Covid-19 Singapore: What about the children?

[nayr69sg]

https://www.cbc.ca/news/canada/calgary/covid-alberta-kids-1.6208827

COVID-19 ER visits and hospitalizations on the rise among Alberta kids​

​

A 14-year-old in Alberta died of COVID-19 on Oct. 7​

Jennifer Lee · CBC News · Posted: Oct 13, 2021 5:30 AM MT | Last Updated: 8 hours ago

The number of children hospitalized with COVID-19 in Alberta is growing. (CBC)
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A Calgary doctor says the emergency room at Alberta Children's Hospital is treating more children for COVID-19 now than during any other wave of the pandemic.
COVID-19 rates among five- to 11-year-olds, who are too young to be vaccinated, skyrocketed in September. And, with such high transmission rates, experts were expecting a corresponding surge in ER visits and hospitalizations.
"The number and frequency of children that we are seeing seeking emergency department care that are testing positive for COVID is higher than at any other time during the pandemic," said Dr. Stephen Freedman, pediatric emergency room physician at Alberta Children's Hospital and professor in the Cumming School of Medicine at the University of Calgary.
"That's reflected in the overall positivity rate in this age group which is higher than it's ever been and it's much, much higher than any other age group."

According to Freedman, his ER is seeing between two and five children per day who are positive for COVID.
"The good news is the majority of these children are still mildly ill — still able to be managed as outpatients. But some do require admission and we do occasionally have a child who is acutely unwell, requiring intensive care unit hospitalization"
Freedman said adults have a much higher rate of severe illness and death from a COVID-19 infection. But as more children catch the virus, there will be a corresponding rise in the number of kids who end up critically ill.

Teen death​

On Tuesday the province's chief medical officer of health reported a 14-year-old died of COVID-19. The boy, from Alberta's central zone, died on Oct. 7.
He is the youngest Albertan to die of the virus since the start of the pandemic. An 18-year-old girl, also from the central zone, died in September.
Alberta's Chief Medical Officer of Health Dr. Deena Hinshaw drew criticism for noting the boy had complex pre-existing medical conditions that "played a significant role" in his death, as she made the announcement during Tuesday's news conference.
"Oh my god, we had our first true pediatric death," said Calgary emergency room physician Dr. Joe Vipond during a Protect our Province update late on Tuesday. The group of physicians began holding their own updates to "fill the void" left by fewer government COVID-19 updates.
"In the [press conference] I heard a caveat that there were comorbidities. In my mind, there are no comorbidities that matter in this instance. A 14-year-old is a 14-year-old And, for the record, if I were to pass away tomorrow I would be listed as a 52-year-old with comorbidities," he said.

• How will the delta variant affect kids? Experts explain what we know and what we don't

Alberta Health statistics show COVID-19 hospitalizations are on the rise among children.
The number of kids (ages 19 and under) hospitalized for COVID-19 has increased by 24.5 per cent (from 323 to 402) since Sept 1.
ICU admissions for children also jumped by 23 per cent (from 60 to 74) over the same time period.
According to Alberta Health, children currently account for about 1.5 per cent of COVID-19 hospitalizations.
Sixteen of the 1,053 people hospitalized for COVID-19 as of Tuesday afternoon are under the age of 18, including four children in intensive care.

MIS-C worries​

All this comes at a time when hospitals are dealing with a resurgence of other viral illnesses kept at bay due to COVID-19 restrictions last year, and at a time when health-care providers are bracing for a potential spike in cases of a rare but serious condition known as multisystem inflammatory syndrome in children (MIS-C) which causes severe inflammation in organs such as the heart and kidneys weeks after a COVID-19 infection.
Surges in MIS-C cases generally turn up about four weeks after the peak in acute COVID-19 infections, according to Freedman.
"The biggest concern is we're not really sure what's going to happen in the coming weeks," said Dr. Sidd Thakore, pediatrician at Alberta Children's Hospital.

"Two or three weeks down the road from now are we going to see a substantial increased number of the multisystem inflammatory syndromes and long-COVID, because those generally take two to six weeks to occur after your primary infection with COVID."
Thakore said kids who develop MIS-C show up in hospital after having had a fever for several days along with other symptoms including abdominal pain, diarrhea, red eyes and fatigue.
"They're the ones that can get sick substantially fast. They can go from looking OK to being in the ICU in the matter of a day or so. So those are the ones that we get quite worried about because of how fast they can proceed."
According to Alberta Health, 48 children under the age of 18 have been hospitalized for MIS-C — which it noted is rare and treatable — including 21 in the ICU since the province began tracking this condition in May 2020.

