With recent pressure and planning to open public schools to in-person learning by the end of summer, the safety of children amid the threat of the coronavirus and the recently discovered Multisystem Inflammatory Syndrome (MIS-C) remains low, according to a New Hampshire health expert.
Samantha House, doctor of osteopathic medicine and section chief of Pediatric Hospital Medicine at the Children’s Hospital at Dartmouth-Hitchcock, said MIS-C is a “serious but very rare disorder,” and the risk of a child contracting it, or COVID-19, is likely to be lower than the risk of catching other infectious diseases that circulate in classrooms annually.
MIS-C was first reported in May in New York City, and there is still little known about the full scope of the disorder that strikes children, but it has been linked to COVID-19 and displays symptoms similar to Kawasaki disease — a rare pediatric inflammatory disease that can lead to toxic shock and coronary-artery aneurysms, according to a June 29 study from the The New England Journal of Medicine.
The study surveyed 186 patients in 22 states, finding collective symptoms of a fever for more than 24 hours, and it affected at least four organs in children — stomach, heart, blood system and respiratory system. The study noted that 80 percent of cases resulted in hospitalization and 70 percent of children were previously “healthy” before learning that they had MIS-C. Four of the 186 children died.
New Hampshire has one reported case of MIS-C. Among the total of 5,952 COVID-19 cases reported in the state, 6.2 percent were people under the age of 20, according to the New Hampshire Department of Health and Human Services.
According to House, “MIS-C seems to peak as active COVID-19 cases are declining within a particular geographic area, suggesting that MIS-C may be a physiologic response to the virus that lags behind acute infection by around one month.”
House cited the one case of MIS-C in New Hampshire and said even when combined with COVID-19 cases, there were collectively more hospitalizations for influenza during the recent flu season.
“To put the pediatric burden of COVID-19-related diseases in context, we can look to recently published data from New York, a state that was hit hard by this pandemic,” House said. “From March 1 to May 10, 2020, researchers in New York found the incidence of confirmed SARS-CoV-2 (COVID-19) infection to be 322 per 100,000 individuals under 21 years of age. The estimated incidence of MIS-C during that time period was two per 100,000 individuals in this age group, emphasizing that MIS-C is a rare complication of a rare pediatric disease.”
Barnett M. Christina, executive director of the New Hampshire School Board Association, said the board’s members “have not heard any mention or concern of MIS-C with respect to COVID-19,” in reference to conversations about concerns over opening schools in the fall.
A survey by the N.H. Department of Education found that among 55,000 people, the majority want to resume school in-person in the fall, including 69 percent of parents and 79 percent of instructors.
The American Academy of Pediatrics is strongly advocating for students to return to classrooms in the fall, noting the importance of in-person learning is “well documented,” and there is “already evidence of the negative impacts on children because of the school closure in spring of 2020.”
Desks six feet apart, masks when they aren’t in the way of harm and avoiding close proximity to peers are among the guidelines the AAP have advised for elementary school children.
“As a pediatrician and a parent of two young children, I strongly agree with the AAP’s guidance,” House said. “With strong partnership between school districts, public-health experts and medical providers, we can and should develop plans to get children safely back to school this fall.”