Warning! Delta Variant Is More Severe In Kids Compared To Previous SARS-CoV-2 Strains, Parents And Teachers Need To be Extra Cautious

Despite the lack of proper data, pediatric physicians across the world are now witnessing that kids are being affected badly by the now fast spreading and dominant Delta variant as the amount of kids being hospitalized and exhibiting severe conditions are rising. In countries like Indonesia, Thailand, Malaysia, UK and even USA, there are not only case increases involving kids but increasing death rates among children and teenagers are sadly also being seen.

 
In the early stages of the COVID-19 pandemic when only the wildtype Wuhan strain was the predominant circulation virus, children were seen to not be affected much however the reverse is now being seen with the advent of the Delta variant.
 
Many experts are now in the conclusion that the Delta variant may cause more severe illness in kids than previous variants.
 
It is very critical for parents, teachers, authorities, policy makers and the general public to start changing their mindsets from what was initially told to them during the initial stages of the COVID-19 pandemic that children are not badly affected by exposure to the SARS-CoV-2 virus and to understand that the Delta variant is a serious threat to all, both adults and children alike.
 
In the last 40 minutes, Reuters also released news that America is witnessing record numbers of children being hospitalized for COVID-19. https://www.reuters.com/world/us/children-hospitalized-with-covid-19-us-hits-record-number-2021-08-14/
 
Thailand Medical News would like to add that this trend is being witnessed in Indonesia, Russia and Iran as well.
 
Although the data remain in short supply, some have suggested it would be reasonable to extrapolate mounting evidence of increased severity with Delta in adults to children.
 
The United States CDC stated that some data suggest most infected with the Delta variant were more likely to be hospitalized than those infected with other variants.
 
A COVID-19 pediatrics infectious disease expert at the University of Alabama and a member of the American Academy of Pediatrics' (AAP) Committee on Infectious Diseases, Dr David Kimberlin, MD told Thailand Medical News, "While we don't know if those data apply to children, the anecdotal information suggests it might. Across the South, where we have low vaccination rates, children's hospitals are experiencing many more cases than they did at the worst of the peak at the end of 2020 and the beginning of 2021, suggesting it's possible that Delta causes more severe disease in children.”

Dr Kimberlin further added, “Even if the virus isn't more severe in kids, we're still staring down the barrel of this gun because its hypertransmissibility is causing more pediatric infections than earlier versions did. It is also concerning as children in the South have returned or are starting to return to classrooms.”
 
A recent AAP data show a sharp increase in COVID-19 cases in kids, totaling 94,000 in the week ending August 5 -- up from almost 72,000 cases the week prior, and 39,000 cases the week before that. Previously, the most recent nadir was approximat ely 8,500 cases for the week ending June 24. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/
 
The AAP data showed that the highest peak of pediatric COVID infections occurred during one week in mid-January ie 211,000 cases. So far, nearly 4.3 million kids in the U.S. have contracted COVID-19 since the start of the pandemic, and they account for 14.3% of all U.S. cases cumulatively.
 
However this past week, they accounted for 15% of cases.
 
In the case of  hospitalizations, which the AAP tracks in 23 states and New York City, kids accounted for 1.5% to 3.5% of total cumulative hospitalizations, and 0.1% to 1.9% of all pediatric COVID cases resulted in hospitalization.
 
The U.S.CDC's COVID Data Tracker shows a total of about 46,000 hospital admissions for kids under 18 since Aug. 1, 2020, with a current 7-day average of 203 pediatric hospitalizations daily-close to the peak 7-day average of 217 during this past winter's surge (for the week ending Jan. 9, 2021). This week's figure is up from a 7-day average of 168 the week prior. https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions
 
The AAP also collects mortality data from 43 states, New York City, Puerto Rico, and Guam, tallying 371 pediatric deaths since mid-May 2020.
 
Young children accounted for 0% to 0.26% of all COVID deaths in those areas, and seven states reported no child deaths at all. Of all pediatric COVID cases in those areas, 0% to 0.03% resulted in death.
 
The AAP report stated, "At this time, it appears that severe illness due to COVID-19 is uncommon among children. However, there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects."
 
The Infectious Diseases Society of America (IDSA) press briefing last week had Dr Ezekiel Emanuel, MD, PhD, of the University of Pennsylvania in Philadelphia, caution all that it's difficult to tease apart severity data in general because increasing hospitalizations could just be the result of increasing cases due to Delta's greater transmissibility. https://vimeo.com/582532403
 
However Dr Emanuel acknowledged anecdotal reports suggesting a more rapid progression of illness compared with the early days of the pandemic. And experts on the ground in hard-hit areas have described greater challenges now compared with previous waves.
 
Dr Mark Kline, MD, chief physician at Children's Hospital New Orleans, told ABC News that the positivity rate in kids rose from 1% to about 20% over the last 30 days. https://twitter.com/Cleavon_MD/status/1424774606506897413
 
Dr Kline said, "We are hospitalizing record numbers of children and the majority are under 12 and can't yet be vaccinated. In Alabama the hospitals are close to complete capacity, and that includes children's hospitals in Mobile and Birmingham. We're deferring scheduled procedures. There are people who need cancer surgery that's being put off because there's no guarantee we'll have a bed available for them. People with heart attacks don't have beds. A child with vehicular trauma doesn't have a place to go because we're full. I think the rate of increase we see in pediatric cases is truly alarming. We've seen a skyrocketing of cases in a very short period of time. It's Delta. It's hypertransmissible. Combine that with the fact that two-thirds of our population in Alabama are not vaccinated, that's not even touching on the kids under 12 who are not able to be vaccinated and you have a recipe for disaster."
 
There are speculations that the Delta variant have already spawned numerous second and third generation variants not just the Delta Plus alone and minor mutations on these emerging variants from the same lineage are causing a massive shift in the pathogenesis. Hence we are not only witnessing more children developing disease severity upon infection but adults are also seeing so many different clinical manifestations.
 
Thailand Medical News hypothesizes that there is even a second or third generation spawn of the Delta variant that does not attack the lungs but rather attacks only the gastrointestinal tract and causes not only symptoms that are similar to IBD or IBS but also gut microbiota dysbiosis and in some cases affecting the ‘gut immune system and giving rise to ‘opportunistic diverticulitis’, something that seems to be occurring very commonly among COVID-19 positive patients these days. In rare cases we are also seeing extreme conditions of ‘leaky gut syndrome’ with resulting sepsis, organ failure and death. More detailed research is needed to verify this.
 
Thailand Medical News also hypothesizes the emergence of yet another unique Delta spawn that merely affects the oral tissues and saliva glands and finds its way to the oronasal nerves and in extreme cases crosses into the brain tissues to cause inflammation. Again we are witnessing many COVID-19 positive patients manifesting these conditions only.
 
The Delta strain is indeed wreaking havoc in all aspects but most importantly special attention needs to be focused on the little ones. As a parent myself, I advocate keeping our children in home isolation and to avoid as much outside contact with others except close family members for the time being and also to be extra vigilant towards the slightest manifestation of any type of medical condition or symptom. Proper nutrition, supplementation, exercise, play and also mental guidance is warranted but do not expose them to any kinds of mental stress due to what is happening as a result of the COVID-19 pandemic.

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