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Kali Cook was 4 when she died after contracting Covid-19 last week in Galveston County, Texas, becoming the county’s youngest resident to die of the disease.
“She was so funny and sassy,” her mother, Karra Harwood, told the Galveston County Daily News of the little girl who loved to play with frogs and worms. “She was so pretty and full of life.”
According to her family, Kali did not have any previously diagnosed health problems and a doctor recently found her to be in good health, Dr Philip Keizer of the Galveston County Local Health Authority told NBC News. She began to develop respiratory symptoms after other family members fell ill with Covid and the next morning she was found dead. An autopsy is in progress.
Keizer said Kali’s death was “really shocking,” but it shouldn’t have been, given that 40% of the county’s cases involve people under the age of 20 and the largest demographic is that of children under 10 years old.
“It turned our community upside down. How could this happen? Why could this happen? ” he said. “But in some ways again, when you step back and watch and see how the delta can spread very quickly and children are now one of the largest unvaccinated groups in the country, it shouldn’t surprise us. , although that was quite shocking. “
As of September 9, nearly 5.3 million children have been diagnosed with Covid-19, or 15.5% of all cases, according to the American Academy of Pediatrics. More than 243,000 cases were reported from September 2 to 9, the second highest number of child cases in a week since the start of the pandemic, accounting for almost 29% of cases reported weekly, according to the AAP. The highest number of cases was just a week earlier, with 251,781 new cases. The AAP reported that after declining in early summer, “cases of children have increased exponentially, with almost 500,000 cases in the past 2 weeks.”
Despite the explosion in cases, the Centers for Disease Control and Prevention and pediatricians and clinical investigators studying the disease still lack evidence that delta causes more serious infections in children and adolescents.
But experts are looking at “red flags that could indicate greater severity of the disease in specific segments of the pediatric population,” said Dr. Jim Versalovic, acting chief pediatrician at Texas Children’s Hospital.
“For example, we are seeing Covid pneumonia and acute respiratory distress in infants and young children,” Versalovic said, adding that some cases were due to respiratory syncytial virus (RSV) -Covid co-infections with a higher rate of hospitalization.
“So it can be difficult to understand if we have more severe disease due to delta or co-infections,” he said.
A definitive answer could still be months away, Versalovic said, although he hopes there will be “more clarity on this matter in calendar year 2021”.
“We need more time to assess data across regions, age groups, different underlying medical conditions and longer term outcomes,” he said.
“These questions can be difficult, and note that this delta increase is only 2 months old,” he said. “We can confidently say that the Delta’s biggest impact on children is simply a greater number of cases or the much greater number of children with Covid. ”
On average, 341 new Covid patients aged 17 and under were admitted to hospitals from the week of September 6 to 12, down slightly from a recent peak of 371 per day from August 29 to September 4, according to the data available from CDC. More than 57,300 children have been admitted to hospitals since August 1, the data shows.
And at least 412 children have died from Covid, according to the latest CDC data, although serious complications in children remain rare.
Dr Sean O’Leary, vice chairman of the American Academy of Pediatrics Committee on Infectious Diseases, said that while the question of whether the virus is more serious for children is important, it is “not as important as the number of children, frankly, at the moment they are infected and hospitalized. “
“We still don’t really have an answer to that question for adult illnesses, where there are at least a lot more hospitalizations than in children, so I think that’s going to be a tough question to answer.”
This month, the CDC found in two studies that child hospitalizations had “almost quintupled between late June and mid-August 2021,” according to one study. This study also found that hospitalization rates were “10 times higher in unvaccinated adolescents than in fully vaccinated adolescents.”
Studies did not find evidence that the delta variant appeared to cause more serious illness in children, but the large number of children exposed led to an increase in the number of children hospitalized with Covid.
Whether or not the delta itself is more severe, doctors say they are noting more and more cases of children falling seriously ill as the pandemic progresses and the delta variant has become predominant.
Dr Inci Yildirim, pediatric infectious disease specialist at Yale Medicine, said it was very rare at the start of the pandemic to see “a teenager intubated for days in intensive care. But now, as more children are infected, more children are hospitalized. “
“This is the first time that I have seen so many pediatric patients with Covid-19 in the hospital,” she said. “That was not the case 8-10 months ago.”
Yildirim said Covid is a milder disease in children than in adults, “but it is not at all a mild disease in childhood, when hundreds of children die.”
Dr Claudette Poole, a pediatric infectious disease physician at Alabama Children’s Hospital, said the hospital was testing all children admitted since the spring of last year for Covid.
Looking at how the virus manifested in children in August 2020, around 44% were completely asymptomatic, she said. Now only 10 percent of children are asymptomatic, she said.
Poole said it seemed to show that the delta might be more likely to cause actual symptoms in children than previous variants.
But she also said a lot is different now at this time of year compared to the same time last year.
“There was a lot more distance learning, we were in much tighter mitigation a year ago than now,” she said. “So it’s a combination of fewer mitigation measures, and certainly a more transmissible virus compared to what we were dealing with last year, and it appears to be more likely to cause symptomatic illness than the previous variant, so it’s like a triple whammy if you don’t mind.
Poole said it was important for people to know that Covid can cause serious illness in children, although it is rarer than in adults.
“We are certainly seeing children ending up in intensive care in numbers that we did not see earlier in the pandemic,” she said. “And when I say intensive care level of care, I mean they get desperately, desperately sick.”
“It’s just alarming to us that so many children are getting sick and requiring hospital care,” she said.
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