COVID, kids & hospitalizations: Increase may be more about transmission, lack of vaccination than delta severity

Local Coronavirus Coverage

While still small, kids’ share of overall hospitalizations rising

JOHNSON CITY, Tenn. (WJHL) – If children you know and love get COVID-19’s delta variant, are they more likely to be hospitalized than they would have been contracting previous variants? (Spoiler alert — probably not.)

But with COVID transmission rates high and younger children more susceptible to infection due to their unvaccinated status, children’s hospitalizations as a percentage of the whole — while still very low — appear to be creeping upward.

Children have accounted for an increasing but still very small share of COVID hospitalizations across Tennessee the past three weeks.

News of children’s hospitals nearing or even exceeding ICU capacity has received much attention lately — but what are the main factors driving a spike in childhood COVID hospitalizations?

While it’s well-established the delta variant is far more contagious and transmissible than previous COVID strains, the question of whether its symptoms in young people are more severe than previous strains remains unanswered. Early signs point to its severity being similar to earlier strains.

“I think the proportion of infections in kids probably does go up in part because they can’t be vaccinated … from a proportionate basis the at-risk population is increasingly young.”

Dr. randy wykoff, etsu college of public health

And what about the lack of approved vaccine for children under 12? Has that led to them representing a greater proportion of the people getting the COVID virus than previously?

News Channel 11 studied available Tennessee Department of Health (TDH) data and spoke with Dr. Randy Wykoff, dean of the East Tennessee State University College of Public Health.

Wykoff’s conclusion so far — and it comes with the caveat that available data still leaves some unknowns — is that the delta variant may not cause more severe symptoms than previous ones, but that children are more at risk of contracting it due to their vaccination status.

“At least with adults I haven’t seen anything that’s shown me that the disease itself is worse,” Wykoff said.

“Initially it looked like it was with the delta variant, but what I’ve seen mostly lately suggests that it may not be the case. I don’t know about pediatrics because I don’t think we really had enough experience with the alpha variant or other variants.”

A recent article in The Atlantic noted that “researchers don’t yet have evidence that it is specifically worse for children, who are getting sick only a small fraction of the time.”

Wykoff said he prefers studying hospitalization and death data because of the significant number of COVID cases that go undetected. That’s usually because they’re asymptomatic or mild enough that the person doesn’t get tested.

The “noise” in the data could be exacerbated when it comes to kids, he said.

‘Six months ago, people weren’t thinking about kids having COVID, and so the only ones who were getting tested were the ones who were really sick,” Wykoff said.

Even with that caveat, kids zero to 10 years old as a percentage of total COVID cases has taken a remarkable upward turn, both in Tennessee and Northeast Tennessee.

ETSU College of Public Health Dean Dr. Randy Wykoff said inability to get vaccinated yet has likely contributed to children accounting for a higher proportion of overall confirmed COVID cases.

So far in August, 11.7% of COVID cases statewide have been in kids 10 and under. That’s almost double the pandemic-long level of 6.1%. The rate was 7% or less until April and hovered between 8% and 8.8% from April-July as the percentage of vaccinated Tennessee adults moved up.

The jump has been even sharper in Northeast Tennessee. Through the entirety of the pandemic, kids 10 and under have accounted for 6.1% of total cases.

In August, that figure is 13.0%, as 562 of the 4,340 cases Aug. 1-17 were among children 10 and under. The rate is 14% in Washington and Greene counties.

Statewide numbers show the proportion of cases among Tennesseans ages 11-20 has also increased in August, but not by as much. It reached a high of 17.2% this month, but that’s only about a third higher than the pandemic-long rate of 13.3%.

With the nation in the throes of a surge and the delta variant twice as contagious as the UK variant — and Tennessee currently in the top five for community spread — Wykoff said the math itself puts a lot of people at risk.

“If you take a variant like delta that is much more transmissible, you’re going to have a lot more infections,” Wykoff said. “You could have the same percent serious illness rate and see a lot more sick adults and sick kids.”

Add in the lack of vaccination availability for kids, and the jump in the percentage of cases among young kids isn’t surprising, Wykoff said.

“I think the proportion of infections in kids probably does go up in part because they can’t be vaccinated. From a proportionate basis, the at-risk population is increasingly young.”

TDH’s has a webpage with “Current COVID hospitalizations” that includes a breakdown showing COVID-positive pediatric patients (17 and under).

On July 28, just before children’s hospitalization totals began spiking, there were nine kids hospitalized with COVID statewide — 1.0% of the 894 total COVID patients in hospitals across Tennessee.

The spike had begun a bit earlier in adults, with the total more than doubling from July 18 to July 28, while children’s rates stayed between 7 and 10 during that period.

But in the three weeks since July 28, while overall COVID hospitalizations have climbed very sharply — nearly tripling to 2,490 — the rise among kids has been even more dramatic, growing nearly seven-fold to 61.

Children 17 and under now account for 2.4% of total COVID hospitalizations. They are 2.1% of COVID ICU cases, at 16 out of 747, and 1.4% of patients on ventilators — 6 out of 435.

Wykoff said parents should be aware that COVID is spreading at a high rate and at least some of the many children who contract it will have serious symptoms.

“The data coming out of the department of health says that there’s an increased number of kids in the hospital with COVID and an increased number in the ICU, and while those numbers are all relatively small compared to adults that’s, it’s a serious issue.”

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