More than 97,000 children in the US have tested positive for COVID-19. Here’s how to care for your kids during the pandemic.
PHOENIX – Arizona is leading the country with its rate of COVID-19 infection among children, a national report says, though there are some limitations to the data.
The report, from the American Academy of Pediatrics and the Children’s Hospital Association, is updated weekly, with the most recent update published on Aug. 6. In both its July 30 and Aug. 6 rankings, Arizona led the nation in COVID-19 infections in children.
Arizona’s pediatric rate is reflective of its overall COVID-19 infection rate, which remains one of the highest in the country when all age groups are included.
Arizona’s rate of cases in children and young adults ages 19 and younger is 1,206.4 per 100,000 people in that age group, and it’s the only non-Southern state in the top five.
The states with the top rates, in order, are Arizona, South Carolina, Tennessee, Louisiana and Mississippi.
Most cases of COVID-19 in children are less severe than they are in older people and do not require hospitalization, but Arizona and some other states have reported cases in children of what appears to be a rare post-COVID-19 infection called multisystem inflammatory syndrome.
In Arizona, 12% of COVID-19 infections are in those 19 and younger, according to the report. Arizona was among 27 states reporting that 10% or more of all their cases were children.
Limits to data include age ranges used by states
The report relies on data from states. Because some states have reporting gaps, and others are using different age groups, metrics and formats, there are some limits to the report, its authors say.
Arizona, for example, collects its data using the age range 19 and younger, which likely includes a fair number of non-pediatric young adults who are in high risk groups, said Dr. Sean Elliott, a Tucson infectious disease physician and a member of the Arizona Chapter of the American Academy of Pediatrics.
Arizona’s results should be considered, along with the weight of ongoing community data, as various school districts consider re-opening plans for in-person school entry, said Elliott, an emeritus professor of Pediatrics at the University of Arizona College of Medicine — Tucson.
“In general, children represent around 8% to 10% of a total community’s infection rates, but the percentages may increase in areas where there is higher community spread like Arizona,” Elliott said.
“So, our 12% of total positives in patients younger than 20 years old likely reflects the robust transmission we just experienced in the preceding month in Arizona communities.”
In Florida, the pediatric breakdown is for kids ages 14 and younger, and some states’ breakdowns were 20 and younger. Others were 17 and younger or 18 and younger.
Arizona was one of 30 states in the report, plus Guam, Puerto Rico and the District of Columbia that used 19 and younger for its age breakdown.
A total of 49 states, New York City, the District of Columbia, Puerto Rico and Guam provided age distributions of reported COVID-19 cases for the report. New York state did not provide age breakdowns for its cases — only New York City did.
In hard-hit New York City, the rate of pediatric COVID-19 infection, at 390.5 cases per 100,000 chlidren, is much lower than the Arizona rate of 1,206.4 cases per 100,000 kids, the report says. New York City’s age range for pediatric cases is birth through 17 rather than the Arizona classification of birth through 19, the data shows.
Alabama’s age range data included individuals up to the age of 24, which is why it does not have a rate per 100,000 children in the report.
It also explains why 22.5% of COVID-19 infections in Alabama are in children, and why Alabama’s percentage in that category ranked highest.
Why is Arizona’s COVID-19 rate so high?
There are two likely explanations for the high Arizona ranking in the recent report, Elliott said.
First, health care providers are able to test more patients now than earlier in the pandemic, when some states were hit hardest. Arizona was hit later than East Coast states.
“Patients young and old who present with mild symptoms only or even just a suspected exposure now can be tested and included in the totals,” he said.
Second, Arizona just came through a period of extremely high infection rates, and the large number of adult patients will drive increased numbers of pediatric patients because of community and at-home exposures, Elliott said.
COVID-19 hospitalization rates in Arizona have been going down, but infection rates remain high.
The U.S. Centers for Disease Control and Prevention’s COVID-19 tracker says Arizona has one of the highest overall COVID-19 infection rates in the country.
As of Wednesday, Arizona’s rate of COVID-19 infections was third in the country behind Louisiana and New York City, according to the CDC tracker, which separates New York City and New York state.
Arizona’s overall COVID-19 infection rate is 2,632 cases per 100,000 people. The U.S. average is 1,562 cases per 100,000 people, the CDC’s Wednesday numbers show.
Kids and coronavirus deaths
The number of deaths of Arizonans age 19 and younger has not changed since the Aug. 6 data: It remains at 11 and one of the higher numbers in the nation, the report says.
The highest numbers of pediatric deaths were in New York City and Texas, which both reported 13 deaths, though New York City’s data was for kids 17 and younger and the Texas data took into account deaths of kids and young adults ages 19 and younger.
Eighteen states and the District of Columbia had not reported any pediatric COVID-19 deaths as of the Aug. 6 report.
“What we do know from these data is that, in children, deaths continue to remain much lower than in older age groups,” Dr. Sean O’Leary, vice chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, said in a news release.
“But as case counts rise across the board, that is likely to impact more children with severe illness as well.”
The American Academy of Pediatrics began collecting data on kids and COVID-19 in April.
Other findings in its latest report:
There have been 380,174 child COVID-19 cases reported, and children represented 9.1% of cases.Between July 9 and Aug. 6, child cases increased 90%, amounting to 179,990 new reported child cases nationwide.Between 0.3% and 8.9% of child COVID-19 cases resulted in hospitalization.In Arizona, 3.3% of child COVID-19 cases had resulted in hospitalization , which as of the Aug. 6 report had totaled 739 children.In states that reported mortality data, 0% to 0.5% of child COVID-19 cases resulted in death and child COVID-19 deaths were always 0.4% or less of all COVID-19 deaths.
“If nothing else, this report should serve as clear notice that COVID-19 remains quite active in many parts of the U.S. and that we all need to work together to control the virus, protect ourselves and navigate safe re-openings of schools and other sources of exposure like bars and gyms,” Elliott said.
The report was “one more source of information about COVID-19 attack rates in children” for pediatricians to use to more successfully treat their patients, Elliott said.
It suggests the U.S. should not be cavalier about the risk to teachers and children in reopening schools, he said.
Follow Stephanie Innes on Twitter: @stephanieinnes
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