With safety measures in place to prevent COVID-19, doctors are seeing a much calmer respiratory season. One child has died from the flu this season compared to a record number last season. Experts explain what that means and what parents should pay attention to.


What's going on with respiratory season? It's something Rashmi Jain, M.D., pediatrician and founder of BabiesMD, Pediatric Urgent Care, has been wondering after noticing fewer common illnesses among the kids she treats at her practice, which has been exclusively telemedicine since the beginning of the pandemic.

She's not the only one: pediatricians across the country have been noticing the trend—and they aren't wrong. Reports show that common illnesses are in fact down.

Seasonal flu cases are at record lows in the United States, according to the Centers for Disease Control and Prevention (CDC). "We haven't seen nearly the level of influenza that we have historically seen in years before," says Meg Meeker, M.D., a pediatrician and bestselling author of Strong Fathers, Strong Daughters. One child has died from the flu this season compared to a record number of 195 children during the 2019-2020 season, according to the CDC. Cases of respiratory syncytial virus (RSV), the most common cause of bronchiolitis and pneumonia in kids younger than 1, are also lower than usual.

But while common respiratory illnesses in kids may be down, experts remind parents they can still contract COVID-19 and more than 1 million have been diagnosed with it. They also say parents should turn their attention to mental health as kids are experiencing more depression and anxiety during the pandemic. Here's the scoop.

Where Did Common Illnesses Go?

Does the change in child illness rates mean bacteria and viruses have disappeared? Of course not. But the preventative measures we are teaching kids could be making the difference in stopping the spread of other illnesses, something the CDC has pointed out. Those include wearing masks, hand-washing, keeping six feet apart including in classrooms, not playing together on playgrounds, and sports being limited and socially distanced.

"It comes down to what we know from previous years," says Dr. Jain. "When kids are in each other's faces, and hugging each other, and coughing on each other, they tend to spread respiratory viruses a lot easier."

It's also important to note there has been an increased vaccination flu rate with more than 197 million doses distributed this season—the highest ever.

As for the fairly common secondary infections kids get during this winter season? Dr. Jain has seen a decrease in those too. When a child's immune system is fighting a respiratory virus, she explains, they are susceptible to secondary infections like ear and sinus infections. These tend to occur when the immune system is down. But because kids aren't getting sick as often, "they may not be prone to those this year," adds Dr. Jain.

Will Less Colds Affect a Kid's Immune System in the Long Run?

The short answer is probably not. "I don't believe that being home this last year with the pandemic and virtually schooling is going to make next winter when they [might be] back in school a lot worse," says Dr. Jain. Worst case scenario, she adds, they may experience a few more colds than this last year, similar to a child entering school for the first time.

In non-pandemic situations, children who are in their first year in school or daycare, typically get sick much more frequently. "That's what builds our immune system," says Dr. Jain. "That's why the second year in school or the second year in daycare, kids do a lot better."

If anything, we might see a positive change among kids who typically get about fix to six colds a year on average. "They are probably going to maintain a lot better hand hygiene and public health hygiene measures," says Dr. Jain. "Colds and flus may be less prominent again next winter, and if they are, we'll have to see if we're actually making a dent in the big picture."

The Rise in Depression and Anxiety

While less kids may be dealing with things like a sore throat and congestion, parents should pay attention to signs of depression and anxiety. These conditions were already on the rise in kids between 6 and 17 years old before the pandemic, but research shows isolation from peers, relatives, and teachers can aggravate symptoms.

A study in June 2020 found 7 in 10 teens were struggling with their mental health. Younger kids are also feeling the effects. There has been a 24 percent increase in children ages 5 to 11 who ended up in emergency rooms for mental health issues compared to 2019 and 31 percent increase for those 12 to 17.

"The most dramatic change we have seen in the acute rise of depression and anxiety in kids as young as 6," says Dr. Meeker. "I recently had a first grader tell me that she was scared that either she or her parents were going to get COVID-19 and die. She was in tears."

While school age kids may struggle with agitation and behavioral issues like defiance, acting out, and anger that weren't present before the pandemic, says Dr. Meeker, older kids between 12 and 20 years old have been "outright depressed."

"Normal, healthy kids that I have known for years suddenly come in with complaints of feeling hopeless, lonely, and pervasive sadness," says Dr. Meeker. "This has been very disturbing to me."

If you notice symptoms of either anxiety or depression in your child, including irritability, differences in sleep patterns, or physical changes like fatigue, it's important to seek help from a health care provider as soon as possible. (See the CDC's full list of symptoms.) And always remember, depression and anxiety are treatable no matter the age.

The Bottom Line

The pandemic has led to an increase in mental health issues among kids, but a decrease in common respiratory illnesses, including the flu, colds, and RSV. Experts credit that to practicing safety health measures like hand-washing, social distancing, and mask wearing. Pediatricians are hopeful that kids may continue to practice these measures even after the pandemic is over leading to less illnesses throughout the years to come.