Children can be severely affected by Covid-19; doctors explain how to protect them

The myth that children cannot get seriously ill because of Covid-19 continues to be disproved as the number of hospitalizations grows during the rise of the Delta variant. More than 49,000 children have been hospitalized with Covid-19 since August 2020 in the United States, according to the US Centers for Disease Control and Prevention (CDC).

This month, an average of 276 children were hospitalized nationwide with Covid-19 every day between Aug. 14 and Aug. 20, CDC data show.

“Half of the children we admitted were under two years old,” said Mark Kline, chief physician at Children’s Hospital New Orleans, this month. “This virus we’re dealing with right now is a game changer. And it’s easily passed from person to person.”

Now, doctors say it’s crucial to protect children against the Delta strain — not just for the sake of their health, but also to help prevent the emergence of more aggressive strains.

Almost half of hospitalized children had no preexisting disease

A lot has changed since the last school year. A more contagious variant – Alpha – has been replaced by an even more contagious one – Delta – as the dominant strain of coronavirus in the United States. In just two months, Delta jumped from 3% to more than 93% of sequenced samples of coronaviruses in the US, the CDC said.

And the weekly count of children infected with Covid-19 has more than tripled in less than a month. About 39,000 new cases were reported during the week ended July 21, according to the American Academy of Pediatrics (AAP). That number soared to 121,427 new cases during the week ended Aug. 12, the AAP said.

Among children hospitalized with Covid-19, many were previously healthy. Nearly half – 46.4% – of children hospitalized with Covid-19 between March 2020 and June 2021 had no known preexisting conditions, according to CDC data from nearly 100 US counties.

child deaths by Covid-19 should not be ignored, says the head of the CDC

While children are much less likely to die from Covid-19 than adults, the deaths are still significant, said CDC Director Rochelle Walensky. At least 471 American children have died from Covid-19, according to CDC data. In the 2019-20 flu season, the CDC confirmed 199 pediatric flu deaths and estimated 434 pediatric flu deaths.

One reason Covid-19 is more deadly to children than other infectious diseases is because many children are vaccinated against other diseases, said James Campbell, professor of pediatrics at the University of Maryland School of Medicine. “No one is dying of polio and measles in the United States. Nobody is dying of diphtheria,” he told CNN last month.

But while children ages 12 to 17 can receive the Covid-19 vaccine in the country, many do not. And it can take several months before a vaccine is authorized for children under 12 years old.

Protecting Covid-19’s children is critical to keeping them in schools

With the highly contagious Delta variant, the CDC recommends that students in kindergarten through 12th grade wear masks at school, along with teachers and visitors. The American Academy of Pediatrics recommends masks in schools for everyone over the age of 2 years.

“Our children deserve to have a safe, full-time, face-to-face learning experience with prevention measures in place. And that includes wearing a mask for everyone in schools,” said Walensky.

Some students are returning to schools for the first time in a year. But long-awaited classroom learning can quickly be undermined by an infection or an outbreak. In Mississippi and Florida, thousands of students starting their school year have already had to be quarantined.

And it doesn’t take long for Covid-19 to close a school again. Just one case can have a ripple effect on students, faculty, and staff. “We need adults to run schools, and if my adults are sick or in need of quarantine, I don’t have adults present to teach,” said Carlee Simon, superintendent of Alachua County Public Schools in Florida.

The school board voted to require face masks for the first two weeks of school, but the Florida governor has threatened to cut funding for schools that require masks. And that worries the superintendent. “When we have families that don’t want to put masks on their children, what they’re doing is not just increasing the chance of being quarantined,” Simon said. “If a student becomes infected, they will also have other students with masks that will need to be quarantined.”

“Everyone wants to move on. Nobody wants to wear masks forever,” said Simon. “But we would like to be safe and have instructional time with our students.”

In addition to masks in schools, the CDC recommends stratifying other strategies, such as better ventilation, physical distance, and testing on a screening basis.

MIS-C and long Covid can leave lasting impacts

The long-term complications of Covid-19 can be significant for children and adolescents — even for some who initially had mild symptoms or no symptoms at all, said the American Academy of Pediatrics. All pediatric patients who test positive should have at least one follow-up exam with a pediatrician, the AAP said.

Pediatricians should be aware of residual or long-term problems with Covid-19, such as respiratory symptoms, which may last for three months or more; heart problems, including a type of heart inflammation known as myocarditis; cognitive problems such as “mental fog”; headache; fatigue and mental health problems, the AAP said.

Children with moderate or severe Covid-19 may be at higher risk for subsequent heart disease, the pediatrician group said. In some cases, children who start out with mild symptoms or even no symptoms of Covid-19 end up hospitalized weeks or months later with a condition called MIS-C – multisystem inflammatory syndrome in children. “It’s a rare but serious condition associated with Covid-19, in which different parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs,” says the CDC.

It happens when “the virus induces your body to produce an immune response against its own blood vessels” — which can cause inflammation of the blood vessels, said pediatrician Paul Offit, director of the Center for Vaccine Education at the Children’s Hospital of Philadelphia.

Often, children with MIS-C do not get very sick with Covid-19. “Usually they are accidentally diagnosed with coronavirus. Someone in the family was infected, a friend was infected, so they did a PCR test, which came back positive. But they were fine, Offit told CNN. “So a month goes by and they develop a high fever. And evidence of lung, liver, kidney, or heart damage. That’s when they come to our hospital.”

According to the CDC, at least 4,404 cases of MIS-C were reported between February 2020 and July 2021 in the US, including 37 deaths; 99% of patients with MIS-C tested positive for coronavirus, and the other 1% had contact with someone with Covid-19. The average age of patients with MIS-C is 9 years.

The CDC says it is working to learn more about why some children and teens develop MIS-C after having Covid-19 or contacting someone with Covid-19, while others do not. “Based on what we now know about MIS-C, the best way to protect your child is to take daily steps to prevent him and his entire family from contracting the virus that causes Covid-19.”

The best measures include getting vaccinated and vaccinating children 12 and older, Walensky said. And even if one of the parents is fully vaccinated, there is a small chance that he will contract an asymptomatic infection and pass the virus on to their children.

That’s why it’s a good idea for all parents of young children to wear masks indoors in public. But the best way to protect unvaccinated children, Walensky said, “is to surround them with vaccinated people.”

Kids can accidentally help stimulate new variants

Protecting children from coronavirus can help everyone in the long run, doctors say. As the virus continues to spread, replicating in new people, the more likely it is to mutate – potentially leading to variants that are even more contagious or that can escape vaccines.

But unvaccinated people – including children – are more susceptible to infection. And they may unknowingly help create new variants, said Offit. “If we are going to continue allowing this virus to spread, we will continue to allow these variants to be created.” “We won’t be able to stop this pandemic until we have a significant percentage of the population vaccinated.”

Deidre McPhillips and Jen Christensen from CNN contributed to this report.

(Translated text. Read the original in English.)