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06 August 2021

Children, Death, and COVID

Warnings: I am not an infectious disease expert by any stretch, and it seems possible (though currently unclear) that the Delta variant seems to be changing much of what we know about children and COVID. But when you Google this stuff, I feel like you mostly find doom-and-gloom journalism, and I wanted to get a real sense of what was going on. I will say that I looked around for but could not really find anything high-quality on "long COVID" in kids; the data just doesn't seem to be there yet.

"Mortality and hospitalization data is pretty clear on children - extremely low mortality and hospitalization rate."
"Extremely low still means children dying. Even one is too many."

How Many Children Have Been Affected by COVID?

The American Academy of Pediatrics calculates that, as of 27 July 2021, 4,198,296 children in the U.S. have been reported by states as having COVID since the beginning of the pandemic, making children 14.3% of all cases. (This is based on data from 49 states, New York City, and three territories.)

As of the same date, 753,956 children have been hospitalized for COVID (based on data from 23 states and New York City). Children account for 2.3% of hospitalizations.

As of the same date, 358 children have died of COVID (based on data from 43 states, New York City, and two territories). Children account for 0.07% of all deaths; 0.01% of all child cases result in death.
 
See also this chart, showing how the vaccine changes your risk:
 

The chart comes from UK data in this Financial Times article, though the dot for "under age 18" does not appear in the source, and seems to have been added by someone on Twitter, citing data from this preprint. If we can believe it, that means someone under 18 has a lower risk of COVID death than a vaccinated 35-year-old. Also note that the chart uses a log scale.
 

How Does That Compare to Other Causes of Death for Children?

 
For purposes of comparison, note that going by the AAP data, 272 children died of COVID in the one-year period from August 2020 to July 2021 (in 43 states, NYC, and two territories).

According to a 2018 article from the New England Journal of Medicine, these were the top ten causes of death in children in 2016:
  1. Motor vehicle crash (4,074 deaths)
  2. Firearms (3,143) [includes homicide (1,865), suicide (1,102), unintentional (126), and undetermined (50)]
  3. Malignant neoplasms (1,853)
  4. Suffocation (1,430) [includes homicide (54), suicide (1,110), unintentional (235), and undetermined (31)]
  5. Drowning (995) [includes homicide (18), suicide (22), unintentional (928), and undetermined (31)]
  6. Drug overdose / poisoning (982) [includes homicide (19), suicide (123), unintentional (761), and undetermined (79)]
  7. Congenital anomalies (979)
  8. Heart disease (599)
  9. Fire / burns (340)  [includes homicide (38), suicide (6), unintentional (272), and undetermined (24)]
  10. Chronic low respiratory disease (274)
Note also that, according to the CDC, during the 2018-19 flu season, 199 child flu deaths were reported, from which they estimate there were actually approximately 434 child flu deaths.

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