Republic file photo An exterior view of Columbus Regional Hospitals sign directing patients to the emergency entrance.
Republic file photo An exterior view of Columbus Regional Hospitals sign directing patients to the emergency entrance.
COLUMBUS, Ind. COVID-19 hospitalizations at Columbus Regional Hospital have climbed to their highest level in over five months as Bartholomew County records its first death from the virus in weeks.
On Wednesday, there were 18 people hospitalized with COVID-19 at CRH, up from 11 two weeks ago and the highest daily total since Feb. 22, according to the most recent data from the local coronavirus task force.
The figures include people who are hospitalized due to COVID-19 infections and people who test positive for the virus but are hospitalized for other reasons, the hospital said.
The majority of hospitalizations are because of COVID illness, said CRH spokeswoman Kelsey DeClue. But we also do have the factor of because of such high community spread, we have a few patients that are in the hospital with COVID but not because of it.
The overwhelming majority of people who are hospitalized at CRH due to coronavirus infections never got vaccinated or didnt keep up with their booster shots, DeClue said.
For more on this story, see Saturdays Republic.
COVID
The Massachusetts Department of Public Health willno longer release daily COVID-19 reports. The following report represents seven days of data beginning Thursday, July 28.
Newly reported cases:9,646
Total confirmed cases:1,813,037
Newly reported deaths:41
Total confirmed deaths:19,939
Newly reported tests:133,419
Total tests:46,692,520
Percent positivity (seven-day average):7.97%
Hospitalized patients:560
Hospitalized patients who are fully vaccinated:334
Hospitalized patients who are primarily hospitalized for COVID-19 related illness:144
ICU patients:57
Intubated patients:15
View an interactive version of the states dashboardhere.
Stay up to date on all the latest news from Boston.com
Nearly 55% of the cases were vaccine breakthrough cases.
PORTLAND, Ore. (KOIN) Oregon Health Authority announced that 40,013 people tested positive for COVID-19 in July.
In their monthly vaccine breakthrough report, OHA reported that 18,622 (46.5%) of the cases were in unvaccinated people and 21,380 (53.4%) were vaccine breakthrough cases.
According to OHA, there have been 292,802 vaccine breakthrough cases in the state. Of those cases, 103,563, or 35.4%, were fully vaccinated and boosted at the time of infection. Only 2.6% of vaccine breakthrough cases have been hospitalized and 0.6% have died. The median age of vaccinated people who died is 80.
The next breakthrough report will be published Thursday, Sept. 8.
Viruses that cause respiratory diseases like the flu and COVID-19 can lead to mild to severe symptoms within the first few weeks of infection. These symptoms typically resolve within a few more weeks, sometimes with the help of treatment if severe. However, some people go on to experience persistent symptoms that last several months to years. Why and how respiratory diseases can develop into chronic conditions like long COVID-19 are still unclear.
I am a doctoral student working in the Sun Lab at the University of Virginia. We study how the immune system sometimes goes awry after fighting off viral infections. We also develop ways to target the immune system to prevent further complications without weakening its ability to protect against future infections. Our recently published review of the research in this area found that it is becoming clearer that it might not be an active viral infection causing long COVID-19 and similar conditions, but an overactive immune system.
Keeping your immune system dormant when there isnt an active infection is essential for your lungs to be able to function optimally.
Your respiratory tract is in constant contact with your external environment, sampling around 5 to 8 liters (1.3 to 2 gallons) of air and the toxins and microorganisms in it every minute. Despite continuous exposure to potential pathogens and harmful substances, your body has evolved to keep the immune system dormant in the lungs. In fact, allergies and conditions such as asthma are byproducts of an overactive immune system. These excessive immune responses can cause your airways to constrict and make it difficult to breathe. Some severe cases may require treatment to suppress the immune system.
During an active infection, however, the immune system is absolutely essential. When viruses infect your respiratory tract, immune cells are recruited to your lungs to fight off the infection. Although these cells are crucial to eliminate the virus from your body, their activity often results in collateral damage to your lung tissue. After the virus is removed, your body dampens your immune system to give your lungs a chance to recover.
