Long-Covid is also a serious illness for children, says senior physician Daniel Vilser from the University Children’s Hospital Jena. He expects an increase in cases in the coming weeks. How do we deal with that?
FOCUS Online: Mr. Vilser, you run a long-Covid outpatient clinic for children and young people. How big do you estimate the danger for children from the virus?
Daniel Vilser: It’s difficult to answer that in just a few sentences. In any case, after two and a half years, I cannot give the all-clear as far as the figures are concerned. The registrations don’t stop. Our waiting list is significant. At the moment we are on October for the next available date.
Now save articles for later in “Pocket”.
And that despite Omicron? The virus variant is considered comparatively harmless?
Vilser: There is now quite good data for adults showing that long-Covid complaints are actually less common with Omikron and only occur about half as often as with Delta. So far there is no such data for children, but I could imagine that it is similar. But to be honest, such figures only say something to a limited extent.
If the probability of suffering from Long-Covid after an infection is halved, but the infections are very high overall, we end up with a significant number of people affected. Children are the population group with the most unprotected contact. Unprotected, the word sounds a bit nasty, but anyone who thinks of typical play situations in kindergarten knows what I mean.
Do you also have long-Covid cases according to Omicron in your outpatient clinic?
Vilser: Yes. Almost all new registrations that we are currently processing come from a time when Omikron was dominant in Germany. The good news is that for the vast majority of children, the long-Covid symptoms improve over time. Incidentally, this is where the waiting list has its advantages: the longer someone is on it, the greater the likelihood that the complaints will no longer be so serious at the time of the appointment.
Does that mean you can generally encourage parents: Long-Covid is not so bad for children?
Vilser: No, unfortunately it doesn’t mean that. About 10 to 20 percent of the patients we see have it bad. These are boys and girls who are often in constant pain, some can no longer lead a normal everyday life, some are bedridden. We still don’t better understand the pathomechanism of the disease, although there are a few theories emerging.
For example, coagulation problems, autoimmune processes, parts of the virus remaining in the body or vascular dysregulations. The treatment options are just as bad. In most cases we can only alleviate the symptoms at the moment. For example, give medication for pain or for better sleep or build up the intestinal flora.
What do you think as a doctor who sees these people every day: is unprotected contact between children, as you say, responsible?
Vilser: When weighing the risks, I think most paediatricians come to the conclusion that contact restrictions for children are the wrong way to go. In terms of the effects of the isolation measures, the study situation is good.
Children were the losers of the pandemic. Many have developed psychological problems, obesity is a big problem and what was missed in school or motor skills will probably not be able to be made up in some cases.
So the question is which is worse: Long-Covid? Or long lockdown?
Vilser: In the meantime, several studies have actually tried to evaluate this, all still data from the delta period, by the way. And again I’ll say in advance: the whole thing is actually not that easy to answer. Does the child’s headache, stomach ache, or exhaustion come from the virus itself? Or are the complaints due to the pandemic and the restrictions?
In short: the symptoms were somewhat more common in children after infection. The plus compared to an uninfected control group varies between 0.8 and 13 percent depending on the study.
Critics would say: that’s not a big difference. So could the supposed long-Covid symptoms also be imagined?
Vilser: Clearly: no. Even a small percentage is a relevant number in millions of infected people. Just as little as everything can be blamed on the Sars-CoV-2 virus, just as little can everything be justified with lockdown and after all there has been no hard isolation for a long time. Despite this, we receive daily inquiries from desperate parents whose children have had complaints. I emphasize: at a time when there was no longer a lockdown.
And yet you reject a return to stricter measures, right?
Vilser: Yes, always assuming we don’t get a new virus variant for which we have to evaluate the whole thing differently. A variant that would be particularly dangerous for children, for example due to the narrow airways, would of course have to lead to a reassessment of the situation. Fortunately, there is nothing to suggest such a development at the moment.
Does that mean you are reasonably relaxed about the coming weeks?
Vilser: Certainly not. The numbers are already extremely high for the warm season. I can’t even think about what’s coming in the fall when we’re going to be doing a lot indoors again. The virus is rushing through, some said in the last wave. I would definitely expect the same for the children.
And there’s nothing left but to accept it and watch idly?
Vilser: No, I didn’t say that. Of course it would be important to have something in the drawer and also to know when to open the drawer. Keywords: smaller classes, teaching in a hybrid format, schools with good sanitation and ventilation systems. Ready-to-use concepts should be available, and have been for a long time. To my knowledge little happened.
Let’s make it clear: Long-Covid can also be threatening for children. From your point of view, new contact restrictions are not an option. Protective measures in schools: none. To be honest: in synopsis, this makes you somewhat at a loss.
Vilser: And you are not alone in that. The situation is just difficult. But of course that’s no reason not to do anything. I expect politicians to give children the best possible protection. I hope that the expected revision of the S3 guideline “Measures to prevent and control Sars-CoV-2 transmission in schools” can provide recommendations.
You have two sons yourself. How do you personally deal with the situation?
Vilser: The younger one had Corona just last week. Of course, one hopes that he will take it well. I didn’t talk to my child about potential long-term effects. If anything is conspicuous, I will react. I don’t think we have any other option at the moment.
In this issue of FOCUS Health you will find everything to do with rehabilitation and cures, as well as the best rehabilitation clinics and health resorts.
