVID-10 require hospitalization? What complications can arise for children?
• What information is there about MIS-C (an inflammatory condition that seems to have a strong link to COVID-19 in children)?

I knew that I would not find definitive answers to some of these questions, but I wanted to gather what information I could. With all of the unknowns and wildly differing opinions that are circulating about COVID-19, I have turned primarily to the CDC as my main source of guidance. 

Acknowledging Individual Circumstances & Making Decisions For Our Kids As Best We Can

As a stay at home mom of 1 young toddler, I am in a privileged position where I can relatively easily follow the CDC’s guidelines for the most part. Doing so does not throw a big wrench in my life or in my family’s life. With that being said, I know that many people are not able to have a parent at home with their children at all times. 

So I realize that my incessant questions about COVID-19 risks may seem a bit ridiculous or irrelevant to people who are not in this same position, and whose life dictates certain necessities like daycare etc. So I want to fully acknowledge that I am just one person with her own circumstances and level of comfort around COVID-19 issues. We all are just doing the best we can given our individual circumstances. This post is only meant to share my experiences and hopefully some useful information and food for thought. 

Now that that’s out of the way, let’s get to the questions.

When Will a COVID-19 Vaccine for Kids Be Available?

In a New York Times article dated 3/30/2021, Debra Kamin writes that a vaccine for kids won’t be available until the end of 2021 at the earliest. Talking with my son’s pediatrician at his recent 15 month old wellness check (April 2021), she said she thinks a vaccine will still be a couple of years away for kids in Orson’s age bracket. 

Although a year (and certainly 2 years) seems like a far ways off, it is true what everyone says about time moving a lot faster with kids. So hopefully a vaccine for kids will be available before we know it!

Studies are Underway

A Harvard Health Publishing article posted on 4/1/2021 states that biopharmaceutical companies Pfizer and Moderna are running studies on vaccines for kids right now, and that Johnson & Johnson will be doing the same soon. Pfizer is testing the vaccine on children from 12-16 years old, and Moderna is conducting one study on infants as young as 6 months old and another in children up to 17 years old. These studies are to test the safety and appropriate dosage levels of the vaccines.

COVID-19 Rates in Children: What is the Risk of My Child Becoming Sick with The Coronavirus Disease?

As of 3/17/2021, the CDC states, “Most children with COVID-19 have mild symptoms or have no symptoms at all. However, some children can get severely ill from COVID-19. They might require hospitalization, intensive care, or a ventilator to help them breathe. In rare cases, they might die.” The CDC also explains that infants under 1 year old and children with underlying medical issues are at greater risk for serious illness from COVID-19. 

That is all quite vague information and rather terrifying sounding, so let’s take a closer look at some statistics.

As of March 22, 2021, the AAP states that 13.4% of reported COVID-19 cases in the U.S. are children. (3,405,638 of the 25,446,361). This number comes from an AAP report that summarizes data from 49 states. 

Ages associated with the term “child” for this report vary somewhat from state to state (eg, Utah defines “child” as 0-14 years old, while Tennesse defines “child” as 0-20 years old). I find this a little bit odd and wanted to make a note of it just to show how even though stats can seem factual and straightforward, they can actually be confusing and misleading when you look into the details.

Taking Statistics with a Grain of Salt

I also wonder just how much this percentage of 13.4% of reported cases actually tells us. If children are often asymptomatic or only have mild symptoms as explained by the CDC, I imagine there could be a lot more children who have had COVID-19 than have been tested and confirmed. So going forward, I suggest taking any statistic I share here with a grain of salt. And to acknowledge that things are likely far more complicated than any one number can explain.

What is a Toddler’s Risk of Getting Severely Ill or Dying from COVID-19?

While the above stats gave me a better idea of COVID-19 rates in children on the whole, I was specifically interested in stats for my son’s age bracket (toddlers). 

The CDC shares several graphs showing COVID-19 cases and deaths by age, race/ethnicity and sex.

0-4 Year Olds

As of 4/4/2021, The CDC reports that 0-4 year olds make up 2% (475,377) of confirmed COVID-19 cases. And less than .1% of deaths from COVID-19 have been in 0-4 year olds (109 deaths). So this information helps put my mind at ease a little bit.

To see graphs for other demographics, you can visit the CDC.

COVID-19 Hospitalization Rates for Children 

While I found it difficult to find any up to date information on hospitalization rates in children due to COVID-19, a report from the CDC posted 12/30/2020 states that while hospitalization rates are low for children compared to adults, they are increasing. They didn’t share any specific numbers with this statement, but they did say that 1 in 3 hospitalized children are admitted to the intensive care unit. This 1 in 3 rate is similar for adults.

I was able to find some specific stats floating around though, for individual states and hospitalization rates among children. For example, New York State reports as of 4/5/2021 that 1% of covid hospitalizations are kids and young adults under 20 years old.

What is MIS-C? How Concerned Should I Be?