 

[nayr69sg]

Most of the arguments here are Adult unvaxxed vs Adult vaxxed.

A lot has been made to ridicule those who dont vax as stupid. Take risk with their lives etc.

But what about the children? below 12? Those we deem the vaccine to be not safe enough for them? Who cannot get vax?

So far we are quite lucky that the kids have mostly mild disease. But still there are risks.

And this part I find a bit suspicious with the vaccines. usually vaccines tend to be developed more for the children. In this case the vaccines deemed to be not safe enough for kids?

Is this a pediatrician thing? I know the pediatricians are some of the most kiasu kiasee doctors among all doctors most conservative and careful everything must test until super safe then try.

Even the obstetricians have passed the vaccine for pregnant women though. Obs rank up there with Peds as kiasu kiasee.

Singapore's experience the kids so far ok?

Hope everyone keeps safe.

@dredd your thoughts on the kids <12 and vaccines?

 

[Leongsam]

Catching Covid when you're young is a good thing if it imparts robust immunity which lasts a long time.

Covid parties for kids should be organised by schools with this aim in mind.

 

[Leongsam]

Measles killed 1 in 1000 kids in the 1950s and almost EVERY SINGLE CHILD would catch the virus but nobody locked down because of measles.

This Covid generation of kids most certainly deserve the title of "snowflakes".

Nearly All Kids Got Measles in the 1950s​

Petr Svab

3-4 minutes

---

Over 600 measles cases in United States in 2014 sounded alarms. It was the highest number of cases of measles since it was declared eliminated in the United States in 2000. If the current trend continues, the country could see 1,000 cases this year, the most since 1992.

It is alarming, since the measles can be life-threatening. For every 1,000 cases of measles in children, one or two will die from it, according to Centers for Disease Control and Prevention (CDC) statistics.

There was a time, however, when measles was extremely common in kids, almost as common as a cold. Prior to development of a vaccination in 1963, nearly all children ached through the illness before the turned 15. Once suffering through it, a person is immune for life. This means if you were born or lived in the country before 1957, you’re almost certainly immune to measles since you’ve probably had it.

So what is the big deal with a disease that disappears on its own after a week of fever and rashes?

Infectious​

Measles spread like a wildfire. If one shares living space with a sick person, one’s almost certain to catch it. Children are most susceptible to measles and so schools—and places like Disney Land—are among the most suitable environments for it to spread.

Isolation helps only in part, as it takes one to two weeks for the disease to develop and one may be infectious a couple days before any symptoms appear.

Complications​

Once catching measles, there is no cure. Children with a strong immunity and enough care suffer discomfort–high fever, dry cough, running nose, skin rash–but all’s usually well after a week or so.

But that’s not the case for ones with a weaker immunity. Measles makes one vulnerable to further infections causing diarrhea, otitis media, pneumonia, and even brain inflammation. In extreme cases, these complications can be deadly.

In United States. about 1 in 20 children with measles develops pneumonia and about 1 in 500 dies. But among children suffering malnutrition and poor healthcare up to one in four dies.

Vaccination ​

During and after the Second World War measles scourged over half a million children a year in United States. Then, in 1954, Dr. Thomas Peebles isolated the virus and few years later first vaccines were tested.

First vaccine was licensed in 1963 and after a few years measles diminished tenfold. With further improvements to the vaccination regime, the disease further receded to just thousands of cases in 1980s, hundreds in 1990s, and finally dozens in 2000s.

Even though some locales with lower vaccination rates suffered outbreaks last year, most notably almost 400 infected in Ohio, there hasn’t been a fatal case since 2005.

Worldwide, even in former measles hotbeds of Africa and Western Pacific there are 4-10 times fewer cases than four decades ago. Still, The World Health Organization reported almost 150,000 died from the disease in 2013.

 

[Leongsam]

Nearly 94,000 Kids Got COVID-19 Last Week. They Were 15% Of All New Cases​

• • Updated August 10, 20213:01 PM ET
  • 
    
    Joe Hernandez
    Twitter

A child watches as a nurse administers a COVID-19 vaccine during a pop-up vaccination event in April at Lynn Family Stadium in Louisville, Ky.
Jon Cherry/Getty Images

Coronavirus cases among children are rising at a time when the highly infectious delta variant is advancing across the United States at a rapid clip.

