This virus also has a number of animal hosts, which is one reason it won’t be eradicated. As other said, it doesn’t “seek out” anyone, it’s an equal opportunity infector. When encountering a vaccinated person, a previously infected person, or (maybe) someone like a younger person with stronger innate immunity, the immune system kicks in and eliminates the virus before it can replicate on a larger scale.

I have no idea how to find that, and I suspect some knowledge of Portuguese would be needed. But fact-checking the numbers still wouldn’t say anything to me about the P1 variant. A difference in proportion could be something as simple as that they are very good about counting Covid child deaths, which are probably less likely to be undercounted anywhere as they are more rare, but are undercounting adult Covid deaths, because the country was on fire with Covid. It’s too simple to say variant more virulent for children, especially when there is other evidence to the contrary. You also cannot compare two countries directly that are so different. I found a study on pediatric Covid and MIS-C in 5 Latin American countries that was mentioned in a related March NYT article about kids dying in Brazil. And this was published in January, so cases occurred long before the February surge of P1 in Brazil. It appears that they hardly tested anyone at all in those countries, (and this series was from major institutions!), because almost HALF of the 409 (can’t even fathom this low number, from over 14 different hospitals in 5 countries) of PCR positives were hospitalized, and 23% of them had MIS-C. Yet they comment some of their colleagues in some countries were too overwhelmed to get data submitted in time, and they say that didn’t even collect a lot of the lab data on these kids that would have been done on pediatric cases in other countries. 🙁 They attribute poor outcomes to socioeconomic factors, but again wonder about genetic differences since the Hispanic population is very much over-represented in MIS-C cases in the US. https://journals.lww.com/pidj/Fulltext/2021/01000/COVID_19_and_Multisystem_Inflammatory_Syndrome_in.1.aspx The suffering of those in less advantaged countries compared to what we have available to us is almost unfathomable.

Mostly it is, but there are some posters here who have said they want masking until children can get vaccinated in the fall, and even some of the places that still have mask mandates now either have a date to remove them soon, or a metric, or are talking about stopping in a couple of weeks. So this isn’t only about the CDC guidelines. I think the official guidelines on masking children under 12 will change as cases fall further, but right now, you are right, they are unvaccinated and are recommended to mask. But with no mandates, more people are going to gradually stop doing it, anyway. The changes just happened, and it takes time for people to loosen up. I know it’s shocking, 😂 but many people also aren’t following pandemic developments as closely as they once did, and as people on the forum still do. There are pragmatic folks, probably trending younger, who will do what’s required at whatever place they are wanting to enter and not worry about it from there. They are thinking, okay, so what are the rules this week?

Well, I really don’t know. Those two papers from Brazil suggested that mortality was not higher for kids. I can’t go by a few newspaper articles and assume they must have it right, while thinking that the people collating the data are the ones who are mixed up. Our own experts aren’t warning it is definitely more virulent for kids; in fact, no one seems to be talking about it anywhere, except *journalists* who are in the business of getting us to click. How do I even know their fact-checking got the numbers correct? These days, I do not. The number you quoted for percentage of pediatric deaths in the US, you got from googling, right? First thing that came up for me, too, only I don’t think that number is correct, because I took another minute and looked at actual numbers, not the ones that article used, which I think were from two asynchronous time periods. The article in another thread is another example of this. An official in Singapore is quoted as saying that the reason they are closing schools is that some of the virulents are worse for kids, and the “Indian” variant is implied. But the very next sentence says that the few kids who have contracted Covid have very mild disease or are asymptomatic! And this is taken as another reason to freak out that the variants are coming and all of our kids will end up in the hospital. But there is never anything to back it up. The same thing happened early on with B117, a few news reports that it was worse in kids, first in the Uk, then when it came here. But that was false. The fear-based reporting on variants has been insane.

A letter published on considerations for the vaccination of children. https://www.bmj.com/content/373/bmj.n1197?utm_source=twitter&utm_medium=social&utm_term=hootsuite&utm_content=sme&utm_campaign=usage Some excerpts.

One seems to be good so far, but people in the know say you need two doses of mRNA for better T-cell responses, especially CD8+, and that may be more important for longer term immunity and protection against variants. Adenovirus vectored vaccines have better T-cell development with the first dose, or so I read. And I know nothing about Novavax. When will we ever see Novavax? I am more interested in that one, if the youngest kids are to be vaccinated, as it seems to have fewer side effects.

