We are at a crossroads with respect to COVID-19 and its impact on children. Over the first year of the pandemic in the U.S., fewer than 6% of COVID-19 cases occurred among children, and most produced only minor symptoms. Unfortunately, the new delta variant of COVID-19 appears to be a gamechanger. Both of us have practiced pediatrics or pediatric infectious diseases for decades, and we are worried.
Never in our lifetimes have Americans encountered an epidemic virus that is both as contagious and virulent as COVID-19. We are witnessing its early effects now, but the worst is yet to come. Already, delta accounts for well over 80% of all new U.S. COVID-19 cases. The average daily case count has increased from about 10,000 to more than 100,000 in just six weeks, and hospitalizations have increased by 41% over the past seven days alone.
In Louisiana, the delta variant accounts for about 90% of new COVID-19 infections, and only about 37% of those eligible are fully vaccinated against COVID-19. Children’s Hospital New Orleans recently has experienced a surge of pediatric COVID-19 cases unlike anything observed previously. The daily census of children admitted to the hospital for COVID-19 has been as high as 20, with as many as five of those children in our intensive care units at any given time.
Ranging in age from infancy to adolescence, several children have been seriously or critically ill, requiring mechanical ventilation. One child has died. Coinciding with an epidemic of another respiratory virus known as RSV, these cases have severely taxed our ability to provide care to other seriously or critically ill children.
Other children’s hospitals across the South are experiencing the same constraints. Unless we turn back the COVID-19 tide, it is only a matter of time before children will have to be turned away from the facilities where they are most likely to receive lifesaving care.
It is no accident that Louisiana currently seems to be the U.S. epicenter for the delta variant of COVID-19. This is largely a pandemic of the unvaccinated, and Louisiana’s vaccination rate places it near the bottom nationally.
Sadly, it appears that children are becoming collateral damage of the refusal by many Louisianans to take any of the safe and highly effective COVID-19 vaccines that have been available for months. Children under the age of 12 are not yet eligible for vaccination, and the rate of vaccination among adolescents 12 or older is just 12%, but there is so much adults could do to insulate and protect children from this pandemic, just by getting vaccinated.
We are not powerless against the delta variant. Vaccination ultimately will rescue us from future surges caused by new variants. In the meantime, social distancing, meticulous hand hygiene and masking can help to blunt transmission of the virus. New Orleans Mayor LaToya Cantrell and Louisiana Gov. John Bel Edwards are to be congratulated for having the courage to issue mask mandates to protect our children and other vulnerable Louisianans. These measures are more important than ever.
We will soon know whether we have the will to blunt this most recent COVID-19 surge. Children are returning to school over the next several weeks, potentially fueling an increase in pediatric COVID-19 cases. Influenza season is just around the corner, and it is likely to be severe, both because last year’s season was the lightest on record and because vaccine fatigue may lead many to forgo influenza vaccination. A strong push now to vaccinate more eligible adults and adolescents against COVID-19 could help to blunt COVID-19 case counts and prevent our overburdened hospitals from hitting a breaking point.
Young children are not able to advocate for themselves. They depend on adults to protect their health and well-being.
Too many in our society have decided that preservation of their own health is not reason enough to be vaccinated against COVID-19. Now that children are falling seriously ill in greater numbers, will these individuals recalculate the risks and benefits and conclude that vaccination is the morally correct path to take? For the sake of the children, we certainly hope so.
Mark Kline is physician-in-chief and chief academic officer and Stephen Hales is chairman of the board of trustees at Children’s Hospital New Orleans. Dr. Kline also is professor of pediatrics at Tulane University School of Medicine and clinical professor of pediatrics at LSU Health Sciences Center.