Children have suffered tremendously from policies that have kept them out of in-person learning and physical activity during the COVID-19 pandemic.
Despite ample data demonstrating the risk of severe illness to be low in kids, attention-grabbing headlines about pediatric hospitalizations and cases of multisystem inflammatory syndrome in children (MIS-C) have instilled fear in parents and caregivers based on a perceived risk of danger.
Of such, these captions have greatly influenced public perception about COVID-19 in children.
A recent study published in the journal Hospital Pediatrics reported cases of hospitalizations in children are being overestimated. A retrospective review of admission data from two of California’s children’s hospitals show up to 46% of the children reported as "COVID-19 hospitalizations" were not admitted for symptoms relating to COVID-19.
The study also found about 40% of patients found to be "SARS-CoV-2 positive" had no manifestations of the virus at all, in other words, they were asymptomatic from the virus. To put it bluntly, because hospitals have instituted universal testing of patients, incidental positive cases were found when kids were admitted for other reasons including mental health disease and orthopedic fractures; not from symptoms of COVID-19.
The implications of these reports are vital because there is a big difference between being admitted for something and being admitted with something.
As these new studies suggest, slashing hospitalization rates for children by nearly half, the true risk of severe COVID-19 in children is even lower than originally thought; a level deemed acceptable in the pre-COVID world.
According to the Centers for Disease Control and Prevention (CDC), each year over 58,000 children under 5 years old are hospitalized with respiratory syncytial virus (RSV). For perspective, 16,013 children (0-19 years) have reportedly been hospitalized with Covid-19, according to the American Academy of Pediatrics. Incorporating the latest reports from California, that number is inflated and even includes adolescents and young adults.
To be certain, there are effects of SARS-CoV-2 in children other than severe illness resulting in hospitalization.
Reports of MIS-C continue to cause concern. However, it is essential to shift from a perceived level of risk to reality. Nearly 4 million children have tested positive for SARS-CoV-2 since the beginning of the pandemic, with 3,742 confirmed cases of MIS-C, of which 35 have resulted in death. While this illness can be debilitating, the calculated risk of developing MIS-C following infection is approximately 0.09%. This illness is likely even more rare since children have been under-tested for the virus.
Other post viral syndromes, including Kawasaki Disease, have similar manifestations and outcomes as MIS-C, occuring in about 3,000-5,000 children every year. Yet children are not required to be kept home or wear face masks in order to prevent these rare illnesses.
In the United States, despite the many circulating pathogens, car accidents are the leading cause of death among children, killing over 600 and injuring almost 100,000 kids each year. Another 800-900 children die from accidental drownings. Devastatingly, approximately 1,700 children die from cancer annually, which at this time, little can be done to prevent.
For kids, comparatively speaking, COVID-19 is not an emergency. The true risk of danger is much less than many others people have accepted without severe restrictions placed on their livelihoods.
When children do get symptoms of COVID-19, they are typically mild, including cough, nasal congestion and fever. Kids also appear to transmit the virus less than adults and have not been primary drivers of local outbreaks and community transmission.
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Since vulnerability to the novel coronavirus increases with age, by now, any adolescent and adult that wants to be vaccinated has been or can be. Because of this, new cases and hospitalizations continue to precipitously decline.
The coronavirus pandemic may not be over, but the emergency is.
As the positivity rate of the nation trends to all-time lows and vaccinated adults are removing their masks, it is time to stop punishing the innocents. Our fear-based restrictions have done enough harm, as demonstrated by the failing education reports and mental health medical claim data. Not to mention, facial recognition skills in young children not only helps them socially but is associated with better academic performance.
Reports that wrongly portray the danger of COVID-19 to kids only provides justification for prolonged restrictions to in-person learning and recreational activities.
The Centers for Disease Control and Prevention (CDC) must stay in front of the data and be transparent regarding the true risk of COVID-19 in children. They also need to reconsider their recommendations for young children regarding mask-wearing, indoors and outdoors.
Knowing that extended restrictions are causing harm, waiting for a vaccine to be available for young kids under an Emergency Use Authorization when COVID-19 is not an emergency for them does not make sense. While it is important to have a safe and efficacious vaccine available for all ages, given the low risk of disease severity in school age children, full Food and Drug Administration (FDA) approval should be sought before offering it to this low risk population.
If we are truly to follow the science, we must allow children to resume their normal activities, accepting that the threat of COVID-19 for them is much lower than many everyday risks.