Eleven-year-old Gabriel Alvarez was looking forward to starting sixth grade at Great Valley Academy because he misses his friends. He’s disappointed school will begin with distance learning.
He isn’t afraid of catching the coronavirus, though he has asthma.
As many as 25% of kids have underlying health problems, such as asthma, that place them at higher risk for complications with COVID-19, according to the Centers for Disease Control and Prevention.
In addition, Latino youth have an increased rate of coronavirus infection throughout California, including Stanislaus County.
With COVID-19 cases soaring, parents, educators and health experts are concerned that infections among children, especially the most vulnerable, may skyrocket if they return to a traditional classroom.
Jesse Alvarez, father to Gabriel, 14-year-old Alex and 9-year-old daughter Marisol, is worried that they’ll have more exposure to COVID-19 in school because some parents don’t take precautions.
“I am concerned about them catching the coronavirus,” said Alvarez. “I’m worried especially for him (Gabriel) because he has asthma, so he’s a high-risk kid.”
Gabriel’s asthma hasn’t flared up this year, but he’s had pneumonia twice, at ages 4 and 7. He remembers how scary it was being in the ambulance and getting the IV needles.
“I am concerned. I’m concerned about everyone,” said Dr. Kristel Holmblad, pediatric pulmonary specialist at Valley Children’s Pelandale Clinic in Modesto. “... The major concerns are the increased risks for respiratory infections for people with underlying diseases like asthma.”
She said children with asthma are doing better than feared, but she warned that could change with COVID-19 cases surging.
Coronavirus infection rates in young age groups
Multiple research studies have shown that compared to adults, children generally have milder symptoms with SARS-CoV-2 infection, and they are less effective at transmitting the virus, but they are not immune.
Children and teens have been the unique victims of a rare, severe COVID-19 complication called multisystem inflammatory syndrome in children, MIS-C, which presents with inflammation in several organs, likely resulting from an extreme immune response to the virus. Nationwide, about 340 cases of MIS-C have been reported to the CDC, and 70% were in Latino or Black children.
More than 275,000 COVID-19 cases have been reported among U.S. youth, including 74 deaths by mid-July. No deaths have been reported among Stanislaus County children.
In April, children accounted for about 2% of cases in the U.S. The early rate may have been artificially low because few kids were tested, as testing was reserved for priority groups, such as hospitalized individuals or those in high-risk jobs. Another factor is that kids were sheltering in place, so they had few exposures outside of their households.
With the relaxing of stay-at-home directives at the end of May, people of all ages ventured out more and mixed with friends and family outside of their households.
By July 2, children accounted for 8% of all cases in California, according to the American Academy of Pediatrics. On July 16, Bloomberg News reported a surge of cases in youth nationwide, with the highest rate in Florida, where about one-third of cases were among youth.
Over the past month, some children and teens have returned to sport practices and summer camps and, despite following CDC guidelines, COVID-19 outbreaks have occurred in camps across the U.S.
These outbreaks may serve as cautionary for children returning to in-person classrooms.
“Kids are incredibly good vectors at spreading viruses, but overall are doing better because they’re staying at home and not in school,” said Holmblad, “Every year when school starts, two weeks in, kids are coming (to her clinic) with colds, etc. I wouldn’t expect it to be different with this coronavirus.”
Latino youth have high rates of COVID-19
Stanislaus County is home to more than 146,000 children and teens younger than 18. The CDC estimates that 25% of children have at least one chronic health condition, and they state that people of all ages with underlying medical conditions are at higher risk for severe COVID-19.
Among children in Stanislaus County, the most common chronic diseases include asthma and obesity. More than 43% of fifth-graders were overweight or obese in 2018, and 20% of children younger than 18 have asthma (2016 data). Other chronic disorders include diabetes, lung disease, immunocompromise and genetic disorders, to name a few.
In Stanislaus County, Latino children account for 58% of individuals younger than 18, and make up at least 50% of COVID-19 youth cases. This rate is likely higher, as race/ethnicity data are missing for nearly 40% of youth cases and Latinos account for 73% of cases in adults.
Compared to non-Latino whites, Latinos have higher rates of underlying medical conditions including asthma, obesity and diabetes, according to the federal Office of Minority Health.
In addition, Latino families are more likely than non-Latino whites to live in low-income households, crowded conditions and multi-generational families. More than 17,000 grandparents live with their grandchildren in Stanislaus County, and at least 8.5% of them are without a parent in the house, in a 2018 county public health report.
Children bringing the coronavirus to older relatives is an additional concern with possible exposures at schools, though research suggests that adults are more likely to transmit the virus to children than vice versa.
On July 17, Gov. Gavin Newsom ordered that schools remain closed in 30 counties, including Stanislaus and San Joaquin, because of high rates of COVID-19.
Gabriel’s mother, Maria Alvarez, said distance learning has been difficult for her with having three children and primarily speaking Spanish.
Like so many parents, she’s in a quandary. She’s eager for the kids to return to school but wants them to be safe. She especially worries about Gabriel since he has asthma.
“Children with chronic lung disease or special needs may be at risk to get sick,” said Dr. Yasuko Fukuda, “For example, they may get COVID from a teacher or therapist, such as speech therapists who travel to different schools.”
Fukuda is the chairperson of the American Academy of Pediatrics, California, and a practicing pediatrician in San Francisco.
The American Academy of Pediatrics recommends that children return to in-person school because of the overwhelming advantages for learning, as well as socializing, access to mental health services, availability of nutrition and exercise, among other benefits for child well-being.
However, the AAP report emphasizes that decisions for reopening schools safely should be based on science, including the burden of COVID-19 in the community.
“Even though kids are lower risk, we’ve got to be strategic at each grade level ... to limit spread (of COVID), not just among themselves but also to teachers, staff and families,” said Fukuda, “and schools need resources to put those measures in place.”
To protect their health, the Alvarez family follows public health guidance: wearing masks, practicing social distancing and minimizing trips outside of the home.
And the Alvarezes, they rely on their faith.
“I’m not afraid of the virus because I pray to God,” said Gabriel. “He’s always going to be around to protect me.”
This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.
To help fund The Bee’s children’s health and economic development reporters with Report for America, go to bitly.com/ModbeeRFA.