A Pediatrician’s Insights on COVID-19 and Kids, with Home-schooling Tips

Dr. Niki Tracy
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Last Updated:

4 min read

girl getting homeschooled

With Hong Kong’s latest COVID-19 waves, school keeps moving between online and offline. All children in Hong Kong have by now experienced online teaching and it will likely remain quite common in kids education.


As this pandemic continues to raise lots of legitimate questions from parents, here is a practical guide brought in partnership with OT&P Healthcare and reviewed by paediatrician Dr. Niki Tracy. Read on to better understand COVID-19 risks, its transmissibility in little ones and how to best support children this year.


COVID-19 in children: risks and symptoms

From observations to date, it appears that the virus affects adults and children differently, with less severity and lower frequency seen in children. As of today, children represent only about 1-5% on average of total confirmed COVID-19 cases worldwide. 


For instance, in the US, while children represent 22% of the population, recent data shows that only 7% of all COVID-19 cases occurred in children.


It is important to note that children tend to be asymptomatic. Indeed, evidence suggests that about 45% of children who tested positive for the virus were asymptomatic. 


Children infected with COVID-19 usually have cough, fever, and sometimes a runny nose or sore throat. In some cases, children only suffer from diarrhoea and vomiting. In rarer instances, children have developed a hyper-inflammatory syndrome as a delayed response to the infection. These symptoms have been said to resemble Kawasaki disease and toxic shock syndrome. The signs of a hyper-inflammatory response can include stomach pain, vomiting, diarrhoea, shock, high fever, rash, and red eyes. While most children recover quickly, deaths have been reported.


Children with respiratory, cardiac, and complex neurological conditions may be more likely to suffer complications. According to the WHO, in a cluster of 345 confirmed infant cases, 23% had an underlying condition such as chronic lung disease (including asthma), cardiovascular disease, and immunosuppression. However, complications did not occur more than would be expected from infection with other common respiratory viruses. 


While the virus is still relatively new and there isn’t much conclusive information yet, the best available evidence shows that COVID-19 poses relatively low risks for school-aged children, where critical cases are as rare as 1% and fatalities remain extremely rare. 

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Transmission of COVID-19 in children

While more research is needed, it is believed that children play a more limited role in the transmission of COVID-19 than initially suspected. 


Consistent evidence to date shows a lower likelihood of infection with the virus, and studies on family outbreaks have shown that in most cases, children are usually not the index case (first one infected). Limited data on positive cases in schools have not demonstrated significant transmission either, except within adolescent populations.


This doesn’t mean that parents should lower their guard and be less vigilant with their children. In fact, as they play with other kids it is essential to maintain good hygiene. This is especially important for toddlers and young children. Indeed, as highlighted in a large-scale study carried out in Korea, children playing with each other, e.g. in playdates while schools are closed, are still potentially exposed to the virus, so basic precautions remain crucial.


Overall, there is no reason at this stage for parents to be extra worried. Just remember to ensure good hygiene at all times: wash hands frequently, wear a mask, and when possible, maintain social distancing.

Tips to balance it all for a successful new school year


Communication is key

Keep in close contact with your kids’ school! Stay up to date with the latest strategies for keeping children safe from the virus. At this time, it is essential to maintain open channels of communication between the school and all parents. Also, check-in with teachers for any extra resources or recommendations to make up for the loss of interactive learning.


A safe learning space

Ensure that your child’s learning environment, at home or elsewhere, has adequate ventilation, air filtration and frequent cleaning of any tangible surfaces, enough space for social distancing, and that there is access to handwashing facilities whenever needed.


Balancing health risks with long-term needs

While the risks of infection can be lowered, they cannot be completely eliminated. There must be a balance between safety precautions and the effects of reduced access to in-school teaching. Lack of in-school teaching can lead to short-term and long-term effects on children’s social, emotional, and behavioural health, as well as the economic well-being and academic achievement of children. As a parent and caregiver, it is important to be aware of this. Try to set up a routine for at-home learning, which will greatly benefit children, and continuously communicate with them to alleviate any concerns.


Adjust according to your child’s learning style

While distance learning can be effective for some, the learning habits and preferences of each child are different. Certain children will benefit from in-person instruction more than others, for example younger children and also children with special needs. Although being at school is not currently possible, other teaching methods exist and if handled well, they can be quite stimulating. Think of the use of whiteboards, coloured paper, or involving movement and gestures that keep kids active. These strategies can be improved through adequate communication with teachers: ask their opinion, and don’t worry about trying and testing.


Set clear boundaries for working at home

As kids are doing their schoolwork at home, it’s likely that you are too. Everyone needs their own time to work on their own tasks. Designate a clear time frame and also the physical area in which your children can do their schoolwork at home. Once tasks are set, let them work independently just like they would for specific tasks at school. While they work on their math or colouring tasks, you can get on with yours.


Incorporate means of rewarding

Be sure to give encourage and support your child. When they are able to focus on their tasks (and let you work on yours), encourage them and thank them. Remember, it is not always an easy task for them, and they are trying their best to adapt too. As a reward, you may want to play a game with them, to keep a healthy separation between work and play time.


Dr. Niki Tracy is a specialist in paediatrics. She holds a Bachelor’s degree in Neuroscience and completed her education at Wellesley College, Oxford University, and the Massachusetts Institute of Technology. She received her Bachelor of Medicine and Bachelor of Surgery degree from the University of Hong Kong. She is a Member of the Hong Kong College of Paediatricians, a Member of the Royal College of Paediatrics and Child Health, a Fellow of the Hong Kong College of Paediatricians, and a Fellow of the Hong Kong Academy of Medicine. She currently works as a paediatrician at the OT&P Family Clinic.



This article is brought to you in partnership with OT&P Healthcare. It is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

Dr. Niki Tracy
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