By Emily Anthes
Pilar Villarraga had spent much of the summer counting down the days until her daughter Sophia’s birthday. In early August, Sophia would turn 12 — and become officially eligible for a Covid-19 vaccine. “I didn’t want her to start school without the vaccine,” said Ms. Villarraga, who lives in Doral, Fla.
And then, in late July, just two weeks before the milestone birthday, Sophia caught the coronavirus. At first, she just had a fever, but on July 25, after four quiet days convalescing at home, her ribs began to hurt. The next day, Ms. Villarraga took her to the emergency room, where chest X-rays revealed that Sophia had developed pneumonia. She soon began coughing up blood.
Sophia was promptly admitted to Nicklaus Children’s Hospital, in Miami.
Her parents, and their friends, were in shock. “I didn’t think that kids could get that sick,” Ms. Villarraga said.
But Sophia was one of roughly 130 children with Covid-19 who were admitted to a U.S. hospital that day, according to the Centers for Disease Control and Prevention. That number has been climbing since early July; from July 31 to Aug. 6, 216 children with Covid were being hospitalized every day, on average, nearly matching the 217 daily admissions during the pandemic’s peak in early January.
Sophia contracted Covid two weeks before turning 12,
when children are officially eligible to receive the vaccine.
And then, in late July, just two weeks before the milestone birthday, Sophia caught the coronavirus. At first, she just had a fever, but on July 25, after four quiet days convalescing at home, her ribs began to hurt. The next day, Ms. Villarraga took her to the emergency room, where chest X-rays revealed that Sophia had developed pneumonia. She soon began coughing up blood.
Sophia was promptly admitted to Nicklaus Children’s Hospital, in Miami.
Her parents, and their friends, were in shock. “I didn’t think that kids could get that sick,” Ms. Villarraga said.
But Sophia was one of roughly 130 children with Covid-19 who were admitted to a U.S. hospital that day, according to the Centers for Disease Control and Prevention. That number has been climbing since early July; from July 31 to Aug. 6, 216 children with Covid were being hospitalized every day, on average, nearly matching the 217 daily admissions during the pandemic’s peak in early January.
Yale doctors: Delta variant becoming more prominent in Connecticut (news12.com)
Hospitals in coronavirus hot spots have been particularly hard hit. On a single day last week, Arkansas Children’s Hospital, in Little Rock, had 19 hospitalized children with Covid; Johns Hopkins All Children’s Hospital, in St. Petersburg, Fla., had 15; and Children’s Mercy Kansas City, in Missouri, had 12. All had multiple children in the intensive care unit.
These numbers have sparked concerns that what had once seemed like the smallest of silver linings — that Covid-19 mostly spared children — might be changing. Some doctors on the front lines say they are seeing more critically
ill children than they have at any previous point of the pandemic and that the highly contagious Delta variant is likely to blame.
“Everybody is a little bit nervous about the possibility that the Delta variant could in fact be, in some way, more dangerous in kids,” said Dr. Richard Malley, a pediatric infectious disease specialist at Boston Children’s Hospital.
Most children with Covid-19 have mild symptoms, and there is not yet enough evidence to conclude that Delta causes more severe disease in children than other variants do, scientists said. What is clear is that a confluence of factors — including Delta’s contagiousness and the fact that people under 12 are not yet eligible to be vaccinated — is sending more children to the hospital, especially in areas of the country where the virus is surging. “If you have more cases,
then at some point, of course it trickles down to children,” Dr. Malley said.
Climbing cases
Many children’s hospitals had been hoping for a quiet summer.
Several run-of-the-mill childhood viruses are less common during the warmer months, and national Covid rates had been declining through the spring. But last month, as Delta spread, that began to change. “The number of positive Covid tests started to climb in early July,” said Marcy Doderer, the President and Chief Executive of Arkansas Children’s Hospital. “And then that’s when we really started to see the kids get sick.”
The vaccines are effective against Delta — and provide powerful protection against severe disease and death — but children under 12 are not yet eligible
for them. So as more and more adults get vaccinated, children make up an increasing share of Covid cases; between July 22 and July 29, they accounted for 19 percent of reported new cases, according to the American Academy of Pediatrics.
