Covid-19 ‘uncommon’ in SA children, including those at school: NICD

A National Institute for Communicable Diseases (NICD) report has found that Covid-19 is "uncommon" in South African children, including schoolgoing children aged five to 18.

According to the report, published on Tuesday, data from other countries suggested that the clinical presentation of Covid-19 differed in children and that they had a lower risk of severe disease compared with adults.

In contrast, the NICD had also warned that the implementation of non-pharmaceutical interventions such as using masks, physical distancing and hand washing or sanitising within schools needed to be strengthened to prevent children acquiring SARS-CoV2 infections.

“The number of deaths in this population was small, but any severe illness in children in this age group is concerning nonetheless and steps to minimise Covid-19 transmission such as physical distancing and use of masks should be consistently applied where possible, even among children,” the report found.

By June 7, a total of 52,991 laboratory-confirmed cases were notified through national laboratory-based surveillance in SA. 

A total of 3,025 (6%) of the confirmed cases were children aged under 18 years.

Among individuals aged under 18, there was a relatively even split between males and females, with 51% female.

The median age of these cases was 11.4 years.

The cumulative incidence risk of laboratory-confirmed cases aged under 18 was 14.7 cases per 100,000, with the highest cumulative incidence risk reported among individuals aged 15-18, rising to 23.6 cases per 100,000. The lowest cumulative incidence risk reported was among cases aged 5-9, with 10.8 cases per 100,000.

As of June 7, a total of 6,353 patients had been admitted to hospital with Covid-19. Of these admissions, 230 (3.3%) were individuals aged under 18.

The majority of admissions up to week 23 were in the Western Cape, representing 63% of all admissions in children reported, the data showed. 

“Respiratory comorbidities were most frequently reported, with asthma being the most frequent, followed by current and past tuberculosis.”

Of the 230 children admitted with Covid-19, 16 (6.7%) were admitted in ICU and six (2.6%) were ventilated at some point during admission.

At analysis, 167 (72.6%) had been discharged, 56 (24.4%) were still admitted, four (1.7%) had been transferred to other facilities and three (1.3%) had died during admission, the report found.

The overall median length of hospital stay was three days.

“The three cases who died were aged one, 15 and 16. They all had severe underlying medical conditions, including dilated cardiomyopathy, leukaemia, hypertension and diabetes mellitus.”