Dr. Tufecki’s newsletter is good, too.https://www.theinsight.org/p/the-few-sentences-that-explain-much I am probably missing some of the subtleties on this, but I think some of this dichotomy is overblown and maybe is more of a scientist “turf war” thing in the semantics of it. I have heard experts acknowledge all year that transmission is over dispersed and that some part of the transmission comes from smaller particles. It was never a dichotomy of droplet vs. aerosol, from what I could see. What has been said for many months is that contact tracing has shown that most infections happen with relatively close contact, which is reflected in the R0. Some occur because of further spread through air, but if more did, we would have a measles situation with a very high R0. I have seen ventilation stressed since at least last summer, but the trouble was that most everyone was stuck on their disinfecting, plexiglass, and 6 feet protocols already from March 2020. We have known that almost no transmission happens outside and that we don’t need masks outside for a year, but outdoor masking became a symbol.

From what I have read, there are school studies that support masking, and some that don’t. I think if they could figure out factors like ventilation and filtration and get down into the nitty-gritty of what is happening in the school, those things might matter more. Little kids in a cloth mask in the same room for hours with each other, every day- the aerosol work seems to suggest that ventilation might be more important than cloth masking in that situation (just my non-expert take). Dr. Hoeg, who published the Wisconsin schools paper, posted some screenshots on Twitter from this group of schools, with four million students, where masks vs. no masks for students don’t seem to show a difference, though this isn’t controlled. https://covidschooldashboard.com I would love to see Disney World numbers! I wonder if they have any way for people to report if they got sick within a certain time frame of their visit, to keep track of those numbers privately. That is one more good thing about lower numbers; they can better study viral transmission in outbreaks again.

I’m making a prediction that by some time in June, if cases continue to be at this level or declining more, CDC will say that children under 12 can also be unmasked in most places. And it will come with an announcement that there is new science, but really it is what they already know now. They do these things step-wise, and they will wait for the end of the school year. I could be wrong, but I am reading the tea leaves. 🙂 Bookmarking post to check back in a few weeks.

I saw an interesting chart from CDC data. It was organized by death rate per 100,000, not infection rate, so doesn’t directly speak to your examples. They listed both death rate and 97% of reduction of that death rate, by age. I presume the 97% is reduction of risk of death if vaccinated? I’m not sure. Anyway, it is always stark to see the age differentials. The risk of a *vaccinated* person over 35 is still higher than an unvaccinated child under 12, and gets to be many times higher the older you go, even though the absolute numbers are very small. Not wanting to contribute to a mask debate, but how much we estimate they help makes a difference in how useful we think masks are as an additive. When not everyone is wearing them anymore, it is not a source control question, but protection to the wearer. The only trial we have for that did not show a 50% benefit for a surgical mask, so I assume it is less than 50%, and from all the many previous mask studies for influenza, I assume much less than 50%, perhaps negligible to up to 20-30% tops. I would not put my faith in any efficacy for a single cloth mask. And I do think there is some element of faith, or belief, involved. It’s all a guess until you have trials. There is some sort of mask study being done in Guinea-Bissau. It would be nice if public health could have a real number estimate for any future infection control efforts. I wonder about this, too. Nobody thinks we will see a big wave again here, but there could be smaller ones. It’s just so unclear how much natural immunity a given place has. Last summer the southern half of the US had spread. That was before anyone was immune, and now that more are, they are saying it will be more seasonal. When we had the 2009 pandemic, there was a lot of sickness over the spring and summer, outside of the usual flu season, but after that it went back to a fall/winter illness.

I don’t know too much about their normal health care capacity. When they were going through the worst time, I was reading articles about how they still have remote areas there with a lot of indigenous people and no hospitals in those areas, and no way to get to a hospital. But I’m under the impression that some of the other countries in that part of the world have some of the same problems. I did not see much reporting on Peru, which had a very high death toll. It is hard to know what really happened in Brazil from just the reports we get here. I think politics and variants are the reasons we heard more about that country than some others.

