For two weeks, children and teachers have been able to remove the mask at school in application of the latest health protocol. But at the same time, the epidemic is picking up again: the number of new daily cases has doubled over the past two weeks. Faced with this epidemic rebound, some establishments are backtracking and taking the initiative to make the mask compulsory again. This is for example the case in several establishments in Finistère, one of the departments with the highest incidence rate smoothed over seven days, close to 1,900 per 100,000 inhabitants on March 25.
But then should we worry about the health of children? Are they more affected than adults? Have the serious forms multiplied among the youngest?
An incidence rate close to that of the rest of the population
According to the latest figures from Public Health France, the incidence rate smoothed over seven days among 10-19 year olds stood at 1,546 on March 24, slightly more than in the rest of the population. Conversely, the incidence rate in children under 10 was somewhat lower, with 978 cases per week per 100,000 children. The virus therefore circulates in the same proportions in minors and in adults.
On the other hand, if we extend to the whole of the fifth wave, that is to say since the beginning of November, children have indeed been more contaminated: the incidence rate among 10-19 year olds has come close to the 7,000 at the height of the surge, almost twice as many as the population as a whole. This is the age group that has reached the highest incidence rate, just ahead of the under-10s. This can be explained by the protocol put in place at that time at the school, which required testing all students in the class three times when a child tested positive. This protocol has been lightened and only one test is now necessary for the classmates of the Covid-positive student.
An increase in hospitalizations to be put into perspective
Beyond the positive cases, it is above all the risk of a serious form that worries the parents. The number of children positive for Covid and hospitalized has indeed been much higher since the start of the fifth wave than during the previous ones. At the end of January, more than 1,150 children were hospitalized with Covid, whereas this figure had never exceeded 200 before. As of March 24, 501 children were still hospitalized with Covid.
If this significant increase is worrying, these figures must nevertheless be put into perspective: the 501 people under the age of 20 hospitalized on March 24 represent only 2% of the 20,000 people hospitalized with Covid. In addition, these figures count all the people admitted to hospital with Covid, but they do not specify whether it is this disease which is the main reason for their hospitalization. A child hospitalized for another reason, but tested positive when arriving at the hospital, is therefore counted in these figures.
However, one point deserves attention: the increase in the number of cases of Pims (pediatric multisystem inflammatory syndrome). This is a severe complication characterized, according to the High Authority for Health, by “a high fever, a marked deterioration in the general state of health and digestive signs”. Public Health France notes in its latest report of February 24 “a very marked increase in the number of Pims cases since the beginning of December 2021 and this number remains high at the start of 2022”. In detail, 226 cases of Pims linked to Covid were identified between November 21, 2021 and February 20, 2022, i.e. more than a quarter of all Pims cases since the start of the pandemic.
“The effect of the influenza epidemic on the attendance of pediatric emergencies has been much more spectacular than that of Covid”, nuance however Christèle Gras-Le Guen, president of the French Society of Pediatrics, contacted by franceinfo. “Covid is really not a major pediatric problem.” According to the latest Oscour bulletin from SPF, just under 1,000 children under the age of 15 went to the emergency room for suspected Covid the week of March 14 to 20, compared to more than 4,000 for the flu.
Uncertainties about the long Covid
Long Covid refers to the persistence of Covid symptoms for at least twelve weeks following an infection. For children as for adults, uncertainties persist about this disease because it is often difficult to attribute or not to Covid symptoms occurring several weeks or months after infection. The conclusions of the various studies agree that children can suffer from this pathology, but the figures put forward vary greatly.
At the beginning of March, a British study (in English) was intended to be rather reassuring by estimating that only 1% of 5-11 year olds and 3% of 11-18 year olds suffered from long Covid. But an American study (in English), published on March 13, claims that more than a quarter of children show symptoms of Covid long after their infection. In France, the High Authority for Health estimates for its part that the frequency of long Covid is lower in children than in adults, and that 2 to 5% of children suffer from it after contracting Covid.
Child deaths remain exceptional
Covid-related deaths among those under 20 are extremely rare, but have increased in recent months compared to the start of the epidemic. Since November 1, 2021, the start of the fifth wave, 27 deaths of people under 20 positive for Covid have been recorded, more than the 20 deaths recorded during the four previous waves, according to figures from Public Health France. Four children have died while infected since the beginning of March.
As on hospitalizations, Christèle Gras-Le Guen wants to be reassuring: “The fifth wave infected many more children than the previous ones, so we may have had children who died of something else after being tested positive. There are also children with chronic illnesses, in whom the fever due to Covid could trigger a crisis of the disease and ultimately cause death. But the journeys of children similar to those of adults, with a death linked only to Covid-19, are extremely rare, if not almost non-existent.