Return to classroom still recommended by experts despite uptick in pediatric covid hospitalizations

Despite a slight increase in pediatric covid-19 hospitalizations at UPMC Children’s Hospital of Pittsburgh, health experts said they think students can safely return to the classroom for the upcoming school year.

Pediatric covid-19 hospitalizations have increased slightly over the past month, although the number of children admitted to UPMC Children’s Hospital remains in the single digits, said Dr. Andrew Nowalk of the hospital’s Division of Pediatric Infectious Diseases.

Still, as the school year approaches, he said children — who tend to experience milder cases of covid-19 than adults — can safely return to the classroom with mitigation measures in place.

Nowalk declined to give a specific figure on how many children were currently hospitalized with the virus, saying the hospital has seen the number “fluctuate day to day,” but he said it isn’t as high as it was during a covid-19 peak in December and January. But he said the number has been higher than it had been in recent months.

“That’s just been in the last couple of weeks,” Nowalk said.

UPMC Children’s Hospital has been seeing pediatric covid-19 patients from across Western Pennsylvania throughout the pandemic, he said.

Allegheny Health Network does not have a pediatric inpatient unit for kids falling ill from covid-19, said Dr. Divna Djokic, a pediatric infectious disease clinician with AHN. Children who require hospitalization, she said, are sent to UPMC Children’s Hospital.

Excela Health, based in Greensburg, directed questions about pediatric covid-19 cases and hospitalizations to Children’s Hospital.

Nowalk said children who are hospitalized with covid-19 typically present “many of the same symptoms that we see in adults,” such as a fever, cough and headache, but they are less likely to be hospitalized.

“Pediatric covid, as we see it, tends to be less severe, on average, than adults who have covid,” he said, adding that children also tend to have shorter hospital stays and a quicker recovery time. Long-haul symptoms, he said, are not nearly as frequent in kids as in adults.

But that doesn’t mean covid-19 can’t make children sick, he said.

At Children’s Hospital, some children have required ventilators, though “not frequently,” Nowalk said. He declined to say whether any current patients were on ventilators.

Some patients who developed Multisystem Inflammatory Syndrome (MIS-C) have been “very sick” and required intensive care, Nowalk said.

Children still are less at risk of severe infection or hospitalization than adults, but pediatric covid cases climb slightly when community-wide cases rise. Nowalk attributed the slight uptick in pediatric hospitalizations to the spike in covid-19 cases throughout the region. Despite concerns about variants such as the highly transmissible delta variant, which has fueled a recent surge in cases, particularly in places where vaccination rates are low, Nowalk said there’s no evidence to suggest variants pose an additional threat to children.

“I think it’s not the variants that increase the risk. It’s how many people in the community are getting sick at the same time,” he said.

Children younger than 12 still don’t have access to vaccines, which means they remain more susceptible to the virus than fully vaccinated adults, Djokic noted.

Most children hospitalized for covid-19 have been unvaccinated, Nowalk said.

Despite the spike in virus cases in the community and among children, Djokic said schools should plan a return to the classroom as a new academic year begins in the coming weeks.

“Most health officials, including the American Academy of Pediatrics, we all agree it’s very important for students to go back to school,” Djokic said.

Transmission in schools, she said, remained lower than in the surrounding communities last year.

School districts should consider mitigation measures such as masking, social distancing and encouraging vaccines for students who are old enough to be inoculated, Nowalk said. He said he believes local school districts should institute a mask mandate for all students, regardless of vaccination status.

“With good mitigation techniques — masking and distancing and vaccination — school districts can open and have class in person, which is very important,” he said.