Over half a million reported child COVID-19 cases in the United States

By Dr. Ananya Mandal, MDSep 10 2020

The American Academy of Pediatrics (AAP) and the Children's Hospital Association have come up with a joint report on the number of children affected by COVID-19 across the United States. Over half a million children have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), they point out. Their report titled, "Children and COVID-19: State Data Report," was released on 3rd September 2020.

Image Credit: Avid Tadevosian / Shuutterstock

What was the report about?

The report covers a total of 49 states. The age-wise distribution of the COVID-19 cases was gathered from New York City, DC, Puerto Rico, and Guam. Age-wise distribution of all the children tested for SARS-CoV-2 infection was obtained from eight states, and 23 states also provided data on children with SARS-CoV-2 who were hospitalized. Complete information on deaths based on age stratification was collected from 43 states and NYC.

Problems faced in collating the data

The report states that the main problem was the different content, formats, and metrics of data that was submitted from different states.

One of the significant differences in the reports was the definition of a "child." Different states had different age ranges defining a child. Some defined a child as those under 14, some under 17, some under 18, some under 19, and some under 20. This created confusion especially when the data obtained from the states was not age classified. A significant chunk of missing information was children that were not tested but infected. NYC was found not to have age-stratified the data reported on children while age distribution was reported in only 8 percent cases from Texas.

Overall reports

From the total data obtained from different states, there were a total of 513,415 total child COVID-19 cases reported. Children with COVID-19 formed 9.8 percent of the total case burden in the United States - 513,415 of the total 5,265,157. The overall rate of infected children in the country was 680 cases per 100,000 children in the population.

Between 20^th August 2020 and 3^rd September 2020, 70,630 new child cases were reported. This is a 16 percent increase in 2 weeks, says the report (from 442,785 to 513,415).

Among the total state tests conducted, children made up a total of 4 to 14.3 percent of tests. The tests were positive among 3 to 17.3 percent of children. Children formed 0.7 to 3.7 percent of all hospitalized patients from the 23 states and NYC that reported the data. Children formed 0 to 0.3 percent of deaths due to COVID-19. A total of 18 states reported no deaths among children. In other states, there were only 19 cases of deaths among children.

Cumulative percentage of child cases

Of the total 513,415 cases of COVID-19 among children, 9 states reported over 15000 cases of COVID-19 in children. Half of the states reported over 7000 cases of COVID-19 in children. Six of the states had less than 1000 cases among children. Thirty-two states have reported 10 percent or more cases of COVID-19 among children. In New Jersey and New York, less than 3.5 percent of cases were children.

While the overall rate of childhood COVID-19 was 680 child COVID-19 cases per 100,000 children in the population, in 19 states, the rate was 650 cases per 100,000 children.

Expert speak

American Academy of Pediatrics President Dr. Sally Goza said in a statement, "These numbers are a chilling reminder of why we need to take this virus seriously... While much remains unknown about COVID-19, we do know that the spread among children reflects what is happening in the broader communities." She added, "A disproportionate number of cases are reported in Black and Hispanic children and in places where there is high poverty. We must work harder to address societal inequities that contribute to these disparities."

Dr. Sean O'Leary, the vice-chair of the AAP Committee on Infectious Diseases, said in his statement, "This rapid rise in positive cases occurred over the summer, and as the weather cools, we know people will spend more time indoors. Now we are heading into flu season. We must take this seriously and implement the public health measures we know can help." He added, "That includes wearing masks, avoiding large crowds, and maintaining social distance. In addition, it will be really important for everyone to get an influenza vaccine this year. These measures will help protect everyone, including children." As per the AAP and US Centers for Disease Control and Prevention (CDC) recommendations, all children over six months of age should get their flu shots.