“They’re the unvaccinated,” said Dr. Yvonne Maldonado, a pediatric infectious-disease specialist at Stanford Medicine and chair of the A.A.P. Committee on Infectious Diseases. “That’s where we’re seeing all the new infections.”
From July 22 to July 29, nearly 72,000 new pediatric Covid cases were reported, almost twice as many as in the previous week, according to the association. At Johns Hopkins All Children’s Hospital, 181 children tested positive for the virus in July, up from just 12 in June.
Most of those children have relatively mild symptoms, such as runny noses, congestion, coughs or fevers, said Dr. Wassam Rahman, the medical director of the pediatric emergency center at All Children’s. “Most of the kids are not very sick,” he said. “Most will go home and be treated with preventive care at home. But as you might imagine, families are scared.”
A small share of children do develop severe disease, showing up at the hospital with pneumonia or in respiratory distress.
Of the 15 children with Covid-19 who were inpatients at Children’s Hospital New Orleans late last week, four — including a 3-month-old baby — were in intensive care, said Dr. Mark Kline, None of the children, including the eight who were old enough to be eligible, had been vaccinated.
“This Delta variant of Covid-19 is an infectious disease specialist’s worst nightmare,” Dr. Kline said. “And there’s just no sign that it has started to plateau.”
Some hospitalized children have other chronic conditions, like diabetes or asthma, that may make them more vulnerable to Covid, but doctors said that they also have seriously ill patients without any obvious risk factors.
Sophia, who was on her school’s track and cross country teams, was healthy and active before getting Covid, her mother said. Her parents were surprised by how quickly she deteriorated. “From one minute to another, she got super bad,” Ms. Villarraga said. “I said, ‘You know, I could lose my child.’”
After Sophia was admitted, doctors began treating her with the antiviral drug remdesivir, as well as antibiotics, steroids and a blood thinner. “From there,
it was a day-by-day thing,” Ms. Villaraga said. “Little by little, she got better.”
Sophia, like most children with Covid-19, is expected to make a full recovery, her mother said. (A small percentage of children may experience lingering, long-term symptoms often known as long Covid.) She was discharged on July 31 and celebrated her birthday several days later — at home, with an ice cream cake.
Delta differences
Ms. Villaraga was not told whether Sophia had the Delta variant, but
more than 80 percent of new cases in the United States are caused by Delta, the C.D.C. estimates, and doctors said that it is clear that Delta is behind the surge in childhood infections.
What remains unknown is whether children who are infected with Delta are actually getting sicker than they would have if they had caught a different variant — or if Delta, which is roughly twice as transmissible as the original virus, is just so infectious that many more children are getting sick.
There is some emerging evidence — mostly from data on adults — that Delta may cause more severe disease. Studies in Canada, Scotland and Singapore,
for instance, have suggested, variously, that Delta may be more likely to lead to hospitalization, I.C.U. admission or death.
But the research is preliminary, experts said, and there is not yet
enough good data on the severity of Delta cases in children.
Delta variant cases in Houston-area children!!!
“There’s no firm evidence that the disease is more severe,” said Dr. Jim Versalovic,the pathologist in chief and interim pediatrician in chief at Texas Children’s Hospital, in Houston, where about 10 percent of children now test positive for the virus, up from less than 3 percent in June. “We certainly are seeing severe cases, but we’ve seen severe cases throughout the pandemic.”
Although not all states report their pediatric hospitalization rates, the data
is available suggests that they have remained essentially steady for months. Nationally, roughly 1 percent of children who are infected with the virus end
up hospitalized, and 0.01 percent die, according to the A.A.P. data. Both hospitalization and death rates have declined since last summer.
It is still possible, of course, that Delta could turn out to cause more severe disease in children. Hospitalization rates, which are a lagging indicator, could rise in the weeks and months ahead. And the rare but serious inflammatory syndrome that develops in some children with Covid-19 can take weeks to appear.
“I think time will tell, really,” Dr. Rahman said. “We need at least a month, maybe two months before we get a sense of trends.”
But in the U.K., where Delta swept through the population before the variant became widespread in the United States, experts say they have not seen clear evidence that the variant is making children sicker.
“There was a wave, there were children who became unwell,” said Dr. Elizabeth Whittaker, a pediatric infectious disease and immunology specialist at Imperial College London. “But not in the kind of, ‘Oh, my gosh, this is very different, this is worrying.’”
