It Turns Out Even Fewer Children Were Hospitalized for COVID Than Originally Reported

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Posted: May 20, 2021 3:15 PM
It Turns Out Even Fewer Children Were Hospitalized for COVID Than Originally Reported

Source: AP Photo/John Minchillo

What our children are being subject to because of this virus is tragic enough. Research has just come out which makes the masking, distancing, and school closures even more needless, though. "New Research Suggests Number of Kids Hospitalized for COVID Is Overcounted," David Zweig reported for Intelligencer. It was discovered that hospitalizations for children were overcounted by at least 40 percent.

That research applies to studies published in Hospital Pediatrics on Wednesday, with commentary from Dr. Monica Gandhi who is an infectious diseases specialist at the University of California-San Francisco, and Amy Beck, who is an associate professor of pediatrics there.

The reason is particularly frustrating because it just seems so sloppy. Emphasis is original:

They wrote, “Taken together, these studies underscore the importance of clearly distinguishing between children hospitalized with SARS-CoV-2 found on universal testing versus those hospitalized for COVID-19 disease.” The studies demonstrate, they said, that reported hospitalization rates “greatly overestimate the true burden of COVID-19 disease in children." Gandhi told Intelligencer that while the studies were both conducted with data from California hospitals, “there is no reason to think these findings would be exclusive to California. This sort of retrospective chart review will likely reveal the same findings across the country.”  

Do we really need a study telling us how about the "importance of clearly distinguishing between" someone being hospitalized with over someone being hospitalized for something? 

Both of these studies used data from California. Emphasis is mine:

In one study, conducted at a children’s hospital in Northern California, among the 117 pediatric SARS-CoV2-positive patients hospitalized between May 10, 2020, and February 10, 2021, the authors concluded that 53 of them (or 45 percent) “were unlikely to be caused by SARS-CoV-2.” The reasons for hospital admission for these “unlikely” patients included surgeries, cancer treatment, a psychiatric episode, urologic issues, and various infections such as cellulitis, among other diagnoses. The study also found that 46 (or 39.3 percent) of patients coded as SARS-CoV2 positive were asymptomatic. In other words, despite patients’ testing positive for the virus as part of the hospital’s universal screening, COVID-19 symptoms were absent, therefore it was not the reason for the hospitalization. Any instance where the link between a positive SARS-CoV2 test and cause of admission was uncertain the authors erred toward giving a “likely” categorization.

In the second study, at the fifth-largest children’s hospital in the country, out of 146 records listing patients as positive for SARS-CoV-2 from May 1, 2020, to September 30, 2020, the authors classified 58 (40 percent) as having incidental diagnosis, meaning there was no documentation of COVID-19 symptoms prior to hospitalization. Like the first study, and as has been typical around the nation, this hospital implemented universal testing of inpatients for SARS-CoV-2. An example of incidentally SARS-CoV-2-positive patients are those who came to the hospital because of fractures. Patients who may have had COVID-19 symptoms but who had a clearly documented alternative reason for them, such as a child with abdominal pain and fever found to be related to an abdominal abscess, were also deemed to have incidental diagnosis. The study categorized 68 patients, or 47 percent, as “potentially symptomatic,” which was defined as when “COVID-19 was not the primary reason for admission for these patients, and COVID-19 alone did not directly require hospitalization without the concomitant condition.” Examples of these patients were those with acute appendicitis, since that condition includes gastrointestinal symptoms that may also present in COVID-19.

And, with such generosity from the study author's it's likely higher than 40 percent. 

Stefan Baral, an infectious diseases epidemiologist, and physician at Johns Hopkins offers what might be the reason for the numbers being so off:

Explaining why the official tallies were found to be so far off, Baral said the electronic databases that hospitals use are administrative in purpose, meant for billing, resource management, et cetera. “They were not designed to infer the prevalence and severity of an infectious virus.” We have a desire for instant, accurate data, he said, but validation takes time. 

Zweig also pointed to a British Medical Journal article co-written by Baral, along with Wesley Pegden and Vinay Prasad. "Covid vaccines for children should not get emergency use authorization," they wrote on May 7, addressing "a different balance of risks and benefits than it did for adults." The opinion piece was originally published for Medium

"Unlike for adults, however, the likelihood of severe outcomes or death associated with covid-19 infection is very low for children, undermining the appropriateness of an emergency use authorization for child covid-19 vaccines," the authors write in the opening paragraph. 

That balance of risks and benefits may be complicated, because of how rare a "severe... outcome" would be:

Unlike for adults, the rarity of severe covid-19 outcomes for children means that trials cannot demonstrate that the balance of the benefits of vaccination against the potential adverse effects are favorable to the children themselves. In short, given the rarity of severe clinical courses and limited clarity of risks, the criteria for emergency use authorization do not appear to be met for children.

When the federal government is so hellbent on curbing vaccine hesitation, as are states with some particular incentives, perhaps they shouldn't be pushing it so hard on children. The authors conclude:

Even in the likely scenario that no significant adverse events materialize, we may still pay a price for the pursuit of emergency use authorizations for covid-19 vaccines in children. Controversy surrounding mass child vaccination under emergency use authorizations could feed vaccine hesitancy in the United States at a time when public attitudes towards vaccination are critical. A wide rollout of child covid-19 vaccines should follow the standard regulatory process as for most children, unlike adults, covid-19 vaccination is not addressing an emergency.

And yet the Pfizer vaccine was approved for children 12-15 years old on May 10. To show they were wasting no time, President Joe Biden and the CDC's Dr. Rochelle Walensky were rushing parents into getting their children vaccinated on May 12.

It's worth emphasizing that before these studies were released, the American Academy of Pediatrics already had hospitalizations for children at already such small percentages. 

  • Children were 1.3%-3.1% of total reported hospitalizations, and between 0.1%-1.9% of all child COVID-19 cases resulted in hospitalization

If the powers that be were being honest, there would be even less excuse to delay school re-openings. Dr. Fauci would also not be saying unvaccinated children need to wear masks to school for the fall, and summer camps would drop their mask requirements.