Pediatric Covid hospitalizations surge to highest on record in U.S. as doctors brace for more

Children are now being hospitalized in record numbers across the United States, and doctors are warning that it could get worse as schools begin to reopen and the swift-moving coronavirus delta variant drives cases higher.

New Covid hospital admissions for kids have reached their highest levels since the U.S. started tracking pediatric cases about a year ago, peaking at an average of 303 new admissions per day over the week ended Aug. 22, Centers for Disease Control and Prevention data shows.

Since most students aren’t old enough to get the shots, doctors and epidemiologists say they fear the surge in Covid hospitalizations could get worse unless more kids get vaccinated and school districts mandate masks and other safety precautions in class.

“It is scary to see the number and severity of Covid-19 cases rising in children with the delta variant and so many kids still left unprotected,” said Dr. Nusheen Ameenuddin, a community pediatrician at the Mayo Clinic. “The pandemic never stopped, and unfortunately, it only takes one lit match to reignite the inferno.”

Kids still account for a very small number of hospitalizations, doctors note, making up roughly 1.8% of all Covid hospitalizations in the U.S. The virus just doesn’t hit children as hard as adults. They are less likely to get infected with Covid than other age groups and generally have more mild symptoms. Out of more than 520,000 Covid deaths the CDC has demographic data on, fewer than 500 were kids under 18.

Still, some children with Covid can end up in the hospital. Some 4,404 children have gotten a rare, but serious, inflammatory syndrome caused by Covid known as MIS-C; 37 have died from it, according to the CDC.

At Wolfson Children’s Hospital in Jacksonville, Florida, 15 children were hospitalized with Covid, with six in the ICU on Monday, according to the facility. The hospital has reported 71 pediatric admissions so far this month and 87 admissions in July, higher than the 49 admissions reported during the community’s previous surge in January.

Dr. Mobeen Rathore, an epidemiologist there, said they are bracing for more cases.

“In the first nine days of school, there were 503 cases of coronavirus in Duval County Public Schools,” Rathore said. “We are not only preparing for acutely ill children but also MIS-C. We are updating our protocols and planning for people, facilities and supplies for any surge.”

Pediatric hospitalizations are highest in Oklahoma, Ohio, Louisiana and Kentucky, after adjusting for population, according to data compiled by the Department of Health Human Services. Those states all have vaccination rates below the national rate, according to the CDC.

While delta is much more contagious than previous variants, causing a surge in pediatric hospitalizations, so far it doesn’t appear to cause more severe disease in children, said Sunitha Kaiser, a pediatric hospitalist at the University of California, San Francisco.

“We only have maybe six or eight weeks of data on delta and so this picture is going to continue to evolve over time,” Kaiser said in a phone interview. “But from what we can see so far, it’s doing the same thing in our bodies in terms of how the infection works, how it gets in and has similar severity and symptoms to prior strains.”

She said vaccinations remain the best strategy for protecting kids as well as the community since the shots are so effective at preventing severe disease, hospitalizations and deaths. “That contagiousness again can be curbed by achieving higher and higher vaccination rates,” she added.

Pfizer and BioNTech’s Covid vaccine has been authorized for emergency use by the FDA for children 12 to 15 while scientists gather more data on that age group; it’s been fully approved for those 16 and older. Moderna’s vaccine has only been cleared for adults, but it’s expecting to soon get authorized for use in 12- to 17-year-olds.

About 62.5% of all adults in the U.S. are fully vaccinated, but just 44% of 16- and 17-year-olds have full immunization against Covid, according to the CDC’s most recent data Monday. Just 34% of kids 12 to 15 have gotten all their Covid shots — the lowest of any age group that’s currently eligible for the vaccine, the data shows.

Dr. Paul Offit, a physician at Children’s Hospital of Philadelphia, where doctors are also seeing a rise in pediatric hospitalizations, said he was frustrated by the lower vaccination rate among children.

“Yes, it’s true we don’t have a vaccine yet for children less than 12, but we do have one for the 12 -to 17-year-olds and there’s only about a 30% uptake,” he said.

He said federal and state health officials should focus on persuading unvaccinated parents to get the shots because they are often the ones who make the choice on whether their children can do so.

Ameenuddin of the Mayo Clinic said she makes it a point to ask her patients and families if they’ve received the vaccine.

“Most eligible people have been saying yes, which is reassuring, and even asking when it will be available for the younger set,” she said.