How will the delta variant affect kids? Experts explain what we know and what we don't
Manitoba doctor says higher community vaccination rates can reduce illness burden for those under 12
As Manitoba parents get ready to send their kids back to school next month, a critical question remains unanswered: What effect will the delta coronavirus strain have on kids too young to be vaccinated?
"It's a timely question obviously," said Dr. Jeff Burzynski, a pediatric intensive care and emergency physician at Winnipeg's Children's Hospital. "As we're seeing a lot of media reports coming out of the southern U.S. in particular of … higher numbers of infections in children, particularly with the delta variant."
There are no approved COVID-19 vaccines for children under the age of 12 and that's raising concerns about what a surge in the more infectious delta variant could mean for kids. Chief Public Health Officer Dr. Theresa Tam warned last month that Canada could be seeing the start of a delta variant-driven fourth wave of COVID-19.
Burzynski said in areas where COVID-19 case numbers increase, there's likely also to be an uptick in the number of children who test positive. He expects community vaccination rates to play a role.
"I think that's a message that needs to be very clearly said: that the higher our community vaccination rates, the lower the burden of illness will be in children," he said.
At this point, Burzynski hasn't seen any kids hospitalized in Winnipeg due to the delta variant. He said approximately 10 young people have been admitted to Winnipeg's Children's Hospital's intensive care unit with COVID-19 since the start of the pandemic, and one of those patients died.
Burzynski said the vast majority of kids who get infected with COVID-19 will have mild symptoms or no symptoms. And while delta is more contagious, he said there hasn't been evidence that it makes kids sicker than other variants.
'A very different virus'
Regina infectious disease physician Dr. Alexander Wong said the rise in delta variant cases in the U.S. is concerning, as the variant is far more contagious and much more easily transmitted.
"Delta has just kind of changed completely our understanding of SARS-CoV-2 and it's a very different virus," said Wong.
Wong said there are still many unknowns around how kids experience COVID-19.
"When you let tens of thousands of kids or hundreds of thousands of kids get COVID then some of them are going to have a bad outcome," said Wong. "And we don't even know what that is going to look like right now because it's all just kind of evolving before us."
He thinks the principles that have been in place in schools to reduce transmission of COVID — such as masking, hand hygiene and testing those who are symptomatic — should remain in place until vaccines become available to the majority of children under 12.
Manitoba released its back to school plan late last week. Some of the previous COVID-19 public health measures in schools have been lifted, including the requirement to wear masks — though they are still strongly recommended.
Manitoba's chief public health officer Dr. Brent Roussin said last week the province can reintroduce a mask mandate if necessary.
Learning from the U.S.
Wong said Canada still has a few weeks before schools open and hopes provinces will follow the science and adapt quickly if needed.
"We're going to learn a lot more about what's going to happen in schools with kids and how COVID affects kids because the U.S. is having it happen, literally now," he said.
"And I don't think the U.S. experience is going to be a positive one. It already isn't."
Dr. Stephen Freedman, a professor of pediatrics and emergency medicine and the Alberta Children's Hospital foundation and professor of child health and wellness at the University of Calgary, is currently leading two studies looking at the effects COVID-19 is having on children.
Freedman said generally speaking, in most provinces in Canada children under 12 are the largest unvaccinated population, so they will be at risk of contracting COVID-19.
While he doesn't want to minimize the risk, he said the proportion of children with an acute COVID-19 infection who need intensive care is well below one percent.
"So, one in a thousand or even less," said Freedman.
Though he points out another risk linked to the disease known as multi-system inflammatory syndrome in children (MIS-C).
He said MIS-C can affect a child's heart and the arteries that feed the heart.
"Those children can become quite sick," he said. "Although it's an uncommon complication of COVID infection. Nonetheless most of those children still do very well and recover from a short-term scary illness that they will have."
He said right now it's important for adults to get vaccinated and parents should make sure their children are immunized when they're eligible.
In the meantime, he said parents can minimize the risk of their kids getting infected.
"While I don't think we need to walk around paranoid about it and we do need to normalize life for our children and our families and our loved ones to a large degree, I still think we need to be cognizant of the risk of infection."
He said that includes doing activities outdoors and wearing masks in crowded places, particularly when other people's vaccination status is unknown.
He also supports requiring mask use in school settings, given it's likely there will be a rise in delta cases in the coming weeks and months across Canada.
"It's 50 per cent more transmissible than the alpha variant, which is the variant that drove the third wave, which means it is extremely transmissible," said Freedman. "If you're in a classroom with other individuals with mild symptoms not wearing masks you can count on it being transmitted."
Burzynski said based on the current epidemiology in Manitoba and high vaccine uptake, he supports the idea of a mask recommendation rather than a mandate in schools for now.
He said Manitoba's plan to run a school-based COVID-19 immunization campaign is a good step. But he thinks allowing those who will turn 12 this year the chance to get vaccinated before their birthday is another way to improve vaccine coverage.