Over the past decade, researchers have identified a variety of specialized stem cells in the lungs that can help regenerate damaged tissue. These stem cells can turn into almost all the different types of cells in the lungs depending on the signals they receive from their surrounding environment. Recent studies have highlighted the prominent role the immune system plays in providing signals that facilitate lung recovery. But these signals can produce more than one effect. They can not only activate stem cells, but also perpetuate damaging inflammatory processes in the lung. Therefore, your body tightly regulates when, where and how strongly these signals are made in order to prevent further damage.
While the reasons are still unclear, some people are unable to turn off their immune system after infection and continue to produce tissue-damaging molecules long after the virus has been flushed out. This not only further damages the lungs, but also interferes with regeneration via the lungs resident stem cells. This phenomenon can result in chronic disease, as seen in several respiratory viral infections including COVID-19, Middle East Respiratory Syndrome (MERS), respiratory syncytial virus (RSV) and the common cold.
In our review, my colleagues and I found that many different types of immune cells are involved in the development of chronic disease after respiratory viral infections, including long COVID-19.
Scientists so far have identified one particular type of immune cells, killer T cells, as potential contributors to chronic disease. Also known as cytotoxic or CD8+ T cells, they specialize in killing infected cells either by interacting directly with them or by producing damaging molecules called cytokines.
Killer T cells are essential to curbing the virus from spreading in the body during an active infection. But their persistence in the lungs after the infection has resolved is linked to extended reduced respiratory function. Moreover, animal studies have shown that removing killer T cells from the lungs after infection may improve lung function and tissue repair.
Another type of immune cells called monocytes are also involved in fighting respiratory infections, serving among the first responders by producing virus- and tissue-damaging cytokines. Research has found that these cells also continue to accumulate in the lungs of long COVID-19 patients and promote a pro-inflammatory environment that can cause further damage.
Understanding the immunological mechanisms underlying long COVID-19 is the first step to addressing a quickly worsening public health problem. Identifying the subtle differences in how the same immune cells that protect you during an active infection can later become harmful could lead to earlier diagnosis of long COVID-19. Moreover, based on our findings, my team and I believe treatments that target the immune system could be an effective approach to manage long COVID-19 symptoms. We believe that this strategy may turn out to be useful not only for COVID-19, but also for other respiratory viral infections that lead to chronic disease as well.
Harish Narasimhan, PhD Candidate in Immunology, University of Virginia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
While the vaccines continue to provide critical, evidence-based protection against the coronavirus, rare cases of myocarditis and pericarditis have been reported.
The Moderna mRNA vaccine may be more likely to cause myocarditis in men aged 12 to 29 years than other vaccines, requiring more surveillance of patients following the administration of booster shots.1 In the United States, cases of myocarditis are 1 to 2 per 100,000 people, regardless of age, with COVID-19 vaccinations only causing 0.2 cases per million people and only causing 1.4 cases of pericarditis per million people.1
Jorge Moreno, MD, assistant professor of medicine at the Yale School of Medicine, although not involved in the study, noted in a discussion with Medical News Today that the data show that cases of myocarditis and pericarditis from COVID-19 vaccinations are quite rare.2
COVID-19, the illness, can also [cause] myocarditis, and that is much more likely than the vaccine itself [causing it], said Moreno in the interview.2
Additionally, dosing was relevant to case numbers as well. Following patients receiving 2 doses of the Moderna vaccine, cases for anyone between the age of 12 to 39 dropped if administered 31 days following the second dose .1 For men aged 18 to 29 years, the dosing interval may need to increase to 56 days or later to ensure a decreased risk of these conditions developing.1
Often caused by viral infections such as COVID-19, myocarditis is the inflammation of the heart muscle and pericarditis is the inflammation of the 2 layered sac surrounding the heart.2 Symptoms of both diseases are present as persistent chest pain, shortness of breath, palpitations, or all 3.1 Most people recover from mild cases, but some cases of myocarditis or pericarditis have become dangerous.1
