If a child has cold like symptoms I don't see doctors using extremely limited tests on that child.
Neither on anyone else. There is no evidence though that this is what transpired behind the discrepancy in numbers. Like I said, it's a theory - just like one of healthier lungs, or a more natural immune system, etc.
sethschroeder said:
The CDC which I have already outlined previously. I am not sure why you keep going in circles.
"There have been very few reports of the clinical outcomes for children with COVID-19 to date. Limited reports from China suggest that children with confirmed COVID-19 may present with mild symptoms "
Nothing in here tells us that CDC believes that such cases were never recorded in the system. How else would they be able to identify a case of mild symptoms as really one of COVID-19? The way to read it is, that they observed cases of mild symptoms, but the testing revealed them to be actually those of COVID-19.
sethschroeder said:
Swartzberg also stresses: “We don’t even know for certain that (children) are getting less disease. There are less than two months of data. We don’t know, in children and adults, how many are infected and don’t even have any symptoms. There could be a lot of us walking around with (what seems like) colds who have this, or they may be asymptomatic.” That, of course, would make the disease and death rates even lower than already thought.
All he is saying is that we don't have enough clinical data. And that may never come through. You may be following this from January, but I have followed most prior outbreaks - incl. MERS and SARS. Little clinical data comes through, as once the outbreak is contained, resources are diverted elsewhere. That's what CDC refers to as the "limited publications", yet that doesn't prevent one from seeing a simple fact: that children in certain past outbreaks were not infected in the same way as adults. CDC is confident enough of it to state so in that COVID-19 FAQ - yes, with usual disclaimers.
sethschroeder said:
The only thing most seem to agree on is that Children are at a decreased risk of death.
Anyone who believes so is using the same dataset as that for the cases. There's no other data.
Let's dig deeper.
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We want a clinical study where both adults and kids are exposed in a very controlled setting to this virus and the infection rates are observed. The Shenzhen CDC research takes a step towards it, though IMO needs much more data to conclude something for the broader population. But - it's a good step.
Until we get such a study done, we won't know of the relative
controlled infection rates. We don't have such data. (We probably won't have one.)
The conclusion of such a study will tell us about the risk of infection across ages fully controlling for everything else. Agreed!
BUT - we do have COVID-19 infection rates among broader (Hubei) children population - and these rates appear to be significantly different from those observed for adults.
This is not a controlled study, so it's not clinical. Yet it tells us that,
in an everyday non-controlled living environment, children seem to be at a lower risk of contracting this virus than the adults - at least children in Hubei/China.
Here are some of the possible reasons again (which we aren't controlling):
-- Children may have healthier lungs or other natural features resisting infection;
-- Children may have a more natural/less stressed immune system;
-- Children may be more active or have a lifestyle preventing lingering around in infected places;
-- Children may be more protected and cared for by their parents and others;
-- Children may interact socially in protected spaces with a priority for keeping healthy;
-- Fewer testing kits may be available to set aside for children/milder cases (as you surmise);
-- etc, etc.
And in all honesty, it's a combination of several such reasons. We don't know how/why/which, but
it does seem to indicate a lower risk for children in an everyday/non-controlled setting.
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Now, compare with CDC's Ebola risk assessment:
https://wwwnc.cdc.gov/travel/diseases/ebola
"For most travelers, there is a very low risk for Ebola. Travelers who have close contact with nonhuman primates (such as monkeys, chimpanzees, and gorillas) or bats in tropical Africa are at risk. "
Do we think that if we send a European or American traveler to West Africa and get them to closely interact with monkeys and gorillas, the risk will remain low? Of course not. CDC disclaims that assessment in the next sentence. Yet, they don't need a controlled clinical study to come up with a low risk assessment for most travelers. "Limited studies" are adequate enough to make a broader/everyday risk assessment.
If you expose children and adults similarly to COVID-19 in a controlled setting, you may get a very different risk assessment than if you do so for most children living their everyday lives with their families.
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Lastly, CDC doesn't have a formal risk assessment for COVID-19 yet, as this is still unfolding. They want to err on the side of caution and have everyone take care. The last major Ebola outbreak, on the other hand, is at least 5 years old - and now well-contained - and that risk assessment took a while to come out as well.