‘Hunker down’: Kansas City doctors warn parents their teens are spreading COVID-19
Someone on my teenager’s baseball team has COVID-19. Someone in my teen’s summer school program has the coronavirus. Someone my teen works with has tested positive. What should I do?
Those are the phone calls rolling into Dr. Natasha Burgert’s office in south Overland Park as she and other local pediatricians watch teenagers and young adults drive up COVID-19 cases in the metro.
The spike has prompted them to sound a warning for parents: With school openings just weeks away, parents must be hyper-vigilant about their teenagers’ activities now to help drive those rates down.
That means teenagers stop going to big parties, especially crowded indoor parties. That means they don’t hang out in big groups at the swimming pool. That means they follow the COVID-19 rules that everyone should know by now but not everyone has been doing.
“We hunker down,” said Dr. Lore Nelson, an adolescent medicine specialist with the University of Kansas Health System. ”It really is going back to the masks, the six feet (of social distance) and washing your hands. And not being in groups. All it takes is one in there.”
How COVID-19 affects children became a political flashpoint for Missouri Gov. Mike Parson over the weekend when he told a St. Louis radio host that schools must reopen even though many students will get the disease.
“These kids gotta get back to school,” Parson said. “They’re at the lowest risk possible and if they do get COVID-19, which they will, and they will when they go to school, they’re not going to the hospitals, they’re not going to have to sit in doctors’ offices.
“They’re going to go home, and they’re gonna get over it and most of it all proves out to be that way if you look at the science of it.”
Critics, including Missouri Democrats, accused him of being cavalier with people’s health.
Children and COVID-19
When it comes to coronavirus cases, teens cannot be lumped in with young children.
A new study of South Korean coronavirus patients showed that children older than 10 are more likely than younger children and adults to spread COVID-19 within a household, according to findings published on the website of the Centers for Disease Control and Prevention. Children younger than 10 spread the virus at the lowest rate.
Young people ages 20 to 24 make up the largest group of coronavirus cases in Missouri, according to data from the state health department. In Kansas, those ages 25 to 34 make up the biggest group of cases.
Burgert could not be more adamant about parents keeping their sick teenagers at home. Her office, Pediatric Associates, is getting calls from parents saying their teenager went to a party over the weekend and now someone else at that party is sick at home with a fever.
“I think the biggest challenge is that I don’t think parents are understanding that if a teenager is exposed to another one of their friends who is positive for COVID, or developing symptoms of COVID, they need to stay home,” said Burgert. “Even without a test. They don’t have to be tested. These parents need to keep their teens at home.
“Many of the families that are calling us with concerns about COVID and their teenagers, in the next breath are telling us that their teenagers are at work or that they’re babysitting or that they’re out with their friends.
“If you’re calling our office with concerns of exposure, that child should be home. That child should be home until you get advice … stop. Don’t move. Don’t go anywhere until you are getting advice from your pediatrician.”
On Fourth of July weekend Burgert sounded the alarm in a tweet.
“Lots of COVID-19 positive tests in teenagers this week. Work exposures. Party exposures. Summer camp exposures. It’s everywhere,” she wrote. “So, if (your) teen is not feeling well --> KEEP THEM HOME. Let’s work together so we ALL make it to the fireworks show next year, OK?”
“If we want to get our kids back to school, which I think we all agree that we do, we have got to be meticulous about our identify and isolate protocols, which right now are primarily based on staying home … regardless of being positive according to a lab,” Burgert said.
“If you know your teenager has been exposed you have got to keep him home. And it stinks and nobody likes it, and it’s not fun, and I get it. But if we want our kids to go back to school and we want to stop driving our community outbreaks, now is the time we all as parents, even (with) our own quarantine fatigue, can’t let our guard down. We still have to step up.”
‘Spiral out of control’
Children under the age of 15 account for only about 30 of the more than 140,000 Americans who have died from the coronavirus, according to CDC data. But children and teens get sick from it, including one Kansas City teen who helped promote a July 3 party in Cass County linked to a cluster of COVID-19 cases.
“Some kids are completely asymptomatic when they’ve had a known exposure. I have had some kids that have been down for, I think the longest was a full 10 days of fever and flu-like symptoms. So I think it does run the gamut,” said Burgert.
“I think it’s a false assumption that they will not be symptomatic at all. Many of them are feeling unwell, but knock on wood, I do agree that most of them are staying out of the hospital.
“That being said, we have had cases of MIS-C (multisystem inflammatory syndrome) here in Kansas City and in our teenagers. So the challenge is we don’t know, we do not know, we have no indication, no predisposition that I can tell you — are you going to have a kid that is asymptomatic or are you going to have a kid that ends up in the hospital?
“I have absolutely no idea which pathway they are going to go down. Most of the kids are having a mild illness. But in the (meantime), what damage is being done by them propagating it to someone else? There’s 100 percent potential of them passing it along. And we don’t know the ramifications of that.
“I think the general public is under the assumption that we know a lot more about how COVID spreads and what to do to protect ourselves against it.”
Lessons for parents
Parents are learning their way around COVID-19, too.
For some parents, COVID-19 is out of sight, out of mind until an email arrives from the swim team with just enough fuzzy details about a teammate being sick to cause alarm and a panicked call to the pediatrician.
“We all have (COVID-19) fatigue,” Burgert said. “We don’t want it to be real. But when it does happen that their kid was possibly exposed, it’s panic-inducing and it’s so stressful. We’re trying to navigate that the best that we can with the parents that call.”
Dr. Jason Newland, a professor of pediatrics at Washington University in St. Louis, has three teenagers of his own.
“My teenagers have their group of friends and I say, ‘You guys just stick together and you’re not going anywhere else,’” Newland said.
“They also need to wear masks and do everything they probably don’t want to do.
“But right now with the level of cases, both in Kansas City as well as St. Louis, we have to stress for our kids, teenagers especially, and even the younger kids, the 10, 11, 12-year-olds, they can definitely wear a mask effectively. And we have to stress social distancing and washing your hands effectively.
“And without that, this is going to continue to spiral out of control as it is.”
Pediatricians know it’s hard to control the comings and goings of teens. They want to socialize. Perfectly normal. But these are anything but normal times.
“So we have a lot of messaging and a lot of important work to do,” said Newland. “And part of that work is reducing the case numbers. And part of that work means not doing things we want to do, like going to the pool party with 20 of our buddies. That can’t happen.”
Burgert said cases among teens started picking up the last week of June in her office and have been escalating ever since. Her theory is that adults, exposed either at work or through travel, gave it to their teenagers.
“Now it has been teenage to teenage exposure, which has happened exponentially … for some families who are not choosing to stay home or not making teens stay home. Then it started to spread like wildfire after the Fourth of July,” she said.
“Now in the last week it’s the teenagers now sending it to the younger siblings too. So it’s all starting to escalate, as we would expect, because that is what happens with a viral illness. This is not a surprise to us.
“But it’s important that the Kansas City area know that it’s legit happening. And if we are knocking on the door of keeping our kids at school, we gotta tighten down.”
This story was originally published July 21, 2020 at 5:00 AM.
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