While it sounds like chances are that most children will not get severely ill from COVID-19, I was still concerned and knew very little about MIS-C; a condition associated with COVID-19 that has been popping up in the news. 

MIS-C is a complication that children can develop from COVID-19 that causes inflammatory problems with organs in the body. According to the CDC  most MIS-C cases are in children between the ages of 1 and 14 (but there have been cases in infants less than 1 year old and young adults up to 20 years old).

In 99% of MIS-C cases, children tested positive for the SARS CoV-2 virus, while the other 1% were reported to be around someone with COVID-19. Cal Matters explains that MIS-C is appearing in some children 3-6 weeks after they had coronavirus. Additionally, MIS-C can occur in children even if they were asymptomatic or had very mild symptoms from COVID-19. 68% of cases are in children who are Hispanic or Latino or Non Hispanic Black, and 59% of cases are male children. 

In an interview by the New York Times, Dr Jean Ballweg states that it is unknown what effects there will be long term for kids who have been treated for MIS-C. In the same article, Dr. Roberta DeBiasi from Children’s National Hospital in Washington D.C. states that while about half of children with MIS-C needed ICU treatment in the first wave that hit the hospital, now 80 to 90 percent of children need ICU treatment (this is following the spike in cases after the 2020 winter holiday season). 

Other key points about MIS-C

• The CDC says that they do not know what causes MIS-C, but that most children get better after getting medical care. 
• The CDC reports that MIS-C cases are highest amongst 5-9 year olds at 34%. 1-4 year olds make up 21% of MIS-C cases, and infants under 1 make up 3% of cases. Other age group case rates are available on the CDC‘s site. 
• As of 4/1/2021, The CDC reports that there have been 3,185 MIS-C cases and 36 MIS-C deaths in the United States.

Is Risk of Infection and Severe Illness Increasing with Emerging Variants?

In a post from Connecticut Children’s Medical Center dated 2/1/2021, they explain that while new variants of COVID-19 spread more easily among adults and children, 3 of the 4 variants that are of greatest concern do not seem to cause more severe illness or risk of death than earlier strains. More research is needed though, to determine if the UK variant (which is thought to spread 70% more easily) causes more serious illness. 

And as of April 2, 2021, the CDC lists 5 variants of concern at present in the US. They also state that it is currently unknown if these variants cause more serious illness than previous strains.

Can Vaccinated People Spread Coronavirus?

I hope that with enough vaccinated adults, there will be some protection against continued spread to children. The CDC explains that there is some evidence suggesting that vaccinated people are less likely to spread the virus or be infected, but that more research is needed. Additionally, they say that they are still learning what kinds of vaccine numbers are needed in order for population immunity.

NPR explains that 70-85% of people in the U.S. need to have immunity in order for community spread to die down. They offer a handy tool to check when your state might reach that 70-85% immunity number. Idaho for example, might reach 70% by September 17, 2021.  

What are Guidelines for Traveling with Kids During the Pandemic?

While the CDC  has updated their travel guidelines as of 4/2/2021 to say that vaccinated individuals can safely travel within the US, this doesn’t provide much guidance for families traveling with unvaccinated children.

Dr Shruti Gohil (with specialties in infectious disease and internal medicine), interviewed by the New York Times, recommends that parents continue to be cautious if traveling with their children. She explains that this means, “…choosing to drive rather than fly; to not allow unvaccinated children to play unmasked with children from other households; and to remain vigilant about wearing masks and regularly washing hands while on the road”. 

While the CDC doesn’t recommend children under 2 wear a mask, they do still encourage hand washing and social distancing. As I thought about trying to keep Orson’s hands clean while on the road, I wondered if hand sanitizer would be a safe option for him. 

What to Expect explains that hand sanitizer with alcohol isn’t safe for young kids. The AAP explains that children can get alcohol poisoning from ingesting even a small amount of hand sanitizer (eg by putting their hands in their mouths or playing with the bottle). And that children under 5 need to be closely supervised when it comes to using hand sanitizer. And for those hand sanitizers that are made for kids, Dr Posner interviewed by What to Expect, explains that benzalkonium chloride is in many kids’ hand sanitizers, which is also toxic for kids.

Final Thoughts on Assessing Risk and Life with a Toddler During COVID-19

While there is certainly cause for concern in these unprecedented times, I am feeling less anxious about my toddler’s safety after examining the available information more closely. I am also trying to remember to keep things in perspective, and to acknowledge that I cannot control everything, COVID-19 related or otherwise. 

This is not to say that I will be throwing caution to the wind. Not at all. You can still find me googling COVID-19 updates and precautions all day long.

And while I may want a very black and white COVID-19 roadmap in regards to what to do or not to do in any given situation, I know that life can be a bit more complicated than that. I just hope we can all exercise compassion and consideration towards one another, and hopefully move past this pandemic ASAP with the least amount of tragedy, illness and hardship.

I would love to hear your thoughts and feelings on pandemic life with young kids, please share in the comments below. Be well ~