It’s the same pandemic, but now it’s drastically different for kids

By Jen Christensen, CNN

Kids are heading back into the classroom for yet another pandemic school year, but this time with the more contagious Delta variant getting more people sick. Navigating school safely will be trickier than ever.

“Everyone keeps reflecting back on last year and saying: ‘Oh, we got through it with school last year, so we’ll get through it this year’, but this year is drastically different,” Dr. Aaron Milstone, a pediatric infectious disease specialist at Johns Hopkins Children’s Center said as he was on his own child’s first-day-of-school event.

Between the Delta variant and more people going to restaurants, weddings and large events without masks than at this time last year, he said, kids face a higher risk of getting sick.

“A lot of people didn’t send their kids to school last year,” Milstone said. “This year there’s just a lot more activity and there’s a lot more density of people getting together, and a lot of those people are unvaccinated and are susceptible to a virus that’s spreading quickly through that population.”

Masks and better classroom ventilation can help protect kids, but to reduce risk further, adults will have to step it up, experts say. More people need to get vaccinated, and more adults need to reduce their exposure to the virus.

As Covid-19 surged across the population recently, cases and hospitalizations among kids “increased exponentially.” They are at their highest numbers since winter, the American Academy of Pediatrics said Tuesday.

After a lull in cases earlier this summer, Johns Hopkins Children’s Center started its surge planning meetings again, Milstone said. The hospital is concerned it will run out of space in the intensive care unit, and his hospital is not alone.

Hospitals expect not just more Covid-19 patients, but also an increase in flu cases and patients with other respiratory illnesses. They’re already treating an early wave of patients with respiratory syncytial virus (RSV), after all of these illnesses were largely absent last year when more people were staying home.

The pandemic and the surge of other respiratory viruses has already brought an “unprecedented strain” to the 220 children’s hospitals represented by the Children’s Hospital Association, CEO Mark Wietecha wrote President Joe Biden last Thursday in a letter asking for help.

“There may not be sufficient bed capacity or expert staff to care for children and families in need,” the letter said.

Delta doesn’t help, but it’s not the sole reason more kids are sick

While the surge in the Delta variant coincides with a surge in cases among kids, it’s not selectively targeting or disproportionately impacting them, said Xiaoyan Song, director of infection control and epidemiology at Children’s National Hospital in Washington, DC.

“It’s very highly contagious,” Song said. But the rise in cases is not just among children.

“The rise in the numbers in children is attributable to the rise in numbers among the adults,” Song said.

Speaking at a White House Covid-19 briefing on Thursday, US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said new research to be published Friday shows cases in children and adolescents 17 and younger increased by nearly tenfold from late June to mid-August.

But, kids do not appear to be getting more severe disease.

“Although we are seeing more cases in children, and more overall cases, these studies demonstrated that there was not increased disease severity in children,” she said. “Instead, more children have Covid-19 because there is more disease in the community.”

Since symptoms can take a few days to develop, Song said, it’s hard to clearly differentiate when kids are catching Covid-19 at school, or if they are exposed to it at family gatherings and social activities.

In England, when the Delta variant became the most prevalent strain in the UK, researchers looked at the number of infections in the schools and found that there were no more than there were with the original virus, according to a a study published in August.

Adults need to do better

Because children under the age of 12 cannot get the protection of a vaccine yet, and probably won’t until fall or winter at the earliest, Walensky said more adults need to get vaccinated.

Walensky cited the two studies that will publish Friday that show vaccinating as many people in the community as possible protects children — even those who are too young to get the vaccine.

“One thing is clear: Cases, emergency room visits and hospitalizations are much lower among children in communities with higher vaccination rates. Vaccination works,” Walensky said.

It’s simple. If there’s less virus in circulation, fewer kids will get sick.

“People really need to self-reflect on their own behaviors,” said Milstone.

While there are so many cases, even the vaccinated should stop interacting with so many people without masks indoors.

“We’re still seeing vaccinated parents who are getting Covid and bringing it home to their family,” Milstone said. “The vaccine is working. It’s keeping you out of the hospital and alive, but right now it isn’t perfectly preventing you from getting any sort of mild illness and that means you can spread it.”

As passionate fights and protests have broken out at school board meetings, some parents have argued people should have a choice about how to protect their kids.

Milstone counters with this: People need to remember personal choice is not fully personal.

“It’s like the speed limit. It protects you, but it also protects other people,” Milstone said. “These behaviors are not just about protecting you. It’s about protecting everyone.”

What parents can do to keep kids safe

Song suggests one of the easiest ways parents can help keep infections out of the school is to talk to their children every day to see how they are feeling and keep them home if they’re sick.

“The point is to make sure we do this before they get on the school bus,” Song said. “If all the parents did their due diligence and the child is looking great and everything’s normal, before they say goodbye to the kids at the school bus or before they drop the kids off, we’ll have a very, very minimum transmission in the school.”

When kids go to school, they should wear masks indoors, keep physical distance from others and regularly wash their hands. Schools need good ventilation and to keep surfaces clean. Teachers and staff must be vaccinated and masked.

“Those are key factors. It is not only just useful, helpful for our school to reduce Covid-19, but also it’s going to help with dramatically keeping the kids healthy and happy and keeping them from getting other types of viruses,” Song said.

Song said Children’s National is already monitoring at least 13 different types of respiratory viruses in circulation.

Parents may also want to limit or modify some activities, Milstone said.

Playdates inside while wearing a mask may be OK, but outdoor activities are better. Regular sleepovers aren’t great, but camping outside may be better. Singing in the choir or doing theater with a mask or with physical distance may be safe. Outdoor sports should be OK, too, but indoor is a little trickier.

Milstone said his kid’s basketball team and volleyball teams were able to play last year without a problem, “but with this variant, we aren’t quite sure if that’s going to be the same,” he said.

“Hopefully, we’ll have a vaccine in time for winter,” Milstone said.

“There are things that we know that put kids at higher risk, so it’s kind of a balancing act, and cutting down on high risk activities,” Milstone added. “This is totally preventable if we put the right things in place to protect kids.”

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CNN’s Maggie Fox contributed to this report