In-Depth: Do kids face more risk from the UK variant?

Kids in school in masks
Posted at 6:14 PM, Apr 06, 2021

SAN DIEGO (KGTV) -- The UK variant is fueling a surge in cases in several states and some health experts are sounding the alarm about the variant’s ability to infect kids.

The original version of SARS-CoV-2, the virus that causes COVID-19, largely spared children, but experts say kids are more susceptible to the highly transmissible B.1.1.7 variant.

However, scientists are still debating whether kids play an important role in the spread of B.1.1.7, and whether the variant causes more severe disease in children like it does with adults.

Over the weekend, epidemiologist Dr. Michael Osterholm made headlines by saying children infected by the variant were playing a “huge role” in the spike in cases in the Midwest.

“Please understand, this B.1.1.7 variant is a brand new ballgame,” he said. “These kids are really major challenges now in terms of how they transmit” the variant.

Dr. Osterholm pointed to states like Michigan, where B.1.1.7 is causing about 70 percent of the new infections and the latest state numbers show K-12 schools have had twice as many outbreaks as any other setting. The average age of hospitalized patients in that state is also decreasing, although hospitalizations of people under 18 remain rare.

Overseas, countries like Israel and Italy have reported spikes in the share of children testing positive relative to their overall caseload since the variant emerged. A hospital in the UK reported an increase in the number of children needing care.

But Rady Children’s Hospital pediatrician Dr. John Bradley says it’s important to put the numbers in context.

“This is not a reason to keep your kids from going to school,” he said. “Yes, B.1.1.7 spreads more. It spreads more in adults. It spreads more in kids. There is nothing unique about B.1.1.7 in children that I have seen from any published data.”

Dr. Bradley said the risk of infection isn’t just higher in children, it’s higher for everyone. A letter published in the British Medical Journal last week concluded that “mounting evidence from the USA and internationally indicates that school-age children do not contribute substantially to the spread” of variants.

And Dr. Bradley points out the data on kids could be confounded by several factors. As more schools reopen, children are undergoing more testing, making asymptomatic cases more likely to find their way into case totals.

The way hospitals report infections might also inflate the numbers. At Rady Children’s Hospital and others, doctors test every kid for the virus whether they come in for a broken bone or bronchitis.

Those who test positive for any reason are considered a “COVID-related hospitalization” in state and federal data even if they’re not showing symptoms of the disease, Bradley said.

“So half of our COVID-related hospitalizations, as we report them, aren't actually caused by COVID. They're incidental findings,” he said.

Vaccinations could be another factor. More and more adults are getting vaccinated, but there are no vaccines authorized yet for kids under 16.

“No kids below age 16 really are vaccinated outside of a clinical trial, so you just have a much more vulnerable population compared to those adults who have already been vaccinated,” said Dr. Christian Ramers of Family Health Centers of San Diego.

Before the UK variant emerged, studies estimated that kids were about half as susceptible to the virus as adults. One of the leading theories is that the virus may have fewer places to infect kids because children have fewer ACE-2 receptors, a feature on the surface of cells that is the coronavirus’s main entry point.

It’s not yet clear how much at risk school-age children are from B.1.1.7, but researchers estimate the variant is roughly 50 percent more transmissible overall.

Early research does not suggest B.1.1.7 causes more severe disease in kids like it does with adults. King's College Hospital in the UK had 60 pediatric cases in the second wave when the variant was common compared to 20 cases in the months prior, but after adjusting for other factors, the researchers “found no evidence of more severe disease.”

Bottom line, Dr. Bradley says schools can reopen and operate safely regardless of the variant -- as long as kids and teachers wear masks.