How Does COVID-19 Affect Kids and Babies?

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Dr. Scott James: You’re listening to TGC Q&A, a podcast from The Gospel Coalition. This is the Christians and Healthcare series, where we seek to answer questions at the intersection of faith and medicine.

My name is Scott James, and I’m a pediatric physician specializing in infectious diseases. That means I get to help take care of kids who have infections or are being evaluated for them. Part of my job is treating kids as well as helping families understand what’s going on with the infectious pandemic that’s going on around them right now. I also serve as an elder in our local church, The Church at Brook Hills.

One of the questions that our listeners sent in is, what should I know about the effect of COVID-19 on children and what is their ability to infect others in the community? That’s a fantastic question. We’ve heard a lot about COVID-19 and how it has affected adults, primarily, how a majority of the infections, and particularly the severe infections, have been happening in the adult populations. That’s true. I count that a grace that children seem to be less affected by this infection.

Less affected in the sense that they are less likely to be infected in the first place, but also if they are infected, they’re less at risk of developing a severe illness or a severe disease. Now, with that said, I do want to be very clear, however, that children can be infected. While a majority of children who are infected end up having a mild illness and end up recovering completely, children can get very sick from it as well.

I don’t want the fact that children are relatively less at risk than adults to translate into anyone’s mind that children are therefore not at risk, and are therefore not needing to participate in any of the community precautions that are going around. Children in one sense actually might be an important reservoir for the infection within the community because as children have milder disease, oftentimes even asymptomatic disease, they still are capable of shedding the virus.

What you might have is a well-appearing child or a child with a runny nose and cough, who’s still going to baseball practice. Still going to the grocery store with mom, still taking part in some of the activities that are going on in these communities as we’re reopening and trying to find a balance between staying open and staying healthy. I want everyone to be aware that that children can be a part of this chain of transmission and so it’s important for them to be participating in the types of risk-reduction activities that are going on around us, as we all seek to reduce the amount of transmission that are in our communities.

The long-term outcome is something also that we’re still looking at. Children who are sick, tend to get better quickly, but there’s still a lot that we don’t know about what a later effect might be. After children recover from an infection, could there be a later effects on their immune system or later inflammatory processes that come into play? The long-term outcomes in children and adults is still something that a lot of research is being put into right now.

It’s still, relatively speaking, very early in the pandemic, as far as that goes in terms of our ability to evaluate a long-term outcome.

The next question we received is, do babies respond well to COVID-19? What wisdom would you have for new parents during this pandemic? That’s a fantastic question because we’re used to looking at babies as a very vulnerable population. These are precious gifts from God that we as parents, new parents in particular, want to bend over backwards to protect and to take care of.

That maternal instinct, that maternal instinct that kicks in, just the thought of being a brand new parent in the middle of a global pandemic is anxiety-inducing for sure. I want to empathize with parents who are thinking through a lot of really difficult questions that I frankly didn’t have to think through when I had a newborn in the home. I want to give some reassurance that babies, even very young babies, two months and under I’m talking, tend to do very well with COVID-19. They can get infected.

There are reports of babies that are infected even very, very close to the time of birth. There’s still a lot of research that needs to go into that to understand exactly when transmission occurs in that. Can a mother transmit the infection to the child in utero, or is it something that happens through the birth process or immediately afterwards through contact? There’s lots still to be determined with that. One thing we do know is that young infants can get infected with COVID-19. Majority of them do very well.

A majority of them do not need significant medical care. Some do however, so as with anything, the statistics are meaningless if it’s your child that’s involved. I can say that a majority of babies do very well, but not all. If your baby is one who is showing symptoms or is acting in a way that might make you concerned that there could be an infection going on, definitely pay attention to that. Babies can get very sick with this. There have been a good amount of case reports and discussions about babies that do need some intensive medical care to get through this.

