Enlarge / Boston Medical Center Child Life Specialist Karlie Bittrich sees to a baby while in a pediatrics tent set up outside of Boston Medical Center in Boston on April 29, 2020.

As COVID-19 cases skyrocket throughout the country, cases are also spiking in infants, children, and adolescents, and the group is now sharing more of the disease burden than ever recorded.

Cases in the young jumped 22 percent in the two weeks between October 29 and November 12, according to a new report from the American Academy of Pediatrics. The week ending on November 12 saw the largest one-week spike recorded in the pandemic, with 112,000 new cases.

There have now been more than 1 million cases in infants, children, and adolescents—collectively “children”—and the group is making up a larger proportion of cases than before. Children now make up 11.5 percent of total cases in the United States. At the end of July, children made up 8.8 percent of cases, up from 7.1 percent at the end of June and 5.2 percent at the beginning of June.

“As a pediatrician who has practiced medicine for over three decades, I find this number [of cases] staggering and tragic. We haven’t seen a virus flash through our communities in this way since before we had vaccines for measles and polio,” AAP President Sally Goza said in a statement.

On the positive side, severe COVID-19, hospitalizations, and deaths still appear relatively rare in children compared with older age groups. However, some children do develop severe disease and die. To date, more than 6,000 children have been hospitalized with COVID-19, and 133 have died.

With many children displaying little to no symptoms, the official case counts in children are likely an underestimate of disease burden. The data is also limited by inconsistent data collection and case definitions as well, the AAP notes. For children with mild to moderate disease, pediatricians are worried about the possibilities of long-term physical health effects. And the doctors are also worried about the mental health effects in all children.


“We know from research on the impact of natural disasters on the mental health of children that prolonged exposure to this kind of toxic stress is damaging,” Dr. Goza said. “We’re very concerned about how this will impact all children, including toddlers who are missing key educational opportunities, as well as adolescents who may be at higher risk for anxiety and depression.”

Those most likely to suffer the most from the disease and pandemic are Black and Hispanic children, the AAP notes. Black and Hispanic children are suffering higher rates of infection and severe disease, and they may be more vulnerable to economic harms and disruptions to educational and social services.

Of the 1,163 cases of multisystem inflammatory syndrome in children (MIS-C)—a rare but life-threatening condition associated with COVID-19 and marked by inflammation of various organs, including the brain, heart, and lungs—75 percent of cases were reported in Black and Hispanic or Latino children, according to data tracking by the Centers for Disease Control and Prevention. In all, 20 children have died from COVID-19-related MIS-C during the pandemic.

The AAP called for leaders to take immediate action to better protect children.

“We urgently need a new, nation-wide strategy to control the pandemic, and that should include implementing proven public health measures like mask wearing and physical distancing,” Dr. Goza said. “This pandemic is taking a heavy toll on children, families and communities, as well as on physicians and other front-line medical teams. We must work now to restore confidence in our public health and scientific agencies, create fiscal relief for families and pediatricians alike, and support the systems that support children and families such as our schools, mental health care, and nutrition assistance.”

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