Pediatric COVID cases increase, but hospitalizations remain low in kids

Coronavirus

HONOLULU (KHON2) — School is back in session, just as COVID-19 cases are reaching an all-time high.

The Hawaii State Health Department is now reporting daily pediatric cases. Since Saturday, Aug. 28, 757 cases have been reported in kids 17 and younger. Doctors say just like the coronavirus last year, children are not getting as sick as adults with the delta variant.

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“So many children we’re diagnosing, they don’t have any symptoms at all, basically, they’re asymptomatic,” explained Nadine Tenn Salle, Chief of Pediatrics at Queen’s Medical Center. “We’re testing them, maybe because they were exposed to someone else, or someone in the household was exposed, and lo and behold, they’re positive.”

One fully vaccinated mom tested positive for the virus and became sick with symptoms.

She works outside, doesn’t interact with people at work, is healthy and in shape, and isn’t 100% sure how she caught the virus. Although, she believes it could be from her daughter’s school.

“I don’t know for a fact. It’s impossible for me to know where I got it, but I do know that there are a lot of cases at my daughter’s school,” Courtney Khan said.

She said she started feeling sick on Saturday, Aug. 21, and took an at-home test that told her she was negative. She felt worse the following day and went by the airport but saw the long line of people waiting to be tested and felt it was a bad idea to stand close in line with other people; by Monday, Aug. 23, she drove to Castle Hospital and took a PCR test. On Tuesday, her result came back positive.

Her daughter never had symptoms or complained of not feeling well. The day her test came back positive, she took her temperature which said she had a fever. She recommends doing a wellness check with your child often.

“Wearing a mask. I mean, having big gatherings and events and things like that, we should not be doing this right now,” Khan said. “Like I am a healthy, young adult that’s vaccinated — and I got so sick.”

Lt. Gov. Josh Green’s family is going through a similar situation.

“Sam, my 10-year-old has a classroom that’s experiencing that,” Green said. “So he’s home for 10 days. So you can imagine that, yes, it scares us as parents, but he’s been fine. We’re doing fine, and that’s the struggle, right? In order to keep kids getting educated, getting good nutrition at schools, meeting their developmental milestones, we’re doing our best to keep spread from occurring.”

Green said the rate of transmission at schools seems to be much lower than in the community. He said close contacts of positive school cases need to quarantine for 10 days.

As for parents who are worried about their kids getting sick or who might have a pre-existing health condition: “In all those circumstances, the Department of Education has to continue to do more to provide distance learning,” said Green.

Doctors also recommend close contacts to test often.

“If there is a family member in a household who has been exposed, whether it’s a child or an adult, then you would want a test. The best practice would be to test everyone in that family to ensure that, so you do know who has it and who doesn’t have it,” explained Hilton Raethel, Healthcare Association of Hawaii CEO.

He also said family members could be on a different infection cycle. Just because one member tests negative, it doesn’t mean they can’t test positive the next day.

Green said it’s easier for the delta variant to spread in unvaccinated households.

“If their parents are unvaccinated, they’re certainly going to spread it to them,” Green said. “It would be very difficult to prevent spread in the household. You can try. Certainly you will isolate, but it’s hard to isolate away from your child.”

“The majority of vaccinated individuals that catch it, the majority, are mild or no symptoms at all,” explained Dr. Tenn Salle. “I never said that they couldn’t get sick — it’s just the majority.”

She said most pediatric cases are from unvaccinated households.

“We’re seeing a lot of the cases in the high schoolers and the middle schoolers, and I think it’s because they’re independent, and while we’re giving a lot of guidance to our children, they get to make a lot of decisions on their own,” she explained. “Whereas the preschoolers and the elementary school, you know, you give them rules, within reason they tend to follow, so I’m not seeing as many positive cases coming from the preschools, and I think it’s because they’ve created small lockdown pods. They have smaller classrooms, and they interact less with anyone other than their family, in their classmates, whereas the older kids are, they’re socializing on just a broader group of people.”

Dr. Ten Salle expects pediatric cases to rise due to the number of active cases.

“COVID is that prevalent in the community right now. It’s on a rise. We’re seeing an incredible uptick of positive cases. So we are going to see asymptomatic patients. We have to presume that it’s around us. And at some point in time, we’re going to be exposed to it. At least we’re going to know somebody personally, or it’s going to be in our household. That shouldn’t make you afraid,” she said.

Dr. Salle said people need to follow the basics: vaccinate, socially distance, wash their hands, and wear a mask. She also said 1% of children will end up in the hospital and 0.4% will become sick enough to require intensive care.

The state said there are currently two pediatric cases in intensive care statewide.

Find more COVID-19 news: cases, vaccinations on our Coronavirus News page

According to the CDC: Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3 to 5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should isolate if they test positive.

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