Dr. Alexandra Clark never thought the COVID-19 pandemic would lead to an increasing number of children hospitalized and suffering.
As the division chief of general pediatrics and pediatric hospital medicine at Loma Linda University Children’s Hospital, she has seen it all in the last few months among patients as young as 2 months to as old as 17: children diagnosed with COVID-19 pneumonia, “ugly chest X-rays,” the need for oxygen support and signs of multisystem inflammatory syndrome in children (MIS-C), the latter of which can involve different body parts becoming inflamed.
But the most difficult part of it all has been watching unvaccinated children ages 12 to 17 suffer serious ailments from COVID-19, which could have been prevented.
“It’s really hard for us in health care to see these preventable infections, these illnesses, impacting the lives of children and families in such profound ways,” Clark said.
“We recently had a young boy admitted to our pediatric ICU, and his mother was simultaneously admitted to the medical ICU. This father/husband was needing to choose ‘do I spend time with which of my gravely ill family members?’ That’s a story that didn’t need to happen.”
COVID-19 cases among children have been steadily increasing in Riverside County for weeks, and with school back in session, they have climbed even more. In the 0 to 17 age group, there were 441 new COVID-19 cases reported for the week ending July 28; 637 cases for the week ending Aug. 4; 982 cases for the week ending Aug. 11; 1,087 cases for the week ending Aug. 18; 1,476 cases for the week ending Aug. 25; and 1,500 cases for the week ending Sept. 1.
As of Monday, there have been 47,610 COVID-19 cases for the 0 to 17 age group since the start of the pandemic, beating the 18 to 24 age group (45,548 cases), 65 to 84 age group (29,234 cases) and 85 and older age group (4,279 cases).
In just June, July and August, there have been 2,050 COVID-19 cases among unvaccinated 12- to 17-year-olds, compared to 60 in vaccinated children, Riverside County Public Health Director Kim Saruwatari shared during a recent Board of Supervisors meeting, adding that 97% of cases in the eligible population have been among the unvaccinated or partially vaccinated.
To make matters worse, there have been four deaths in the 0 to 17 age group in Riverside County since the start of the pandemic, including a 4-year-old, the youngest person to die, from western Riverside County with no underlying health conditions.
“Our hearts are breaking in health care to see so much suffering for so long,” Clark said. “We’re just at the place where we know that there is very good ability to decrease the risk of severe disease with the vaccine.”
Read more: Unvaccinated people 37x more likely to get COVID-19, 120x more likely to die than the vaccinated in Riverside County
Read more: COVID-19: 4-year-old among 8 new deaths reported in Riverside County
Trends seen among children
So far, Coachella Valley hospitals report they have not admitted COVID-19 patients younger than 18 this summer. If a child were to get sick with COVID-19 and need a higher level of care, they would be transferred to Loma Linda University Children’s Hospital.
At that hospital, there have been one, 12 and 41 admissions for the months of June, July and August, respectively.
Briana Pastorino, director of public relations at Loma Linda University Health, said the children’s hospital is running a daily census in the mid-teens of hospitalized patients who are COVID-19 positive.
In the last COVID-19 surge, Clark said there were more children coming into the hospital for other ailments or care, but they also ended up testing positive for the virus. This time around, “a large percentage” of children are being admitted because of COVID pneumonia, she said. The majority of admissions have come from those 12 and older.
For those with COVID pneumonia, many have required longer amounts and higher levels of oxygen, along with IV antiviral medicine and high doses of steroids to suppress the immune response. Clark has also noticed a correlation between children’s obesity and the severity of illness. The most severe pediatric patients have been those whose body mass index is greater than the 90th to 95th percentile, which places them in the overweight or obese weight status categories.
The hospital has also seen its first cases, three since June, of MIS-C patients from the delta surge. Much is unknown about the condition, such as what causes it, but inflammation can occur in children’s heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.
Symptoms of MIS-C include a fever and any of the following: abdominal pain, bloodshot eyes, chest tightness/pain, diarrhea, extreme fatigue, headache, low blood pressure, neck pain, rash or vomiting.
“This MIS-C is very specific to this COVID SARS-CoV-2, and the amount of illness we’re seeing in children after their original COVID infection with the MIS-C is very unique,” she said.
Among teenagers, Clark said some have experienced heart problems with dilation of their arteries. At this point, though, it’s “impossible” to know the long-term impacts to children’s overall health and wellbeing, which is “a real tragedy because these children have many, many years to live still, and we want to try and decrease the risk of long-term side effects from an infectious process that we have the ability to prevent.”
Clark anticipates that over the next two to four weeks the hospital will see more MIS-C cases.
MIS-C is similar to Kawasaki disease, a long-standing inflammatory disease, which primarily affects children younger than 5.
How to keep kids safe
With school back in session, parents are increasingly worried about children getting sick with COVID-19.
Locally, both the Desert Sands Unified and Palm Springs Unified school districts have more than 75 confirmed COVID-19 cases among students and staff members, while the Coachella Valley Unified School District has reported 34 student and staff cases.
Loma Linda University Children’s Health has a pediatric urgent care in Indio, and Clark said visits have “skyrocketed” since Coachella Valley schools opened, mainly with parents bringing in kids with cold-like symptoms.
Keeping children safe in schools is possible, Clark said, if mitigation factors are in place, such as getting everyone 12 and older vaccinated, keeping masks on during the school day and encouraging frequenthand-washing.
She also encourages families to spend time doing healthy outdoor activities together, such as riding bikes or swimming, and limiting contact to a few families or friends.
The biggest push, however, is getting children ages 12 and older vaccinated. Michael Osur, assistant director for Riverside County Public Health, hopes that with the Pfizer vaccine receiving full approval from the U.S. Food and Drug Administration, “more people will get vaccinated because the key is vaccination, more than anything.”
Children younger than 12 are not eligible to receive a vaccine, but an emergency use authorization could come later this year.
Clark has heard some families express concerns over possible long-term effects with the vaccine, such as fertility issues, but there’s no evidence that shows that the COVID-19 vaccines cause fertility problems in women or men.
There have been more than 1,000 reports of cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) among young males after getting their second COVID-19 vaccine, according to the Centers for Disease Control and Prevention. Reports are rare, and almost all cases have been mild and been resolved quickly, according to John Hopkins Medicine.
“Nothing is without zero risk and that’s dependent on your own genetics, your own state of your body, but we have some more than 350 million doses of the vaccine given in the United States alone, so that’s a lot of data elements that we know,” Clark said.
“We can say that of the millions of people in America who have been infected, along with the more than 500,000 deaths, when you look at what COVID infection can do to you and the risk of the vaccine, the risk of the vaccine is much, much lower than the risk of the virus itself.”
She recommends families speak with their health care providers to get trusted information on COVID-19 and vaccines.
Ema Sasic covers health in the Coachella Valley. Reach her at email@example.com or on Twitter @ema_sasic.
Originally Appeared Here