News from the FDA/CDC

Children and COVID: ED visits and new admissions change course


 

New child cases of COVID-19 made at least a temporary transition from slow increase to decrease, and emergency department visits and new admissions seem to be following a downward trend.

There were almost 87,000 new cases reported during the week of Aug. 5-11, which is down by 10% from the previous week after 4 consecutive weeks of increases, according to a report from the American Academy of Pediatrics and the Children’s Hospital Association. For some historical perspective, the latest weekly count falls below last year’s Delta surge figure of 121,000 (Aug. 6-12) but above the summer 2020 total of 26,000 (Aug. 7-13).

Number of weekly COVID-19 cases reported in children, United States
Pediatric cases since the start of the pandemic now total almost 14.3 million, which represents 18.4% of all reported cases, based on AAP/CHA data collected from state and territorial health departments that applied varying definitions to the age of affected children and may no longer be reporting at all. The Centers for Disease Control and Prevention, which use a standard age range to define child cases from all states and territories, puts the total number of cases at 14.6 million and total deaths at 1,736 in children aged 0-17 years.

Measures of serious illness finally head downward

The prolonged rise in ED visits and new admissions over the last 5 months, which continued even through late spring when cases were declining, seems to have peaked, CDC data suggest.

That upward trend, driven largely by continued increases among younger children, peaked in late July, when 6.7% of all ED visits for children aged 0-11 years involved diagnosed COVID-19. The corresponding peaks for older children occurred around the same time but were only about half as high: 3.4% for 12- to 15-year-olds and 3.6% for those aged 16-17, the CDC reported.

The data for new admissions present a similar scenario: an increase starting in mid-April that continued unabated into late July despite the decline in new cases. By the time admissions among children aged 0-17 years peaked at 0.46 per 100,000 population in late July, they had reached the same level seen during the Delta surge. By Aug. 7, the rate of new hospitalizations was down to 0.42 per 100,000, the CDC said on its COVID Data Tracker.

The vaccine is ready for all students, but …

As children all over the country start or get ready to start a new school year, the only large-scale student vaccine mandate belongs to the District of Columbia. California has a mandate pending, but it will not go into effect until after July 1, 2023. There are, however, 20 states that have banned vaccine mandates for students, according to the National Academy for State Health Policy.

Nonmandated vaccination of the youngest children against COVID-19 continues to be slow. In the approximately 7 weeks (June 19 to Aug. 9) since the vaccine was approved for use in children younger than 5 years, just 4.4% of that age group has received at least one dose and 0.7% are fully vaccinated. Among those aged 5-11 years, who have been vaccine-eligible since early November of last year, 37.6% have received at least one dose and 30.2% are fully vaccinated, the CDC said.

Recommended Reading

Hypertension heightens risk for severe COVID-19, even in the fully vaxxed
MDedge Emergency Medicine
Two distinct phenotypes of COVID-related myocarditis emerge
MDedge Emergency Medicine
Children and COVID: Many parents see vaccine as the greater risk
MDedge Emergency Medicine
‘Striking’ disparities in CVD deaths persist across COVID waves
MDedge Emergency Medicine
Evusheld for COVID-19: Lifesaving and free, but still few takers
MDedge Emergency Medicine
COVID skin manifestations vary by type of variant, U.K. study finds
MDedge Emergency Medicine
Children and COVID: Weekly cases top 95,000, admissions continue to rise
MDedge Emergency Medicine
Updates on treatment/prevention of VTE in cancer patients
MDedge Emergency Medicine
Children and COVID: Severe illness rising as vaccination effort stalls
MDedge Emergency Medicine
Guidelines: Convalescent plasma not recommended for most hospitalized with COVID
MDedge Emergency Medicine