COVID-19 ER visits and hospitalizations on the rise among Alberta kids

EDITOR'S NOTE: In this story, the death of a 14-year-old boy with cancer was wrongly attributed to COVID-19 by the province, which later retracted the statement and apologized to the family on Oct. 14. Please see the update here.

A Calgary doctor says the emergency room at Alberta Children's Hospital is treating more children for COVID-19 now than during any other wave of the pandemic.

COVID-19 rates among five- to 11-year-olds, who are too young to be vaccinated, skyrocketed in September. And, with such high transmission rates, experts were expecting a corresponding surge in ER visits and hospitalizations.

"The number and frequency of children that we are seeing seeking emergency department care that are testing positive for COVID is higher than at any other time during the pandemic," said Dr. Stephen Freedman, pediatric emergency room physician at Alberta Children's Hospital and professor in the Cumming School of Medicine at the University of Calgary.

"That's reflected in the overall positivity rate in this age group which is higher than it's ever been and it's much, much higher than any other age group."

According to Freedman, his ER is seeing between two and five children per day who are positive for COVID.

"The good news is the majority of these children are still mildly ill — still able to be managed as outpatients. But some do require admission and we do occasionally have a child who is acutely unwell, requiring intensive care unit hospitalization"

Freedman said adults have a much higher rate of severe illness and death from a COVID-19 infection. But as more children catch the virus, there will be a corresponding rise in the number of kids who end up critically ill.

Teen death

On Tuesday the province's chief medical officer of health reported a 14-year-old died of COVID-19. The boy, from Alberta's central zone, died on Oct. 7.

He is the youngest Albertan to die of the virus since the start of the pandemic. An 18-year-old girl, also from the central zone, died in September.

Alberta's Chief Medical Officer of Health Dr. Deena Hinshaw drew criticism for noting the boy had complex pre-existing medical conditions that "played a significant role" in his death, as she made the announcement during Tuesday's news conference.

"Oh my god, we had our first true pediatric death," said Calgary emergency room physician Dr. Joe Vipond during a Protect our Province update late on Tuesday. The group of physicians began holding their own updates to "fill the void" left by fewer government COVID-19 updates. 

"In the [press conference] I heard a caveat that there were comorbidities. In my mind, there are no comorbidities that matter in this instance. A 14-year-old is a 14-year-old And, for the record, if I were to pass away tomorrow I would be listed as a 52-year-old with comorbidities," he said.

Alberta Health statistics show COVID-19 hospitalizations are on the rise among children.

The number of kids (ages 19 and under) hospitalized for COVID-19 has increased by 24.5 per cent (from 323 to 402) since Sept 1.

ICU admissions for children also jumped by 23 per cent (from 60 to 74) over the same time period.

According to Alberta Health, children currently account for about 1.5 per cent of COVID-19 hospitalizations.

Sixteen of the 1,053 people hospitalized for COVID-19 as of Tuesday afternoon are under the age of 18, including four children in intensive care.

MIS-C worries

All this comes at a time when hospitals are dealing with a resurgence of other viral illnesses kept at bay due to COVID-19 restrictions last year, and at a time when health-care providers are bracing for a potential spike in cases of a rare but serious condition known as multisystem inflammatory syndrome in children (MIS-C) which causes severe inflammation in organs such as the heart and kidneys weeks after a COVID-19 infection.

Surges in MIS-C cases generally turn up about four weeks after the peak in acute COVID-19 infections, according to Freedman.

"The biggest concern is we're not really sure what's going to happen in the coming weeks," said Dr. Sidd Thakore, pediatrician at  Alberta Children's Hospital.

"Two or three weeks down the road from now are we going to see a substantial increased number of the multisystem inflammatory syndromes and long-COVID, because those generally take two to six weeks to occur after your primary infection with COVID."

Thakore said kids who develop MIS-C show up in hospital after having had a fever for several days along with other symptoms including abdominal pain, diarrhea, red eyes and fatigue.

"They're the ones that can get sick substantially fast. They can go from looking OK to being in the ICU in the matter of a day or so. So those are the ones that we get quite worried about because of how fast they can proceed."

According to Alberta Health, 48 children under the age of 18 have been hospitalized for MIS-C — which it noted is rare and treatable — including 21 in the ICU since the province began tracking this condition in May 2020.