New state-level data analyzed by the American Academy of Pediatrics and the Children's Hospital Association shows that children accounted for roughly 15% of all newly reported COVID-19 cases across the nation for the week ending on Aug. 5.

Nearly 94,000 child cases of COVID-19 were recorded during that period, a 31% increase over the roughly 72,000 cases reported a week earlier. In the week before then, there were 39,000 new child cases.



The American Academy of Pediatrics and the Children's Hospital Association said that new coronavirus cases in children have been increasing since July after a period of decline in the early summer.

"This virus is really tracking the unvaccinated," said Dr. Yvonne Maldonado, a professor of pediatrics and infectious diseases at Stanford University. "Because children under 12 are not able to be vaccinated, we're just seeing the same increase in infections in that group because [the delta variant] is so infectious."

Parents are searching for answers​

One big question for parents — whether delta is making kids sicker than previous strains — still has no clear answer.

But the numbers appear to show that severe illness, hospitalization and death are rare in children infected with the coronavirus.




In states where data was available, less than 2% of all child COVID-19 cases required hospitalization and 0.00% to 0.03% were fatal.

"I'm not seeing any patterns that suggest the virus is more virulent or more serious or more severe in children than it was before this variant appeared," Maldonado added.

Concerns about the strain on the pediatric health care system​

Still, the growing number of children hospitalized with COVID-19 could further strain an already overburdened pediatric health care system.

Many children's hospitals are not only dealing with patients who've contracted the coronavirus but also kids with issues indirectly related to the pandemic. Many children have developed mental health problems stemming from social isolation, and others deferred medical care during the peak of the outbreak last year.



"These kind of indirect impacts of COVID have actually been a much bigger volume impact on pediatric intensive care capacity than the direct count of COVID kids," said Mark Wietecha, CEO of the Children's Hospital Association.

Despite no sharp rise in the number of hospitalizations, Wietecha said many children hospitalized with COVID-19 now, likely driven by the delta variant, are sicker than those who had contracted previous strains. While the overall picture remains unclear, he said pediatric hospitals are nonetheless now in need of specially trained medical staff who understand the unique requirements of treating young patients.

Cases are spiking in children as many of them prepare for the start of a new school year, which is now tinged with uncertainty. Some states are attempting to block school districts from requiring students to wear masks.

 

[dredd]

Most of the arguments here are Adult unvaxxed vs Adult vaxxed.

A lot has been made to ridicule those who dont vax as stupid. Take risk with their lives etc.

But what about the children? below 12? Those we deem the vaccine to be not safe enough for them? Who cannot get vax?

So far we are quite lucky that the kids have mostly mild disease. But still there are risks.

And this part I find a bit suspicious with the vaccines. usually vaccines tend to be developed more for the children. In this case the vaccines deemed to be not safe enough for kids?

Is this a pediatrician thing? I know the pediatricians are some of the most kiasu kiasee doctors among all doctors most conservative and careful everything must test until super safe then try.

Even the obstetricians have passed the vaccine for pregnant women though. Obs rank up there with Peds as kiasu kiasee.

Singapore's experience the kids so far ok?

Hope everyone keeps safe.

@dredd your thoughts on the kids <12 and vaccines?

Covid seems to be a lot kinder to kids than adults. Vaccination for under 12? The jury is out for that but always a good thing to wait for more science and data to come in before making the move....

An interesting article from The Lancet Infectious Diseases:

COVID-19 vaccines for children younger than 12 years: are we ready?​

• Xiaohui Zou
• Bin Cao

Published:June 28, 2021DOI:https://doi.org/10.1016/S1473-3099(21)00384-4
https://plu.mx/plum/a/?doi=10.1016/S1473-3099(21)00384-4&theme=plum-jbs-theme&hideUsage=true

On May 5, 2021, Canada became the first country in the world to approve COVID-19 vaccine for emergency use in children aged 12–15 years; later the same month, the US Food and Drug Administration and European Medicines Agency also gave the green light to the Pfizer-BioNTech COVID-19 vaccine for adolescents.

Children younger than 12 years are the next population who need a safe and efficient COVID-19 vaccine. In The Lancet Infectious Diseases, Bihua Han and colleagues reported the results of a double-blind, randomised, controlled, phase 1/2 clinical trial, which showed that the inactivated COVID-19 vaccine (CoronaVac) had good safety, tolerability, and immunogenicity in youths aged 3–17 years. This promising result should inspire the ongoing trial of other COVID-19 vaccines in children younger than 12 years.
Children contributed 14·1% of the total COVID-19 cases in the USA.

