A big question remains over how the more contagious delta variant will affect children.
As the delta variant of the coronavirus sends case counts surging, millions of U.S. children are heading back to school in person, many for the first time in more than a year. It’s a confluence of events that has some parents, educators and health officials worried.
The vast majority of children are unvaccinated, making them one of the populations most vulnerable to the virus. Crowd them together, mix in a more transmissible variant, and it could create a perfect recipe for infection and spreading COVID-19 if extra precautions like wearing masks aren’t taken.
Vaccines offer the best protection, but many children can’t yet get COVID-19 shots. While vaccines for children younger than 12 are in testing, it could still be months before they’re available for most children in elementary and middle school. Their younger siblings will probably have to wait longer.
Even once vaccines are in hand for the youngest, it’s unclear how many will get the shots. Most eligible 12-year-olds and teens have yet to get vaccinated. Some people have even questioned whether children need to be vaccinated now, given that their risk of becoming severely ill from COVID-19 is less than that of adults.
That is true: Most children who get COVID-19 recover with no lingering effects. But a year and a half into the pandemic, there’s still much that researchers and doctors don’t know about the consequences of the disease for kids. Among the unknowns: How often do kids develop lingering symptoms, or long COVID-19? Why do some healthy children develop serious, run-amok inflammation weeks after recovering from COVID-19? For some kids, that complication comes even more out of the blue: They weren’t even aware they were infected.
Now the delta variant is causing yet more uncertainty. Studies primarily involving adults show that it’s making people sicker than earlier versions of the coronavirus. Will it hit kids harder too?
Researchers are beginning to gather the data needed to answer those questions, though there is a dearth of data so far on kids and delta. The emerging picture suggests that while the virus remains no big deal for many children, it is a serious problem for others.
A top 10 killer
“It drives me crazy to hear over and over again that the virus is not serious for children,” said Andrew Pavia, a pediatric infectious diseases doctor at the University of Utah in Salt Lake City. While COVID-19 doesn’t tend to strike kids as hard as it does adults, “By every measure, its impact is greater than the impact of influenza,” he said July 13 during a news conference sponsored by the Infectious Diseases Society of America.
Since the U.S. Centers for Disease Control and Prevention began tracking flu deaths in 2004, childhood deaths from flu in the United States have ranged from a low of 37 in the 2011–2012 flu season to a high of 199 in the 2019–2020 season. Flu nearly disappeared in the 2020–2021 season as precautions against the coronavirus helped limit the spread of some other respiratory illnesses, too — except some colds, for still-mysterious reasons (SN: 2/2/21). That flu season set a new low with one pediatric death reported. The coronavirus, however, proved deadly to more than twice the number of children as flu claimed over the last 18 months. As of August 4, COVID-19 has killed 416 U.S. children of the nearly 4.3 million infected since January 2020.
“Anything that kills more than 350 children a year is going to automatically rank in the top 10 causes” of childhood death, says Debbie-Ann Shirley, a pediatric infectious diseases specialist at University of Virginia Health in Charlottesville.
While it’s a small fraction of the more than 600,000 COVID-19 deaths in the United States, these numbers raise alarms for some health experts.
“Think about if 300 children had died over the past year from lightning strikes or from shark attacks,” says Taison Bell, a critical care and infectious diseases doctor who directs UVA Health’s medical intensive care unit. “We would be doing things a lot differently when it came to going to the beach or being outside when it was raining.”
Now, the number of infections in kids is increasing. From July 30 to August 5, there were 93,824 new COVID-19 cases in children, according to the American Academy of Pediatrics. That’s up from 71,726 new cases in the last week of July, which nearly doubled the 38,654 cases from the previous week. And as infections rise, the number of hospitalizations and deaths will too. With millions of children infected, “even a small percentage adds up to tens of thousands of children being hospitalized for COVID-19,” Shirley says.