As schools reopen around the country we are all taking part in the greatest epidemiological experimentation there ever was. I’ve spent hours trying to quantify an unquantifiable risk for many families. Any patient can get a letter from me they prefer to return to school after 2-3 weeks. This gives schools some time to learn how to manage COVID19. Not going back to the classroom is a very difficult decision given the recent climb in teen suicides in Orange County. I encourage getting back to school for those starving for that social connection.
Nonetheless, don’t be fooled by the fact that a majority of childhood COVID19 cases are asymptomatic or mild. We now have data showing the amount of hospitalizations is much higher than the flu. Until now we really haven’t known what happens to kids that DO get hospitalized. What are their symptoms? What percent have underlying conditions? What percent die? Here are the numbers...(and these are with schools shut and kids outdoors for the summer!)
Hospitalization rate: 8 kids per 100,000 are hospitalized due to COVID19. This is MUCH higher than the flu but MUCH lower than the adult hospitalization rate (165 per 100,000). This is per 100,000 population and not per 100,000 infected.
Kids younger than 2 years old (25 per 100,000) had the highest rate of hospitalization compared to kids older than 2 (see figure).
ICU rate: 33% of hospitalized kids got sent to the ICU.
Ventilation rate: 6% of kids in ICU required a ventilator.
Underlying conditions: 43% of hospitalized kids had an underlying medical condition. The most common condition was obesity, lung disease, and prematurity.
Symptoms: 54% of hospitalized kids had fever/chills, followed by nausea/vomiting, abdominal pain, or diarrhea (42%).
Death rate: 1% of children died during hospitalization. This is compared to 29% of hospitalized adults.
Translation? Children can (and do) develop severe COVID19 illness, but the vast majority survive to hospital discharge. What happens after discharge (i.e. long term effects) is still in question. Hospitalization rates are increasing.