During research assessing the correlation between reported cases of myocarditis and pericarditis and vaccinations, investigators at the University of Alberta went through 46 studies and analyzed 8000 reported cases. Based on their findings, they then narrowed the age range to being between the ages of 0 to 39 years. Subsequently, they observed that cases for males over the age of 40 years were very low to none, according to the data.2
While the study authors noted that the data made clear that the time between dosing of the Moderna mRNA vaccine should be prolonged, they also observed that the data did not make clear if young men should avoid the Moderna vaccine entirely and be advised to get the Pfizer mRNA vaccines.1
The FDA and the CDC here in the US did not find that the difference was substantial enough to make that recommendation [for young men to avoid the Pfizer vaccine], Morena said in the press release.2
The study authors also noted the importance of better communication of the risks and benefits of the vaccine for young men and their families, along with more access to non-mRNA vaccine alternatives.1 Although more research regarding personal risk factors and pre-existing conditions should be done to assess potential risk further, the authors explained that due to the evolving nature of COVID-19, study findings remain limited to the investigators understanding of mechanistic studies and how easily diagnosable the diseases are. Additionally, although pericarditis and myocarditis often coexist, myocarditis is more easily identifiable and diagnosed using imaging and troponin protein level testing.1
The authors also noted that long term follow-up may help investigators further understand the natural history, disease recurrence, and risks of COVID-19 even with its evolving nature. To address this, multicenter prospective studies could guide researchers to understand why the vaccines cause these rare cases of heart inflammation.1
References
Public Health Officials Announce 30,762 New Cases of Coronavirus Disease Over the Past Week IDPH
The U.S. Department of Health is rolling out its "We Can Do This" COVID-19 education campaign ahead of the schoolyear, hoping to increase the vaccination rate among children by educating parents in trusted spaces, and the library is becoming a critical location in the effort.
Dr. Cameron Webb, a senior advisor on the White Houses COVID-19 team, was a special guest for Thursdays story time at Hyattsville's Library. He shared more than a book with families.
Back-to-school is right around the corner, so we want families, we want everybody to have their best protection, he said.
While vaccination rates for children 6 months to 5 years old are the lowest of any age group with 3% vaccinated, Webb hopes parents will step up before little ones reenter school and day care.
We want to make sure that everybody has that protection against COVID-19, but its coming at a time where a lot of people are processing how they look at the pandemic differently.
In Hyattsville, one of the most diverse communities in Prince George's County, it was clear early on that the approach to accessing the vaccine had to be different.
We were the community that was hardest struck in the region, yet we were the last to receive testing and the last to receive vaccines, Prince Georges County Council member Deni Taveras said.
Washington, D.C., Maryland and Virginia local news, events and information
The county's libraries stepped in to help improve access.
We would receive a phone call, and a customer would say, Im an undocumented immigrant. Im having trouble getting through to the vaccine clinic. Theyre telling me I cant get a vaccine, Prince George's County Memorial Library System acting co-CEO Nicholas A. Brown said. And we would tell them exactly what to say. Get on the phone with the vaccine provider to clarify what the policies are. And it was that level of library-to-family connection that helped people get to these resources really quickly.
Thursdays clinic reminded how libraries have pivoted, becoming more than just a place to check out books.
They have a such a nice space for children, so I think it's really great that they tied those two together to offer the vaccine to the community while having children's events here, mother Jillian Campbell said.
Parents said they are adjusting to the new reality and the back-to-school list is changing.
School is starting September or Aug. 22, and he needs to get vaccinated, so we are really, really glad that its being offered over here, mother Grace Burrell said.
It was only a one-day clinic, but the public library is open to share information on where to find other clinics like it by calling local branches during library business hours.
The American Library Association is working alongside the U.S. Department of Health and Human Services to launch similar campaigns around the country.
The coronavirus disease 2019 (COVID-19) is an acute respiratory disease that is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As a result of the rapid transmission of SARS-CoV-2 and its high morbidity and mortality rates, COVID-19 remains a significant threat.
Study:Does Influenza vaccination reduce the risk of contracting COVID-19? Image Credit: alessandro guerriero / Shutterstock.com
Initially, the development of herd immunity once the vaccinated population reached 70% was believed to reduce the transmission of SARS-CoV-2.
