The delta variant has led to a rise in Covid-19 cases and hospitalizations among children, many of whom are not yet eligible to be vaccinated—and the situation has some providers concerned about how the variant affects children. 

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Cases rise in children amid delta surge

According to CDC data, Covid-19 cases among children have been increasing since early July. In the past week alone, 216 children on average were hospitalized with Covid-19 every day—almost matching the 217 daily hospitalizations among children at the pandemic's peak in January, the New York Times reports.

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And although vaccines are effective against the coronavirus, including the delta variant, children under 12 are not yet eligible to be vaccinated. As a result, as more adults get vaccinated, children are beginning to make up a greater share of new coronavirus cases.

According to the American Academy of Pediatrics (AAP), children accounted for 72,000 new Covid-19 cases, or 19% of all new cases, between July 22 and July 29.

While most children who contract Covid-19 experience relatively mild symptoms, such as a runny nose or fever, some children have experienced more severe symptoms and need to be hospitalized. Hospitals experiencing Covid-19 surges have been particularly affected, the Times reports, with children's hospitals in Arkansas, Florida, and Missouri reporting numerous hospitalizations and multiple children in the ICU.

Some doctors have reported seeing more critically ill children now than at any other point of the pandemic, a trend they say may stem from the highly contagious delta variant.

"Everybody is a little bit nervous about the possibility that the delta variant could in fact be, in some way, more dangerous in kids," Richard Malley, a pediatric infectious disease specialist at Boston Children's Hospital, said.

Is delta worse for children?

Although some studies suggest the delta variant may be more likely to lead to hospitalization, ICU admission, or death in adults, it is still unclear whether the same is true for children, according to the Times.

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"There's no firm evidence that the disease is more severe," Jim Versalovic, pathologist in chief and interim pediatrician in chief at Texas Children's Hospital, said. "We certainly are seeing severe cases, but we've seen severe cases throughout the pandemic."

In addition, available pediatric hospitalization data suggests that Covid-19 hospitalization rates among children have been essentially the same for months. Nationwide, around 1% of children with Covid-19 end up hospitalized, and 0.01% die, according to data from AAP.

Ultimately, however, it is likely too soon to tell whether the delta variant causes more severe disease in children, the Times reports. Hospitalization rates could still rise in the weeks going forward, and cases of a rare but serious inflammatory syndrome in children may not develop and be reported until weeks later.

"I think time will tell, really," Wassam Rahman, medical director of the pediatric emergency center at Johns Hopkins All Children's Hospital, said. "We need at least a month, maybe two months before we get a sense of trends."

In the meantime, experts say that the best way to reduce cases among children and reduce the burden on hospitals is for older children and adults to be vaccinated.

'I just never want to go through that again'

In addition to concerns about the delta variant, many doctors are seeing children, including those who only had mild or even asymptomatic infections—experience lingering post-Covid symptoms, otherwise known as "long Covid."

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These symptoms vary but can include fatigue, headaches, memory problems, changes in taste and smell, and more, the Times reports. Although estimates of how many children are affected by long Covid vary, a study cited by Francis Collins, director of the National Institutes of Health, suggested that between 11% and 15% of youths who had Covid-19 will experience long-term symptoms.

"We don't yet have any sort of good predictors of who will be affected, how much they'll be affected and how quickly they'll recover," Molly Wilson-Murphy, a neuroinfectious disease specialist at Boston Children's Hospital, said. "We don't have any sort of magic treatment."

According to the Times, symptoms of long Covid can be debilitating for children, disrupting their schoolwork, sleep, extracurricular activities, and even mental health.

For example, one young Covid-19 patient in Dallas, Will Grogan, a 15-year-old student, tennis player, and Eagle Scout, said after he was infected with the coronavirus in October 2020, symptoms caused him to struggle in class to the point that he worried if he would ever be a high-performing student again.

"I'm not really a dramatic guy, but it's turned me into much more of a worrier,” Grogan said. "My idea of Covid before I got it was, 'You know what, if I get it, I'll get it over with and I'll have the antibodies and I'll be good.' But oh, my gosh, I just never want to go through that again. Never." (Anthes, New York Times, 8/9; Belluck, New York Times, 8/8)