As COVID cases spike among children, concerns rise

Though hospitalizations and deaths are very low, the American Academy of Pediatrics notes the effects the pandemic is having on education and mental health.
By: | November 24, 2020
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As school districts continue to revamp decisions on remote vs. in-person learning, the American Academy of Pediatrics released data showing a large rise in cases of COVID-19 across the U.S. among children from the previous two-week period.

According to statistics from the Academy and Children’s Hospital Association, there were more than 250,000 positive cases among children (0-19) from Nov. 5 to Nov. 19, a 28% increase over the prior two-week period. The total number of children nationwide who have been infected with coronavirus is more than one million, which represents nearly 12% of overall cases in the United States.

Overall, there have been more than 3 million people infected since the start of November, the most of any month since the start of the pandemic.

There is concern from the Academy that the coming holidays and the winter months could present further increases in cases and put older family members and those with co-morbidities at risk. It has urged calls for mask wearing and physical distancing along with a new national strategy to limit spread and support “schools, mental health and nutrition assistance.”

“As a pediatrician who has practiced medicine for over three decades, I find this number staggering and tragic,” AAP President Sally Goza said in a statement. “We haven’t seen a virus flash through our communities in this way since before we had vaccines for measles and polio. We must do more now to protect everyone in our communities. This is even more important as we approach winter, when people will naturally spend more time indoors where it is easier for the virus to be transmitted.”

The Academy and the Centers for Disease Control have both noted the academic losses and other effects being sustained by children, whose visits to emergency rooms for mental health have increased 25% since March.

“We know from research on the impact of natural disasters on the mental health of children that prolonged exposure to this kind of toxic stress is damaging,” Goza said. “We’re very concerned about how this will impact all children, including toddlers who are missing key educational opportunities, as well as adolescents who may be at higher risk for anxiety and depression.”

Where it’s spiking

Two bits of positive news for school districts considering an in-person model –  numbers around hospitalization rates and mortality of children continue to remain low compared with the general population. Including infants, 17 states have reported no child deaths from COVID-19.

The highest reported hospitalization rate of children who get coronavirus has been New York City at 5.6%, followed by New Jersey at 2.6% and Rhode Island at 1.8%. Only New York City (at .14%) has shown a mortality rate above .03%, and those statistics include infants. Texas has reported 33 child deaths, the most of any state, but an overall percent of child cases resulting in death was not given.

Still, school districts should consider monitoring local and state numbers as well as their own reporting when seeking guidance on reopening. Some states and their districts all might be better positioned to reopen, in terms of staffing, cleaning protocols, social distancing measures and the weather, including staff and children having to remain indoors for long periods.

The state with the highest percentage of children with COVID-19 compared with the general population is Wyoming (23.4%), followed by South Carolina (18.2%) Tennessee (18.2%), Alaska (17.6%) and New Mexico (16.9%). The states/areas reporting the lowest percentage are New York City (4.8%), New Jersey (6.3%), Florida (6.3%), Texas (6.9%), though Florida only gauges children 0-14; most are in the 0-17 or 0-19 range.

The states with the highest number of cases per 100,000 children are North Dakota (5,589), South Dakota (3,992) and Wisconsin (3,727).

Only 10 states provided testing numbers in children, with four states showing positivity rates above 10%: Iowa (23.3%), Nevada (16%), Arizona (13.1%) and Wyoming (11.5%).