After all this period of Covid-19 alarm and its soaring Delta, this fall, millions of US children will return to school in person, many for the first time in more than a year. At the same time, the new delta variant has sparked rising coronavirus cases. The collision of these two events worries many people, including health officials.
Most children have not yet been vaccinated against COVID-19. This makes them one of the most vulnerable groups to the virus. Now put all these babies together in the same place and mix in a super infectious variant. Suddenly, you have the perfect recipe for spreading COVID-19, at least if extra precautions aren’t taken, like wearing face masks.
What is a vaccine? Vaccines offer the best protection. Nevertheless many children are not yet qualified to get the COVID-19 vaccine. While vaccines for children under the age of 12 are being tested, it may take months before they are offered to most children through middle school. And their younger siblings will likely have to wait even longer.
Even once vaccines are available to younger people, it is unclear how many will receive them. Right now, 12-year-olds and teens can get a COVID-19 vaccine. However, most didn’t get the shot. Some people have even wondered if children really need a vaccine. After all, their risk of becoming fatally ill from COVID-19 is much lower than for adults.
This is all true. Most children who contract COVID-19 recover with no long-term effects. But a year and a half into the pandemic, there is still a lot that researchers and doctors don’t know about what the disease can do to children.
For example: how often do children develop persistent symptoms, also known as “long COVID”? Why do some healthy children develop severe, raging inflammation weeks after recovering from COVID-19? In some children, this complication appears in children who they didn’t even know they had been infected.
Now the delta variant adds new questions. Studies largely in adults show that this variant makes people sicker, and faster, than previous versions of the coronavirus. Will it hit children harder too?
At this time, there is little data on the risk of the delta variant for children. But the emerging picture suggests that while the virus poses little risk to many children, it does to some it could be pretty serious.
Covid-19 Delta variant: the threat to children
COVID-19 infections in children are on the rise. From 6 to 12 August, there were 121,000 new cases of COVID-19 in children. That number was reported by the American Academy of Pediatrics. It was a big jump from 93,824 a week earlier and 71,726 new cases in the last week of July. It was already almost double compared to a week earlier (38,654 cases).
As infections increase, the number of hospitalizations and deaths will also increase. With millions of infected childrensays Debbie-Ann Shirley, even a small share “It adds up to tens of thousands of children hospitalized for COVID-19”. Shirley works at the University of Virginia Health. It’s in Charlottesville. There, he studies infectious diseases in children.
What is the role of face-to-face lessons in the spread of COVID-19? Many infected children go through without symptoms or with only a few colds. For others, coronavirus infection can be life changing, observes Andrew Pavia. He is an infectious disease doctor. He cares for children at the University of Utah in Salt Lake City.
If you’re the kid who ends up in a hospital’s ICU for a week, “there’s nothing mild about that,” he says. Or what if a child “develops a long COVID and fails a semester of school and doesn’t make it to college? Or does he lose his athletic scholarship? ” These are serious issues.
“It makes me crazy to hear over and over that the virus is not serious for children,” Pavia said. “In any case,” he explains, “the impact of COVID-19 is greater than the impact of the flu.” He shared this observation on July 13. He was speaking at a press conference. It was sponsored by the Infectious Diseases Society of America.
The US Centers for Disease Control and Prevention, or CDC, began monitoring deaths from influenza in 2004. Since then, childhood deaths in the United States from influenza have ranged from a low of 37 in the 2011-2012 flu season. to a maximum of 199 in the 2019- 2020 season.
The flu almost disappeared in the 2020-2021 season. Coronavirus precautions have helped limit the spread of the flu. It did the same for some other respiratory diseases (except some colds, for reasons that are still a mystery).
Last year’s flu season marked a new low. Only one infant death was reported. But since January 2020 alone, COVID-19 has killed 423 of the nearly 4.3 million U.S. children who have been infected. In the week between August 4 and 11, seven children died of COVID-19.
“Anything that kills more than 350 children a year will automatically be ranked in the top 10” of infant deaths, says Shirley. And COVID-19 has killed almost so many. Children remain a small fraction of the 625,000 people who have died of COVID-19 in the United States. However, their number has raised alarm bells for some health experts.
Imagine “if 300 children had died in the past year from lightning strikes or shark attacks,” says Taison Bell. “We would do things very differently when it came to going to the beach or staying outside when it rained,” says this doctor. He deals with intensive care and infectious disease medicine. He also heads the ICU of UVA Health.
