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Children may represent only a small proportion of confirmed cases of coronavirus disease 2019 (COVID-19) in the current pandemic, but they are at the centre of every paediatrician’s mind and the primary focus of their work. While much of the COVID-19 pandemic preparedness and response is rightly focused on adults, paediatricians should be reassured that children have not been forgotten. In the UK, the Royal College of Paediatrics and Child Health (RCPCH) has produced extensive guidance for paediatricians that are available online (https://www.rcpch.ac.uk/resources/covid-19-guidance-paediatric-services). At the same time, Public Health England (PHE) provides regularly updated guidance for healthcare professionals, focusing particularly on infection control and testing for COVID-19 (https://www.gov.uk/government/collections/wuhan-novel-coronavirus). PHE is also working with National Health Service (NHS) and academic colleagues to answer important questions about childhood COVID-19, including the course of illness and outcomes in neonates and children, the risk of vertical transmission during pregnancy and the role of children in infection and disease transmission in the community.
Global COVID-19 situation
Coronaviruses typically cause mild upper respiratory tract infections, but they have been responsible for three major outbreaks associated with severe illness and death: severe acute respiratory syndrome (SARS) in 2002, Middle East respiratory syndrome (MERS) in 2012 and, now, COVID-19. Genomic analyses indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, originated in bats1 and was probably transmitted to humans through an intermediate host, most likely pangolins (scaly anteater-like mammals).2 The illness was first recognised in Wuhan, Hubei Province, China, in early December 2019, and spread rapidly across the continents, leading the World Health Organization (WHO) to declare COVID-19 a public health emergency of international concern (PHEIC) on 30 January 2020 and then a global pandemic on 12 March 2020. By 28 April 2020, there were >3.2 million COVID-19 cases and >225 000 deaths worldwide (https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases).
COVID-19 in the UK
In the …
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