What I’m Reading: “Children and COVID-19: State Data Report”

I have been poring through the statistics in the joint report from the American Academy of Pediatrics and the Children’s Hospital Association, “Children and COVID-19: State Data Report” and it is illuminating.

Each state reports the data differently, but some numbers were quite clear. Appendix Table 3A says that Massachusetts had 1,558,231 children in 2019, so I will use that number to calculate hard numbers out of the percentages.

• Hospitalization rate for this population has been consistently around 2% all summer, ticking up to 2.2% in early August. (Appendix Table 2B)
• Mortality rate has been nearly cut in half since April, and is now at 0.02% for children. (Appendix Table 2C)
• Infection rate in kids has steadily increased, and increased greatly each week since school years ended (Appendix Table 2A). For folks who say, “I see kids out together all the time!” these data should be informative: you may see them, but that doesn’t mean it’s a safe choice on their part. The increase also suggests that adult caregivers are getting more and more lax with each passing week. With schools opening, it is likely the infection rate will grow, possibly by a great margin.

The most-recent infection rate was 500.7 per 100,000 children (Appendix Table 2A) and 469.6 in Massachusetts, while under Phase 3 restrictions (Table 3A). This means for every 1,000 students in your school district, about 5 students will be infected (assuming rates do not increase as restrictions are lifted). School population totals can be found on the School Profiles page for your town. I live in Canton, which had 3,297 students in 2018-2019. If enrollment remained consistent, that would mean 16 or more students would become infected. I work in Braintree with an enrollment of 5,795 in 2018-2019, which means 29 or more could become ill. In my school, 3-4 kids would get sick, assuming the rate doesn’t increase. Very roughly, there’s about a 1 in 10 chance of one of them being hospitalized.

Statewide, 7,324 children would become infected, 161 would be hospitalized, and 1-2 would die. It is concerning to see how the infection rate has stepped up each week as governors have rolled back restrictions in order to “open the economy.” Theoretically, kids are still in some form of quarantine, but the reopening of schools will vastly increase their raw number of community contacts (Ten-fold? Probably more, but I don’t have the data on kids’ normal summer contacts compared to their school-year contacts) and any remaining quarantine will effectively end as social pressures increase on children and caregivers alike to permit social gatherings.

If rates increase and, instead of 3 kids getting sick, 30-40 of my students become ill, that’s an entirely different calculus, especially as odds increase of a mortality. Beyond the mortality rate however, I am concerned about findings of damage to the kidneys and other organs in recovered patients, and even some indications of neurological/intellectual damage. Unlike other illnesses (like the flu, for example) where the prognoses are (a) full recovery, or (b) death in rare cases, coronavirus has a wide range of outcomes: full recovery, recovery after months-long hospitalization, significant long-term organ damage, brain damage, lung damage, or death. Personally, I don’t want to envision a world in which a student dies and a handful develop Kawasaki Syndrome (multi-system inflammatory disease).