Are children more affected by the resumption of the epidemic than in previous waves?

For the past two weeks, children and teachers have been able to take off their masks in accordance with the latest school health protocol. But at the same time the epidemic is picking up speed again: the number of new cases every day has doubled in the past two weeks. Faced with this renewed outbreak of the epidemic, some establishments are stepping back and taking the initiative to reintroduce the obligation to wear masks. This is the case, for example, in several establishments in Finistère, one of the departments with the highest incidence rate smoothed over seven days, almost 1,900 per 100,000 inhabitants on March 25.

But should we then worry about children’s health? Are they more affected than adults? Have the serious forms increased among the youngest?

An incidence rate close to that of the rest of the population

According to the latest figures from Public Health France, the seven-day smoothed incidence rate among 10-19 year olds was 1,546 on March 24, slightly more than the rest of the population. In contrast, the incidence rate in children under 10 years of age was slightly lower, at 978 cases per week per 100,000 children. The virus therefore circulates in equal proportions among minors and adults.

On the other hand, if we extend to the entire fifth wave, since early November, children were actually more contaminated: the incidence rate among 10-19 year olds has approached the 7,000 level of the increase, almost twice that of the general population. This is the age group that has reached the highest incidence rate, just ahead of the under-10s. This can be explained by the protocol put in place at the school at the time, which required all students in the class to be tested three times if a child tested positive. This protocol has been relaxed and only one test is now required for the Covid positive student’s classmates.

An increase in hospital admissions must be put into perspective

In addition to the positive cases, it is above all the risk of a severe form that worries parents. The number of children who tested positive for Covid and were hospitalized has in fact been much higher since the beginning of the fifth wave than during the previous ones. At the end of January, more than 1,150 children were hospitalized with Covid, while that number had never exceeded 200 before. As of March 24, 501 children with Covid were still hospitalized.

If this significant increase is worrying, these numbers still need to be put into perspective: the 501 people under the age of 20 hospitalized on March 24 represent only 2% of the 20,000 people hospitalized with Covid. In addition, these figures count all people hospitalized with Covid, but do not indicate whether this disease is the main reason for their hospitalization. A child who was hospitalized for another reason but tested positive upon arrival at the hospital is therefore included in these figures.

However, one point deserves attention: the increase in the number of cases of Pims (pediatric multisystem inflammatory syndrome). This is a serious complication that is characterized by, according to the High Authority for Health “high fever, significant deterioration in general well-being and digestive problems”. Public Health France states in its latest report of February 24th “A very significant increase in the number of Pims cases since early December 2021 and this number remains high in early 2022“. In detail, 226 cases of Pims related to Covid were identified between November 21, 2021 and February 20, 2022, i.e. more than a quarter of all Pims cases since the beginning of the pandemic.

The impact of the influenza epidemic on pediatric emergency care has been far more spectacular than that of Covid,” Nuance however Christèle Gras-Le Guen, President of the French Society of Paediatrics, contacted by franceinfo. “Covid really isn’t a big pediatric problem.” Just under 1,000 children under the age of 15 went to the emergency room for suspected Covid in the week of March 14-20, compared to more than 4,000 for the flu, according to SPF’s latest Oscour bulletin.

Uncertainties about the long Covid

Long Covid refers to the persistence of Covid symptoms for at least twelve weeks after infection. In children as in adults, there is uncertainty about this disease, as it is often difficult to identify whether or not Covid symptoms appear several weeks or months after infection. The conclusions of the various studies agree that children can suffer from this pathology, but the figures given vary greatly.

A British study in early March (in English) should be rather reassuring by estimating that only 1% of 5-11 year olds and 3% of 11-18 year olds had long-term Covid. But an American study (in English), released March 13, claims more than a quarter of children are showing symptoms of Covid long after they are infected. For its part, in France, the High Health Authority estimates that the incidence of long covid in children is lower than in adults and that 2 to 5% of children suffer from it after being infected with covid.

The death of children remains the exception

Covid-related deaths among the under-20s are extremely rare but have increased in recent months compared to when the epidemic began. Since November 1, 2021, the start of the fifth wave, there have been 27 deaths of people under the age of 20 who have tested positive for Covid, more than the 20 deaths recorded in the four previous waves, according to figures from Public HealthFrance. Four children have died infected since the beginning of March.

As with the hospitalizations, Christèle Gras-Le Guen wants to reassure: “The fifth wave infected many more children than the previous ones, so we may have had children who died of something else after testing positive. There are also children with chronic conditions where the Covid-related fever could trigger a disease crisis and eventually lead to death. But children’s voyages similar to those of adults, with a death linked only to Covid-19, are extremely rare, if not almost non-existent.

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