DETROIT – Among the many alarming consequences of the recent outbreak of Covid-19 in Michigan, there is one that is of particular concern to doctors: a record spike in child hospitalizations.
Michigan Health & Hospital Association data shows the number of children hospitalized with severe symptoms of Covid-19 peaked at 70 this week – twice as many as those hospitalized during the wave’s worst days which swept the state in November.
The numbers have public officials across the country monitoring Michigan, raising questions about why the B.1.1.7, or British, coronavirus variant behind the latest wave here is leading to more cases of seriously ill children.
“It’s the burning answer in my mind,” said Dr Rosemary Olivero, an infectious disease pediatrician at the Helen DeVos Children’s Hospital in Grand Rapids, who treats eight children with severe symptoms of Covid-19, including five in intensive care units. .
“I can’t say that this variant all of a sudden makes children much sicker,” she said, noting that the increase in hospitalizations is more likely the result of the infection of a bigger one. number of children “but we’re having a really severe flare.”
The risk of children dying from the virus remains very low in the United States. The latest report from the American Academy of Pediatrics and the Children’s Hospital Association shows that while children have accounted for 14% of Covid-19 infections since the start of the pandemic, they represent a tiny fraction of deaths.
But children now represent a higher percentage of those infected than at the start of the pandemic. The American Academy of Pediatrics report shows that children accounted for 1 in 5 cases detected across the country during the second week of April. In Michigan, infection rates among children are now higher than they were at any time during the pandemic. As of April 17, the 10 to 19 age group had the highest rate of new cases in the state, averaging more than 1,150 cases per day over the previous week. For children under 10, the average was 400 new cases per day.
Since vaccines are still not available for children under 16, it means more children could be at risk.
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“We all know it’s more serious in older people, but it’s absolutely not correct to say it’s benign in other people, and it’s also true for children,” said the Dr. Sean T. O’Leary, vice chair of the infectious disease committee for the American Academy of Pediatrics.
He noted that the Covkid Project, which tracks child deaths from Covid-19 using government reports and press accounts, had documented 582 child deaths as of the end of March, this which could make the disease one of the top 10 causes of child death in the United States.
Still, most children hospitalized with Covid-19 have a high chance of surviving, said Dr Bishara Freij, chief of pediatric infectious diseases at Beaumont Hospital in Michigan. The project has only recorded 10 child or adolescent deaths from Covid-19 in Michigan since the start of the pandemic.
“The vast majority will recover because we have learned a lot during this pandemic about how to deal with these children,” he said.
But the road to recovery can be difficult and painful for children and their parents, he said.
“It was all really, really scary,” said Kari Barrows of Hazel Park, Mich., Whose daughter Karissa, 16, just returned home after a five-day stay at Beaumont Children’s Hospital. “I was panicking, crying a lot.”
The hospital’s Covid-19 safety rules meant Barrows was quarantined in his daughter’s room for the duration of her stay, unable to leave or take turns with her husband as her daughter struggled to breathe. “I would go and hide in the bathroom to cry because I didn’t want her to see me cry. I didn’t want to scare him.
Karissa had Covid-19 pneumonia, which is the main factor behind the current rise in child hospitalizations in Michigan, said Freij, who treated her.
The acute symptoms are similar to those of adults infected with severe forms of the virus. When Covid-19 pneumonia appears in children, it is more likely to affect adolescents with pre-existing conditions such as diabetes and obesity rather than younger, healthier children.
Michigan hospitals say they are not seeing large numbers of children with multisystem inflammatory syndrome, a rare but dangerous complication of Covid-19 that affects otherwise healthy children.
Doctors say they typically see these cases weeks after Covid-19 peaks, as the syndrome is not caused by the virus itself but by the body’s immune response. So even as Michigan sees its spring surge this week begin to slow down, doctors are bracing for an increase in cases of rare inflammatory disease in the weeks to come.
Parents should be on the alert, said Michelle Elkhoury, whose 4-year-old daughter Juliana spent nearly a week at Beaumont Children’s last month as inflammatory syndrome hit her heart, kidneys and others. organs.
“It was probably the worst week of our lives as parents,” she said. “We were in the hospital and we didn’t know what was going to happen.”
Elkhoury didn’t know anyone in her family had had the virus until Juliana developed a high fever, bloodshot eyes and a telltale rash. The family had spent the past year worrying about the safety of their elderly relatives. It never occurred to them to worry about their young daughters, she said.
That’s probably true for many people, said Dr. Arnold S. Monto, professor of public health and epidemiology at the University of Michigan and acting chairman of the Food and Drug Administration’s advisory committee, which is considering them. emergency use applications from Pfizer and BioNTech to expand their Covid. -19 vaccines for children from the age of 12.
At the start of the pandemic, when most people with the virus had a variant similar to that which originated in Wuhan, China, in 2019, children and young adults were less likely than older people to be infected, a he declared.
Then the British variant began to sweep Michigan.
This variant is “very clearly more transmissible and therefore more likely to involve a larger age group,” Monto said. Since children were less likely to be infected last year, they were less likely to have natural antibodies to protect them from the virus. They are also too young to be vaccinated.
These facts, combined with the reopening of schools and restaurants and the resumption of sports for young people, which have been linked to several outbreaks of Covid-19 in Michigan, have created conditions that appear to have increased the risks of infection of children, he said.
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Although a recently published study suggests that the UK variant doesn’t make children sicker than the other variants, that’s still a question for scientists trying to answer conclusively, he said.
What is not in dispute, however, is the fact that more and more children are falling ill.
Children’s hospitalization rates rose 311% between February 19 and April 20, said John Karasinski, director of communications for the health and hospital association.
Adult hospitalization rates have increased even faster – by 400% over the same period, he said – but the rate among children is disappointing.
“We should definitely be concerned about this,” said Dr. Kengo Inagaki, a pediatric infectious disease specialist at the CS Mott Children’s Hospital at the University of Michigan. “We still have to be careful. We need to respect the distance, wear masks and avoid gatherings, as this is the best way to prevent Covid, regardless of the tension.
Now that vaccines are widely available for adults, some people might feel like the pandemic is over, but that’s not yet true, he said.
“We are not far from the end of the pandemic.”