I thought that was the point you were making. The article posted, and others published about the same time, were talking about children being severely affected in Brazil. I pointed out a quote that said deaths were 0.5% of the total, and you noted that this is quite a bit higher than the proportion of child deaths for the US (even though I don’t know if either number was accurate, but agreeing Brazil’s is reported as higher without digging into it). If Brazil has lower absolute Covid death numbers than the US, but higher absolute numbers of pediatric deaths, and the claim is that this is because of the variant, aren’t you saying that the variant has a proportionately higher level of virulence for children compared to wild type, than it does for adults?

Lots of thoughts. I agree about younger kids being okay around just family for a while. There is a point for most school-aged kids where this changes, though. We are now over a year, and it’s the second end of school year with limitations. Someone compared to polio epidemics, but those were during the summer; kids weren’t limited from school and activities for over a year. It’s just a lot. I’m concerned about people unmasking a few weeks too soon. I don’t think masking was ever going to happen through the summer and into the fall, the way most people would like, with cases coming down like they are. Maybe in a couple of states they would have, and maybe those still will. I am not anti-mask at all. I think that it is hard to tease out any effects of masks from distancing, both voluntary and otherwise, and gathering limits. And I don’t see that public health was very good at showing where the infections were happening, other than the big outbreaks that were obvious. Even back in the summer and early fall when the contact tracing was pretty good, I never saw much about that, other than the obvious demographics of who was getting sick more often: lower income communities, minority communities, certain essential workers. I find it interesting how masks are described here as another tool just like vaccination is a tool, as though they are comparable. I don’t see it that way at all. It’s more like a Covid-infected person is like a gaping wound, and a mask is putting a little bandaid over it and going about your day. A vaccine is like preventing the wound in the first place, or having a tiny scrape instead that doesn’t even need a bandaid.

Must politics be part of everything? Someone who is hesitant and also feels this way about anyone with an R next to their name is probably not the target of that promo, anyway.

I don’t understand what you’re saying. I am not arguing for anything, but pushing against the idea that some news reports saying that higher proportions of young children dying of Covid in Brazil automatically means that the P1 variant is the reason. I threw out ideas from there. I am not arguing for any of them, but I think we need to look further than a simplistic assumption about a particular variant. Clearly the doctors and scientists who study such things are doing that. I didn’t spend a lot of time searching, but here, for example, is an analysis showing that CFR increased in Brazil in February compared to the baseline mortality Sept-Jan. That could be for reasons other than the variant, too, as they note, but the mortality only went up for age>20, not for pediatric patients. https://www.medrxiv.org/content/10.1101/2021.03.24.21254046v1.full.pdf Another similar CFR comparison for another region of Brazil, again showing greater difference in severity and mortality in the February wave in adults, but all but one result nonsignificant for differences in severity and CFR in the pediatric group. https://www.medrxiv.org/content/10.1101/2021.04.13.21255281v1.full.pdf Now, at least from these, certainly CFR looks worse after P1, but that still doesn’t say that there is something about the variant that makes it more virulent, so that it will be more virulent if it, say, infects someone right now, here in the US. There could be, which is not the same as must be. I don’t know, that seems obvious to me. 🤷‍♀️ It’s such a multifactorial situation. And I still can’t easily find anything that says there is something about the variant which makes it particularly worse for young children. And that is what others were claiming by those numbers, that the 0.5% of deaths means that it is proportionally worse for children. From these papers that doesn’t seem to be the case. Maybe there are studies somewhere, but I would think if there were something definitive, it would be reported on, as that would be pretty important.

I think it is hasty to conclude this. The ACIP meeting had an update on variants. P1 has some of the same major RBD mutations of concern as B1351. Have there been reports of that variant being more virulent in children? There was mention in the meeting of the specific concerns with each variant, and there was no mention of increased virulence in children from P1. And these are some of the top scientists in the US who are in charge of keeping track of such things, during the same meeting where there were other presentations about why 12-15 year olds should have access to vaccination. I could not find any scientific articles or mentions anywhere about this, except for a few reports in major media. Even the scientists quoted in the media do not say they think the virus is more virulent in young children. They say they do not know why more children have died there. I am not claiming that it is impossible that virulence could be the reason, but we know so very little that I think it is premature to say it is something about the variant.

