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

For two weeks, children and teachers have been able to remove their masks at school in accordance with the latest health protocol. But at the same time, the epidemic is starting to grow again: the number of new cases per day has doubled in the past two weeks. Faced with this epidemic resurgence, some factories are backtracking and taking the initiative to make masks mandatory again. This is the case, for example, of several establishments in Finistère, one of the departments with the highest incidence rate leveled over seven days, close to 1,900 per 100,000 inhabitants on 25 March.

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

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

According to the latest data from Public Health France, on 24 March the leveled incidence rate over seven days between the ages of 10-19 stood at 1,546, slightly more than in the rest of the population. In contrast, the incidence rate in children under 10 was slightly lower, with 978 cases per week for every 100,000 children. The virus therefore circulates in the same proportions in minors and adults.

If, on the other hand, we extend to the entire fifth wave, that is, from the beginning of November, children are in fact more contaminated: the incidence rate between 10-19 year olds has approached 7,000 at the height of the surge, almost double the population in its together. This is the age group that reached the highest incidence rate, just before the under 10s. This can be explained by the protocol in place at that time at the school, which required testing all students in the class three times when a child tested positive. This protocol has been lightened and now only one test is needed for the Covid positive student’s classmates.

An increase in hospitalizations to put into perspective

Apart from the positive cases, it is above all the risk of a severe form that worries the parents. The number of Covid-positive and hospitalized children was in fact much higher since the beginning of the fifth wave than the previous ones. At the end of January, over 1,150 children were hospitalized for Covid, a figure that had never exceeded 200 before. As of March 24, 501 children were still hospitalized with Covid.

If this sharp increase is worrying, these figures must still 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. Furthermore, these figures count all people admitted to hospital with Covid, but do not specify whether this disease is the main reason for their hospitalization. A child admitted to hospital for another reason, but tested positive on arrival at the hospital, is then counted in these figures.

However, one point deserves attention: the increase in cases of Pims (pediatric multisystem inflammatory syndrome). It is a serious complication characterized, according to the High Health Authority, by “high fever, marked deterioration in general health and digestive signs”. Public Health France notes in its latest report of 24 February “a very marked increase in the number of PIMS cases since the beginning of December 2021 and this number remains high at the beginning of 2022“. In detail, 226 cases of Pims linked to Covid have been identified between 21 November 2021 and 20 February 2022, or more than a quarter of all Pims cases since the beginning of the pandemic.

The effect of the influenza epidemic on pediatric emergency attendance was much more spectacular than that of Covid “, nuance however Christèle Gras-Le Guen, president of the French Society of Pediatrics, contacted by franceinfo. “Covid is not really a serious pediatric problem”. According to SPF’s latest Oscor bulletin, just under 1,000 children under the age of 15 went to the emergency room on suspicion of Covid in the week of March 14-20, compared to more than 4,000 for the flu.

Uncertainties on the long Covid

Long Covid refers to the persistence of Covid symptoms for at least twelve weeks after an infection. Uncertainties about this disease persist for children as well as for adults because it is often difficult to attribute or not to Covid symptoms that occur several weeks or months after the infection. The conclusions of the various studies agree that children can suffer from this pathology, but the advanced figures vary greatly.

In early March, a British study (in English) it had to be quite reassuring by estimating that only 1% of 5-11 year olds and 3% of 11-18 year olds suffered from Covid for a long time. But an American study (in English), released on March 13, says more than a quarter of children show symptoms of Covid long after infection. In France, the High Authority for Health estimates that the frequency of long Covid is lower in children than adults and that 2 to 5% of children suffer from it after contracting Covid.

Infant deaths remain exceptional

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

As for hospitalizations, Christèle Gras-Le Guen wants to be reassuring: “The fifth wave has infected far more babies than the previous ones, so we may have had babies who died from something else after testing positive. There are also children with chronic illnesses, in whom Covid-related fever could trigger a disease crisis and ultimately lead to death. But adult-like children’s journeys, with a death linked only to Covid-19, are extremely rare, if not almost non-existent.

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