Now more than ever, the role of a parent or caregiver entails supporting children and young persons in battling both the flu and SARS-CoV-2 infection. As flu season approaches and the pandemic continues, we offer insight into a parent’s worst nightmare: mortality rates of flu and COVID-19.
Understanding the potential scale of the challenge in fighting deadly respiratory infections remains paramount in managing our day to day lives in a pandemic. It is important to consider the potential impact of experiencing the flu and SARS-CoV-2 simultaneously.
On rare occasions, children die from the flu. According to the Centers for Disease Control and Prevention (CDC), between 2004-2018, pediatric flu-related deaths of children each year have ranged from 37 to 188 deaths.
One exception during this period is noteworthy. In the period from April 2009 to September 2010, we experienced 358 pediatric flu-related deaths as the H1N1 pandemic raged. The CDC reported that nearly 80% of these pediatric deaths occurred among children without full vaccination.
The CDC noted that not all pediatric flu-related deaths are reported, however. To address this limitation, they developed statistical models to estimate actual number of deaths. For example, during the 2017-2018 time interval, 188 flu-related deaths were reported to the CDC. However, their model estimated that nearly 600 flu-related deaths occurred during this period.
We have more information about the flu virus than SARS-CoV-2, as it has been more prevalent over the years. A recent CDC report discusses the impact of COVID-19 on people 21 years and younger, who make up about 26% of the population in the United States. The report tracks SARS-CoV-2 cases from 50 states, New York City, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands. During the period between February 12 and July 31, there have been 391,814 cases of COVID-19 in those 21 years and younger, with the first case reported in March, as well as the first death.
During this time period, 121 COVID-related deaths were documented among people 21 years old or less, the majority, at 45%, were Hispanic persons, followed by 29% non-Hispanic Black persons and 4% American Indian or American Alaskan persons. Seventy percent of the 121 deaths occurred in people aged 10 to 20 years old, while people aged 1 to 9 years old accounted for 20% of the total. Additionally, males represented 63% of the death count.
Of the 121 deaths discussed in the study, 25%, or 30, reported no underlying health problems, 75%, or 91 people, had at least one underlying condition, while 45%, or 54 people, had at least two. The most common underlying conditions included asthma, obesity, neurologic and developmental conditions, and cardiovascular issues.
The findings suggest that Hispanic and non-Hispanic Black groups are disproportionately impacted by the virus among younger populations. While providing a useful snapshot, the study is limited, as case-based surveillance data underestimates cases of COVID-19 as compared with aggregate case reports from states. In particular, data on cases by race/ethnicity are not comparable, and case fatality rates by race/ethnicity cannot be calculated. This limitation demonstrates the need for additional research related to the impact of COVID-19 on racial and ethnic groups.
As the flu season beckons, it is imperative for schools, colleges, community partners, and health care providers to collaborate in order to reduce the negative impact of the social determinants of health, such as limited access to health care services due to a lack of insurance, child care, transportation, or paid sick leave.
In addition, young persons experiencing crowded living conditions, food and housing insecurity, poverty, education inequities, and racial discrimination have increased risk of COVID-19 disparities. Avoiding and surviving respiratory disease among our youth and young adults requires individual and collective investment.
Read this CDC report at https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e4.htm?s_cid=mm6937e4_w.
William F. Tate IV is the executive vice president for academic affairs and provost at the University of South Carolina; Educational Foundation Distinguished Professor in the Departments of Sociology and Family & Preventive Medicine. Find him on Twitter @WFTate4.
Kally Xu is a John B. Ervin Scholar and Gephardt Institute Civic Scholar at Washington University in St. Louis, where she is a candidate in the 3-2 Masters of Public Health in the George Warren Brown School of Social Work and the A.B. program in International and Area Studies and Asian American Studies.