In children, COVID-19 is usually mild and often asymptomatic. However, in rare cases, children can become seriously ill and need hospitalisation and intensive care. One of the possible adverse outcomes has been termed multisystem inflammatory syndrome in children (MIS-C);
Children with MIS-C have fever and become severely inflamed, and develop multisystem disorders involving the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal tract. The overall mortality of MIS-C is approximately 1–2%. Evidence has shown an association between COVID-19 and MIS-C occurrence. These adverse outcomes of COVID-19 in children justified the necessity to vaccinate children against COVID-19, as the BNT162b2 vaccine has shown 100% efficacy in children aged 12–15 years.
• View related content for this article
Herd immunity against COVID-19 is the prerequisite to end this pandemic, either through vaccinations or natural infection. Most estimates placed the threshold at 65–70% of the population gaining immunity, mainly by vaccination. However, widely circulating virus variants and persistent vaccine hesitancy make this threshold difficult to reach. A worldwide survey showed only 54% of respondents reported that they would definitely have a COVID-19 vaccination if it were available.
In addition, novel variants with increased transmissibility and enhanced immune-evasion changed the herd-immunity equation.
Thus, the calculation has to be revised upwards and children must be covered in the immunisation campaign. Moreover, from an epidemiological perspective, if we leave children unvaccinated when adults achieve immune protection, we cannot exclude the possibility that unvaccinated children become the virus shelter, given that most COVID-19 cases in children are mild and asymptomatic.
The inactivated vaccine in Han's trial induced higher titres of neutralising antibodies compared with adults aged 18–59 years who received the same vaccine; the Pfizer-BioNTech vaccine showed a similar trend: vaccinees developed higher titres of neutralising antibodies in children aged 12–15 years than in those aged 16–25-years.

Children's strong response means that they are more likely to develop immune overactions than adults, such as fever and allergy, so COVID-19 vaccine for children should balance a protective immune response and side-effects. For the inactivated vaccine, CoronaVac, the 3 μg dose induced higher titres of neutralising antibodies than the 1·5 μg dose, whereas it showed no significant difference in side-effects between the two doses, so 3 μg doses were used for phase 3 trials in children. But for other vaccines, such as the mRNA and viral vector vaccines, lowering the vaccination dose used in adults should be considered in the clinical trial for children.
The safety and efficacy of COVID-19 vaccine in adults cannot guarantee the same performance in children. COVID-19 illness in adults post-vaccination was identified by onset of symptoms of acute respiratory illness; whereas in children, most COVID-19 cases are mild and asymptomatic, and parents might not be aware of the infection since children get sick more frequently than adults (such as with common colds), which would make the infection rate underestimated and efficacy overestimated. Moreover, children younger than 12 years are at their key stage of growth and development; caution should be taken to evaluate the long-term effect of vaccine on children's development. Although vaccinating children is essential to reach herd immunity and limit the severity of COVID-19, safety should be the paramount factor to be considered before COVID-19 vaccine can be rolled out in younger children. Given the distinct immunogenicity profile and development stage of children, post-marketing surveillance of the vaccine safety should be done and maintained for a longer period than that in adults.

 

[mojito]

Most of the arguments here are Adult unvaxxed vs Adult vaxxed.

A lot has been made to ridicule those who dont vax as stupid. Take risk with their lives etc.

But what about the children? below 12? Those we deem the vaccine to be not safe enough for them? Who cannot get vax?

So far we are quite lucky that the kids have mostly mild disease. But still there are risks.

And this part I find a bit suspicious with the vaccines. usually vaccines tend to be developed more for the children. In this case the vaccines deemed to be not safe enough for kids?

Is this a pediatrician thing? I know the pediatricians are some of the most kiasu kiasee doctors among all doctors most conservative and careful everything must test until super safe then try.

Even the obstetricians have passed the vaccine for pregnant women though. Obs rank up there with Peds as kiasu kiasee.

Singapore's experience the kids so far ok?

Hope everyone keeps safe.

@dredd your thoughts on the kids <12 and vaccines?

Ban them from skool lah. No entry to malls and Mac donners. Punish them for not being big farmer customer.

 

[sweetiepie]

Current sg adult death 192. The formula pap use is 1 little sinkie head = 1k old fart heads.
Still got 80% buffer before pap inject kids mai kan cheong.