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 children and older children.

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 about the age group of children it was referring to when discussing the risks of infant 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 typically face with 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 long-term prevalence of 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 themselves in danger and never have been. “; “A subset of long-standing COVID research linking the severity of the disease to the likelihood of persistent symptoms implies that the risk may be significantly lower in children than in the general population. ”

REVIEW

July 12, 2021, New York magazine published an article by journalist 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 some caveats. statements made in the article, in particular 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 issues, 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 that of influenza, but with that comes vigilance . “This may be true for the younger age groups, around the age of 5,” he said, as 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 research into COVID, particularly with regard to 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 UK study was published using self-reported data from a mobile app to monitor symptoms. Of the 1,379 children aged 5 to 17 who had a symptomatic infection, 1.8% had symptoms lasting at least 56 days. The study thus concluded that the 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 particularly the case with lockdowns and school closures, which have been put in place to reduce the spread of the virus, but which can harm the development of the child.

In general, pediatricians agree that the benefits of face-to-face learning outweigh the risks. The US Centers for Disease Control and Prevention (CDC) also states 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 issue is also a divisive one as some parents oppose measures such as requiring masks for their children.

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

Some hospitals in the United States have seen an increase in hospitalizations of children for COVID-19[2], although it is not clear whether this is due to the fact that 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 due to the fact that young people now account for a greater proportion of infections and those under 12 are not vaccinated.

COMMENTS FROM SCIENTISTS

Alasdair Munro, Senior Clinical Research Fellow 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 themselves in danger 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 new 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 become 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 for a long time 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 counted appear at the same rates in 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 the severity of the disease to the likelihood of persistent symptoms implies that the risk may be considerably lower in children than in the general population. “

I don’t see what this refers to. But it contains the red flags “subset”, “implicate” 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