US coronavirus study warns sick children could overwhelm health system

Paediatric services in the US could be overwhelmed by thousands of sick infants and young children – an overlooked group which has a higher risk of serious illness from Covid-19, the disease caused by the new coronavirus, according to a new study.

While children are at a lower risk of fatality from Covid-19 compared to the elderly, the very young were most at risk of becoming seriously ill and the sheer weight of population numbers in the United States meant the need to be prepared for an influx of cases was urgent, the study said.

The research was led by Elizabeth Pathak, a population health scientist and president of the US think tank Women’s Institute for Independent Social Inquiry, and warned against a sense of complacency about the impact of the disease on children.

The most conservative estimates considered in the study showed that one in 200 children in the US would be infected with the virus, with 991 severe enough to require hospitalisation.

In the most extreme scenario, three out of five US children would be infected, with 118,887 becoming seriously ill.

“Severity and case fatality are much lower for children than for elderly persons, and this truth has created a sense of complacency that Covid-19 is not a major concern for children’s health,” according to the study which was published last week in the Journal of Public Health Management and Practice.

“Because there are 74 million children 0 to 17 years old in the United States, the projected number of severe cases could overextend available paediatric hospital care resources under several moderate cumulative paediatric infection proportion scenarios for 2020, despite lower severity of Covid-19 in children than in adults.”

The US has struggled to cope with the spread of the virus – which was first reported late last year in central China – with the greatest number of confirmed cases in the world by far and myriad failures in virus detection, testing, and a lack of equipment for frontline medical workers.

Pathak and her colleagues estimated that 176,190 children in the US had been infected with the virus, based on data showing 74 children admitted to paediatric intensive care units in 19 states in the US, as of April 6.

For every admission of a child to an intensive care unit – estimated at 11 per cent of children hospitalised for the virus – the researchers calculated a further 2,381 children were infected with the Covid-19 virus who remained in their local communities.

The report cited studies from China which found infants at the highest risk of becoming severely or critically ill with the virus, at 10.6 per cent, followed by 7.3 per cent of severe or critical infection for those aged between one and five, falling to 4.2 per cent among children between six and 15 years old.

The study’s projections for the US also took into account the high level of undetected cases among children – likely for those with asymptomatic or mild cases – and the lower detection rate among children, estimated by the researchers to be only 15 per cent compared to adults.

The researchers recommended planning for health care systems to cope with severe paediatric case infections and greater education for parents on infection control practices, as well as plans for early detection, treatment, and isolation of children infected with the virus.