Hardest hit are the unvaccinated, a group that includes about 50 million children under the age of 12. Because there are more cases among children, more children also suffer from the most severe forms of the disease. According to the Centers for Disease Control and Prevention, an average of 216 children with COVID were hospitalized each day during the week ending August 6. At the (previous) peak of the pandemic in early January, it was 217. As for the severity of the disease in children, we are back in the worst days of the pandemic.
The hospital where I practice in Birmingham, Alabama is filling up quickly. We are treating almost twice as many COVID-positive patients as at the peak of the last peak in January. About a quarter of them are ventilated or heart-lung bypass (ECMO) machines. I hear similar stories from my colleagues in hospitals in the South, and we’ve all seen the news reports of children with critical, life-threatening illnesses who have to seek care in another state because their home hospital is out of space.
There’s a lot about the delta variant that we don’t know yet, but what we do know is bad. We know that delta is incredibly contagious. A person infected with the delta variant has 1,000 times more of the virus in their nose than people infected with the original form of the virus. On a contagious scale, only measles is more contagious. Presumably this is why delta is spreading so quickly, although there may be other ways the virus evolves to spread so much more easily. What that means for his rapid march across the South is part of the story that hasn’t been written yet. The adult delta data from other countries is discouraging and suggests that we should prepare for the increased risk of hospitalization and death.
Whether this also applies to children, we do not yet know. Are more and more children being hospitalized because this variant is more dangerous for individual children, or because the variant is more easily transmitted and therefore more people become ill in total? Either way, we end up in the same place, where really sick kids fill our hospitals instead of our classrooms.
If that scenario scares you as much as it scares me, I urge you to do what you can now. First, if you are 12 years of age or older and have not been vaccinated, apply for the vaccine as soon as possible. It is absolutely the best way to protect yourself and the children in your life, including those under the age of 12 who are not yet eligible for the vaccine.
Second, wear your mask. There is some evidence that masks are effective in preventing outbreaks in schools, hospitals and other places where people gather.
Although I am afraid, I also feel a lot of hope. We have some tools we can use now to protect ourselves and our communities. We just need the will to use them.
David W. Kimberlin, MD, is a professor of pediatrics in the division of pediatric infectious diseases at the University of Alabama at Birmingham.