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Over the past three decades, Dr Toni Darville has treated some of the sickest children with viral illnesses, especially the flu.
“I’ve seen a lot of kids get extremely sick from the flu,” said Darville, chief of pediatric infectious diseases at the Children’s Research Institute at the University of North Carolina. Some have developed pneumonia. Others had to be placed on machines called ECMOs to help their damaged hearts and lungs heal.
Complete Covid coverage-19 pandemic
But the Covid-19 pandemic was different. Darville estimates that she has seen about the same number of critically ill children with coronavirus in a single season as she has over 30 years of treating critically ill children with influenza.
“I just don’t think the general public understands the severity and intensity of this virus,” she said.
While children in general have been spared the worst impact of Covid, they can, in rare cases, become seriously ill and in some cases die. As politicians and school districts fight for masks for children, frontline doctors want parents to understand that Covid is different from the flu.
“There are more differences between seasonal flu and Covid-19 than there are similarities,” said Dr Kavita Patel, a primary care physician in Washington, DC and former director of health policy under the President Barack Obama, on NBC’s “Nightly News” this week.
The flu is well known, while the virus that causes Covid has been known to humanity for less than two years. Questions remain about how best to treat critically ill children with Covid and whether they will develop lasting problems from the virus.
Flu vaccines are widely available for all children, while no Covid vaccine has been licensed for children under 12. More than half of children – 60% – get the flu shot each year, which doctors say helps prevent hospitalization and death. The vast majority of children who die from influenza are not vaccinated.
To complicate matters, the hypercontagious delta variant, which swept the country in July and now accounts for more than 90% of new cases. It’s still unclear whether the variant – which is more transmissible than seasonal flu – causes more serious illness in children, but doctors report that they are seeing more children in hospital than at any time of the day. pandemic. (Even getting a clear picture of hospitalizations is difficult, as only 23 states, plus New York City, break down their hospitalizations by age, according to the American Academy of Pediatrics.)
Flu vs. Covid
Of particular concern to doctors is the unpredictable nature that children will get very sick from due to Covid.
Doctors know who is most at risk for serious illness from the flu. They include babies too young to get the flu shot, as well as children with chronic health conditions, such as asthma and diabetes, according to the Centers for Disease Control and Prevention.
Most pediatric flu deaths occur in children with underlying health conditions, said Dr Andi Shane, chief of the pediatric infectious disease division at Emory University School of Medicine.
About half of children hospitalized with Covid also have underlying medical conditions, such as obesity and asthma, said Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics Infectious Disease Committee, as well as the head of the pediatric infectious diseases division. illnesses at Stanford University School of Medicine.
But it also means half have no underlying disease, she said, making it “difficult to predict which healthy children will get serious infections.”
The range of symptoms and complications also varies. “The flu makes you sick,” Darville said. “Children come to the hospital with influenza pneumonia and, rarely, one will die.”
But Covid can cause other complications, she said, ranging from “horrible diarrhea, very high fevers” to a type of heart inflammation called myocarditis. And mild or even asymptomatic cases of Covid in children can lead to a dangerous inflammatory disease called multisystem inflammatory syndrome in children, or MIS-C, which occurs several weeks later. Little is known about the effects of long Covid, which causes persistent symptoms, in children.
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Covid cases are steadily increasing in children, most of whom are not vaccinated. The week of July 29, the American Academy of Pediatrics reported 93,824 pediatric cases of Covid, up from 71,726 the week before.
As cases increase, hospitalizations will likely follow. Doctors are already feeling the pressure of a non-seasonal wave of winter viruses in the summer, including RSV, or respiratory syncytial virus, which lands an unusual number of children in intensive care units.
Growing cases of Covid are expected to collide with back to school, as battles over mask use continue. Doctors say they are worried about what will happen as large numbers of unvaccinated children return to school this fall and winter.
“I imagine that with Covid on top of everything else we’re going to be very busy in the hospital,” Darville said.
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