However, the rate of vaccination in different nations varies depending on their specific economic situation. As a result, developed countries often have a higher vaccination rate as compared to underdeveloped countries. This increases the risk of prolonging the pandemic due to the emergence of mutated strains of SARS-CoV-2.
Several studies have observed that the risk of infection and disease transmission are independent of completing a COVID-19 vaccination regimen. Although the risk of developing a severe infection is lower in vaccinated people, the transmission of SARS-CoV-2 variants between vaccinated and unvaccinated individuals still occurs and can subsequently lead to the emergence of new variants.
Currently, ten SARS-CoV-2 variants are being monitored, two of which are considered variants of concern (VOCs). Thus, there remains an urgent need to better understand the evolution of SARS-CoV-2, as well as develop novel treatments and preventive measures that mitigate its spread and adverse effects on human health.
Previous studies have assessed whether countermeasures used to protect against other types of viruses could reduce the adverse effects of COVID-19. Influenza and COVID-19 are two respiratory viral diseases that have similar modes of transmission, clinical outcomes, hospitalizations, complications, and death rates. Additionally, the transmission of these viruses often peaks during the winter months.
The most effective strategy to prevent and control influenza epidemics is annual influenza vaccination. Similar vaccination campaigns have also been important in controlling the COVID-19 pandemic.
The SARS-CoV-2 Omicron variant, which was first detected in South Africa on November 24, 2021, acquired at least one of its mutations from the common cold virus that was also present in the same infected cell. The symptoms of Omicron infection are also very similar to that of the common cold.
Notably, flu vaccination has previously been found to reduce intensive care unit (ICU) admissions, hospitalizations, and mortality from SARS-CoV-2 infections. However, such findings are contradictory and insufficient. Further research is needed to better understand the protective role of the flu vaccine on COVID-19 infections.
A new Spanish study published on the preprint server medRxiv* describes the association between the risk of contracting COVID-19 and the seasonal flu vaccine in patients for whom the flu vaccine is recommended.
The current study involved patients who were considered high-risk for flu complications and were, as a result, recommended for vaccination. The clinical history of the patients was collected to obtain information on COVID-19 diagnosis and flu vaccination.
Study participants living in nursing homes were studied separately due to different living conditions. Both trivalent and quadrivalent flu vaccines were administered to the study participants.
The Mortality in small Spanish areas and Socioeconomic and Environmental Inequalities (MEDEA) deprivation index was used for the analysis of health inequalities and identification of regions with socioeconomic vulnerability. Information on the gender, age, risk factors for flu vaccination, the incidence of COVID-19, and flu vaccine receipt were also collected.
Out of the 429,537 study participants, about 45% were vaccinated against the flu, while 56.8% were women. Participants over the age of 80 were most likely to be vaccinated. Moreover, about 4% of vaccinated people and 4.44% of unvaccinated people contracted COVID-19.
Patients with risk factors for flu complications, such as those with cardiovascular diseases, lung problems, diabetes mellitus, and kidney problems, who also received the flu vaccine were at a lower risk of contracting COVID-19.
Probability of contracting COVID-19 depending on whether or not the patient had received the flu vaccine.
High MEDEA values were associated with lower vaccination rates and a higher risk of COVID-19. Additionally, at high MEDEA index values, people under 60 years of age were associated with higher COVID-19 incidence rates as compared to those over the age of 60.
The current study demonstrates that the flu vaccine could reduce the risk of COVID-19 among individuals who are at high risk for flu complications. However, continuous and effective immunizations are required to reduce the burden of respiratory diseases, especially during a period in which influenza and COVID-19 overlap.
Further research is needed to develop preventive strategies against both diseases simultaneously, as there is a high probability of living with both viruses for a long time.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
The West Virginia Department of Health and Human Resources (DHHR) reports as of August 5, 2022, there are currently 3,414 active COVID-19 cases statewide. There have been 11 deaths reported since the last report, with a total of 7,184 deaths attributed to COVID-19.
