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As schools are about to begin new year, COVID cases trend younger

As the rate of new coronavirus infections climbs across the Tri-State area and nation, the age of people contracting the virus that causes COVID-19 is trending younger.

Schools are taking precautions against the spread of the virus in classrooms. Washington County Public Schools officials this week announced plans to start the school year with students and staff masked to prevent the spread of the virus. West Virginia health officials said earlier this month students in Berkeley and Morgan counties will be required to wear masks to school if the COVID-19 transmission rate surpasses 50 cases per 100,000 residents.

Health professionals in other parts of the country have said they are seeing more young people, particularly children, needing hospitalization as a result of infection.

COVID-19 vaccination is still not authorized for ages 11 and younger, but companies such as Pfizer and Moderna are working toward that.

The Food and Drug Administration provided emergency use authorization for the Pfizer vaccine to be available to ages 12 and older, and for the Moderna and Johnson & Johnson (Janssen) vaccines for ages 18 and older, according to the FDA's website.

Representatives of Tri-State area hospitals said this week they don't have any COVID-19 patients younger than 20 to 29 years old.

Although child cases remain rare locally, a spokeswoman said Meritus Health east of Hagerstown has seen the younger trend in age for those with COVID-19.

"The hospitalized COVID-19 patients have been younger on average recently as compared to six months ago," Joelle Butler wrote in email Friday. "Our current average age for COVID-19 inpatients is 60.5 years old, but we have 29-, 39- and 48-year-olds, nine in their 50s and five between the ages of 60-65."

Percentage of child cases rising

The American Academy of Pediatrics recently reported there were 121,427 new child COVID-19 cases reported in the United States between Aug. 5 and 12. Children made up 18% of the weekly reported cases across the country. The week prior, that figure was 15%.

Between July 29 and Aug. 12, there was a 5% increase in the total number of recorded child COVID-19 cases in the U.S., which stood at more than 4.4 million since the start of the pandemic, according to the Academy of Pediatrics.

A doctor in Escambia County, which is in Florida's Panhandle, told the Pensacola News Journal that he saw a 2-week-old baby with COVID-19 go into cardiac arrest.

The News Journal, which is part of the USA TODAY Network with The Herald Mail, quoted Dr. Jason Foland as saying he has recently seen more children, from newborns to teenagers, who are in the intensive-care unit or need critical care due to COVID-19.

"Eventually this is going to become such an issue for the children's hospital that we'll be limited in our capacity to take care of the other things, like a broken arm or appendicitis," said Foland, Studer Family Children's Hospital pediatrician-in-chief.

If severe cases warranted specialized care, Tri-State area hospitals could transfer pediatric COVID cases to hospitals similar to Studer, including Children’s National Hospital in Washington, D.C., and Penn State Health Children’s Hospital in Hershey, Pa.

Butler, the Meritus spokeswoman, said the Washington County health system would look to a children's hospital in extreme cases, but would manage less severe cases locally.

"We are seeing a rise in some other respiratory viruses, including a common seasonal virus called RSV (Respiratory Syncytial Virus infection)," she said Tuesday. "Many of the admissions have been due to this virus, which has some symptoms that mimic those of COVID-19."

WellSpan Health, based in York, Pa., also has inpatient pediatric units at its hospitals in Chambersburg and York, said Dr. Christopher Russo, director of pediatrics and medical director for quality and innovation for WellSpan.

"In the rare event that a child requires a higher level of care than can be provided at these two hospitals, arrangements will be made … to transfer the patient quickly to an available pediatric intensive care unit located at a dedicated children's hospital," Russo wrote in an email sent by the health system's communications office.

WVU Medicine, which operates medical centers in Berkeley and Jefferson counties in West Virginia, also has local facilities to care for youth COVID cases.

"We have provided inpatient care for COVID positive children who are stable and do not require mechanical ventilation on our pediatrics unit at (Berkeley Medical Center)," Barbara Sherman, system director of quality/patient safety for Berkeley and Jefferson medical centers, said in an email through the communications office.

But, like with Meritus and WellSpan, WVU Medicine would send certain child cases elsewhere if need be.

"If we had a child who required that level of intensive care, we would transport him/her to the closest facility with an appropriate open bed for that higher level of care," Sherman said.

A spokeswoman for Children's National acknowledged that the rate of new infections in children is increasing, mirroring the adult population, but said that hasn't meant an increase in hospitalizations.

"Children’s National has NOT seen an increase in the rate of hospitalized kids," Diana Troese, public relations manager for the hospital, said in an email Tuesday. "At this time, we do not see that the Delta variant is translating into a higher rate of kids being hospitalized, which is good."

Penn State Health spokesman Scott Gilbert on Wednesday reported there were no pediatric COVID inpatients at the facility. 

However, Gilbert noted in an email response that the hospital has received child COVID-19 patients during the pandemic.

"Penn State Health Children’s Hospital is the only children’s hospital between Pittsburgh and Philadelphia fully equipped to treat the most severely ill children of central Pennsylvania," he said.

Hospitals in West Virginia have good capacity in their intensive care units to treat COVID patients, said Jim Kaufman, president and CEO of the West Virginia Hospital Association.

The association, a not-for-profit organization representing 59 hospitals and health systems including WVU Medicine's Berkeley and Jefferson medical centers, has heard from hospitals who see 40% to 70% of their ICU beds taken up by COVID patients.

However, that strain is mitigated some because there are enough hospitals in the state to take patient transfers.

"One of the beauties of health care, and especially the hospital industry, is we work together," he said in a phone interview Wednesday.

"That said, hospitals are used to dealing with emergency situations. After 18 months, it's wearing on staff. … The most important thing a community can do to help its hospital at this point is get vaccinated."

What's causing more young people to contract the virus?

The younger trend is being fueled by those who have not been vaccinated, as well as variants of the coronavirus that are more easily transmitted between people, said Russo, the WellSpan pediatrics director.

"A larger percentage of seniors have received their COVID-19 vaccines than compared to younger patients, leading to a rapid spread of COVID-19 among individuals in their 20s, 30s, 40s, and 50s, predominantly those that are not vaccinated," he said, noting the average COVID case age of 66.2 years old is "quickly trending younger."

"The added wrinkle is that with Delta variant being more transmissible, even vaccinated individuals have the chance of spreading it to others who are not vaccinated, including children, even if they themselves never get seriously ill," Russo said.

At Meritus, unvaccinated people make up the majority of coronavirus patients.

"On average, more than 90% of hospitalized COVID-19 patients are unvaccinated for the virus," Butler said.

Russo said that as of Monday, 98% of hospitalized COVID-19 patients at WellSpan were not vaccinated.

"While breakthrough cases have occurred in those that are vaccinated, it is the unvaccinated individuals that are requiring a level of care that may lead to hospitalizations and death."

Published in The Herald-Mail, August 2021.

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