Kids could bear the brunt of the COVID pandemic come fall, N.J. experts warn – NJ.com

The edge in the doctor’s voice carried a warning.

Dr. Lawrence Kleinman did not mean to interrupt the question. But he broke in before it could be asked, emphatically dispelling the notion that children are not vulnerable to the coronavirus.

“Can I stop you for a second?” said Kleinman, not really asking. “I think that’s a myth.”

From the early days of the pandemic, children have been viewed as having only mild cases of COVID-19, if they got sick at all. But the professor and vice-chair for academic development in the Department of Pediatrics at Rutgers New Jersey Medical School contends that thesis is wrong.

And it’s why he worries about next school year, when New Jersey and other states plan to send nearly every student back into the classroom.

“I think it’s always been a risk for kids. Kids have always been a vulnerable population,” Kleinman told NJ Advance Media. “Kids have always been spreading. And kids have always been getting sick, and we keep saying that they’re not.

“This pandemic began with the myth that children are spared, and we’ve never gotten it fully out of our head, even though every time there’s evidence, it steers us to recognizing the risk of and for kids.”

That could pose a serious problem in September.

Nearly 3.5 million children have tested positive for the coronavirus since the onset of the pandemic, according to the American Academy of Pediatrics and the Children’s Hospital Association. More than 92,000 cases have been reported in New Jersey.

Almost 64,000 U.S. cases were reported just from March 25 to April 1 — 18.2% of the national total.

A growing number of those infections are caused by variants, experts say.

The United Kingdom strain — the highly contagious B.1.1.7 variant that originated in Britain — continues to spread across New Jersey, one of the factors fueling the third wave of the pandemic. It shows increasing infectivity among young people, experts say.

“Our understanding of the variants and how they’re affecting kids is really emerging right now,” said Stephanie Silvera, an epidemiologist and professor at Montclair State University. “So there does seem to be evidence in particular that (the) U.K. variant seems to be sort of overcoming the challenges of infecting children. So they’re more likely to be infected and transmitting.”

Based on early data, people between 20 and 40 were believed to be the biggest spreaders of the U.K. variant, she said.

“Now that’s starting to shift a bit younger, especially for this U.K. variant,” Silvera said.

Children can be infected with the coronavirus, get sick and spread it, the Centers for Disease Control and Prevention says — even if fewer kids have been sickened compared to adults.

While most children with the coronavirus have mild symptoms or no symptoms at all, some children can get severely ill from COVID-19. Seven children have succumbed in New Jersey alone.

And more than 110 kids have also suffered from multisystem inflammatory syndrome in children (MIS-C), a post-COVID-19 inflammatory condition. Nearly 3,200 cases and 36 deaths have been reported nationwide.

The CDC sounded the alarm Monday about recent outbreaks involving young people “related to youth sports and extracurricular activities,” said Director Rochelle Walensky. CDC guidance calls for limiting those activities, even if the rise in child infections has not resulted in a surge of pediatric hospitalizations.

But hope is on the way — at least for older kids.

A COVID-19 vaccine approved for 12 to 15 year olds could be on its way, maybe even in time for the fall. Pfizer/BioNTech’s vaccine showed 100% efficacy among young adolescents in clinical trial results, the companies announced last week. They said they plan to submit the data to the U.S. Food and Drug Administration for expanded emergency use authorization of the two-dose vaccine.

The Pfizer/BioNTech vaccine is currently approved for people 16 and older.

But experts are less hopeful about a vaccine for kids younger than 12 — at least in time for September.

Pfizer/BioNTech launched another study of its vaccine only last month in children 6 months to 11 years. Moderna is also testing its vaccine in kids, running separate clinical trials involving children 6 months to 11 years and 12 to 17.

Although Silvera is hopeful those 12 and up will be vaccinated, “that still doesn’t address elementary school children,” she said.

That’s why Kleinman is concerned about kids returning to school.

“I think that you’re not going to have the early school-aged kids and the preschool kids (vaccinated),” he said.

Kleinman said he’s not opposed to reopening schools provided it’s done safely. But he’s wary that every school will be able to ensure social distancing, ventilation and mask-wearing.

New Jersey schools have documented 240 COVID-19 outbreaks and 1,070 cases this academic year despite precautions — as well as several districts that never reopened their classrooms.

Kleinman disagrees with the CDC on two issues: that 3 feet of separation in classrooms — instead of 6 feet — is safe and that vaccinated people can mingle with others who have not been inoculated.

“Unfortunately, to my mind, the CDC is missing the nuance in this,” Kleinman said. “And the nuance is if your bubble is vaccinated, it’s OK to do these things. But it’s not OK if the other folks whom you’re in contact with in your bubble are not all safe. Then you have to take precautions.”

Kids also can spread the virus, and come September, problems could arise.

“I think everybody’s acting from a good place — let me be very clear about that,” Kleinman said. “I think nobody is looking to get kids infected. But we carry this myth of kids aren’t important in the pandemic with us, and therefore we don’t even think about it. It’s just not top of mind. And I think that’s really harmful and dangerous.”

Dr. David Cennimo, an infectious disease expert at Rutgers New Jersey Medical School, said he’s not against reopening schools. But like Kleinman, he has concerns.

To reopen safely, protocols will need to be followed rigorously, he said.

“CDC did put out a fair bit of data showing that schools were safe,” Cennimo said. “Now, what I think everyone needs to keep in mind is that they showed the schools were safe with precautions in place.”

Cennimo referred to a recent CDC study showing low COVID-19 transmission in 20 elementary schools that had reopened in Salt Lake County, Utah. But the CDC conducted the investigation between early December 2020 and Jan. 31 — a time, Cennimo noted, when the variants were less prevalent. That’s a major factor to consider, he said.

“Those precautions that were done and seem to have worked were done in the setting of the COVID virus circulating in the U.S. at that time, not one of the variants we are seeing now,” Cennimo said.

But the problems extend beyond the classroom, experts say.

If restrictions continue to ease, if masks increasingly come off faces, and if adults and families begin gathering, younger kids who have not been vaccinated will be at risk, according to Kleinman.

“While the vaccines do clearly reduce infection and hugely reduce death, and they reduce transmission as evidence is showing, they do not eliminate these things,” he said. “And so now the kids are going to bear the brunt of adults loosening up and working out their COVID fatigue with one another.”

Silvera fears supply and demand will be an issue when a vaccine is approved for kids, just as it has been for adults.

“There’s still a number of people over the age of 65 who haven’t been able to get their vaccine in New Jersey, even though they’ve been eligible for a while,” she said.

Silvera also worries about vaccine hesitancy.

“We’re not only going to have to address supply and demand issues,” she said, “but overcoming issues of vaccine hesitancy, which we’ve seen with adults, and I think will be even greater when we’re starting to shift towards vaccinating children.”

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Spencer Kent may be reached at skent@njadvancemedia.com.