DHHR has confirmed the deaths of a 90-year old male from Putnam County, an 89-year old male from Upshur County, a 64-year old female from Upshur County, an 85-year old male from Putnam County, a 96-year old female from Cabell County, an 80-year old female from Cabell County, a 91-year old female from Cabell County, a 93-year old female from Cabell County, an 82-year old female from Greenbrier County, an 85-year old male from Jackson County, and a 74-year old female from Mingo County.
Summer is a time for family reunions and celebrations, and it is painful to report that many families are experiencing the deepest grief today, said Bill J. Crouch, DHHR Cabinet Secretary. I urge each West Virginian to make the choice to be up-to-date with COVID vaccines and boosters to help stop this loss of life.
CURRENT ACTIVE CASES PER COUNTY: Barbour (47), Berkeley (180), Boone (53), Braxton (14), Brooke (29), Cabell (152), Calhoun (8), Clay (8), Doddridge (8), Fayette (77), Gilmer (10), Grant (17), Greenbrier (80), Hampshire (39), Hancock (36), Hardy (51), Harrison (130), Jackson (56), Jefferson (79), Kanawha (288), Lewis (24), Lincoln (41), Logan (92), Marion (99), Marshall (78), Mason (73), McDowell (68), Mercer (152), Mineral (40), Mingo (67), Monongalia (134), Monroe (44), Morgan (21), Nicholas (38), Ohio (81), Pendleton (8), Pleasants (8), Pocahontas (16), Preston (28), Putnam (133), Raleigh (213), Randolph (21), Ritchie (15), Roane (41), Summers (31), Taylor (26), Tucker (17), Tyler (14), Upshur (36), Wayne (55), Webster (17), Wetzel (19), Wirt (10), Wood (234), Wyoming (58). To find the cumulative cases per county, please visit coronavirus.wv.gov and look on the Cumulative Summary tab which is sortable by county.
West Virginians ages 6 months and older are recommended to get vaccinated against the virus that causes COVID-19. Those 5 years and older should receive a booster shot when due. Second booster shots for those age 50 and over who are 4 months or greater from their first booster are recommended, as well as for younger individuals over 12 years old with serious and chronic health conditions that lead to being considered moderately to severely immunocompromised.
Visit the WV COVID-19 Vaccination Due Date Calculator, a free, online tool that helps individuals figure out when they may be due for a COVID-19 shot, making it easier to stay up-to-date on COVID-19 vaccination. To learn more about COVID-19 vaccines, or to find a vaccine site near you, visit vaccinate.wv.gov or call 1-833-734-0965.
To locate COVID-19 testing near you, please visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.
Children are now preparing to head back to school for the third time since the onset of the COVID-19 pandemic. Schools are expected to return in-person this fall, with most experts now agreeing the benefits of in-person learning outweigh the risks of contracting COVID-19 for children. Though children are less likely than adults to develop severe illness, the risk of contracting COVID-19 remains, with some children developing symptoms of long COVID following diagnosis. COVID-19 vaccines provide protection, and all children older than 6 months are now eligible to be vaccinated. However, vaccination rates have stalled and remain low for younger children. At this time, only a few states have vaccine mandates for school staff or students, and no states have school mask mandates, though practices can vary by school district. Emerging COVID-19 variants, like the Omicron subvariant BA.5 that has recently caused a surge in cases, may pose new risks to children and create challenges for the back-to-school season.
Children may also continue to face challenges due to the ongoing health, economic, and social consequences of the pandemic. Children have been uniquely impacted by the pandemic, having experienced this crisis during important periods of physical, social, and emotional development, with some experiencing the loss of loved ones. While many children have gained health coverage due to federal policies passed during the pandemic, public health measures to reduce the spread of the disease also led to disruptions or changes in service utilization and increased mental health challenges for children.
This brief examines how the COVID-19 pandemic continues to affect childrens physical and mental health, considers what the findings mean for the upcoming back-to-school season, and explores recent policy responses. A companion KFF brief explores economic effects of the pandemic and recent rising costs on households with children. We find households with children have been particularly hard hit by loss of income and food and housing insecurity, which all affect childrens health and well-being.
