Doctors worry about disparities in children of color
Ana Amira Rivera celebrated her first birthday on Thursday. But earlier this month, her mother feared her little girl might not succeed.
Ava woke up one night in early August with a fever and seizures. Estefani Lopez rushed her to the emergency room, where her daughter stopped breathing, becoming limp in her arms. The otherwise healthy baby has been diagnosed with COVID-19.
Doctors stabilized Ava and said she needed to go to intensive care immediately, but there were no beds. All of Houston’s pediatric intensive care units were full. It was helicoptered up close, 150 miles away, to Temple, Texas.
“My heart has collapsed,” said Lopez, 22. “I felt like I was going to lose my daughter before she was even 1 year old.”
While serious illnesses, hospitalizations and deaths from COVID-19 are still considered rare in children, those of color like Ava have been disproportionately sickened. And with cases climbing as the contagious delta variant tears apart the unvaccinated, health experts fear what’s to come.
COVID-19 vaccines are not yet available for children under 12, and with the reopening of schools, more and more children are becoming infected. In Florida, where new cases are leading the nation and Governor Ron DeSantis has banned school districts from imposing masks, children have made up about 10% of cases since the start of the pandemic, according to the American Academy of Pediatrics.
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At national scale,children accounted for more than a fifth of the COVID-19 cases reported during the week ending Aug. 19, the AAP reported. In the past two weeks alone, cases in children have increased by 7%. Doctors expect it to get worse.
Science is still catching up with the pediatric surge, but experts worry about children of color, who disproportionately suffer from lack of access to health care, obesity and other chronic conditions, and COVID-19 too. The gap is likely to persist.
“I don’t see a reason why it wouldn’t be,” said Dr. Sean O’Leary, pediatric infectious disease specialist in Denver, Colorado and vice chair of the AAP Committee on Infectious Diseases. “These children are at a higher risk of hospitalization in general.”
People of color have disproportionately higher hospitalization rates in all age groups, including children under 18, according to the Centers for Disease Control and Prevention.
From the start of the pandemic until last month, black, Hispanic, American Indian and Alaskan native children have all been hospitalized about three times as often as white children and teens, according to the CDC.
To date, more than a third (34.8%) of the more than 450 children and adolescents who have died from COVID-19 were Hispanic, according to CDC figures. Almost a quarter (23.3%) were black, even though black children make up only 13% of American children. Hispanic children make up about 25%. White children, who make up half of American children, made up less than a third of those who died.
And more than half – 63% – of children reported with the rare but severe multisystem inflammatory syndrome associated with COVID-19 were Hispanic or black, according to CDC data.
Dr Cindy Darnell Bowens, who oversees the pediatric intensive care unit at Children’s Medical Center in Dallas, said the medical community is working to determine which children are most at risk of becoming seriously ill.
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“We are concerned about children who do not have access to treatment, to routine follow-up visits, to preventive care, to obesity, to asthma, to diabetes,” she said. “I am concerned that these children are more likely to fall seriously ill from this disease and other illnesses.”
Across the medical center, more than three dozen children were hospitalized with COVID-19 on Wednesday, a spokeswoman said. While touring intensive care that day, Darnell Bowens, also a professor of intensive care at the University of Texas Southwestern, said she saw many children with these comorbidities.
“We are seeing a significant number of obese adolescents with respiratory failure due to COVID,” said Darnell Bowens. “There appears to be a link with the severity of the disease and obesity, but it is difficult at this point to say how causal this link is.”
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Pediatric pulmonologist and professor of pediatrics, Dr. Deepa Rastogi specializes in asthma in children of color and asthma linked to obesity at Children’s National Hospital in Washington, DC. suffering from obesity could be at higher risk of COVID-19.
Rastogi said it’s possible to infer that the same racial disparities seen in adults could continue in children.
“For the sake of the children I care for, I hope this is not the case,” she said.
New York City pediatrician and member of the American Academy of Pediatrics Dr Judith Flores said it was adultsto get vaccinatedto ensure that children are surrounded by a “good protective community”.
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“The most important thing for them is to make sure that as many people around them are vaccinated,” said Flores, who provides COVID-19-related education to Latin American communities. “If you look at it nationally, the risk is determined by your locality, the risk is determined by your community, as well as the infection rate and the vaccination rate.”
Experts like Darnell Bowens are fighting against the clock to keep children alive and healthy, and to learn more about COVID-19.
“I feel like we all need roller skates,” she said. “With admissions and discharges, our ongoing surgeries and resuscitation of the children, we’ve gone down to 15 out of 10. We’ve been operating at full capacity for weeks now.”
Lopez wants people to buy into the mask warrants and get the shots. She said it’s the least adults can do to protect others, especially children and babies who can’t effectively wear masks.
“You might be able to fight it, but my daughter almost died of it,” she said.“Our children, they have their whole life ahead of them.”