American Academy of Pediatrics says number of kids with COVID rose 90% in a month

August 11, 2020
Closeup of girl's face in mask
Kids are more likely to get COVID-19 than many parents realized. Photo by Sarah Pack

As families across South Carolina prepare for school to reopen, whether online or in person, a new report on kids and COVID-19 underscores the importance of controlling the virus. 

The American Academy of Pediatrics and the Children’s Hospital Association looked at data from each state and found there were almost 180,000 new cases of COVID-19 in children across the country between July 9 and Aug. 6. That’s a 90% increase during that time period compared to all of the previously reported cases in children.

The report notes that in South Carolina, which categorizes everyone 20 and under as children in its COVID-19 reporting, more than 14,000 kids have tested positive since the pandemic began.

The big numbers may come as a shock to some people who have been following research on COVID-19 in children. For example, a June article in the journal Nature Medicine estimated people under 20 years old were half as susceptible to COVID-19 infection as people over 20. And an early report in the journal Pediatrics noted that kids did not seem to be significant drivers of the pandemic. 

Dr. Allison Eckard 
Dr. Allison Eckard

So what’s going on? Was that all a mistake? No, said Allison Eckard, a pediatric infectious diseases physician at MUSC Children’s Health. The studies were small and reflected the time in which they were conducted. But now that researchers have more information, they want the public to know that children are not immune to COVID-19 — and it’s important to remember that as schools reopen.

Here’s a little more about that earlier research.

One, it was done at a time when people were staying home more. “Early on, say in March and April, when everything was locked down and schools were closed, that’s when a number of small studies came out suggesting kids weren’t as readily infected and may be less likely to transmit the virus,” Eckard said. “From the very beginning I said you have to be very cautious about making any definitive conclusions until we have more data.”

Two, back then, not many kids were being tested. That’s changing. “As the testing has increased and the prevalence in certain parts of the country has increased, naturally, our number of children infected is going to increase. With more widespread testing, we are testing many more children with mild symptoms or no symptoms at all but are still infected. There was never a doubt in my mind that children were at risk of getting infected with COVID-19,” Eckard said.

Three, research suggesting that kids were unlikely to spread the virus lacked the context we’re now getting with more testing and better contact tracing. “When these studies came out, most showed that the person who brought the infection into the household was an adult, which led to the idea that only adults could give it to children and not the other way around. But this was at a time when schools were closed and children were generally on lockdown,” Eckard said. 

“Are children less likely to infect others if they’re positive? I would say that the data are still sparse, and we need more studies now at a time when infection rates are high and children are more likely to get exposed to the virus outside of the household. It may depend on various factors such as the age of the child, but we just don’t know enough yet. And, we need to be cautious because even if children are less likely to infect others, the number of transmissions from children to others will naturally increase as our community prevalence increases.”

That prevalence in children is now up to about 9% of all positive cases, according to the new reportThat’s true both nationally and among the people tested for COVID-19 by MUSC Health, which classifies children as under the age of 18.

“Kids are still much less likely to be hospitalized and/or die from COVID-19 than adults. But the possibility that they will pass along the virus to others is a key factor in the delicate balance that schools, their employees and families have to strike," Eckard said. “You have to weigh the importance of sending children to school for their own educational and socioemotional development versus their risk of taking it back to their family members.”

While South Carolina has reduced the growth of the coronavirus, the rate is still considered high. “If we’re going to reopen schools while there is still such a high transmission rate, we have to do everything we can within the schools and in the community to make it successful — including keeping children in small groups, using physical distancing and requiring people to wear masks,” Eckard said.

“The AAP’s big push is that schools need to reopen if they can, but schools need to utilize mitigation strategies to make it work. I completely agree. You’re not just implementing these strategies to protect the children and teachers from getting infected. You’re also doing it to prevent these children from getting exposed at school and then having to miss school for extended periods of time when they are sent home to quarantine. Worse yet, we are also trying to prevent these children from bring the virus home to their family members.”

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