Dual surges
Whether or not Delta turns out to be more severe, the variant is clearly driving a surge of new infections in both children and adults, especially in areas where vaccine coverage is low. “The rates among children are going up because the rates among unvaccinated family members in their homes are going up,”
Dr. Maldonado said.
And more infected children means more hospitalized children.
“It’s a numbers game at this point,” Dr. Versalovic said.
Making matters worse, many hospitals are also reporting a highly unusual spike in children with respiratory syncytial virus, a contagious flu-like illness that typically strikes in the fall and winter. R.S.V. cases were abnormally low last winter, likely because of lockdowns and pandemic precautions, but cases have been rising as officials lift restrictions and children begin to mingle.
Children’s Mercy Kansas City had nearly three times as many R.S.V. patients as Covid patients late last week, while Texas Children’s had nearly 1,500 positive R.S.V. tests in the last 90 days, hospital officials said.
“That has created a dual surge,” Dr. Versalovic said. “Because both
viruses are widely circulating, we’re seeing a much greater impact.”
The combination of R.S.V. and Covid has pushed Children’s Hospital New Orleans to capacity. “We haven’t had an empty bed in any of our intensive care units in six weeks,” Dr. Klein said.
It is not yet clear when children under 12 may be eligible for vaccination, but in the meantime, experts said, the best way to reduce the danger to children, and relieve the stress on hospitals, is for older children and adults to get vaccinated, which will help curb Delta’s spread.
“The safest way to never find out whether Delta is more aggressive to children than the original strain is to really enhance vaccination,” Dr. Malley said.
1988 Yellowstone wildfire – Bing video
ELHistSoc – Crossing the River, by Bicycle, Foot, Car or Wagon without the use of Bridges or Boats (east liverpool historical society.org)
(1) 1908 ohio river dried up – Bing
1908 ohio river dried up:
#ClimateReport – Twitter Search / Twitter
U.N. Panel Issues Stark Climate-Change Warning (msn.com)
MLB power rankings: Phillies surge to first place, Mets fall apart in NL East (msn.com)
WMO: New climate report is a clarion call for urgent action | World Meteorological Organization
#ClimateChange is rapid, widespread and intensifying, says new #IPCC#ClimateReport With every additional amount of global warming, changes get larger. This is a clarion call for urgent and sustained #ClimateActionhttps://bit.ly/2VH2TMW
The Intergovernmental Panel on Climate Change #IPCC is the leading world body for the assessment of #climatechange.
The #IPCC released its latest #ClimateReport today, #ClimateChange 2021: the Physical Science Basis. ipcc climate report – Bing video “The role of human influence on climate system is undisputed.” – Working Group I
Co-Chair @valmasdelIPCC (@IPCC_CH) / Twitter
Report 
https://bit.ly/WGICC2021
Watch the video, 
(1) World Meteorological Organization – Bing video
(2) physical science base on climate change – Bing video
(3) The Intergovernmental Panel on Climate Change – Bing video
#ClimateReport
We live in unprecedented times… #IPCC#ClimateReport
Struggling to grasp #IPCCReport2021? I doodled this little explainer before a similar report in 2019. Might help. Let’s hope #COVID19 has done us a favour in understanding how to #bendthecurve#ClimateEmergencyLorna Gold – Climate Generation
The new UN climate report proves what we’ve already known: humanity’s obsession with material progress at the expense of ethical or moral considerations toward people or earth has put us on a path to doom.
Incremental approaches to such an emergency are useless.
Eat less meat, travel less, buy less, share, enjoy what you’ve got, think of others, stop making things extinct, before we are.
At the risk of being smug, I have – Gone veggie (9 yrs) – Stopped flying (5 yrs) – WFH (3 yrs) – Public transport when I can – Electric car when I can’t – Green tariffs I know not everybody can do all of these things. You can all do at least 4, right now
Really chilling calls on @mrjamesob from listeners about when they realised the severity of the #ClimateEmergency on a personal level. As one caller said, it’s one thing to research the crisis and write papers, it’s another to drive through a forest fire near your home.
Though the photo may look cool, it’s not the meeting point
of the Atlantic and Pacific oceans https://bit.ly/379Qrrj
Social media photo shows glacial runoff hitting Gulf of Alaska,