WHAT PARENTS NEED TO KNOW ABOUT CORONAVIRUS
The risk to children and pregnant women in the U.S. is currently low, but experts remain vigilant.
By Hallie Levine
As coronavirus continues to spread across the globe, we’re working to answer the questions on many parents’ minds. For the latest updates, read the New York Times’s live coronavirus coverage here.
The new coronavirus is spreading rapidly throughout the world — and parents are increasingly on edge. According to the most recent reports, more than 92,000 people have been sickened and at least 3,000 have died since an outbreak began in December in Wuhan, China. While the majority of confirmed cases are still in mainland China, the virus has since spread to at least 71 countries, with more than 100 confirmed cases and at least six deaths in the United States.
On Feb. 25, the Centers for Disease Control and Prevention said that the coronavirus would most likely spread to communities in the United States. “It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen,” said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, during a news media briefing. “We are asking the American public to work with us to prepare, in the expectation that this could be bad.”
Previously, the bulk of the cases in the United States were connected to the Diamond Princess, the cruise ship that was docked in Japan after it was revealed that some guests on board had tested positive for coronavirus. But a growing number of those who have been diagnosed in the United States have occurred after contact with an infected person or after no known connection to previous cases, suggesting that the virus is spreading among communities.
Since outbreaks in other countries seem to be picking up steam, infectious disease experts in the United States, while not panicked, are expressing concern. Dr. William Schaffner, M.D., a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, said he’s more worried than he was a couple of weeks ago. “While in the United States, it’s only been a handful of cases, in several countries, such as South Korea, Iran, Italy and Japan, it’s spreading now into the community. I’m not sure it’s entirely out of control in these countries, but it’s certainly threatening.”
The outbreak is on the razor’s edge of becoming a pandemic, he said, with the next few weeks being “very critical because we will see whether this virus will start being contained or break free and spread in a number of locations around the world.”
If you’re a parent or expecting, should you be worried? Here’s what to know.
What is a coronavirus?
The term “coronavirus” refers to a family of viruses; “think of them as a large group of cousins, who are similar in many ways,” Dr. Schaffner said. Many live exclusively in animals, but scientists have identified seven different strains, including the latest one, SARS-CoV-2, which can infect people.
The strains that typically infect humans generally cause symptoms that are no more severe than the common cold. But “every once in a while, a rogue coronavirus jumps from animals to humans, and is more severe,” Dr. Schaffner said. That’s what happened with the SARS coronavirus, which was responsible for a deadly epidemic in 2003 and was believed to have spread to civet cats from bats before infecting humans in the Guangdong province of southern China in 2002. Similarly, the MERS coronavirus, which was first identified in 2012, spread from bats to camels to people in Saudi Arabia and has since been responsible for at least 858 deaths.
Experts think the new coronavirus originally came from a bat, but are unclear on how it spread directly to humans. Many people originally infected with it in Wuhan had a link to a large seafood and live animal market, which suggests infected animals there spread the disease.
Why are experts so concerned about this new coronavirus?
Unlike other, more mild coronaviruses, this one is causing many deaths. Experts still don’t know much about it, including how contagious it is or how it spreads. “Right now, we’re basing it on a historical perspective of SARS and MERS, which both caused hundreds of deaths,” said Dr. H. Cody Meissner, M.D., chief of the division of pediatric infectious disease at Tufts University School of Medicine and a member of the American Academy of Pediatrics’ Committee on Infectious Diseases.
At the moment, the new coronavirus seems to be milder than SARS or MERS. “It looks like most of the deaths so far have occurred in older adults, who had other coexisting health conditions such as heart disease or diabetes,” Dr. Schaffner said. “But obviously, it still has the potential to make many people so sick that they end up in the hospital, not only in Southeast Asia, but with global travel, all over the world.”
How different is it from the common cold or flu?
Coronavirus infections, in general, are virtually indistinguishable from other respiratory infections. In mild cases, they cause a runny nose, cough, sore throat, fatigue and fever. But with the new coronavirus, patients tend to have a fever, cough, and shortness of breath. “From a physician’s perspective, if a patient comes in with the Wuhan coronavirus, we can’t tell just from examining them what they have,” Dr. Schaffner said.
As a precaution, medical centers across the country are now asking patients who have respiratory symptoms or a fever if they’ve recently traveled to Wuhan, or have had contact with anyone who has recently traveled there. If they have, they’re put in isolation until testing rules out the new coronavirus.
Do I need to stockpile face masks?
