American Academy of Pediatrics Tracks Children’s COVID-19 Cases by State, Reflecting Increasing Cases

Pediatricians emphasize the need for communities to lower virus numbers before reopening schools in-person

The American Academy of Pediatrics and the Children’s Hospital Association, in a weekly report that compiles state-by-state data on COVID-19 cases in children, found that between July 9 and Aug. 6, there were 179,990 new child cases -- an increase of 90% in child cases over 4 weeks.  The data - while limited because of its reliance on how each state reports its cases -- underscores the urgent need to control the virus in communities so schools may reopen.

The report, updated every Monday here, also confirms that children are not immune to COVID-19, and that that they can become infected with the virus and become sick.

“In areas with rapid community spread, it’s likely that more children will also be infected, and these data show that,” said AAP President Sally Goza, MD, FAAP.  “As a pediatrician, I urge people to wear cloth face coverings and be diligent in social distancing and hand-washing. It is up to us to make the difference, community by community.”

The AAP calls for an effective testing strategy so communities can determine appropriate choices about school openings. The academy applauds new reporting requirements, including data by age and race/ethnicity, that took effect Aug. 1.

The AAP began collecting data on COVID-19 cases in children in April, drawing on cases each week taken from state and local health department websites. The data is compiled into a weekly report to produce a state-level picture of COVID-19 cases among children. A total of 49 states, NYC, DC, Puerto Rico and Guam provide age distributions of reported COVID-19 cases.

While imperfect, the data provides a broad snapshot of how COVID-19 is infecting children. Some findings:

• There have been 380,174 total child COVID-19 cases reported, and children represented 9.1% of all cases. Between July 9 and Aug. 6, there were 179,990 new child cases, an increase of 90% in child cases. 
• In the 9 states that reported testing data, children made up between 3%-12% of total state tests, and between 3.7%-18.6% of children tested were tested positive.
• In the 20 states plus NYC that reported hospitalizations, children were 0.5%-5.3% of total reported hospitalizations, and between 0.3%-8.9% of all child COVID-19 cases resulted in hospitalization.
• In the 44 states and NYC that reported mortality data, children were 0%-0.4% of all COVID-19 deaths, and 19 states reported zero child deaths. In states reporting, 0%-0.5% all child COVID-19 cases resulted in death.

Researchers call for better methods and access to testing. States are using different age groups, metrics and formats for their data, and there are gaps in the data they are reporting. This impacts how the data can be interpreted.  

Most cases of COVID-19 in children are less severe and do not require hospitalization.

“What we do know from these data is that, in children, deaths continue to remain much lower than in older age groups,” said Sean O’Leary, MD, MPH, FAAP, vice chair of the AAP Committee on Infectious Diseases. “But as case counts rise across the board, that is likely to impact more children with severe illness as well. To protect everyone in our communities – children, teens, and older adults – we must follow all the public health measures that we know can contain the virus. This includes physical distancing, wearing cloth face coverings, washing our hands, and avoiding large gatherings.”

Some of the increase in numbers of cases in children could be due to more testing. Early in the pandemic, testing only occurred for the sickest individuals. Now that there is more testing capacity, to test anyone with symptoms, the numbers reflect a broader slice of the population, including children who may have mild or few symptoms.  

“We are still learning more about this virus,” Dr. Goza said. “The data raises more questions that researchers would like to explore. For now, we know that there are ways to reduce the spread of this virus. We must work together to keep our families safe.”

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds