Summary
As COVID-19 cases increased among adults, it also increased in children, along with cases of a new inflammatory syndrome. Like the adult population, Latino children carried an excessive proportion of cases.
This is an article in Spanish.
At least seven children in California have died from COVID-19 since the pandemic began, more than 350,000 children have tested positive for the virus and the number of young people diagnosed with a new, rare inflammatory syndrome continues to spread.
All of these statistics are increasing just as a new, highly contagious strain of the virus worries parents and experts, and because the state is trying to reopen schools next month.
“We are at a critical time because the total number of cases of COVID is increasing so much,” said Dr. Jackie Szmuszkovicz, pediatric cardiologist at the Children’s Hospital in Los Angeles, said. “We are seeing more children with MIS-C in the last few weeks after the big increase (in cases) in the community.”
MIS-C, or multisystem inflammatory syndrome in children, is the name of a new inflammatory syndrome that affects a small number of children three to six weeks after experiencing coronavirus, even if they have had mild or no symptoms. .
Although the children were spared the worst effects of the coronavirus and the high death rate among adults, the youngest Californians are still at risk, especially given the current boom. Children usually experience mild to no symptoms of the infection, but this is what happens to a small number of people a few weeks later, which doctors are concerned about. Pediatricians are preparing for a wave of inflammatory syndrome cases three to six weeks after the current boom, especially with the new more transmissible variant, Szmuszkovicz said.
Children do get sick
Although severe COVID-19 was uncommon in children, there was a small increase in more serious cases recently, said Dr. Erica Lawson, a rheumatologist at UCSF Benioff Children’s Hospital San Francisco.
“We see more kids at the end of the track, who are sick enough to be admitted,” she said. ‘It’s because of the higher numbers in the community. If you have an appearance in the community, the more cases you have, the worse you will appear. ‘
Dr Behnoosh Afghani, an expert expert on infectious diseases at UCI Health in Orange County, hopes that the spread of the vaccine will reduce the number of infections in adults and thus also contribute to fewer infections among children. Children under the age of 16 cannot be vaccinated, but if more adults are vaccinated around them, it will increase the protection of children, she said.
The California Department of Public Health reports that at least six minors have died from COVID-19 since the pandemic began. At least one other child has died in Southern California at the Los Angeles Children’s Hospital, which has not yet made the state’s score.
The state does not identify which of the children had the inflammatory syndrome and how many had COVID-19 at the time of their death. It also does not provide information on where they live or their age, although there have been confirmed deaths in Orange County, one in the Central Valley and two in Los Angeles.
Children are a rare post-COVID syndrome
MIS-C, the rare inflammatory syndrome, was discovered last year in children who previously had coronavirus. Originally it was Kawasaki disease, a post-infection syndrome that plagues young children, but doctors linked the new syndrome to COVID-19. It is characterized by overwhelming inflammation in the body that can sometimes affect important organs and can lead to heart failure. Children get fever, some have abdominal pain, vomiting or diarrhea, rash, are very tired and have red eyes.
To date, 176 children in California have been diagnosed with the inflammatory syndrome.
“These children develop a lot of inflammation in their bloodstream and can affect various organ systems, including the heart,” Lawson said. San Francisco Hospital and its campus in Oakland have so far treated about 20 children with the syndrome, but have had no deaths, she said. Most children were Latino.
Statewide, Latino children are responsible for 64% of COVID-19 cases among children under 18 where race and ethnicity are known, but are only 48% of state children, according to the Department of Public Health.
Lawson argues that children’s issues reflect what is going on with adults. In California, Latinos are responsible for 54% of adult cases. They are mostly essential workers – such as managers, restaurant cooks and grocery workers – and sometimes live in busy circumstances with family members or other family groups where it is difficult to isolate.
According to the Centers for Disease Control & Prevention, racial and ethnic trends among children also reflect adults. Most children in the US who were diagnosed with the infection and the inflammatory syndrome were Latino or Black.
As of January 8, there were 1,659 cases of MIS-C among children and 26 deaths. According to the federal agency, the average age is 8 and more than 70% of cases occurred in Latino or Black children.
Pediatricians advise parents to be on the lookout for signs of MIS-C a few weeks after their children or if they are sick with the virus. Some families may not realize that their children had the virus before they showed signs of the syndrome, Szmuszkovicz said.
