Analysis: our data analysis shows an increase in child cases, especially females, but low numbers admitted to hospitals 

By Carol Barron and Yvonne Corcoran, DCU

In Ireland, childcare facilities reopened towards the end of June 2020 for children of essential or frontline workers, while primary and post primary schools reopened nationally at the end of August or by early September. We've examined the Epidemiology of COVID-19 in Ireland daily reports in combination with the Covid-19 14 day Epidemiology Reports to look at the incidence of Covid-19 across various age groups since the schools have reopened. 

Covid-19 and children up to 4 years of age

The cumulative numbers of Covid-19 positivity in 0 to 4 year olds are low in comparison to all other age cohorts. 

In the four week period from August 2nd to August 31st, the test positivity rate increased by 44% for this age group, while the increase in cases from September 1st to September 28th was 70.3%. As social distancing measures are not possible within this cohort, the increase in cases is not unexpected. This increase is not mirrored in an increase in hospitalisation rate or admissions to ICU in this age cohort and occurred in the context of increasing cases in all age cohorts nationally.  There were no deaths in September in this age cohort and overall case fatality ratio is zero. 

Children aged from 5 to 14 years of age

The cumulative numbers of Covid-19 positivity in 5 to 14 year olds is slightly higher, but remains low in comparison to all adult age cohorts.

Using the month of August as a baseline, we saw an increase of 58.6% in test positivity in this age cohort. This is not associated with schools as they not yet reopened. From September 1st to September 28th, the percentage increase was 89%. This increase is not mirrored in an increase in hospitalisation rate or admissions to ICU and occurred in the context of increasing cases in all age cohorts nationally. There were no deaths in September in this age cohort and the overall case fatality ratio is zero.

What does the data saw about 15 to 24 year olds?

The 15 to 24 year old age group saw a significant increase in numbers from August, which was prior to the primary and post primary schools reopening. This category accounted for 9.01% of all cases in August, rising to 11.81% in September. This increase is not mirrored in an increase in hospitalisation rate or admissions to ICU and occurred in the context of increasing cases in all age cohorts nationally. There were no deaths in September in this age cohort and the overall case fatality ratio remains at 0.02%.

Again, using the month of August as a baseline, there was an increase of 27.7% in cases involving 15 to 24 year olds between August 2nd and August 31st. Secondary schools had reopened by September 1st and the increase in cases rose to 57.8% between then and September 28th.

More cases seen in females than males

There is a gender split in child Covid-19 cases. There are more confirmed Covid-19 cases in females across the last four months than males in in children up to 4 years of age (boys 51.3 - 143.3 per 100,000 and girls 52.5 – 161.9 per 100,000).

The picture is mixed for 5 to 14 year olds, with females having more confirmed cases in June and July and males having higher numbers of confirmed COVID-19 cases in August and September (per 100,00 of the population). There are many more confirmed COVID-19 cases in females (432.1 – 832.2 per 100,000) across the last four months than males (227.4 – 603.1 per 100,000) in the 15 – 24 year old group.

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'Children have a low hospitalisation, ICU admission and death rate from Covid-19'

In the first two weeks after schools re-opened, approximately 26% of national testing was conducted with children up to 10 years of age and the positivity rate in the second week was 1.9%. As of last week, the HSE report that more than 4,000 children and teachers have been tested for the coronavirus since schools re-opened with 264 cases in total linked to schools. This significant increase in testing numbers within the school aged population is a reflection of understandable parental, teacher, child and societal anxiety.

It is clear from the data to date that children have a low hospitalisation, ICU admission and death rate from Covid-19. However, the indirect effects stemming from over-burdened health systems, loss of household income due to pandemic-related unemployment and disruptions to child services may be substantial and widespread.

If we are to comprehend the true impact of this pandemic on child health, wellness and mortality, it is vital to understand the prevailing levels and trends in child infection rates, hospitalisations, ICU admissions and mortality rate over time. This will allow for a more comprehensive overview of the full impact of Covid-19 on the child population physiologically, psychologically, emotionally and educationally.

Dr Carol Barron is an assistant Professor in School of Nursing, Psychotherapy and Community Health at DCU. Dr Yvonne Corcoran is an assistant Professor (Children's Nursing) in the School of Nursing, Psychotherapy and Community Health at DCU.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