Despite job losses that threatened employer-sponsored insurance coverage early in the pandemic, uninsured rates have declined likely due to federal policies passed during in the pandemic and the safety net Medicaid and CHIP provided. Following growth in the childrens uninsured rate from 2017 to 2019, data from the National Health Interview Survey (NHIS) show that the childrens uninsured rate held steady from 2019 to 2020 and then fell from 5.1% in 2020 to 4.1% in 2021. Just released quarterly NHIS data show the childrens uninsured rate was 3.7% in the first quarter of 2022, which was below the rate in the first quarter of 2021 (4.6%) but a slight uptick from the fourth quarter of 2021 (3.5%), though none of these differences are statistically significant. Administrative data show that childrens enrollment in Medicaid and CHIP increased by 5.2 million enrollees, or 14.7%, between February 2020 and April 2022 (Figure 1). Provisions in the Families First Coronavirus Response Act (FFCRA) require states to providecontinuous coveragefor Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding.
Children have missed or delayed preventive care during the pandemic, with a third of adults still reporting one or more children missed or delayed a preventative check-up in the past 12 months (Figure 2). However, the share missing or delaying care is slowly declining, with the share from April 27 May 9, 2022 (33%) down 3% from almost a year earlier (July 21 August 2, 2021) according to KFF analysis of theHousehold Pulse Survey. Adults in households with income less than $25,000 were significantly more likely to have a child that missed, delayed, or skipped a preventive appointment in the past 12 months compared to households with income over $50,000. These data are in line with findings from another study that found households reporting financial hardship were significantly more likely to report missing or delaying childrens preventive visits compared to those not reporting hardships. Hispanic households and households of other racial/ethnic groups were also significantly more likely to have a child that missed, delayed, or skipped a preventive appointment in the past 12 months compared to White households (based on race of the adult respondent).
Telehealth helped to provide access to care, but children with special health care needs and those in rural areas continued to face barriers. Overall, telehealth utilization soared early in the pandemic, but has since declined and has not offsetthe decreases in service utilization overall. While preventative care rates have increased since early in the pandemic, many children likely still need to catch up on missed routine medical care. One study found almost a quarter of parents reported not catching-up after missing a routine medical visit during the first year of the pandemic. The pandemic may have also exacerbated existing challenges accessing needed care and services for children with special health care needs, and low-income patients or patients in rural areas may have experienced barriers to accessing health care via telehealth.
The pandemic has also led to declines in childrens routine vaccinations, blood lead screenings, and vision screenings. The CDC reported vaccination coverage of all state-required vaccines declined by 1% in the 2020-2021 school year compared to the previous year, and some public health leaders note COVID-19 vaccine hesitancy may be spilling over to routine child immunizations. TheCDC also reported34% fewer U.S. children had blood lead level testing from January-May 2020 compared to the same period in 2019. Further, data suggest declines in lead screenings during the pandemic may have exacerbated underlying gaps and disparities in early identification and intervention for lower-income households and children of color. Additionally, many children rely on in-school vision screenings to identity vision impairments, and some children went without vision checks while schools managed COVID-19 and turned to remote learning. These screenings are important for children in order to identify problems early; without treatment some conditions can worsen or lead to more serious health complications.
The pandemic has also led to difficulty accessing and disruptions in dental care. Data from the National Survey of Childrens Health (NSCH) show the share of children reporting seeing a dentist or other oral health provider or having a preventive dental visit in the past 12 months declined from 2019 to 2020, the first year of the pandemic (Figure 3). The share of children reporting their teeth are in excellent or very good conditions also declined from 2019 (80%) to 2020 (77%); the share of children reporting no oral health problems also declined but the change was not statistically significant.
Recently released preliminary data for Medicaid/CHIP beneficiaries under age 19 shows steep declines in service utilization early in the pandemic, with utilization then rebounding to a varying degree depending on the service type. Child screening services have rebounded to pre-PHE levels while blood lead screenings and dental services rates remain below per-PHE levels. Telehealth utilization mirrors national trends, increasing rapidly in April 2020 and then beginning to decline in 2021. When comparing the PHE period (March 2020 January 2022) to the pre-PHE period (January 2018 February 2020) overall, the data show child screening services and vaccination rates declined by 5% (Figure 4). Blood lead screening services and dental services saw larger declines when comparing the PHE period to before the PHE, declining by 12% and 18% respectively among Medicaid/CHIP children.
