Cases of the coronavirus among children are increasing, making it more important for those around them to get vaccinated, and for children to wear masks at school and in public, four Delaware pediatricians said this week.
Speaking during Ask the Pediatricians, a live broadcast on www.delaware.gov on Tuesday, Aug. 31, moderator Dr. Karyl Rattay, director of the Delaware Division of Public Health, said doctors in Delaware saw about 25 cases of the coronavirus daily recently in children ranging in age from birth to 4 years old, including 84 on a single day in August.
Among children ages 5 to 17, the incidence of the virus jumped from 54 to 333, “a significant increase in a short period of time,” Rattay said.
“We don’t know what the next month or two will look like,” Rattay said, adding that, statewide, there have been more cases, as well as additional hospitalizations, in all age groups, plus many more clusters of illness in childcare facilities.
Rattay said 18,173 Delaware children younger than 18 have tested positive for the coronavirus since the pandemic began, and about 30 percent of the children hospitalized with the virus had no underlying health conditions. Children with ailments such as asthma, or those who are obese, are most at risk. Long-term health effects from the coronavirus include headaches, fatigue, cardiovascular disease, respiratory illnesses and cognitive problems.
Rattay was on the panel with Dr. Priscilla Mpasi, public health manager, at Henrietta Johnson Medical Center in Wilmington; Dr. Marisel Santiago, chief of pediatrics at La Red Health Center in Georgetown; and Dr. Craig Shapiro, attending physician with the Division of Pediatric Infectious Diseases and medical director of antimicrobial stewardship at Nemours Children’s Hospital.
As of Aug. 25, only 51.5 percent of those ages 12 to 17 — who can be vaccinated with the Pfizer vaccine — had received at least one dose of the vaccine to protect against the coronavirus. Adults who get vaccinated protect the children they live with, Rattay said.
Side effects from the vaccine, Mpasi said, are similar to those from all childhood vaccines and include soreness and redness at the site of injection and an elevated temperature.
Santiago said that, generally, the side effect is soreness in the arm, although some have body aches. Children report fewer side effects than their parents, she said.
Asked when the FDA could approve a vaccine for children 5 to 11 years old, Rattay said she wished she had a magic ball to know that answer but said doctors have heard it could become available between October and late December.
“Studies are still under way. … We’re ready as a state. We have a great network,” she said.
Not only aren’t young children able to get vaccinated, but they are also not always wearing masks, which are important when children are in close contact with each other, as they are in schools. Also important are good ventilation, handwashing and hand sanitizing, Rattay said.
Masks protect from contracting the virus, she said, and contrary to misinformation being distributed on social media and elsewhere, do not impact lung development, weaken the immune system, make it harder for children to breathe, trap carbon dioxide or force them to breathe the air they exhale, she said.
Replying to a submitted question, Rattay said she recommends weekly testing for anyone who is not vaccinated. Shapiro agreed, saying testing is important, especially since anyone who has the virus can spread it, even if they are asymptomatic.
Asked what concerns parents are taking to doctors, Santiago said they ask about the safety of a vaccine not completely approved by the FDA, and she explains to them that it is safe and protects children, while sharing supportive data.
Mpasi said that, although many children aren’t getting as sick with COVID-19 as adults, it is possible.
“We’re not sure of what might happen. … Your child may not have some of the greatest symptoms of COVID-19 … but they are around other children in schools,” she warned.
Santiago said parents are bombarded daily with false information on social media that scares them.
“Sometimes they believe it,” she said, and Rattay agreed, saying it presents a challenge.
Concerning schools offering virtual classes, Rattay said experts will “wait and see what happens,” but doctors are “certainly hopeful that schools can stay open.”
Mpasi agreed that doctors want to see children in school as much as possible. Children she has talked to, she said, are excited about going back to school and socializing with their friends. Some said they learn better in the classroom. Parents have the responsibility of reminding children to wear masks and frequently wash their hands, she said.
Shapiro said parents also ask about side effects from the vaccine, such as inflammation of heart muscles, or they believe the risk of a child getting sick is too low to get them vaccinated. But it is heartbreaking when children sick with the virus end up hospitalized, he said.
“Seeing the patient in the hospital brings it to a personal level for me. We have a tool — the vaccine — which we didn’t have a few months ago, that can save lives. I can’t even begin to emphasize how incredible that is that we are able to get it into people’s arms. We are seeing what it is doing in the adult population and the deaths it has prevented,” Shapiro said.
Santiago said that, last year, she didn’t see severe cases of the coronavirus in children, but a few had more serious symptoms, causing them to feel more tired and making it more difficult to play sports.
Replying to a question about why adolescents who are vaccinated still have to wear masks in school, Rattay said only 40 percent are fully vaccinated, so the majority remain at risk. Even those who are vaccinated can become infected or spread infection, she said.
Shapiro said it’s important to reduce transmission of the disease, and the best way to do that is by wearing masks.
“It’s not just about myself or my children. It’s about our whole community. … We need to look at it as a group effort,” Shapiro said.
Replying to a question about what treatments are available for children diagnosed with the coronavirus, Shapiro said the best treatment is prevention and being sure everyone in the household with young children is vaccinated.
Treatments for those 12 or older include antibodies, administered intravenously and an effective treatment with few side effects.
Mpasi said she has seen limited cases of the coronavirus in children, and infected children had rather mild symptoms, including prolonged cough, fever and body aches. Patients with asthma used inhalers for relief, she said.
Agreeing, Santiago said she has not seen many cases and that the illness, in her patients, has been manageable so far. In two instances, children had underlying conditions, such as asthma, but they responded well to treatment, she said.