No. The C.D.C. recommends that only infected patients and their health care providers wear N95 respirator masks, which are a special type of mask intended to filter out 95 percent of airborne particles. But there’s limited evidence of their utility even among these groups, said Dr. Mark J. Mulligan, M.D., division director of the infectious diseases and vaccine center at N.Y.U. Langone Medical Center. When physicians treat a person infected with the disease caused by the virus, they wear “a face shield, gown, and gloves,” he said. “There’s no good research to suggest that wearing an N95 mask when you’re out in public, even if there’s an outbreak in your area, will shield you against the disease.”
Standard surgical masks also can’t fully protect you from contracting the virus.
Should parents be worried?
Right now, no. “I’m still not panicked, given the precautions the United States government is taking,” Dr. Mulligan said. The C.D.C. is currently screening all flights from China, examining passengers for signs of fever, cough and shortness of breath.
The good news, Dr. Meissner said, is that cases in children have been very rare. According to a report published in JAMA in February, most people infected with the coronavirus were between 49 and 56 years old. “It appears that when kids do get it, they have much milder symptoms,” Dr. Meissner said.
It’s also important to keep things in perspective, Dr. Mulligan added. “Flu is killing a lot more Americans, including children,” he said. “There’s no doubt the influenza virus will cause many more illnesses, hospitalizations and even deaths than this coronavirus.”
[What parents should know about this season’s flu.]
What steps should parents take at this point?
You should take the same precautions you would take to protect your child from the common cold or flu. “We know for sure that it spreads readily from person to person, akin to influenza,” Dr. Schaffner said of the new coronavirus. “We also now think it can spread from people who are infected with the virus, but not yet showing symptoms. We don’t know if this is a frequent occurrence, but it can happen.”
As always, encourage children to wash their hands frequently and thoroughly with soap and water for at least 20 seconds. (Alcohol-based hand sanitizers can work in a pinch, but they’re generally not as effective as soap and water, Dr. Meissner added.) Hands should be washed before children eat, after they use the bathroom, come inside from outdoors or touch something dirty like garbage. If you see someone coughing or sneezing, try to keep your kids as far away from them as possible. “We believe that the respiratory secretions from coronaviruses can’t travel more than six feet,” Dr. Meissner explained.
Travel is also fine, Dr. Meissner added, but use common sense and caution. For the most part, domestic trips and even most international ones are still OK. The C.D.C. has been updating its travel notices to countries like China, South Korea, Japan, Iran and Italy, so check them before you plan a trip. If you’re planning a cruise for spring break, the C.D.C. also urges you to avoid ones that travel to or from Asia.
If there is an outbreak in your town, Dr. Schaffner said you should practice what’s known as social distancing. This means staying at home and binging on TV, rather than going out and about to movies, sports events and other activities. Schools may close, at least temporarily, and people who can work from home will be encouraged to do so.
For now, Dr. Schaffner said, if you and your kids still haven’t gotten a flu shot, get one. As of March 2, there have been 18,000 flu-related deaths in the United States this season, with 125 in children. “Parents are used to the flu, so they don’t worry as much about it,” Dr. Schaffner said. “But taking steps to protect their children from it are much more important.”
I’m pregnant. Should I be concerned?
Yes, but no more than you would be about coming down with the flu. During pregnancy, parts of your immune system are depressed, which makes you more susceptible to complications from viruses such as influenza and chickenpox, explained Dr. Steven Gordon, M.D., an infectious disease specialist at the Cleveland Clinic. (Pregnant women, for example, are nearly 3.5 times more likely to end up in the hospital from the flu than women who aren’t expecting, according to a study published in June 2019 in the Journal of Infectious Diseases.) “It makes sense that a pregnant woman would be at higher risk of complications from this virus than a nonpregnant one,” he said. “But you also need to keep in mind that your risk in general of getting this disease is very, very low.”
There isn’t much information on how the new coronavirus affects pregnancies, though preliminary research suggests it isn’t likely to be transmitted from a mother to her baby through the womb. A study published in February in The Lancet followed nine pregnant women who were infected in Wuhan. All of the newborns, who were delivered via cesarean section, tested negative for the coronavirus, and there were no traces of the virus in the mother’s amniotic fluid, cord blood or breast milk. While there have been news media reports of one newborn who was diagnosed with the virus 30 hours after being born, “it’s not clear if it was transmitted across the placenta, or if the infant got the virus shortly after birth from its mother,” Dr. Schaffner said.
The C.D.C. does caution that it has observed miscarriage and stillbirth in pregnant women infected with other related coronaviruses (SARS-CoV and MERS-CoV). High fever during the first trimester of pregnancy — which can happen after infection with the new coronavirus and with illnesses such as a cold or flu — can also increase the risk of certain birth defects, including spina bifida, cleft lip and anencephaly (where a baby is born without parts of the brain and skull).