After months of stalling vaccination efforts south of the border, multiple states and hospitals are now reporting spikes in COVID-19 among American kids ahead of the back-to-school season this fall and amid a Delta variant surge.
Officials are pointing to a lack of vaccination in both eligible children and the broader population — who can reduce a child’s risk of exposure if fully vaccinated themselves — as well as the highly contagious Delta variant as key factors in the spike in children needing care.
The Delta variant is now also the main circulating variant of the virus in many parts of Canada and experts say a jump in infections in kids here remains a possibility if a fourth wave builds up strength this fall.
“Will we see more hospitalizations overall in the coming weeks and months? I have no doubt. Will that be reflected in pediatrics? Probably,” said Dr. Jesse Papenburg, a pediatric infectious disease specialist with McGill University.
“But right now I wouldn’t say that there’s any cause for alarm at this point.”
Children under the age of 12 are not yet eligible for any of the COVID-19 vaccines approved for use in Canada or the U.S., or similar countries.
Public health officials have cautioned repeatedly over recent months as overall vaccination rates climb that COVID-19 is increasingly becoming a disease of the unvaccinated — and that includes children poised to head back into classrooms throughout the fall and winter.
Chief public health officer Dr. Theresa Tam said on Tuesday that all available evidence so far indicates Canada is at the start of a “Delta-driven fourth wave” that will primarily hit young people.
“We expect cases to be concentrated largely in younger unvaccinated people,” she said, cautioning that a surge and any potential spread to older people could still stress health-care systems.
Dr. Steve Flindall, an emergency room physician in Toronto, offered similar thoughts.
“I think schools are going to be the front lines of this next wave,” he said.
What exactly that will look like, though, remains unclear.
There’s no clear evidence so far to suggest the Delta variant causes more severe symptoms in children.
The U.S. Centers for Disease Control and Prevention has said the variant is “likely more severe” in adults than previous variants, but that has not been extended to children and researchers have cautioned that even that assessment still needs to be backed up with more data.
Where the data is clear is around the fact that the Delta variant is significantly more infectious than previous variants and that infected people carry a much higher load of the virus in their nose and throats — a pattern documented even in vaccinated people.
Papenburg said as cases rise overall, so can severe outcomes among the unvaccinated.
“I can’t say that the Delta variant will cause more severe disease than other COVID infections in kids,” he explained. “But the concern here is that because you’re going to have more cases, because it is a more transmissible virus, you’re going to wind up seeing the tip of the iceberg — the most severe cases –occurring more frequently.“
Three of the country’s leading pediatric hospitals told Global News that unlike U.S. hospitals, they are not seeing any increase in either hospitalization numbers or severity of symptoms among children.
“SickKids has not observed an increase in COVID-19 hospitalizations or disease severity among children in recent months,” said Sarah Warr, spokesperson for the Hospital for Sick Children in Toronto.
Patrick Moore, spokesperson for the Children’s Hospital of Eastern Ontario (CHEO), said the same.
“We are not seeing an increase here, thankfully,” Moore noted.
A spokesperson for Alberta Health Services offered similar comments about the Alberta Children’s Hospital, noting staff there have not documented any increase in hospitalized children or severity.
Their comments come after an outbreak of COVID-19 among campers forced a closure of the Muskoka Woods summer camp in Ontario’s cottage country over the weekend, and after data from Alberta in the late spring and early summer that suggested children were making up a growing portion of cases.
According to the Alberta data, those under the age of 18 made up roughly 20 per cent of cases in March, roughly 33 per cent of cases in May and as of June, were leading the province for new infections.
So what does it all mean for parents weighing sending kids back to school?
Ontario on Tuesday released hotly awaited guidance for the return to classrooms, focusing on requiring masking, cohorting students, social distancing, and improving ventilation. Vaccines will not be required.
Papenburg said there are clear benefits for kids being back in school and that there will be risks that come along with that. How they balance out though, he said, is part of what everyone will be watching.
He pointed to the challenging mental health impact of prolonged distance learning, and said there are measures schools can take to try to reduce the risks as much as possible — things like enforcing masks, improving ventilation and making sure students are social distancing, even during meals.
“I think we need to see it as a positive thing that we can send our kids to school and it’s going to bring benefits to them,” he said. “Will there be associated risks because of community transmission of COVID-19? There will be, and we’ll see how those risks are managed once cases start to increase.
“We know that there’s not one magic bullet for preventing COVID-19 transmission in schools.”
—With files from Global’s Abigail Bimman and Caryn Lieberman.