I’m thankful that overall the vast majority of babies do not need that. I do think though, in thinking about how babies are typically thought of as a vulnerable population, I think as a new parent, I would encourage all parents, but new parents in particular, to let that be an object lesson in our mind. That the baby could be at risk of getting COVID-19, could be at risk of a severe illness even. You want to protect that baby with every instinct that you have as a parent.

That’s a God-given instinct that you want to protect that baby. While I’m saying babies in particular are not at significantly increased risk, let this be an objective reminder to us that there are plenty of people in the community around you that are at significant risk, that are at increased risk of needing hospitalizations, ventilation. Or even an increased risk of death, if you look at some certain subpopulations in age categories. That protective instinct that you have for your baby, I would encourage you to foster that for your entire community.

That’s why I think it’s important for us all, no matter how you assess your own risk, for us all to be playing a part in our community health. That means all of us taking this seriously, all of us doing what we can to reduce the transmission in our community. We want to recognize that there’s consequences all around, on both sides of this equation. There are a prolonged and devastating consequences to complete lockdown and shutting down the community.

Economic and psychosocial fallout that happens there is tremendous. We don’t ever want to overlook that. At the same time, on the other hand, there’s tremendous fallout and consequences in terms of lives lost and the health of loved ones being affected if we are flippant about this, or just not seeking to be a part of the solution, not seeking to be a part of reducing transmission in our community. I just encourage everyone to keep vulnerable populations in their mind and look for ways to be a part of the solution, not a part of the problem.

Look for ways to limit the spread of infection in your community. Those are relatively simple steps. It means stay home if you’re sick. It means cover your nose and your mouth with the mask to protect others, not to protect yourself, but to protect others because you may be shedding it and not know. It means staying with some reasonable distancing between others, avoiding close contact to try to limit the amount of transmission that that can happen. It just means washing your hands often, so whether hand sanitizer or just good old fashioned soap and water.

Doing little things that we can in our life that allow us to get on with life in a way, that allows us to actually be out in our communities and be participating and letting the kids go to school. The kids need to go to school. Be a part of reducing the amount of transmission in your community by doing these simple things like wearing a mask and maintaining social distancing so that at-risk populations cannot get unnecessarily infected. That the rest of society, all of society, can go on and continue to flourish as much as we can in the middle of all this.

By allowing businesses to stay open and allowing children to go to school and allowing parents to stay in work rather than having to figure out what to do with their child who’s doing virtual school. Yeah. There’s hard decisions to make all across the board here as a new parent. Going back to the baby part of the question. A new parent has an additional layer of difficult decisions and anxieties to make during the middle of all this.

I just encourage us all to just trust in the Lord and see that He has put us in this place to serve our community. We’re here as a blessing to those around us and so even in the middle of pandemic, God is good. He’s given you a way to navigate through this in a way that glorifies Him and loves your neighbor.

The last question that our listeners sent in is, how does your faith intersect with your work? That is a fantastic question, is one that I love to answer. It’s not so much that my faith intersects with my work. It’s that my faith is the foundation of my work. My identity first and foremost is in Jesus Christ and so when I think about who I am and what I do, I don’t think of myself as a doctor first and foremost.

I think of myself as a child of God, as someone who has been saved by grace through faith in Jesus Christ. My identity is in Him and everything else is just a beautiful gift encompassed within that, that flows out of that. God has given me adoption and redemption from my sins and He’s given me a present that is growing in holiness through the work of His spirit. He’s given me a future to look forward to glory with Him forever. The whole of my salvation, one of those I’ve been saved, I’m being saved and I will be saved.

That’s the air that I breathe. That’s why I do what I do because I believe that. I think a big part of that is that God has given me a vocation, so along with all those other gifts of sanctification and justification and all of that. He’s also given me a vocation, which is a calling to be where He places me and to work for His glory and for the good of those who are around me in whatever situation He’s placed me in. It’s one of those grow where you’re planted scenarios. I look at my vocation as being called to be a physician, being called to work with families.

