Fact vs. Fiction: Is there a risk of serious COVID-19 illness as kids head back to school?

PITTSBURGH — We’re seeing scary numbers on rising COVID-19 cases in children, so we wanted to drill down as kids head back to school to better understand how the delta variant has changed the game.

In this Fact-Fiction: Back to School report, 11 Investigates’ Angie Moreschi looks at who is most at risk and whether more otherwise healthy children are getting sicker now.

Is there an issue at your child’s school that you’d like us to investigate? Contact our investigators by emailing 11investigates@wpxi.com or calling (412) 237-4963.

Child Cases on the Rise

Cases of COVID-19 among children are on the rise. The American Academy of Pediatrics reported 180,000 new cases among children nationwide, over the past week. That is leading to more hospitalizations, but the AAP says both hospitalizations and deaths are still “uncommon,” even now with the more infectious delta variant.

The biggest concern is over a spike in hospitalizations for children in states with lower vaccination rates like Florida, Texas, Louisiana and Alabama, which has put a significant strain on intensive care unit beds in those areas.

But how is that impacting kids here in Pennsylvania, since we have a higher vaccination rate? The PA Department of Health reports 65% of Pennsylvanians 18 and older are fully vaccinated, ranking fifth among all states.

“It definitely seems like it is affecting children more than it did in previous parts of the pandemic,” said Dr. Zac Aldewereld, a pediatric critical care doctor with UPMC Children’s Hospital in Pittsburgh.

Impact of Delta Locally

While the Keystone State is not seeing major spikes in serious illness among children, there is still concern.

“Still low numbers but we are starting to see some rising cases, even in the hospital,” Aldewereld said. “I have seen some very sick patients in the ICU recently, personally. Although I don’t want to draw conclusions off of a small number, so far.”

Two weeks ago, UPMC Children’s Hospital reported publicly that it did see a spike in children with COVID-19 coming into the emergency room, with 20 new cases in just one week.

We wanted to get an update on those numbers to see if that trend is continuing or has leveled off, but a hospital spokesperson said they “are not providing updated daily numbers at this time.”

When pressed, we were told: “We have single digit hospitalizations daily at this point. Cases are just slightly increased since mid-July.”

Most at risk for hospitalization

A recent study done in conjunction with the Centers for Disease Control and Prevention looked at data for kids and COVID-19 from March 2020 through January 2021. It showed 63% of children hospitalized with COVID-19 had underlying conditions.

The top risk factors for hospitalization among children:

  • Type 1 diabetes
  • Obesity
  • Congenital heart and circulatory issues

The study also reported asthma was associated with a higher risk of COVID-19 illness in hospitalized children for those between the ages of 12 and 18.

Since this study only looked at data through January 2021, before the delta variant became dominant, we wanted to find out if more healthy children are being hospitalized now.

So we asked our expert: Are more healthy children being hospitalized with COVID-19 now or is it still mostly kids with underlying conditions?

Dr. Aldewereld: “We’ve definitely seen that kids with underlying conditions are seeming to be disproportionately represented and seem to be at higher risk of disease. But we’re definitely seeing kids that have absolutely no underlying conditions. I, personally, in the ICU have taken care of previously healthy kids ranging in age from four weeks old, all the way up to 17-18 years old.”

When it comes to COVID-19 deaths among children, which are rare, the study showed an overwhelming number, 95%, had pre-existing conditions.

Even so, Dr. Aldewereld cautions parents not to let their guard down.

“I will point out that the chronic conditions they talked about (in the study)—things like asthma and obesity—are extremely common,” he said.

The bottom line: Some previously healthy children are being hospitalized with COVID-19, but it still appears to primarily involve children with underlying conditions.

Advice for Parents

While cases in our region are still low, Dr. Aldewereld says he worries that if Pennsylvanians are not proactive, we could also see a spike in serious cases.

“The biggest thing is masking and vaccines. We believe very strongly in them. They have been shown to be safe and effective, and it’s really the most important thing they (parents) can do for their children,” Dr. Aldewereld said.