How often are Canadian kids actually getting seriously ill or dying from COVID-19?
Youth make up 20% of Canada's cases in the pandemic, but less than 2% of hospitalizations
It would be any parent's worst nightmare during this pandemic: a child contracting COVID-19, falling seriously ill and dying.
Tragically, that's been the reality for multiple Canadian families this year. In Ontario this month, a 13-year-old girl infected with the virus died at her home in Brampton. Earlier in April, the deaths of two children were tied to COVID-19 complications — a 16-year-old in Quebec, and a toddler in B.C.
And in January, B.C. also had its youngest death yet from the illness: a baby who died from COVID-19 while being treated at the children's hospital.
The harrowing headlines may give parents pause, but how much are children and teens actually at risk from this virus during the pandemic's third wave?
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Thankfully, though variants are circulating and cases in many regions remain high, including among younger Canadians, serious illness or death among youth remains rare. Even so, medical experts do say parents need to remain vigilant in the months ahead — since it'll be a while before Canadian kids get the protection of vaccinations.
Are more kids and teens getting COVID-19 now?
There is emerging data showing that, yes, more young people are now getting infected, hospitalized, and even dying from COVID-19.
Earlier this year, as virus transmission ramped up, Quebec health authorities warned more adolescents and children were being admitted to hospital with COVID-19, totalling around one per cent of all COVID-related hospitalizations — double that of the first wave.
In Ontario, provincial data shows only three COVID-19 deaths have taken place among people 19 and under over the course of the pandemic.
Various hospitals, however, are now experiencing a spike in youth admissions.
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"I would say that in the first two waves of COVID-19 at our hospital, at SickKids, we were seeing maybe one or two children in hospital at any one time," said Dr. Jeremy Friedman, associate pediatrician-in-chief at Toronto's Hospital for Sick Children.
"Now we see maybe four children in hospital at any one time. But these are very, very, very small numbers when you consider the population — the size of the population — that we're serving."
Friedman says it's largely because community transmission levels remain stubbornly high, resulting in more infections across the board for anyone who's not yet vaccinated, but he stressed the number of serious cases among kids does remain "extremely low."
So are youth now getting sicker from this virus?
Medical experts say recent instances of serious COVID-19 infections faced by Canadian youth are likely tied to the overall rise in cases in the general population.
"You're looking at very small proportions of very sick children," said Ottawa-based pediatric infectious disease physician Dr. Nisha Thampi.
"But when we're seeing increased transmission in the community, we can expect to see more kids and youth with rare complications of COVID-19."
At a country-wide level, children and youth have made up nearly 20 per cent of COVID-19 cases but less than two per cent of hospitalizations, and very few of the country's roughly 25,000 deaths over the course of the pandemic — eight in total.
At the same time, there's emerging evidence that variants of concern could be both more transmissible and more capable of causing serious illness. But that doesn't seem to be translating to more severe symptoms among kids.
One U.K. analysis, published in the medical journal the Lancet in mid-February, compared the effect of the B117 variant — first identified in that country — with the initial strain of the coronavirus. The researchers found "no evidence of more severe disease" in children and young people.
Friedman agreed there hasn't been any major change in the dynamic for Canadian youth.
"I think that COVID-19 in children is still, in the vast majority of cases, a pretty mild illness," he said.
What serious COVID-19 symptoms in children should parents watch out for?
While severe cases and deaths associated with COVID-19 remain rare among children and teens, medical experts say there are certain symptoms that should prompt concern.
Dr. Christopher Sulowski, chief of the pediatric emergency department at McMaster Children's Hospital in Hamilton, Ont., said for any child infected with the coronavirus, it's important to make sure they stay hydrated by drinking fluids regularly. Excessive vomiting, or fewer trips to the bathroom, are typically associated with dehydration, he said.
If a child shows those warning signs, it's worth a trip to the hospital.
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Parents should also monitor for any changes in their child's breathing. If it seems unusual or laboured, Sulowski said that's cause for concern. And if a child is coughing to the point where they can't catch their breath, or struggling to breathe in general, it's time to seek prompt medical attention as well.
In some cases, COVID-19 symptoms can progress quickly, so Sulowski said any parent who feels their child may be in distress should go with their gut.
"We always acknowledge the fact that parents do know their kids best," he said.
How should parents navigate the months ahead while children remain unvaccinated?
More parents will be getting their shots in the months ahead, but children and teens will remain unprotected for the foreseeable future, and many adults still won't have full immunity yet.
So what does that mean for families navigating a second summer of pandemic life in Canada, whether that's attempting vacation plans or mixing kids from different households for social outings or day camp, if local restrictions allow?
Unfortunately, since this virus will still be circulating and most Canadians won't yet have full immunity, Thampi said it will be important for families to maintain protective measures in their daily lives — including minimizing interactions with people from outside their home, physical distancing and mask-wearing.
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That means gathering indoors with other families for a cottage weekend or a child's birthday party remains a no-go because of the risk level, said Dr. Peter Juni, scientific director of Ontario's COVID-19 Science Advisory Table.
But that doesn't mean kids should stay cooped up all summer long. Juni stressed both kids and adults should feel free to socialize outside with precautions in place, including wearing a mask if you're spending extended time around others, even it's just children playing in close quarters at a playground.
According to medical experts, the rare and tragic deaths of Canadian kids from COVID-19 offer a reminder to all families to remain vigilant.
"I think it is a wake-up call that kids are vulnerable," Thampi said.
- An earlier version of this story reported that more people in Ontario under the age of 20 have died of COVID-19 during wave three of the pandemic than in either wave one or wave two. In fact, only three COVID-19 deaths in total have been reported in Ontario in the 19 and under age group since the start of the pandemic.Apr 29, 2021 6:51 PM ET
With files from Marcy Cuttler, Christine Birak