“What we are noticing is that the number of cases is ballooning over a short period of time,” said Nicholas Rister, M.D., pediatric infectious diseases physician at Cook Children’s Medical Center.

This rapid increase in COVID-19 cases is causing concern among physicians that we will see the virus spread even further, especially with the Fourth of July weekend ahead of us.

“We understood that as we re-opened Texas we would see more cases,” said Dr. Rister. “I think these numbers show that this disease spreads among all people, and that includes children.”

Ninety percent of the positive cases at Cook Children’s have been among symptomatic children. The most common signs parents should be aware of are cough, fever, mild respiratory symptoms, rash and stomach pain. More severe symptoms may require hospitalization and can progress to respiratory failure but thankfully remain uncommon in children.

At this time, the number of infected children needing hospitalization remains low, with six patients currently being treated at Cook Children’s Medical Center. But Dr. Rister says while the majority of children are able to recover on their own, some will need oxygen support and even a ventilator.

“It’s rare for a child to become so ill they need a ventilator because of the virus, but we have seen it and it’s something we want to prevent,” he said.

The ages of COVID-19 patients span from infants to 20 year olds, with no real concentration on one age group over another.

“It’s tough to say where someone gets the virus from, but big events with lots of people are a common way transmission occurs,” Dr. Rister explained. “We have seen children who we believe became infected at youth sporting events and summer camps.”

Dr. Rister says it’s important to limit your child’s exposure to large groups as much as possible, and always try to wear a mask, maintain social distance and wash your hands as much as possible.

“We know it’s hard to say all children should wear a mask, but as much as you can, it’s going to make a difference,” he said. “Every day we hear about COVID numbers on the news, but most families haven’t seen it despite how common it is. I think it’s important to remind people that the boogie man is real, this thing is out there and the precautions you are taking are very important.”

As for the Fourth of July, Dr. Rister hopes families will still find a way to celebrate while taking into consideration the risk for contracting and transmitting COVID-19.

“The question to ask yourself is ‘how many people are you going to be around and how exposed will you be?’. If you can effectively social distance, wear a mask and you’re in a smaller group, then I think those are very reasonable things to think about doing,” Dr. Rister said. “The larger group activities like being around big groups of people at pools, large cookouts, sporting events, large fireworks displays where you are close to other people; those events are what we’re worried about.”

For families trying to decide how many people to invite for Fourth of July gatherings, consider whose most at risk. If you have elderly grandparents or people who are ill, Dr. Rister advises you to be cautious.

“We’re not saying you can’t have a celebration, but we do think you need to have a real honest talk about how you can limit risks.”

The Emergency Department at Cook Children’s sees eye and face injuries from projectiles (fireworks that launch or that have parts that explode off), hand and finger injuries from holding items while they explode and burns of every type, especially when children are running around barefoot.

U.S. Consumer Product Safety Commission (CPSC)’s annual death and injury report on fireworks incidents indicates that nearly half of these injuries occurred to children younger than 15 years of age. The culprits? Firecrackers, bottle rockets and sparklers – yes, sparklers.

Sparklers are considered by many to be the “safe” firework. But even an innocent looking sparkler can get as hot as the flame on some blow torches and can easily ignite clothing?

“Every firework has its dangers and there simply isn’t one that I would consider completely safe,” said Justin Smith, M.D., a pediatrician in Lewisville. “Parents would be safest to take their children to an event and watch fireworks. You will have a good time and can view from a distance.”

Remind your friends and neighbors, before they touch a flame to any fireworks, to make sure it’s legal to do so where they live.

Prevent the Tragedies

If fireworks can be used legally where you live and you do want to use them, here are a few guidelines CPSC recommends they follow:

1. Never allow young children to play with or ignite fireworks. Adults should always supervise fireworks activities.
2. Never try to re-light or pick up fireworks that fizzle and don’t go off.
3. Never point or throw fireworks at another person.
4. Keep a bucket of water or a garden hose handy in case of fire or other mishap. After fireworks fully complete their functioning, douse the spent device with plenty of water from a bucket or hose before discarding to prevent a fire.

More guidelines are at CPSC’s Fireworks Information Center.