“We really want to encourage people not to delay care because we see that earlier treatment leads to the best results,” she said. “In some cases, the syndrome can affect heart function and cause coronary aneurysm.”
Los Angeles Children’s Hospital has cared for the largest number of afflicted children – 51 so far – from 4 months to 17 years old. According to the hospital, two children died, one in December and one in January. Due to the privacy of patients, the hospital will not disclose any other information about the children.
The treatment of MIS-C seems to work well if applied early, she said. Most children receive IV fluids and others also need medications such as steroids and intravenous immunoglobulin, while some require respiratory support, from oxygen to a ventilator.
“In some cases, the syndrome can affect heart function and cause coronary aneurysm.”
Dr. Jackie Szmuszkovicz, Pediatric Cardiologist at Los Angeles Children’s Hospital
In Los Angeles, Alexis Winter is watching her two young daughters extra closely. Her entire family, including her 3-year-old and 14-month-old, had COVID-19 last month.
“It’s scary, and I’m not trying to obsess over it,” Winter said, adding that her children have been almost one month since their infections.
She said she did not know how the family got the infection and that they were very careful not to communicate with others because Winters was at high risk.
It started with her husband and then Winter and the kids got sick. Her daughter (3) went up to bed and did not feel well the next day. Then her baby was super picky and had a raspy voice. None of the girls had fever, she said.
“For the children, the complications are not worth the risk,” she said. ‘If I could go back in time and find out what happened, I would. Because it’s scary to know they’ve had the virus and been exposed to it. ”
Is the new variant more dangerous for children?
As more children get the virus, pediatricians are eagerly looking for the new, more transmissible variant first found in the UK. The variant, known as B117, ended up in California last month and one study suggests it is more contagious and affects younger people. But Imperial College officials who published the study said more research was needed.
Meanwhile, it was also found that a second variant, this origin in Denmark, was responsible for an outbreak in the Bay Area in recent days. There is little information about the Denmark variant and children.
Pediatricians say that even if the new UK variant is not children like adults, they expect more children to continue to get sick.
“If it’s generally more contagious, more kids will get it too,” Lawson said. ‘Children do get COVID – they just do not get very sick. If the new strain is more transmissible in humans, it is likely that more children will get it. ”
And that means more cases of the inflammatory syndrome a few weeks later, Szmuszkovicz said.
“We need to be open-minded and very vigilant and ready for anything to come,” she said.
The British variant appeared in the Golden State by the time government Gavin Newsom announced incentives to get primary school pupils back on campus by February.
‘Children do get COVID, and they just do not get sick. If the new strain is more transmissible in humans, it is likely that more children will get it. ”
Dr. Erica Lawson, Rheumatologist at UCSF Benioff Children’s Hospital San Francisco
Is it time for the school to reopen?
Afghani from UCI Health said returning to school was critical to children’s health, but “at the same time we need to be careful until we see a clear decrease in the incidence of the disease.”
Lawson said the school is important and points out that schools that have remained open or reopened have safety procedures.
“Children really suffer at home and families suffer without the ability of children to go to school,” she said. “I think for the health of our communities, the mental health of our children and the priorities of parents it can be done and it needs to be done safely.”
But she acknowledged that if the new tension in children broke out, things would have to change.
Szmuszkovicz said everyone should follow the rules if the state decides that children can go to school again.
“All of us want to have children with other children again and have to learn at school,” said Dr. Jackie said. “How we are going to get to that point safely is that each of us individually is doing what we can to stop the spread of COVID in the community.”
Gian Schwehr, a mother in Los Angeles, said she was not sure if she would send her 10-year-old son back to school even though the family had COVID-19 over Christmas. Its symptoms lasted about 24 hours.
Schwehr said even though her son already had the virus, she does not want to put him in a situation where he might be close to others who have it, especially if the new variant makes it easier for children to get it.
“I’ll have to think about it,” she said. “If he did not have it, I would not send him. There is certainly no easy choice. ”
In an earlier version of this story, the timing of some deaths at Children’s Hospital Los Angeles was incorrectly mentioned.
CalMatters coverage of early childhood issues is supported by grants from First 5 Los Angeles and The Ralph M. Parsons Foundation.