I wonder if the promotion by influential people may have already had the effects they are going to have. It helps persuade some, while others feel manipulated by it. Dolly Parton probably did a lot of good. But I wonder how much affect it had, for example, for Dr. Fauci to point out Dr. Corbett and say, look, this scientist is Black, so if you are Black, you should trust the vaccine. I don’t know, it can seem a little cringe. Like I doubt that promo done by a bunch of Republican governors, or was it Congressmen, did much for the vaccine effort. I do give everyone kudos for even trying. I think we need public health ads, but I really think that time will help lower vaccination rates. People will go for their doctor visits, and it will come up. Time passes and nothing else bad is happening from vaccines, and they get fully approved, more people will take it. And outbreaks may happen, and some who thought we were pretty much “done” so that they don’t need a shot, will change their minds.

From this BBC article and a couple of other sources I came across, it seems the issue is that the number of infections in the country was overwhelming, and that there was a lack of good medical care at least in some cases. I found more than one story about children who were quite sick but sent home. https://www.bbc.com/news/world-latin-america-56696907 The statistic here suggests that headlines and absolute numbers are misleading here. This number is still higher than for the US, where we have a couple of hundred pediatric deaths from age 0-17, and that is concerning. But I don’t conclude it is probably from a variant. I think a more virulent variant would make EVERYONE sicker, particularly the older and medically fragile who are already worst hit by Covid. There is nothing about P1 that suggests it would be preferentially worse for young children, is there? What else could it be? Lack of pediatric facilities? Pediatric hospitals full of adults with Covid, so they send kids home thinking they will be okay? Higher percentages of obesity in very young children than other countries (probably not)? Doctors less aware of MIS-C or not able to treat it properly? Maybe they are using antibiotics or other medications there that are causing problems for young children. Are they more accurate at counting the pediatric deaths than they are for the adults? Probably there are other possibilities I’m not thinking of.

😅 As much as we would like to think experts have all the expert knowledge, a lot of what is done in the real world is done mostly because some humans think it seems like a good idea. 🙂 Both before and during the pandemic. Science is amazing, and science is imperfect and lacking, both are true.

I have no idea what it is, but this seems right. Maybe higher for hospitalized patients, but if we mean milder cases, yes. We will know more as time goes on. Sometimes people have only loss of smell, and that is counted in surveys as long Covid. While I really don’t want to lose my sense of smell for months, as it is unpleasant and even potentially unsafe, it is not the same as being short of breath and having debilitating fatigue and cognitive problems for many months. Insomnia is another symptom that is very high in certain surveys. Insomnia can be awful if it is frequent and persistent. But if the only symptoms are insomnia and anxiety, how can I know for sure that this is because of Covid, even if it started after I had Covid? We need much better data and we need to compare to people that have had influenza and other respiratory viruses, and compare to usual levels of symptoms in the population- there is some percentage of people who will say they have insomnia, anxiety, fatigue, muscle pain, etc. at any given time if you do a survey. They need to distinguish between people who initially had a severe case vs. mild and see if there are differences.

I think they assumed they had other common respiratory viruses, since while reduced, these were still around. I think most kids were still attending school most of the year. They also saw some differences in symptoms between groups. What is the false negative and false positive rate of PCR for Covid in young children? There could have been some kids in the positive group that didn’t have Covid, also. Antibody testing isn’t perfect, either. They could have tested for other viruses when symptomatic, but that’s probably pretty expensive for all those children with mostly mild disease. This part was reassuring for me, after seeing some stories reported this past year.

Adding this here. Preprint, done through the Mayo Clinic. https://www.medrxiv.org/content/10.1101/2021.04.27.21256193v1.full.pdf

Sure, it’s significant. It’s a much better done study than the others, and it is a smaller percentage that is probably closer to the true number than other estimates that have been stated in the thread or in surveys. It still won’t be 4% of children who contract Covid, because it’s been estimated that 50%, more or less, of children are asymptomatic. These children were tested because they had symptoms. These children were all school-aged (the Australian study had younger children), and parents all had smart phone access and might represent certain socioeconomic groups more than others.

Yeah, two weeks, yikes. What I’ve seen and heard is that even 3-4 weeks might be closer than optimal, but time was of the essence to get trials done. One virologist said that the reason the efficacy curves seemed to diverge so early after the second dose could be still from effects of the first dose. I guess immunity takes some time to be optimal. There was a recent study that showed antibody levels were even higher when the doses were given twelve weeks apart.