Childrens mental health challenges were on the rise even before the onset of the COVID-19 pandemic. A recent KFF analysis found the share of adolescents experiencing anxiety and/or depression has increased by one-third from 2016 (12%) to 2020 (16%), although rates in 2020 were similar to 2019. Rates of anxiety and/or depression were morepronounced among adolescent females and White and Hispanic adolescents. A separatesurveyof high school students in 2021 found that lesbian, gay, or bisexual (LGB) students were more likely to report persistent feelings of sadness and hopelessness than their heterosexual peers. In the past few years, adolescentshave experienced worsened emotional health, increased stress, and a lack of peer connection along with increasing rates of drug overdose deaths, self-harm, and eating disorders.Prior to the pandemic, there was also an increase in suicidal thoughts from 14% in 2009 to 19% in 2019.
The pandemic may have worsened childrens mental health or exacerbated existing mental health issues among children. The pandemic caused disruptions in routines and social isolation for children, which can beassociated with anxiety and depressionandcan have implicationsfor mental health later in life. A number of studies show an increase in childrens mental health needs following social isolation due to the pandemic, especially among children who experience adverse childhood experiences (ACEs). KFF analysis found the share of parents responding that adolescents were experiencing anxiety and/or depression held relatively steady from 2019 (15%) to 2020 (16%), the first year of the pandemic. However, the KFF COVID-19 Vaccine Monitor on perspectives of the pandemic at two years found six in ten parents say the pandemic has negatively affected their childrens schooling and over half saying the same about their childrens mental health. Researchers also note it is still too early to fully understand the impact of the pandemic on childrens mental health. The past two years have also seen much economic turmoil, andresearchhas shown that as economic conditions worsen, childrens mental health is negatively impacted. Further, gun violence continues to rise and may lead to negative mental health impacts among children and adolescents.Researchsuggeststhat children and adolescents may experience negative mental health impacts, including symptoms of anxiety, in response to school shootings andgun-related deathsin theircommunities.
Access and utilization of mental health care may have alsoworsened during the pandemic. Preliminary data for Medicaid/CHIP beneficiaries under age 19 finds utilization of mental health services during the PHE declined by 23% when compared to prior to the pandemic (Figure 4); utilization of substance use disorder servicesdeclined by 24% for beneficiaries ages 15-18 for the same time period. The data show utilization of mental health services remains below pre-PHE levels and has seen the smallest improvement compared to other services utilized by Medicaid/CHIP children. Telehealth has played a significant role in providing mental health and substance use services to children early in the pandemic, but has started todecline. The pandemic may have widened existing disparities in access to mental health care for children of color and children in low-income households. NSCH data show 20% of children with mental health needs were not receiving needed care in 2020, with the lowest income children less likely to receive needed mental health services when compared to higher income groups (Figure 5).
While less likely than adults to develop severe illness, children can contract and spread COVID-19 andchildren with underlying health conditionsare at an increased risk of developing severe illness.Data through July 28, 2022 show there have been over 14 million child COVID-19 cases, accounting for 19% of all cases. Among Medicaid/CHIP enrollees under age 19, 6.4% have received a COVID-19 diagnosis through January 2022. Pediatric hospitalizations peaked during the Omicron surge in January 2022, and children under age 5, who were not yet eligible for vaccination, were hospitalized for COVID-19 at five times the rate during the Delta surge.
Some children who tested positive for the virus are nowfacing long COVID. A recent meta-analysis found 25% of children and adolescents had ongoing symptoms following COVID-19 infection, and finds the most common symptoms for children were fatigue, shortness of breath, and headaches, with other long COVID symptoms including cognitive difficulties, loss of smell, sore throat, and sore eyes. Another report found a larger share of children with a confirmed COVID-19 case experienced a new or recurring mental health diagnosis compared to children who did not have a confirmed COVID-19 case. However, researchers have noted it can be difficult to distinguish long COVID symptoms to general pandemic-associated symptoms. In addition, a small share of children are experiencing multisystem inflammatory syndrome in children (MIS-C), a serious condition associated with COVID-19 that has impactedalmost 9,000 children. A lot of unknowns still surround long COVID in children; it is unclear how long symptoms will last and what impact they will have on childrens long-term health.
