No Risk for Children from Covid? ? ?
Just catching up on my healthcare readings and ran across an article in my email account from MedPage Today. The articles come on a daily basis and I also get them from Modern Healthcare (which limits articles), Health Affairs, NEJM, JAMA, etc. It is more than I could read at any one time unless, I give up more time to read and absorb them.
There has been much conversation and arguing on whether there should be vaccinations for children. I have been waiting for something addressing the issues by those opposing it in a clear, concise, manner including some medical reasoning. “Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, June 2021 appears to do such.
The calculus of risk changes drastically when considered from a public health lens, especially with considerations unique to children.
“From 1999 to 2019, influenza was the eighth leading cause of death in children. Yet this season, one pediatric flu death has been documented. This year’s result is likely due to aggressive non-pharmaceutical interventions (NPIs). In the same 2020-2021 season, the American Academy of Pediatrics reports (as of early June) 327 U.S. deaths in children, and the CDC reports 452 both due to COVID-19 (both are underestimates, as data is incomplete). In comparison and in ~ 1 year COVID-19, has killed twice as many children as influenza does most years, and hundreds more in the same interval of time, despite painstaking efforts to prevent infection.”
“Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today
COVID-19 is a leading cause of death amongst children.
In approximately 1 year, COVID-19 killed twice as many children as influenza does most years, and hundreds more in the same interval of time, despite painstaking efforts to prevent infection.
Dissenting views have drawn distinctions between the hospitalization of children with Covid-19 and from Covid-19.
As explained, such a distinction has merit. As cases in children are usually milder, or asymptomatic, and are screened within the hospital; it can be said some cases certainly reflect incidental findings.
Two such examinations have noted that nearly half of these pediatric hospitalizations were unrelated to COVID-19. Authorities should be cautious about accepting the generalizability of these reports.
Applying the distinction to the entire U.S., Covid-19 still amounts to approximately 100,000 pediatric hospitalizations over the span of ~ one year This numeric is based on statistics generalized to the CDC estimates, or at least a minimum of 20,000, based on COVID- 19 NET data. All the Covid-19 estimates far exceed the number of hospitalizations during the pre-vaccine period for several vaccine-preventable diseases on the childhood vaccination schedule.
- Multisystem inflammatory syndrome in children (MIS-C) is a post-COVID-19 syndrome of the pediatric population, has a far greater risk of morbidity and mortality, and includes heart dysfunction. Initial infections resulting in MIS-C are frequently asymptomatic and the condition appears 4 to 6 weeks later. Of the documented cases in the U.S., an approximate 1% were fatal.
- Post-acute sequelae of COVID-19 (PASC) or commonly called “long COVID,” is also a risk. One estimated frequency of pediatric PASC comes from some studies note it to be as high as 42% of cases (as identified in the article, this is thought to be too high). medRxiv’s “Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2″ refined or calculated the percentage to be 1.8%.
Twenty-five (1.8%) of 1,379 children experienced symptoms for ≥56 days.
Few children (15 children, 0.9%) in the negatively-tested cohort experienced prolonged symptom duration; however, these children experienced greater symptom burden (both throughout their illness and at day 28) than children positive for SARS-CoV-2. Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2, medRxiv
The 1.8% statistic corresponds to 480,000 U.S. children having symptoms lasting longer than 56 days. Collecting additional data over time will clarify the significance of PASC as a pediatric health problem. Clinics have been opened specifically to treat the condition which suggests the burden is significant. Adults have been experiencing similar conditions after being cleared of Covid-19.
COVID-19 is much worse for many groups than it is for children.
Covid19’s impact on children is significant to their social and emotional wellbeing and their physical health as well. Children are not supposed to die their loss can be especially shattering in part because it is not supposed to happen to someone so young. As a whole what does it say about us as adults willing to risk their well being when facing one of the biggest modern threats to their safety. we are so willing to be complacent?
Complacent in the face of 400 deaths, 20,000 to 100,000 hospitalizations, hyperinflammatory syndrome with a significant risk for death and disability, and persistent symptoms after apparent recovery. Is indifference, a casual lack of concern with an “oh, it could never happen to him or her, the intelligent approach to Covid-19? I think not and especially for children..
“Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, Edward Nirenberg and Risa Hoshino, MD, June 2021
There is also the problem that children can carry COVID and pass it on to others. Since most schools were closed early and a lot of teaching was done remotely, we haven’t seen all that much transmission by children, but that is changing.
Kaleberg:
People underplay the risk having said children do not get as ill as adults. It is true, they may not. And if your child draws the short straw. And yes children do transmit colds etc. easily to one another and to their teachers.
I’m not sure what the denounced complacency is exactly here. Kids seemed pretty well looked after during this pandemic. Some got sick and some tragically died, but if I think about the many steps taken to reduce their exposure, complacency is not good characterization.
i suppose the real threat is opening, without any controls in place (and good luck getting any with kids involved). so given that, its a given that covid will find a fertile ground to flourish. one wonders how to stop this, with many objecting based on politics (covid doesnt care about politics, its an equal opportunity infected any one it cant). some object to vaccines in general, even though several diseases were controlled by them (in fact several that essentially gone away came back, with a vengeance, and many people died as a result. again, viruses dont care about your views, they care only about being to reproduce, you deciding against vaccines is just a surrender to them, cause herd immunity well require many to die to get, eventually)
Eric
i guess i am not sure either. but i seem to remember hearing a lot of “open the schools, kids don’t get Covid,” rhetoric.
exclusive of MIS-C and PASC, different variants of Covid seem to have different impacts on younger populations…when the UK was first experiencing the initial phases of their Alpha wave, there was considerable press on how school children were more susceptible to that variant than the original strain…now there is a lot of press on how more children are dying of Covid in Brazil, where the P1 variant is dominant…
for instance, from the NYTimes, fairly recently: Why Are So Many Children in Brazil Dying From Covid-19?
i gather the Alpha variant is now dominant in the US, with Delta in ascendancy…
rjs:
Back to the masks and social distancing before Delta hits. There will be some a large percentage who will resist and get sick trying to be macho to government intervention.
Apart from medical facilities there are no mask requirements in WI. Capacity is at 100% for public spaces. There is nothing much to resist here. It might be unwise to go maskless at a crowded bar, but it says nothing about being macho to government intervention anymore. Being more cautious than the rules require might have health benefits is a better description.