MANSFIELD -- COVID-19 is already wreaking havoc on the 2021-2022 school year. Cases are spreading rapidly among Richland County students, many of whom are too young to be vaccinated.
Multiple school districts have been affected -- some have had to cancel school for the day, others (including Madison, Lexington and Crestview) have had entire buildings go to a temporary period of remote learning as a result.
With the rise of the highly contagious Delta variant, public health officials are looking with renewed interest on the impact of the virus on children.
While the variant and its effects are still being studied, most public health officials believe the variant is less dangerous to children than other strains of COVID-19.
It is, however, more contagious.
Dr. Joseph Gastaldo, medical director of infectious diseases at OhioHealth, said it's also crucial to understand that children can get and spread COVID-19. As case rates rise in the community, case rates will rise among children too.
“It is still true that if kids get COVID, they don't get as sick; however we are seeing more pediatric hospitalizations and more deaths,” Gastaldo said. “We're seeing more severe COVID outcomes in children, although it's rare. And kids can get long COVID.”
Sherry Smith, nursing supervisor at Richland Public Health, confirmed that public health officials are beginning to see cases of “long COVID” in both children and adults. Long COVID occurs when formerly infected people continue to experience complications or health problems months after infection.
“We’re also seeing long COVID and effects of long COVID starting to show up from cases that had COVID last summer. Lasting effects in their heart and lungs,” Smith said.
State and national health officials have begun to observe higher rates of Multisystem inflammatory syndrome in children (MIS-C). MIS-C was first identified in April 2020 by doctors at children’s hospitals in the United States and the United Kingdom, according to John Hopkins Medicine. MIS-C is an illness that can occur after COVID-19 infection and affects mostly school-age children. While MIS-C is rare, it can be dangerous.
The CDC describes MIS-C as a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. Symptoms include fever, gut pain, bloodshot eyes, chest tightness or pain, diarrhea, extreme fatigue, headache, low blood pressure, neck pain, a rash and vomiting.
Nevertheless, most children infected with COVID-19 are experiencing more mild symptoms. Gastaldo stated that in his own practice, he’s seeing children infected with the delta variant present symptoms similar to those of the common cold or an upper respiratory infection -- headache, runny nose, sneezing and a sore throat are all common.
Less common symptoms include diarrhea and a change in taste and smell. Whether or not a child has a fever isn’t a reliable way to determine whether or not they are infected with the delta variant.
“You can have COVID-19 with or without a fever. There's plenty of people who have COVID who don’t even have a fever,” Gastaldo said.
Smith said she’s also seeing cold-like symptoms among pediatric COVID-19 cases. Richland Public Health attempts to contact every positive case in Richland County to conduct interviews on their symptoms.
“We’re seeing slightly different symptoms (with the Delta variant) especially in children,” she said. “We’re still seeing the cough and loss of smell and taste, but not as common. We’re more commonly seeing in children headache, sore throat, runny nose, sometimes a fever. We’re also hearing reports of ear aches.”
Gastaldo believes that despite the rise in COVID-19 cases among children, keeping kids in school should remain a public health priority.
“I think everybody agrees the priority is to keep kids in school. That's what's best for them,” he said. "It's best for learning and it's really suboptimal for people to get their learning through Zoom.”
To do that, Gastaldo believes schools should use every mitigation strategy available, including masks, contact tracing and adequate ventilation systems.
“Masks do have a role. None of the mitigation measures are perfect, but additively they work together,” he said. “Wearing a mask does no physiological harm to a child, in fact, somebody's life may be saved by wearing a mask.
“I would say for people who don’t want mask requirements, ‘Would you rather have your kid in school for their education or have them at home?’”
Smith agreed masks are one of the best prevention measures that we have right now, especially in individuals who are not vaccinated.
“It goes along with practicing proper hand hygiene, staying home when you're sick and social distancing,” she said.
Administrators from both districts said they hope the masks will keep schools from having to go remote.
Gastaldo believes vaccination also has a role to play in limiting pediatric COVID-19 cases.
“The more adults that are vaccinated, the fewer infections we’re going to see in kids. We need to vaccinate kids 12 and above,” Gastaldo said.
Studies done by the CDC argue that both individual vaccination and a high level of vaccination in the community can protect children from the virus.
During a press briefing on Sept. 2, CDC Director Rochelle Walensky discussed two recent studies on COVID-19 and children. The studies compared pediatric case rates, emergency room visits and hospitalizations during the winter surge, when vaccination rates were low, with this summer, when vaccination coverage had increased and Delta was the dominant variant of the virus.
“From late June to mid-August, in the context of low community vaccination coverage and the rapid spread of the Delta variant, cases for children and adolescents 17 and under increased by nearly 10-fold, which aligns with the increase seen for the general population,” Walensky said.
“Although we are seeing more cases in children and more overall cases, these studies demonstrated that there was not increased disease severity in children. Instead, more children have COVID-19 because there is more disease in the community.”
Both studies found that communities with a higher rate of vaccination have lower case rates among children -- even those too young to get vaccinated.
The second study found that in August 2021, the rate of hospitalization for children was nearly four times higher in states with the lowest overall vaccination coverage when compared to states with high overall vaccination coverage.
“Both studies — one thing is clear: Cases, emergency room visits and hospitalizations are much lower among children in communities with higher vaccination rates. Vaccination works,” Walensky stated. “As the number of COVID-19 cases increase in the community, the number of children getting sick, presenting to the emergency room and being admitted to the hospital will also increase.”
The first study, which analyzed data from hospitals in 99 counties across 14 states, also showed that the vaccine is highly effective at protecting children from severe COVID-19 outcomes.
“The hospitalization rate among unvaccinated adolescents, those aged 12 to 17, was nearly 10 times higher than that among fully vaccinated adolescents during the month of July,” Walensky said.