COVID-19 vaccines were recently authorized for children between the ages of 6 months and 5 years, making all children 6 months and older eligible to be vaccinated against COVID-19. Vaccination has already peaked for children under the age of 5, and is far below where 5-11 year-olds were at the same point in their eligibility. As of July 20, approximately 544,000 children under the age of 5 (or approximately 2.8%) had received at least one COVID-19 vaccine dose. Vaccinations for children ages 5-11 have stalled, withjust30.3%have been fully vaccinated as of July 27 compared to60.2% of those ages 12-17. Schools have been important sitesfor providing access as well as information to help expand vaccination take-up among children, though children under 5 are not yet enrolled in school, limiting this option for younger kids. A recent KFF survey finds most parents of young children newly eligible for a COVID-19 vaccine are reluctant to get them vaccinated, including 43% who say they will definitely not do so.
Some children have experienced COVID-19 through the loss of one or more family members due to the virus.Astudyestimates that, as of June 2022, over 200,000 children in the US have lost one or both parents to COVID-19. Another study found children of color were more likely to experience the loss of a parent or grandparent caregiver when compared to non-Hispanic White children. Losing a parent can have long term impacts on a childs health,increasingtheir risk of substance abuse, mental health challenges,poor educational outcomes, andearly death. There have been over 1 million COVID-19 deaths in the US, and estimates indicate a17.5% to 20% increasein bereaved children due to COVID-19, indicating an increased number of grieving children who may need additional supports as they head back to school.
Children will be back in the classroom this fall but may continue to face health risks due to their or their teachers vaccination status and increasing transmission due to COVID-19 variants. New, more transmissible COVID-19 variants continue to emerge, with the most recent Omicron subvariant BA.5 driving a new wave of infections and reinfections among those who have already had COVID-19. This could lead to challenges for the back-to-school season, especially among young children whose vaccination rates have stalled.
Schools, parents, and children will likely continue to catch up on missed services and loss of instructional time in the upcoming school year. Schools are likely still working to address the loss of instructional time and drops in student achievement due to pandemic-related school disruptions. Further, many children with special education plans experienced missed or delayed services and loss of instructional time during the pandemic. Students with special education plans may be entitled to compensatory services to make up for lost skills due to pandemic related service disruptions, and some children, such as those with disabilities related to long COVID, may be newly eligible for special education services.
To address worsening mental health and barriers to care for children, several measures have been taken or proposed at the state and federal level. Many states have recently enacted legislation to strengthen school based mental health systems, including initiatives such as from hiring more school-based providers to allowing students excused absences for mental health reasons. In July 2022, 988 a federally mandated crisis number launched, providing a single three-digit number for individuals in need to access local and state funded crisis centers, and the Biden Administration released a strategy to address the national mental health crisis in May 2022, building on prior actions. Most recently, in response to gun violence, the Bipartisan Safer Communities Act was signed into law and allocates funds towards mental health, including trauma care for school children.
The unwinding of the PHE and expiring federal relief may have implications for childrens health coverage and access to care. TheAmerican Rescue Plan Act (ARPA) extended eligibilityto ACA health insurance subsides for people with incomes over 400% of poverty and increased the amount of assistance for people with lower incomes. However, these subsidies are set to expire at the end of this year without further action from Congress, which would increase premium payments for 13 million Marketplace enrollees. In addition, provisions in the FFCRA providing continuous coverage for Medicaid enrollees will expire with the end of the PHE. Millions of people, including children, could lose coverage when the continuous enrollment requirement ends if they are no longer eligible or face administrative barriers during the process despite remaining eligible. There will likely be variation across states in how many people are able to maintain Medicaid coverage, transition to other coverage, or become uninsured. Lastly, there have also been several policies passed throughout the pandemic to provide financial relief for families with children, but some benefits, like the expanded Child Tax Credit, have expired and the cost of household items is rising, increasing food insecurity and reducing the utility of benefits like SNAP.