As a pediatrician I have a really special gift of working directly with families during sometimes some pretty heavy and some pretty crisis situations. Just holding their hands and walking through the valley with them and just being a presence with them. Not just medically as I hopefully cure their child and get them on the road back to wellness, but also as I care for them spiritually and mentally and emotionally during the course of all of that. Being a pediatrician is a unique aspect to that vocation as well.

I think I take a step back and I look at my role as a physician. I see it as a shepherding role, a ministerial role, just in the sense that so much of my work is actually connecting with people and helping meet their needs, right? They come to me with issues. They come to me with medical problems and I’m just in a position to be able to walk alongside them and minister to them as I treat them and help them out with that. I also look at it from just the scientific standpoint. I think of a verse in Psalm 19, where we know very well that the heavens declare the glory of the Lord.

I fully believe that. I think this creation that God has given us testifies to His goodness, His majesty. I want to know Him better every single day of my life. I spend time in the word to get to know Him specifically, to get to know Him as He reveals himself directly through the word. Then more specifically through Jesus Christ, but also look into just the general revelation around me. I look to know Him truly through that, and so while general revelation is different than a specific revelation of scripture, I value what I learn about God from that.

If I can look up into the heavens and see that the heavens declare God’s glory, if I can look through a telescope and see God’s glory outward, I think that also means that I can look through a microscope and go the reverse level. Instead of looking more expansive, I can look more microscopic and I can see God’s glory under a microscope, just as much as I can under a telescope. As a scientist, as a researcher, a lot of my work is literally spent looking under microscopes.

I do that with a view towards God has placed me here to discover amazing things about who He is and what He has done in this creation. That involves all sorts of things that intersect with the world of medicine and healthcare and developing medications that can help people. I see God’s glory in nature, and I view one of my roles as a scientist is to study the truth of God as He has it out there ready for us to see. I do that with a decidedly Christian thought process in which I’m thinking about who God is and why He’s designed this thing that I’m looking at.

Why he’s designed all of this the way He has. It’s a joy to be able to discover new things and to press deeper into that and to get to know Him through His creation and the way that intersects with human beings through medical innovation and healthcare. That is a real joy for me. I do it hopefully … Not perfectly, but every day, I’m trying to do it for the glory of God.

As we close our time together, I just want to encourage everyone as we think through this series, Christians and healthcare, I just want to encourage us as Christians to view public health, to view the way that we interact with the healthcare system, with individual healthcare providers and with our community in general, as we think through public health and safety. Let’s do that from a decidedly Christian viewpoint. Let’s have God’s design in mind.

Let’s remember that each and every person that is out there is not just a statistic, is not just someone who may or may not have COVID-19. Every single person is made in God’s image and bears the dignity and value that God has given to them as a result of that. It’s easy to get lost looking at line graphs and bar graphs of COVID trends and things of that nature. I just encourage us as Christians, of all people as Christians, let’s be the ones who don’t get bogged down in numbers, but we remember the lives that are involved here.

I just encourage us all to be a part of the solutions that are going on around us, as we seek to just help our communities flourish. Our local health department here is using language that sounds very, very similar to love your neighbor. I find that so much of the motivation behind the health messaging that’s out there right now is as a community, let’s take care of each other. Let’s love one another. Let’s love our neighbor. Let’s do what we can to help protect other people and save lives.

I think as Christians of all people, if we can’t get behind that message and be a part of that process, then I don’t know. It just feels a bit disconnected with our faith if we take a back seat in those conversations, or even sometimes more concerning if we are vocal about our disagreement of some of those things. I think, just think through the community aspect and loving one another aspect of this from every standpoint. That doesn’t mean it’s easy. That doesn’t mean that there are not massive hurdles and again, consequences on both sides of every question that you ask. But we can represent God in the middle of all that.

We can demonstrate His love, His grace, His patience, His kindness, all of the fruits of the spirit that we can muster through His grace in this time. I just encourage you to represent Christ out there and let Him be glorified, even in the midst of the chaos that we do see around us.