Coronavirus: Delta causes more hospitalizations for children in the US

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Children with severe courses of Covid-19: Delta spreads mainly in the unvaccinated population

Photo: HANNAH BEIER / REUTERS

Sophia Villarraga's birthday was at the beginning of August.

She was twelve years old, in the USA children from this age can be vaccinated against Covid-19.

Her mother Pilar Villarraga had been looking forward to the day so that her daughter would not have to start the new school year unvaccinated.

But Sophia was unlucky: two weeks before her birthday, she was infected with the corona virus.

This is how the "New York Times" describes it, which spoke to the family from Florida.

Sophia developed a fever and was supposed to cure herself at home first.

After four days, her ribs started to hurt.

The following day, her mother took her to the hospital, where an x-ray showed pneumonia.

Sophia coughed up blood.

"I didn't think children could get so sick," Pilar Villarraga tells the New York Times.

But Sophia is apparently no exception.

On the same day as the then eleven-year-old, 130 children with Covid-19 came to the hospital across the US.

A graphic from the US Disease Control Agency (CDC) shows how the curve for hospital admissions among 0 to 17-year-olds rose sharply at the end of July - with an overall low number of cases.

In the first week of August this year alone, an average of 203 children came to the clinic every day, compared to 168 in the previous week.

The last time there were so many deliveries in this age group in January when the last corona wave peaked in the USA.

Delta wave also plays out among children

So far it has been said that children and adolescents have a very low risk of getting seriously ill with Covid-19.

According to the NYT, medical professionals in the US are now seeing more seriously ill children than ever since the pandemic began.

Could the highly contagious Delta variant be a reason?

"Everyone is a little nervous that the Delta variant could actually be a little more dangerous for children," says Richard Malley, a specialist in pediatric infectious diseases at Boston's Children's Hospital.

This assumption has not been scientifically proven.

So far, studies have consistently shown that the vast majority of children and adolescents develop only mild symptoms - if at all - when infected with the coronavirus.

So far, however, the data situation regarding delta is still thin.

"So far, there is no solid evidence that the disease is more severe in Delta," says Jim Versalovic, chief pathologist at Texas Children's Hospital in Houston, USA, where around ten percent of children currently have a positive corona test.

"We are seeing very severe cases right now, but we have seen severe cases a number of times during the pandemic."

The increase in hospital admissions for children could also have other reasons than the characteristics of the mutant.

On the one hand, the number of corona cases is rising again worldwide.

In the USA, too, the delta variant is currently causing a drastic increase in new infections.

Most recently, a seven-day average of 97,400 new corona infections was reported daily.

And that leads to a simple calculation: the more people are infected, the higher the number of severe courses and hospitalizations.

Vaccination rate still low

On the other hand, the vaccination rate among 12 to 17-year-olds is not as high as among adults.

In the United States, children aged twelve and over have been vaccinated for a longer period of time.

However, the authorities do not keep statistics on how many in the age group have already received a vaccination.

It should be more than in Germany.

In this country, around 12.6 percent of children and adolescents are currently considered fully vaccinated.

Although there is still no general vaccination recommendation for this age group, the health ministers decided last week to offer vaccinations to all 12 to 17 year olds.

Under-12-year-olds still completely unprotected

Children under the age of twelve, on the other hand, cannot even be vaccinated because no vaccine has been approved for them - not even in the USA. The pharmaceutical company Biontech / Pfizer announced in June that it would also test its vaccine on very young children. However, no application for approval has yet been submitted. According to US media, the Biontech partner Pfizer wants to submit the application to the US FDA in winter. The European Medicines Agency Ema could follow shortly thereafter. It remains to be seen whether the data from the Standing Vaccination Commission (Stiko) will be sufficient to make a general vaccination recommendation.

In this age group, the delta variant initially only encounters unprotected hosts who have numerous social contacts at the same time through school lessons and daycare visits.

The Delta variant, which according to current estimates is up to 60 percent more contagious than previous variants, can spread like wildfire there.

Several countries, including Germany, are currently observing that the corona cases are increasing, especially among younger people.

The fact that the increase in severe cases in children is taking place in the USA could also be related to the population structure there.

There are more overweight children in the USA than in Europe, for example.

Obesity is considered a risk factor for a severe course of Covid-19.

The head of the Standing Vaccination Commission at the Robert Koch Institute, Thomas Mertens, said in an interview with SPIEGEL that the situation in the USA is therefore not comparable to that here: »In the USA, vaccinations are for 12 to 17 year olds recommended, but there the disease burden from Covid-19 is much greater at this age than in Germany, "said Mertens.

“That is probably because more children there have a metabolic syndrome - obesity, high blood pressure, impaired lipid metabolism and high blood sugar.

In addition, the medical care of many children in the USA is a little worse than here. "

In addition, there is no general mask requirement.

The CDC recommends that all school children wear masks this fall.

However, the decision as to whether this is also compulsory at the respective school rests with the states.

"Most children are not very sick"

However, the vast majority of children - this is still the case after an infection with the Delta variant - only have mild symptoms.

This is also confirmed by the US doctors named in the NYT article: "Most children are not very sick," says Wassam Rahman, medical director at the Johns Hopkins All Children's Hospital in Florida.

They have a runny nose, a cough, or a fever - most of the time they can cure themselves at home.

Sophia Villarraga had no risk factors and yet it hit her hard.

After the illness, the girl recovered and was released shortly before her twelfth birthday.

As long as children under the age of twelve cannot be vaccinated themselves, common measures such as wearing a mask, keeping their distance, ventilation and hygiene protect them the best. And the more people are vaccinated, the lower their risk of infection becomes. If the total number of cases is low, it becomes less likely even for unprotected children to become infected and possibly get seriously ill with Covid-19.