The New York Magazine article on the risks of COVID-19 for children is accurate, but it would be helpful to have more context regarding the difference in risk between young and older children.

0
8

CLAIM

In children, “the risk of death from COVID-19 is actually lower than from the flu. The risk of serious illness or hospitalization is about the same ”.

DETAILS

Exact: In general, children have a lower risk of hospitalization and death from COVID-19 than adults.
Lack of context: As a population, children can cover a wide range of ages. The article lacked nuance on the age group of children it was referring to when discussing the risks of child mortality. For example, the COVID-19 risks faced by very young children are different from those faced by adolescents. Viral variants, like Delta, can also alter the level of risk children in general face from COVID-19.

KEY TO TAKE AWAY

Overall, children are at a lower risk of serious illness and death from COVID-19 compared to adults. However, very young children face a different level of risk than older children such as adolescents. Long COVID, a condition in which people infected with SARS-CoV-2 continue to show signs of illness even weeks and months later, has been documented in children. Definitive information regarding the prevalence of long-term COVID in children is lacking, but research is currently underway to answer this research question.

FULL CLAIM: “[A]In children, the risk of death from COVID-19 is actually lower than from the flu. The risk of serious illness or hospitalization is about the same […] children are not in danger themselves and never have been. “; “A subset of long-standing COVID research linking disease severity to the likelihood of persistent symptoms implies that the risk may be significantly lower in children than in the general population.”

MEET AGAIN

July 12, 2021, New York magazine published an article by reporter David Wallace-Wells, titled “The Kids Are Alright: Why Now is the Time to Rethink COVID Safety Protocols for Kids – and Everyone”. The article discussed the lower risks of hospitalization and death that children face from COVID-19 compared to adults. The article has proven popular on social media platforms and has racked up more than 23,000 Facebook engagements to date, including more than 4,200 shares, according to social media analytics tool CrowdTangle.

Experts who examined the scientific credibility of the article found it to be generally accurate, although there were instances in the article that required more context for readers to understand the caveats of some of the statements made in the article, especially the different levels of risk faced by children. of different ages and our still incomplete understanding of the long COVID. [See scientists’ full comments.]

Alasdair Munro, a pediatrician and senior clinical researcher at the University of Southampton, told Health Feedback that “These are controversial questions, but there is nothing wrong or misleading in the article.” He agreed with the author that “there is no doubt about the low risk of death and serious illness in children”, but also stressed that “comparisons with other infections are difficult due to poor or inconsistent data ”.

Guillaume Hanage, associate professor of epidemiology at Harvard TH Chan School of Public Health, agreed with the author that the risk of death from COVID-19 is lower than from influenza, but that comes with a on guard. “This may be true for the younger age groups, the under 5s or so,” he said, given that influenza is a disease that disproportionately affects the very young and the very old. But “the situation is different with older children, and especially adolescents,” he warned.

Long COVID, a condition in which people infected with SARS-CoV-2 continue to show signs of illness even weeks and months later, has been documented in children. Some of these persistent symptoms include shortness of breath, fatigue, and cognitive problems. Munro and Hanage both agreed on the early stages of long-term COVID research, particularly regarding its prevalence in children, which means there is not enough information. for the moment to draw definitive conclusions.

During the writing of this review, a study in the UK was published using self-reported data from a mobile app to monitor symptoms. Of the 1,379 children aged 5 to 17 years who had a symptomatic infection, 1.8% had symptoms lasting at least 56 days. The study thus concluded that long COVID in children is “rare”[1].

The question of balancing the benefits and risks to children of COVID-19 protective measures has been controversial during the pandemic. This is especially the case with lockdowns and school closures, which have been put in place to reduce the spread of the virus, but can negatively affect child development.

In fgeneral, pediatricians agree that the benefits of in-person learning outweigh the risks. The United States Centers for Disease Control and Prevention (CDC) also stipulate that “Students benefit from in-person learning, and the safe return to in-person teaching in fall 2021 is a priority.”

Therefore, the issue of protective measures to be implemented in schools has become critical, given the increased transmissibility of the Delta variant and the fact that children under 12 cannot receive COVID-19 vaccines. at the moment and are therefore vulnerable to infection. This question is also a subject of divisionbecause some parents oppose measures such as requiring masks for their children.

CDC recommend masking inside for anyone over the age of two, and the American Academy of Pediatricians recommended that children wear masks to reduce the spread of the virus, including to protect children under 12, who are not vaccinated. But it is still largely up to schools to decide to follow this recommendation and some states have banned mask warrants for schools absolutely.

Some hospitals in the United States have seen an increase in hospitalizations of children for COVID-19[2], although it is not clear if this is because the Delta variant, now the dominant strain in the United States, is more likely to cause serious illness in children. The spike could simply be because young people now account for a greater proportion of infections and because those under 12 are not vaccinated.

COMMENTS FROM SCIENTISTS

Alasdair Munro, Principal Investigator in Clinical Research in Pediatric Infectious Diseases, University of Southampton:
These are controversial questions, but there is nothing incorrect or misleading in the article. There is no doubt about the low risk of death and serious illness in children, although comparisons with other infections are difficult due to insufficient or conflicting data on other diseases. This is perhaps the only thing that could be clarified in the article.

The article correctly highlights inconsistencies in the field of research into post-acute symptoms of COVID-19 in children. People will see these risks from a different perspective depending on their origin (including political).

Guillaume Hanage, Associate Professor of Epidemiology, Harvard TH Chan School of Public Health:

Extract from the article: “[A]In children, the risk of death from COVID-19 is actually lower than from the flu. The risk of serious illness or hospitalization is about the same […] children are not in danger themselves and never have been.

This may be true for the younger age groups, around the age of 5. This is because the risk of serious consequences from influenza increases in this age group – influenza is worse at the ends of age: the very young and the elderly. The caveat is that I don’t know how the newer variants affect this age group. I don’t think they would make it worse, but that evidence should be gathered. However, the importance of preventing infections in this age group stems more from their ability to pass them on to others. As vaccinations get very high, the importance of infections in this age group will decrease.

The situation is different in older children, and especially adolescents.

From the article: “Some surveys have shown alarming numbers, but those that find COVID long in about a third or even half of those infected are almost certainly overestimates, and those suggesting 10% may well be too. – since some of the symptoms being counted appear at the same rates among those who have never contracted COVID. “

Long COVID is very difficult to study due to lack of good control groups etc, clinical definition etc. Having said that, I don’t buy this argument purely on the basis of its quality. The correct assertion that the evidence base is not strong does not mean that the reality necessarily supports the author’s position.

From the article: “A subset of long-standing COVID research linking disease severity to the likelihood of persistent symptoms implies that the risk may be significantly lower in children than in the general population. “

I can’t think of what this refers to. But it contains the red flags “subset”, “imply” and “may”. Note that I am not passing judgment on whether the risk is in fact lower than the general population, noting only that you cannot draw a solid conclusion based on this evidence.

THE REFERENCES


Source link