Furthermore, not all US children suffer from COVID-19 alike. For example, 18.5% of the US population is Hispanic or Latino. Yet Hispanic and Latino children account for 36% of infant deaths from coronavirus. Black children are also overrepresented among infant deaths from COVID-19. While 13.4 percent of the U.S. population is black, about 22 percent of infant deaths from COVID-19 were black children.
COVID 19 and serious consequences for children
Roberta DeBiasi saw her share of truly COVID-19 sick children, at the Children’s National Hospital in Washington DC, she is the head of infectious diseases. Nearly 2,900 children have been treated there for the coronavirus. Of these, more than 550 were hospitalized. About 175 ended up in intensive care.
Nationwide, children represent between 1.3% and 3.5% of people admitted to hospital for COVID-19. Like adults with severe cases of the new coronavirus, children who end up in hospital tend to have underlying medical conditions. These range from obesity and lung diseases to diseases that affect the nerves and muscles.
Another 165 children were treated at the Children’s National Hospital for MIS-C. It is short for Multisystem Inflammatory Syndrome in Children. The immune system of its victims causes inflammation to such an extent that it can lead to organ failure. It appears four to six weeks after a coronavirus infection. It can also affect children who initially had mild cases or no symptoms.
There’s no good way to know who will develop MIS-C, says DeBiasi. It can also happen to previously healthy children. “This is what makes it a little scary”, He says. Children of color tend to suffer more severe consequences than MIS-C. Black and Latino children were overrepresented among children treated at Children’s National for the disease.
DeBiasi and colleagues shared this finding on June 25 in the Journal of Pediatrics. Nationally, 63% of 4,404 children with confirmed cases of the rare syndrome were black or Latino. Some drugs that calm the immune system help. And many children seem to make a full recovery.
But as of July 30, MIS-C has claimed the lives of 37 US children. Doctors have only known about the rare inflammatory condition for just over a year. And MIS-C’s long-term impacts on a child’s health are yet another mystery. DeBiasi and his colleagues started a study on its long-term effects.
Some children suffer from “long COVID”
They are also looking at long COVID in children. It can include a mix of symptoms. They can range from exhaustion, shortness of breath after activity, and loss of taste and smell to problems with thinking and memory. And the effects can last for weeks or months. “If you are in school and are trying to learn”, notes DeBiasi, “It’s not okay to have memory problems”. Even seemingly mild cases “Have an impact on the quality of your life”.
No one is quite sure how common the long-term effects of COVID-19 are in children. DeBiasi’s new three-year study will follow more than 1,000 children and young adults who have had COVID-19. Their impacts will be compared with other children in the families of the participants who have never contracted COVID-19.
In a study of children in the UK, COVID-19 usually ran its course in about five to seven days. Younger children tended to improve faster. But about 4 percent of babies still had symptoms a month after getting sick. This is according to an August 3 report in Lancet Child & Adolescent Health. And these long-term effects occurred more often between the ages of 12 and 17 than in younger children. Nearly 2 in 100 children still had symptoms two months after the onset of the disease, the researchers found.
In a Swiss study of 109 school-age children, about 4 in 100 had at least one symptom three months after contracting COVID-19. The researchers shared these findings on July 15 on JAMA.
In both studies, children who had colds or other respiratory illnesses sometimes had symptoms that lasted up to a month or more. This suggests that the virus causing COVID-19 isn’t the only one that can cause persistent impacts.
During the entire course of the pandemic, children accounted for 14.3% of all infections. This is a discovery from the American Academy of Pediatrics. Since the emergence of the delta variant, children now account for a slightly larger share of cases. They accounted for 19% of all cases in the United States in the last week of July. It was up from just under 17% the week before. In mid-August it was 15%.
But that higher percentage of children since the start of the pandemic may be due to the fact that children under 12 cannot yet receive the vaccine. Only about 30% of young people between 12 and 17 years old are fully vaccinated. It may not mean that children are more susceptible to the virus. They may simply constitute a larger share of the group that remains vulnerable.
And although the delta is more contagious, it’s unclear whether it causes more serious illness in children as it appears in adults. Some doctors report that children infected with the delta variant are getting sick. But at Children’s National Hospital, “We don’t see any difference in how children get sick,” says DeBiasi.
Furthermore, there is no sign that they are more likely to end up in hospital if they have been infected with the delta variant, He says. But there is still some basic math to consider: The more children get sick with this super contagious variant, the more they could face serious long-term illness.