Thread by @drgregkelly

Those who argue that #COVID19 is not a concern in children because it only rarely causes serious illness and death might be surprised to learn that there are whole fields of medicine devoted to preventing kids getting sick and dying from other rare conditions

We also need to understand that even though the risk per infection is very low, if a very large number of kids are infected, that becomes important. Even a tiny percentage of a very large number is a large number.

In wealthy countries, very few children die, so even rare causes of death are significant. Eg, congenital heart disease affects ~1/100 kids & only 1/2 of that is life threatening. We can treat vast majority, meaning “only” causes ~150 deaths in Australia annually, 70 in infants

That's only 0.1% of deaths in Australia. But that doesn't mean we just decide not to worry about congenital heart disease. Because child deaths are rare, that 0.1% still makes it THE LEADING cause of hospital admission & death in infancy (outside newborn period)

We spend tons of resources on treating it. There are specialist pediatric cardiologists, pediatric cardiac anesthetists, dietitians, surgeons, speech therapists, intensive care specialists, etc.

Even subspecialties within those - fetal cardiologists, pediatric echocardiographers

Major children's hospitals have heart centers, cardiology wards & cardiac ICUs. Hospitals overseas specialise in management of vanishingly rare SUBTYPES of congenital heart disease like Ebstein's or PA /VSD /MAPCAS

All for a rare set of conditions that 'only' cause 0.1% of death

And heart disease is common compared to really rare pediatric conditions like metabolic and immunological disorders, which again are recognised and important fields in their own right.