(CNN) — The myth that children cannot become seriously ill from Covid-19 is increasingly debunked as more children are hospitalized during the Delta variant wave.
More than 49,000 children with Covid-19 have been hospitalized as of August 2020, according to the U.S. Centers for Disease Control and Prevention.
This month, an average of 276 children with Covid-19 were hospitalized each day between August 14 and 20, data from the CDC shows.
“Half of the children we have included are under 2 years old,” said Dr. Mark Kline, chief physician at Children’s Hospital New Orleans, this month.
“This virus that we’re dealing with now is a game changer. And it’s so easily transmitted from person to person.”
Now doctors say it’s crucial to protect children from the Delta variant — not just for their health and personal learning, but also to prevent more aggressive variants from developing.
Nearly half of children hospitalized with Covid-19 had no known underlying condition
A lot has changed since the past school year. A more contagious variant – Alpha – has been replaced by an even more contagious variant – Delta – as the dominant strain of the coronavirus in the US.
In just two months, Delta jumped from 3% to more than 93% of sequenced coronavirus samples in the US, the CDC said.
And the weekly number of children newly infected with Covid-19 has more than tripled in less than a month.
About 39,000 new cases were reported in the week ending July 21, according to the American Academy of Pediatrics.
That number rose to 121,427 new cases in the week ending Aug. 12, the AAP said.
Of the children hospitalized with Covid-19, many were previously healthy.
Nearly half — 46.4% — of children hospitalized with Covid-19 between March 2020 and June 2021 had no known underlying condition, according to CDC data from nearly 100 U.S. counties.
Covid-19 deaths in children should not be ignored, says CDC chief
While children are much less likely to die from Covid-19 than adults, the deaths are still significant, said CDC director Dr. Rochelle Walensky.
At least 471 American children have died from Covid-19, according to CDC data. For the 2019-20 flu season, the CDC reported 199 confirmed deaths from pediatric flu and an estimated 434 deaths from pediatric flu.
One reason Covid-19 is more deadly for children than other infectious diseases is because many children are vaccinated against other diseases, said Dr. James Campbell, professor of pediatrics at the University of Maryland School of Medicine.
“Nobody dies of polio, nobody dies of measles in the United States. Nobody dies of diphtheria,” Campbell told CNN last month.
But while children ages 12 to 17 can get a Covid-19 vaccine, many have not. And it could be several months before a vaccine is approved for children under 12.
The 7-year-old daughter of Rebecca Calloway, Georgia, is one of thousands of young children who are testing various doses of Covid-19 vaccines to make sure they are safe and effective before being authorised.
Part of the reason Calloway enrolled Georgia in the pediatric vaccine trial is because she recently lost her 3-year-old daughter to another unexpected disease — type 1 diabetes — and doesn’t want any more families to lose a child to COVID-19 .
While infant deaths from Covid-19 and type 1 diabetes are rare, “you don’t want to be so statistical,” Calloway said.
Protecting children from Covid-19 is key to keeping them in school
With the highly contagious Delta variant, the CDC recommends that students from kindergarten through grade 12 wear masks at school along with teachers and visitors.
The American Academy of Pediatrics recommends masks in schools for anyone over the age of 2.
“Our kids deserve to learn full-time, in person, safely with preventative measures. And that includes masks for everyone in schools,” Walensky said.
Some students go back to school for the first time in a year. But the much-anticipated classroom learning can quickly derail due to an infection or outbreak.
In Mississippi and Florida, thousands of students just starting their school year have already been quarantined.
And it doesn’t take much for Covid-19 to close another school. Even one case can have a ripple effect on students, teachers and staff.
“We need adults to run schools, and if my adults are sick or in quarantine, I don’t have adults to teach the school,” said Carlee Simon, Superintendent of Alachua County Public Schools in Florida.
The school board voted to require face masks for the first two weeks of school, but the Florida governor has threatened to cut funding for schools that require masks.
And that worries the inspector.
“If we have families who don’t want to have masks on their child, what they’re doing isn’t just[increasing the likelihood]they have to be quarantined,” Simon said.
If a student becomes infected, “they will also have other students who were wearing masks and who should also be quarantined.”
“Everyone wants to move forward. Nobody wants to have masks forever,” said Simon. But “we want to be able to be safe and have educational time with our students.”
In addition to masks in schools, the CDC recommends layering other strategies, such as improved ventilation, physical distancing, and screening-based testing.
MIS-C and prolonged Covid could have lasting effects
Long-term Covid-19 complications can be significant for children and adolescents, even some who initially had mild or no symptoms, according to the American Academy of Pediatrics.
All pediatric patients who tested positive should have at least one follow-up examination with a pediatrician, the AAP said.
Pediatricians should watch out for residual or long-term Covid-19 problems, such as respiratory symptoms, that can last for three months or more; heart problems, including a type of heart inflammation known as myocarditis; cognitive problems such as “brain fog”; headache; fatigue and mental health problems, the AAP said.
Children who had moderate or severe Covid-19 may be at greater risk of subsequent heart disease, the pediatricians group said.
In some cases, children who start with mild or even no symptoms of Covid-19 are hospitalized weeks or months later with a condition called MIS-C – childhood multisystem inflammatory syndrome.
MIS-C is “a rare but serious condition associated with COVID-19 in which various parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs,” says the CDC.
It happens when “the virus prompts your body to mount an immune response against your own blood vessels” — which can cause inflammation of the blood vessels, said pediatrician Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital in Philadelphia.
Often children with MIS-C do not start very sick with Covid-19.
“Usually children are picked up incidentally as having (coronavirus). Someone in the family was infected, a friend was infected, so they got a PCR test. And they turn out to be positive. … Then it goes well,” Offit told to CNN.
“Then a month goes by and they get a high fever. And signs of lung, liver, kidney or heart damage. Then they come to our hospital.”
At least 4,404 cases of MIS-C, including 37 deaths, have been reported between February 2020 and July 2021, the CDC said.
It said 99% of MIS-C patients had tested positive for coronavirus, and the other 1% had contact with someone with Covid-19.
The median age of patients with MIS-C was 9 years.
“CDC is working to learn more about why some children and adolescents develop MIS-C after COVID-19 or contact with someone with COVID-19, while others don’t,” the CDC says.
“Based on what we now know about MIS-C, the best way to protect your child is to take daily actions to prevent your child and the entire household from contracting the virus that causes COVID-19.”
The best steps parents can take to protect their children include vaccinating and vaccinating children ages 12 and older, Walensky said.
And even if a parent is fully vaccinated, there is a small chance that they will develop an asymptomatic breakthrough infection and pass the virus on to their children.
Therefore, it is a good idea for all parents of young children to wear masks in indoor public environments.
But the best way to protect unvaccinated children, Walensky said, “is to surround them with vaccinated people.”
Children can accidentally stimulate new variants
Protecting children from getting Covid-19 could help everyone in the long run, doctors say.
As the coronavirus continues to spread and replicate itself in new people, it is more likely to mutate — potentially leading to even more contagious variants or a variant that could evade vaccines.
“That, of course, is the concern,” Walensky said.
Fully vaccinated people are less likely to become infected with the Delta variant.
But unvaccinated people — including unvaccinated children — are more prone to infections. And they can unconsciously help create new variants, Offit said.
“If we continue to spread this virus, we will continue to create these variants,” he said.
“We won’t be able to stop this pandemic until we vaccinate a significant percentage of the population.”