As the delta variant spreads, more children need hospital care

The current delta-fueled wave of COVID-19 is sending more children to local hospitals and across the country, a sign, doctors say, adults need to do a better job protecting children, especially those in under 12 who cannot be vaccinated.

Nationally, hospitalizations of children for COVID-19 increased 84% between July 10 and July 31, from 665 to 1,224, according to the US Department of Health and Human Services. In that region, the number of pediatric hospitalizations fell from four to 13 in New Jersey and from 20 to 28 in Pennsylvania between July 10 and July 31. Although on the rise, hospitalization rates remain low; 1.1 per 100,000 children in Pennsylvania and 0.7 per 100,000 in New Jersey.

According to a report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association, only 0.1% to 1.9% of all known cases in children lead to hospitalization. The actual percentage is likely even lower because many infected children go untested, said Sara Bode, director of school health services at Nationwide Children’s Hospital in Columbus, Ohio, and chair of an AAP committee on school health.

However, the trend worries experts.

Bode said hospitalizations of children generally increase in concert with those of adults in their community. In the past two weeks, she said, the number of children testing positive and those requiring hospitalization has doubled in her hospital. Although the numbers remain low, “this is an important trend that we need to pay attention to,” she said. She fears the situation will worsen in the fall when children return to school, people will spend more time indoors, and the virus will spread more easily.

The AAP report says the number of children testing positive for COVID-19 fell from its summer low of 8,447 on June 24 to 71,726 on July 29. At the height of the winter push in mid-January, there were more than 211,000 cases in children.

Report says 358 children died COVID-19, including two in Delaware, seven in New Jersey and 15 in Pennsylvania. Pennsylvania includes everyone up to age 19 in its child case data, while New Jersey goes up to 17 years.

A UK study published in Lancet Child and Adolescent Health this week said the average illness in children lasted six days and 98% made a full recovery within eight weeks. However, 4.4% had symptoms – fatigue was the most common – that lasted more than a month. Those 12 and older tended to have more symptoms and a slightly longer course than younger people.

Bode said most children hospitalized with COVID-19 only need a few days in the hospital, but some have been sick enough to require a stay in the intensive care unit.

Doctors at St. Christopher’s Hospital for Children in Philadelphia and UPMC Children’s Hospital in Pittsburgh both said more children are testing positive and in need of hospital care. The number of people with COVID-19 fell from four on June 20 to 10 on July 25 in St. Chris. The numbers are still single digits at UPMC, but the positivity rate for outpatient testing has risen significantly last week from 1.9% to 7%, said John Williams, head of the infectious diseases division. pediatric. It is a sign of community spread.

Jonathan Miller, head of primary care at Nemours duPont Children’s Hospital in Wilmington, said his hospital only had two patients who tested positive for COVID-19 on Wednesday morning, and neither were admitted because of virus. He said that his region has not seen an increase in the number of cases so far either. In July, 20 children tested positive, the least since May 2020. The peak was in January 2021 with 91 positive tests.

Williams expressed concern that children under 12 cannot yet receive vaccines, the delta variant is spreading quickly, and many people have taken fewer precautions.

“The only thing that protects these young children is the rest of us and as a country we are doing a bad job protecting these young children right now,” he said. He said vaccination rates need to increase in older children and adults, and everyone, whatever the vaccination status, must wear masks more often.

Local and national pediatricians are also seeing an increase in other respiratory viruses that have given us a break while we stay at home, social distancing and masking. The most serious of these are respiratory syncytial virus (RSV) and parainfluenza. Doctors said the common cold had managed to spread throughout the pandemic. RSV and parainfluenza usually strike in the fall and winter, but make a strong early onset. In St. Christopher, 76 children tested positive for RSV in June and 110 in July. “It’s definitely an abnormal summer,” said Emily Souder, an infectious disease doctor there.

So far, doctors have seen no evidence that delta makes children sicker than previous versions of the virus or causes different symptoms. It is not known if they can spread it more easily. Some children who had to be hospitalized for COVID-19 in general had underlying health issues, but many were healthy before they developed breathing problems or pneumonia. Some children infected with the virus may also develop MIS-C, or multisystem inflammatory syndrome, a potentially serious illness. Souder said St. Christopher’s saw more than 30 children with MIS-C during the pandemic.

Doctors say the best way for parents to protect their children is to get vaccinated themselves, to vaccinate eligible older children, to socialize with other vaccinated people and to wear masks in public places. Souder says it’s better to eat outside than inside with kids in a restaurant.

The AAP recommends that everyone wear masks inside schools. Solder thinks it’s best for the kids to go back to face-to-face learning, and she wants it to work. Mitigation efforts like masking worked last year. “It wasn’t the kids who had problems with this,” she said.

She called it “a real travesty” that some adults are fighting against measures that would protect children, vulnerable adult staff, classmates with health problems and poorly immunized communities. “It’s really the adults’ responsibility to keep promoting that, to mold for your own children how to use these strategies,” she said.

If schools start without blanket masking, Bode said, “the consequence is that we’re going to go back to virtual learning.” Her own children are vaccinated and she would always recommend that they mask themselves at school so that it is “normative” for all children.

When asked what type of masks children should wear, Bode replied “a mask they will keep”. Miller said children’s masks with adjustable earrings are “really useful.”

It’s too early to know if masks and distancing will work as well with delta. “I think we have to take that into account,” Bode said. “We have to follow the data.

Miller says the virus should have taught us to be careful by now. “It’s probably worth it to be a little more conservative than you think necessary,” he said, “because we as a society continue to burn ourselves. “