More than a million children have been diagnosed with Covid-19 in the United States since the first case in the country was identified on January 20. The data, released last week by the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA), shows that children, including infants and teens, make up one in every 11 reported cases.
As of November 12, 1,039,464 children have tested positive for the coronavirus based on data collected from state health departments. More than 112,000 new cases in children were reported during a one-week period ending on November 12, marking the largest increase in Covid-19 cases among children in a single week since the pandemic began.
“As a pediatrician who has practiced medicine for over three decades, I find this number staggering and tragic,” says AAP president Sally Goza 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.”
These numbers are likely underestimates, as many children who have been infected with the virus often experience mild or no symptoms at all, making them less likely to get tested.
Goza says the sobering number should be an incentive for policymakers to enact nationwide public health practices.
"We urgently need a new, nation-wide strategy to control the pandemic, and that should include implementing proven public health measures like mask wearing and physical distancing,” Goza urges.
So far, children don’t seem to be driving the spread of Covid-19 in adults, and infections in children are much lower than those in adults, Dyani Lewis reported for Nature last month. Schools and daycares may seem like hotbeds for coronavirus transmission because they are places where large groups of people gather indoors for extended periods of time, but young children seem to spread the virus less frequently, for reasons yet unknown, says Walter Haas, an infectious-diseases epidemiologist at the Robert Koch Institute in Berlin.
“They seem rather to follow the situation than to drive it,” Haas tells Nature, meaning, for example, if community or regional transmission is high, school transmission will be high, too.
The recent increase in pediatric Covid-19 cases reflects an overall increase in cases across the adult population. At least 26 states reported an uptick in child cases higher than 25 percent in the one-week period ending on November 12, according to the AAP, which is in-line with national trends. About 29 states nationwide saw a 30 percent increase in cases across the population during the same one-week time period, reports David Mills and Dana Cassell for Healthline.
Based on the AAP analysis, which focuses on data from 42 states and New York City, hospitalization and death from Covid-19 still appear to be uncommon among children. Of the 1 million Covid-19 cases in children, there have been 133 Covid-19 deaths, which accounts for a mere 0.06 percent of total deaths in the country.
However, a rare-but-serious condition associated with Covid-19 called Multisystem Inflammatory Syndrome in Children (MIS-C) has afflicted 1,163 children in the U.S. Most have recovered from MIS-C, but little is known about the cause of the disease or its long-term effects.
Though children face a lower risk of infection than older patients, being infected with the virus is not the only way that kids’ health has been negatively impacted by the pandemic, explains Rick Malley, a senior physician in infectious diseases at Boston Children’s Hospital.
“Even though children are relatively protected from the acute form of Covid-19, the reason why we explain to parents to protect everyone [is because] even the very young could suffer terrible consequences from this infection,” Malley tells Adrianna Rodriguez of USA Today.
According to a recent report from the Center for Disease Control and Prevention, mental health-related visits to the emergency departments in the past year saw a 24 percent increase for children ages 5 to 11 and a 31 percent increase for children ages 12 to 17.
“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 says. “Most natural disasters have an end, but this pandemic has gone on for over eight months, and is likely to continue to disrupt our lives for many more.”
Pediatricians also saw a decline in annual doctor visits this year, meaning children may be falling behind on several medical milestones, like measles and whooping cough vaccinations. Compared to 2019, there were 22 percent fewer immunizations for children ages two and younger against infectious diseases, according to data from Centers for Medicare and Medicaid Services.
“This pandemic is taking a heavy toll on children, families and communities, as well as on physicians and other front-line medical teams,” Goza says. “We must work now to restore confidence in our public health and scientific agencies, create fiscal relief for families and pediatricians alike, and support the systems that support children and families such as our schools, mental health care, and nutrition assistance.”