‘The numbers are low until it’s your child’: US records more coronavirus child cases despite ‘myth’ it can’t harm them

Skylar Herbert loved dressing up and performing. She adored going to kindergarten. She started reading at age 4. She liked “girly things” and bling.

“She could take over a room,” her grandmother Leona Pannell Herbert said.

About a month ago, Skylar started to complain of headaches. Within days, she was hospitalised in the Detroit suburbs, where she was diagnosed with Covid-19, the disease caused by the novel coronavirus, and then with a rare form of meningitis. Her brain started swelling, and she was placed on a ventilator. On Sunday, surrounded by doctors and her family, the 5-year-old became the first child in Michigan to die of Covid-19 and one of several paediatric deaths in the United States.

Skylar’s death stands as a heartbreaking exception in a pandemic that has largely spared children even as it ravages older populations and people with underlying medical conditions. She was both young and without known underlying conditions. Her death serves as a reminder that the coronavirus can present peril to people at any age.

In Michigan, about 1 per cent of the 32,967 reported Covid-19 cases have been in patients younger than 20, state statistics show. The average age of coronavirus patients who die in Michigan is 74.

Her story disproves “the myth now that children couldn’t get it,” said her father, Ebbie Herbert. The family has agreed that the hospital may use Skylar’s tissue to research Covid-19, her mother said.

Boston Children’s Hospital, one of the nation’s major paediatric medical centres, reported a jump in Covid-19 admissions last week when as many as 13 patients were hospitalised with the disease at one point. Over the course of the pandemic, Boston Children’s has admitted 25 children, said Michael Agus, the hospital’s chief of medical critical care. By Monday, the number of patients at Boston Children’s with Covid-19 had fallen to 11, with three in intensive care.

Children’s National Hospital in the District reported a steady increase in cases, as did Children’s Hospital of Philadelphia. Doctors at both hospitals say they believe the increase correlates to the surge of cases in the broader populations of those cities, though the number of adults infected still dwarfs the number of children testing positive.

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Julia Sammons, medical director of the Philadelphia hospital’s Department of Infection Prevention and Control, said fewer than 10 per cent of the children who test positive at the hospital require inpatient care. Of those patients who are hospitalised, she said, about 5 per cent have experienced severe symptoms. At Seattle Children’s Hospital, which has been tracking the virus since late February, 1 per cent of children who have been tested have the virus. Of those, few experienced severe symptoms, according to infectious-disease specialist Janet Englund.

“The numbers are low,” Englund said. “Until it’s your child.”

Data from the Centres for Disease Control and Prevention and empirical evidence from doctors at several of the nation’s top paediatric hospitals suggest children, by and large, are less severely affected by the virus.

As of April 6, when the CDC published its last comprehensive report on the coronavirus and children, 2 per cent of confirmed Covid-19 cases had occurred in people under age 18. That mirrored data from China and Italy, which reported that children accounted for about 2 per cent of infections.

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Children who test positive appear to experience severe symptoms at a far lower rate than adults.

“Relatively few children with Covid-19 are hospitalised, and fewer children than adults experience fever, cough, or shortness of breath,” the CDC wrote in that 6 April study, which also made clear that “severe outcomes have been reported in children.” As of Tuesday, the CDC’s data included two deaths of children between the ages of 1 and 4, one death of a child between 5 and 14 years old, and 17 deaths of people between 15 and 24.

While disease trackers have said they believe more people in the United States are infected with the virus than the data shows, specialists said the figures on paediatric deaths are probably a true reflection of the most severe toll among children.

“I think we are seeing the children who are becoming ill. I don’t think there are many sick kids staying home going unrecognised by the health-care system,” Agus said. “Are there kids getting over this infection with hardly any symptoms? For sure. That seems very likely to be the case and has been the case in other countries.”

Robert Posada, associate professor in the Divisions of Infectious Diseases and Medical Education at Mount Sinai Kravis Children’s Hospital in New York, said the hospital has admitted about 20 children with Covid-19, with no major uptick in recent days. He said most of those children sick enough to require inpatient treatment are dealing with underlying conditions, something echoed by doctors at paediatric wards elsewhere. At Children’s Hospital of Philadelphia, Sammons said about 25 per cent of patients who have tested positive for Covid-19 suffer from asthma. At Mount Sinai, the numbers have been similar.

“I would say that more than half of those patients have had some underlying condition. Some of them are patients with cancer, a couple of patients with diabetes. One patient, at least one or two, that are transplant recipients,” Posada said.

Yet some children may not be clearly or easily tracked. Michigan had 266 confirmed cases of Covid-19 in children and youths as of Monday. Of those, 147 stayed in their homes, 23 were hospitalised and 96 were of unknown status, said Bob Wheaton, a spokesman for the Michigan Department of Health and Human Services.

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While Skylar did not suffer from underlying conditions, she did fall into other categories that meant she was at higher risk of contracting the virus. Skylar was African American, and CDC data shows that black patients account for 33 per cent of reported cases; census data shows that 13.4 per cent of the US population is black. And Skylar’s parents have jobs that force them to continue working outside the home during the pandemic.

Skylar lived with her mother, LaVondria Herbert, a Detroit police officer for 25 years, and father, Ebbie Herbert, a firefighter for 18 years, in a neighbourhood in Detroit with one of the highest rates of the coronavirus.

“When talking about Skylar’s story – it brings to heart for me, her parents are first responders. And first responders have anxiety about infecting people in their household,” said Michigan Lt. Gov. Garlin Gilchrist, a Democrat who leads a new state task force on racial disparities related to Covid-19. That task force will be dedicated to Skylar’s memory, he said in a briefing Monday.

“They’ve been on the front line and they’ve served with honour and integrity,” said Michigan Gov. Gretchen Whitmer, a Democrat. “They did not deserve to lose their child to this virus. Nobody does.”

Skylar’s death was mourned in Detroit on Facebook, in homes and in fire stations.

“Skylar touched our hearts with her cheerful spirit and brightened our Sundays with her smile,” the Metropolitan Church of God wrote in a Facebook post that was shared more than 120 times by Monday evening.

“My daughter was a giver, sunshine and light. She would give anything she had, a sucker right out of her mouth,” said her mother, LaVondria Herbert. Her father, Ebbie Herbert, added: “Our daughter would come up out of the blue and say I love you.”

Her parents spent Tuesday trying to figure out how a funeral for a vibrant girl can take place in Detroit amid a pandemic. They haven’t come up with an answer. But they want the world to know Skylar’s life and death serve as a message to take Covid-19 seriously.

“We just want the world to know that this can happen to anyone,” Herbert said. “This could have been your kids.”

The Washington Post