Rise in child COVID-19 cases, hospital stays alarms officials

COVID-19 hospitalizations among children have risen to the highest levels of the pandemic, prompting debate on whether the delta-driven surge is more ferocious in kids or if the fast-moving variant is reaching young people who are increasingly out and about and often unvaccinated.

It’s a daunting trend in a pandemic that fell hardest on older Americans before the arrival of vaccines and is worsening right as schools reopen.

Hospital admissions among those aged 0 to 17 are at their highest peak of the pandemic, averaging 313 per day over the past week, up from 281 per day during the prior seven-day period. 

Roughly 12,300 people overall are being admitted to the hospital for COVID-19 each day in the U.S., so pediatric admissions make up close to 2% of all patients.

Total pediatric hospitalizations have risen above 2,000 just a few weeks after National Institutes of Health Director Francis Collins said: “The largest number of children so far in the whole pandemic right now are in the hospital — 1,450 kids in the hospital from COVID-19.”

“Our children’s hospital is getting more admissions and this is true of the children’s hospitals across the state,” said William Schaffner, an infectious diseases specialist at Vanderbilt University.

The Virginia Health Department on Thursday said that a child from Fairfax who was under the age of 10 died from COVID-19, making it the first pediatric death from the virus in the northern part of the state and 10th in the state overall.

The trend is upending pre-conceived notions about the coronavirus, which battered nursing homes and older adults before the debut of vaccines last year.

Scientists say severe outcomes among children remain rare, with about 450 of the 630,000 deaths from the COVID-19 pandemic occurring in minors, according to federal data.

Pediatric cases accounted for 1.6% to 3.6% of total hospitalizations in two dozen states analyzed by the American Academy of Pediatrics (AAP). Only 0.2%-1.9% of all the child COVID-19 cases have resulted in hospitalization. A study of 44 states found children were 0.00%-0.22% of all COVID-19 deaths.

Still, the speed of the delta variant is worrying and any bout of pediatric illness is heart-wrenching for affected families. 

The growing crisis is heavily impacting Southern states where overall vaccination rates lag.

“This is not your grandfather’s COVID, this delta variant is a new and unexpected challenge for us,” Dr. Mark Kline, the physician-in-chief of Children’s Hospital New Orleans, told ABC’s “Good Morning America” this week.

Scientists are trying to figure out if the variant has characteristics that make it more dangerous to children or if the trend is the byproduct of high contagion and the lack of isolation, as society reopens and teens or children socialize without stay-at-home orders in place.

Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said she believes the increase in pediatric cases and hospitalizations is “likely the result of overall community transmission generally, and more specifically the delta variant’s increased transmissibility.”

She said the recent spike is largely one of bigger absolute numbers across all age groups from the delta surge, including children, rather than an increase in the percentage of kids requiring hospitalization after infection.

Some doctors, however, wonder if something deeper is at play.

“We’re seeing quite severe illness,” Dr. Kline told ABC. “We can say that this [delta] virus is more contagious for sure. What we don’t yet know with certainty is whether it is more virulent. But certainly to my eyes, and I think to what others are seeing across the region, children are experiencing more severe disease than they have in the past.”

Roughly 9 in 10 seniors — an age group hammered by the virus last year — have received at least one dose of a COVID-19 vaccine, while children under age 12 are not yet eligible for a vaccine while clinical trials play out.

The pediatric academy said it is worried about the long-term impacts of disease while kids wait for their turn to get shots.

“There is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects,” the AAP said.

Infections among younger people are spiking right as schools reopen across the country, sparking debate about mask mandates and other rules designed to tamp down transmission.

Over 180,000 pediatric cases were tallied in the week ending Aug. 19, comparable to levels during the winter surge, according to AAP.

“After declining in early summer, child cases have increased exponentially, with over a four-fold increase the past month, rising from about 38,000 cases the week ending July 22nd to 180,000 the past week,” it reported.

Dr. Walensky said everyone eligible should get vaccinated to “effectively shield” those aged 11 or younger.

White House COVID-19 Coordinator Jeff Zients on Friday touted improvement in reaching eligible adolescents — 50% of Americans aged 12 to 17 have received at least an initial vaccine dose.

“This is critical progress as millions of kids head back to school,” he said.

Florida Gov. Ron DeSantis and Texas Gov. Greg Abbott have tangled with schools who are imposing COVID-19 requirements in schools, notably mask mandates. They say parents should choose whether to cover their kids’ faces, while the Biden administration says schools should be free to do what’s necessary to stop the virus from spreading within their walls.

A Florida judge on Friday blocked Republican Gov. Ron DeSantis’ executive order prohibiting mask mandates in schools. Leon County Circuit Judge John Cooper ruled in favor of a group of parents who filed a lawsuit against the Republican governor, arguing his order puts their children’s safety at risk if there is a coronavirus outbreak at school.

Mr. DeSantis is expected to appeal.

The Texas Supreme Court, however, recently sided with Mr. Abbott, ruling the governor has the right to impose mask mandates but local governments do not.

“The Texas Supreme Court has sided with the law, and the decision to enforce mask mandates lies with the governor’s legislatively granted authority,” Texas Attorney General Ken Paxton said. “Mask mandates across our state are illegal, and judges must abide by the law. Further non-compliance will result in more lawsuits.”

Others are worried that federal guidance doesn’t go far enough or is out-of-date, given the recent rise of the delta variant.

“We are not looking at updating our school guidance right now,” Dr. Walensky said. “I can tell you that most places where we are seeing surges and outbreaks are in places that are not implementing our current guidance.”

• Emily Zantow contributed to this report.