Note from Michael, Dec. 28, 2021 | Kids and COVID

From the desk of Dr. Michael Gardam, Health PEI CEO

Hi Everybody,

There have been a lot of questions flying around regarding children and COVID, and more recently, children and Omicron. A lot of our communication to date has been about adults, so I thought it might be helpful to deviate from our usual Health PEI-related update and instead provide a bit of a summary of what we know so far for the youngest patients we serve.  Most of what we know is from variants before Omicron and to a lesser extent, Delta. 

Infection risk: Children can become infected as easily as adults and the risk of infection increases with the child’s age with high school aged children having a similar rate of infection as younger adults. It is expected that Omicron will cause an even higher rate of infection in children—currently the data from other countries suggest that Omicron infection predominates in younger age groups although this is early days and this may well change. 

Settings where children become infected: This is similar to adults: children tend to become infected at home, often from an infected adult, or in group settings such as schools, teams etc.

How contagious are children, once infected?: This is a bit tricky to determine as the transmission risk is hugely influenced by other control measures like physical distancing, degree of contact tracing, masking etc. Children can shed the same amount of virus as adults and certainly can transmit in households.  While early on in the pandemic it was hypothesized that children, especially <5 years old didn’t have much of a role in transmission, this is no longer thought to be the case. 

Symptoms: the symptoms of infection in children are similar to adults; however children are more likely to have no symptoms at all. 

Severity of disease: Like with adults, the severity of illness is clearly decreased by vaccination. All things being equal however, children do tend to have less severe illness than adults, including rates of hospitalization. Those children that have underlying medical conditions such as genetic, neurologic, metabolic conditions and congenital heart disease are at increased risk for severe disease compared to other children. Similar to adults, children with obesity, diabetes, asthma and other chronic lung diseases, sickle cell or immune suppression are also at increased risk. Very rarely, children (peak age is 5-11 years) can develop a serious condition called Multisystem Inflammatory Syndrome (MIS-C).

Persistent symptoms (aka long covid):  Children can have persistent symptoms such as fatigue, headache, muscle pains, difficulty breathing and others, just like adults. The frequency of prolonged symptoms is fairly common as they are with adults i.e. > 1 in 10. 

To sum all of this up, the differences between children and adults is not as great as it was first thought early in the pandemic.  Children can get infected and transmit to others.  They clearly seem to have less serious disease and are more likely not to have symptoms. Like with adults, being vaccinated largely protects against more serious illness. 

I hope this was helpful to those of you who may see some children with COVID and for those with young children of your own.  Mine are in their 20s but I still worry about them!

Please send questions, comments, or submissions for these notes to, subject line “Notes for Michael”.

Last Updated
Tue, 12/28/2021 - 18:30