As schools re-open across the country and the coronavirus pandemic enters its seventh month in Canada, we spoke to Dr. Fatima Kakkar, a pediatric infectious disease specialist at CHU Sainte-Justine in Montreal, about the latest evidence on transmission of COVID-19 among children.
Kakkar is the principal investigator on a study by the Canadian Paediatric Surveillance Program which is capturing clinical information across the country on children under 18 who were hospitalized with COVID-19. The group published preliminary results this week about the severity of COVID-19 in children in Canada.
Have any children died of COVID-19 in Canada?
According to the Paediatric Surveillance Program, there are no children under the age of 18 that have died from COVID-19 in Canada.
Have any children been admitted to the intensive care due to COVID-19?
Yes, there have been children admitted to ICU due to COVID-19 across Canada. The Surveillance Program has data on 13 pediatric patients across Canada, but Kakkar says there might be up to 29 children who have been admitted so far.
In comparison, 2341 adults over 19 have been admitted to ICU in Canada as of Sept. 10.
“I can speak from a personal experience that it is not at all the same disease that it is in adults and that they haven’t had the same level of complications and they have not required high levels of ventilation or very long,” Kakkar said.
How does this admittance rate compare to other diseases?
Generally, Kakkar says, COVID is much milder in kids than other routine viruses.
“For example, last year, during flu season, we had deaths from flu here in Canada. We had hundreds of ICU admissions from flu in Canada. It’s been a very, very different disease than what we were expecting,” she said.
What are the symptoms of COVID-19 in children?
Generally, the most common symptom in children is fever, said Kakkar. Additional symptoms include an equal mix of respiratory symptoms like cough, sore throat, and digestive ailments like vomiting and diarrhea.
“The symptoms have been very mild, and it hasn’t been the same kind of respiratory illness or vascular illness that we’ve seen in adults where right away they’ve had trouble breathing,” she said.
In fact, she says, in some of the hospitalizations of children with COVID-19, the patients had been admitted to the hospital with another ailment like an arm fracture or appendicitis.
Are there lingering effects in children who have had COVID-19?
One of the main post-infection issues for children around the world has been cases of multisystem inflammatory syndrome in children (MIS-C).
According to the B.C. Centre for Disease Control, MIS-C is likely an exaggerated immune response, leading to severe widespread inflammation.
Symptoms can include rashes, fever and swelling of the hands and feet, according to the BCCDC.
There have been a “few” cases in Canada, although researchers are still collecting and analyzing that data at this point, and the exact number of cases is still being determined, said Kakkar. Results are expected in the next few weeks.
“The difficulty is making the clear link to COVID because up until now, we haven’t had easy access to serology testing,” which would show whether or not someone has had COVID-19 in the past, she said.
“But there’s some cases where they’ve been able to link it to COVID.”
Schools are opening across the country. Will this lead to more cases of COVID-19 among children?
Kakkar says during the first wave, the majority of cases of COVID-19 in children were those who got it from their parents who were essential workers and had to be outside of the home. The case count among children might have generally been lower because they were mostly isolating at home, and it could increase as children leave home.
The fact that many children were generally isolated at home during the first wave of the coronavirus pandemic might have kept their infection numbers low, says Dr. Fatima Kakkar. (Nathan Denette/The Canadian Press)
“It is reasonable to think that there will be cases in children now that children are out and about in the school setting,” she said.
However, she added, the severity of COVID disease in children is mild compared to pretty much every other respiratory illness that they might have gone through in previous years.
Do children transmit COVID-19 easily?
“We don’t have 100 per cent of that answer,” said Kakkar.
Children are typically “great vectors of infection,” she said, mostly because they can’t necessarily control all of their actions and easily touch their noses, faces, and other surfaces.
“That said, you know, we don’t really quite understand the dynamics of transmission, for example, how much virus each individual might have, how easily they transmit it,” she said, noting anecdotal examples of families where one child was infected and the other one remained unaffected.
Measures like hand washing and physical distancing continue to be essential, and will help protect children from more than just COVID-19, say experts. (Thilelli Chouikrat/Radio-Canada)
“We have to be under the assumption that children will probably spread it because we want everybody to take their precautions but I don’t think it’s a given,” she said.
Kakkar also noted that the additional precautions for COVID — hand-washing, mask-wearing, and physical distancing — also prevent the spread of other diseases and infections like flu, influenza and ear infections.
“We’ve never had such strict measures in place, so we might actually see less of these other common viral illnesses,” she said.
“We’re in for the long-haul. These measures work.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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