Just catching up on my healthcare readings and ran across an article in my email account from MedPage Today. The articles come on a daily basis and I also get them from Modern Healthcare (which limits articles), Health Affairs, NEJM, JAMA, etc. It is more than I could read at any one time unless, I give up more time to read and absorb them. There has been much conversation and arguing on whether there should be vaccinations for children. I have been waiting for something addressing the issues by those opposing it in a clear, concise, manner including some medical reasoning. “Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, June 2021 appears to do such. The calculus of risk changes drastically when considered from a public
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Just catching up on my healthcare readings and ran across an article in my email account from MedPage Today. The articles come on a daily basis and I also get them from Modern Healthcare (which limits articles), Health Affairs, NEJM, JAMA, etc. It is more than I could read at any one time unless, I give up more time to read and absorb them.
There has been much conversation and arguing on whether there should be vaccinations for children. I have been waiting for something addressing the issues by those opposing it in a clear, concise, manner including some medical reasoning. “Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, June 2021 appears to do such.
The calculus of risk changes drastically when considered from a public health lens, especially with considerations unique to children.
“From 1999 to 2019, influenza was the eighth leading cause of death in children. Yet this season, one pediatric flu death has been documented. This year’s result is likely due to aggressive non-pharmaceutical interventions (NPIs). In the same 2020-2021 season, the American Academy of Pediatrics reports (as of early June) 327 U.S. deaths in children, and the CDC reports 452 both due to COVID-19 (both are underestimates, as data is incomplete). In comparison and in ~ 1 year COVID-19, has killed twice as many children as influenza does most years, and hundreds more in the same interval of time, despite painstaking efforts to prevent infection.”
“Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today
COVID-19 is a leading cause of death amongst children.
Dissenting views have drawn distinctions between hospitalization of children with Covid-19 and from Covid-19. As explained in the article, such a distinction has merit. As cases in children are usually milder or asymptomatic and are screened within the hospital. It can be said some cases certainly reflect incidental findings.
Two such examinations have noted that nearly half of these pediatric hospitalizations were unrelated to COVID-19 and we should be cautious about accepting the generalizability of these reports.
However, applying the distinction to the entire U.S., Covid-19 still amounts to approximately 100,000 pediatric hospitalizations over the span of ~ one year This numeric is based on statistics generalized to the CDC estimates, or at least a minimum of 20,000, based on COVID- 19 NET data. All the Covid-19 estimates far exceed the number of hospitalizations during the pre-vaccine period for several vaccine-preventable diseases on the childhood vaccination schedule.
- Multisystem inflammatory syndrome in children (MIS-C) is a post-COVID-19 syndrome of the pediatric population, has a far greater risk of morbidity and mortality, and includes heart dysfunction. Initial infections resulting in MIS-C are frequently asymptomatic and the condition appears 4 to 6 weeks later. Of the documented cases in the U.S., an approximate 1% were fatal.
- Post-acute sequelae of COVID-19 (PASC) or commonly called “long COVID,” is also a risk. One estimated frequency of pediatric PASC comes from some studies note it to be as high as 42% of cases (as identified in the article, this is thought to be too high). medRxiv’s “Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2″ refined or calculated the percentage to be 1.8%.
Twenty-five (1.8%) of 1,379 children experienced symptoms for ≥56 days. Few children (15 children, 0.9%) in the negatively-tested cohort experienced prolonged symptom duration; however, these children experienced greater symptom burden (both throughout their illness and at day 28) than children positive for SARS-CoV-2. Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2, medRxiv
The 1.8% statistic corresponds to 480,000 U.S. children having symptoms lasting longer than 56 days. Collecting additional data over time will clarify the significance of PASC as a pediatric health problem. Clinics have been opened specifically to treat the condition which suggests the burden is significant. Adults have been experiencing similar conditions after being cleared of Covid-19.
COVID-19 is indeed much worse for many groups than it is for children. Covid19’s impact on children is significant to their social and emotional wellbeing and their physical health as well. Children are not supposed to die their loss can be especially shattering in part because it is not supposed to happen to someone so young. As a whole what does it say about us as adults willing to risk their well being when facing one of the biggest modern threats to their safety. we are so willing to be complacent?
Complacent in the face of 400 deaths, 20,000 to 100,000 hospitalizations, hyperinflammatory syndrome with a significant risk for death and disability, and persistent symptoms after apparent recovery. Is indifference, a casual lack of concern with an “oh, it could never happen to him or her, the intelligent approach to Covid-19? I think not and especially for children..
“Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, Edward Nirenberg and Risa Hoshino, MD, June 2021