As children return to classrooms across Canada, there has been a surge in COVID-19 cases, but this is not causing a rise in hospitalizations, Canadian pediatricians say.
Just days into the new school year that kicked off this month, COVID-19 outbreaks forced schools to shut in several provinces, raising concerns about how the rest of the school year will proceed.
Many children remain unvaccinated in Canada, as the COVID-19 shots have so far not been approved for those under the age of 12.
“We’re definitely seeing a lot more infections in populations who have not been vaccinated or subsets of the population who have not been vaccinated,” said Dr. Jesse Papenburg, a pediatric infectious disease specialist and medical microbiologist at the Montreal Children’s Hospital of the McGill University Health Centre.
He said children under 12 who don’t have access to the vaccine yet are susceptible to the highly transmissible Delta variant, which has become the dominant variant of concern in Canada, warning that the country will continue to see more cases in young children.
While the Delta variant is contributing to more infections, children are still only mildly symptomatic from it, said Dr. Fatima Kakkar, a pediatric infectious diseases specialist at the CHU Sainte-Justine in Montreal.
“There’s definitely a rise in (cases among) the under 12 (age group) … but what we’re not seeing, in turn, is a rise in the severity,” she told Global News.
Papenburg agreed. He said even though children represent a greater proportion of the cases, “it’s reassuring that, to date, we haven’t really seen an uptick in hospitalizations in that same age group.”
In Ontario, over the past two weeks, there were 1,310 COVID-19 cases in children between the ages of 0-9, but only 12 hospitalizations, as of Sept. 16, provincial data showed.
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On Saturday, there were 168 new cases and on Friday, 155 for the 0-11 age group.
Despite that, a spokesperson for Toronto’s SickKids Hospital said it has not seen any significant increases in COVID-19 hospitalizations or disease severity due to the Delta variant.
This is in contrast to the situation across the border in the United States, which saw a record number of children hospitalized for COVID-19 last month.
The current rate of new hospital admissions is four times more than what it was in June 2021, according to data from the Centres for Disease Control and Prevention (CDC).
As of Sept. 9, children represented up to four per cent of total cumulated hospitalizations and up to two per cent of cases among children resulted in hospitalization, the latest report by the American Academy of Pediatrics (AAP) showed.
The least vaccinated states were leading the spike in the children’s cases, New York Times reported this month.
Meanwhile, in Latin America, many hospitals of Costa Rica, Guatemala and Belize, are “completely saturated” with child COVID-19 patients, Carissa F. Etienne, director of the Pan American Health Organization (PAHO) said in a press conference Wednesday.
She said children, who are not yet eligible for vaccinations in most countries, are representing a larger percentage of COVID-19 hospitalizations and even deaths.
However, some U.S. studies show that the Delta variant is not causing more severe illness as compared to the original strain of COVID-19, which is an encouraging sign, experts say.
“What we’re not seeing is a change in how it’s presenting, so there’s no change in the symptoms and there’s so far no change in the severity, but we continue to monitor,” said Kakkar.
Rare deaths and severe illness
Since the start of the pandemic, children have been least affected by COVID-19, but they’re clearly not immune to the virus. Although rare, deaths have also been reported in Canada.
On Friday, a COVID-19-positive child under the age of 10, who had underlying health conditions, died in Ontario’s Waterloo region. It was the third death in that age group for the province.
“This a rare occurrence but it is tragic nonetheless, and it is a reminder of how serious the effects of COVID-19 can be,” Dr. Hsiu-Li Wang, Waterloo Region’s medical officer of health, said Friday.
Severe outcomes such as hospitalizations and deaths in young children, especially those who don’t have other severe chronic medical conditions, remain very rare, said Papenburg.
But having comorbidities – such as severe lung disease, obesity or disability – does put kids at a higher risk of being hospitalized and potentially having serious COVID-19 complications, said Kakkar.
In general, children experience mild to no symptoms because of a robust immune response, experts say.
Kakkar said, because children frequently tend to get other coronavirus infections that cause the common cold each year, they have an innate immune system that is used to responding to infections.
“Their innate immune system is really primed and ready to go and so much more easily combats the first signs of COVID than, for example, in adults who might not have as frequent respiratory infections,” she explained.
Children also produce higher levels of antibodies against COVID-19 and the duration of the protection is longer, Kakkar added.
In Canada, both Pfizer and Moderna have been approved for children aged 12 and up, but trials for younger kids are still ongoing.
Pfizer intends to submit data to Health Canada on trials of its COVID-19 vaccine in children under 12 by the end of the year, the company told Global News last month.
Getting younger children vaccinated will be crucial towards ending the pandemic as it will not only protect them but also help reduce community transmission, said Papenburg.
“I think it will play a key role in really being able to manage COVID-19 infections in a way that does not affect our daily lives to try to manage it more as a winter virus disease,” he said.
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