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November 16, 2020 – Since the start of the COVID-19 pandemic, more than 1 million infants, children and adolescents have been diagnosed with the illness, according to data released Monday by the American Academy of Pediatrics and Children’s Hospital Association, which are tracking data reported by state health departments.  

As of Nov. 12, a total of 1,039,464 children have tested positive for COVID-19 since the onset of the pandemic. In the one-week period ending Nov. 12th, there were 111,946 new cases in children, which is substantially larger than any previous week in the pandemic. The increase tracks surges in the virus in communities across the U.S.  

“As a pediatrician who has practiced medicine for over three decades, I find this number staggering and tragic. We haven’t seen a virus flash through our communities in this way since before we had vaccines for measles and polio,” said AAP President Sally Goza, MD, FAAP. “And while we wait for a vaccine to be tested and licensed to protect children from the virus that causes COVID-19, we must do more now to protect everyone in our communities. This is even more important as we approach winter, when people will naturally spend more time indoors where it is easier for the virus to be transmitted.” 

The AAP calls on elected leaders to immediately enact a new, national strategy to reduce the spread of the virus and address myriad harms resulting from the pandemic.  

“We urgently need a new, nation-wide strategy to control the pandemic, and that should include implementing proven public health measures like mask wearing and physical distancing,” Dr. Goza said. “This pandemic is taking a heavy toll on children, families and communities, as well as on physicians and other front-line medical teams. We must work now to restore confidence in our public health and scientific agencies, create fiscal relief for families and pediatricians alike, and support the systems that support children and families such as our schools, mental health care, and nutrition assistance.”     

In addition to children infected with the virus, the pandemic has taken a toll on children’s health in numerous ways.   

  • Family stress and mental health: According to a national survey, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. According to the Centers for Disease Control and Prevention, visits by children and adolescents to the emergency department for mental health problems increased more than 24% during the pandemic.  
  • Disruptions to education have impacted not only children’s academic performance but family stability and equity from lost wages caused by school closings. 
  • Children have reduced access to health care during the pandemic, as demonstrated in a recent data analysis by the Centers for Medicare & Medicaid Services. Compared with the same time period in 2019, there were 22% fewer immunizations for children 2 and younger against other infectious diseases like measles and whooping cough and 44% fewer (3.2 million) child screening services.  The AAP is concerned about children missing developmental and other screenings that normally take place during these visits. 
  • Children were already vulnerable to abuse and neglect before the pandemic, and research has shown that accumulated stressors like job loss and illness put families at risk of child maltreatment.  Increased stress and isolation place children at immediate risk of severe harm, neglect and even death. 

Severe illness due to COVID-19 remains rare in children. But the AAP urges health authorities to do more to collect data on longer-term impacts on children, including how the virus may harm children’s physical health after the acute illness has resolved. The AAP also calls for more research into the emotional and mental health effects the pandemic is having on children and adolescents.  

“We know from research on the impact of natural disasters on the mental health of children that prolonged exposure to this kind of toxic stress is damaging,” Dr. Goza said.  “Most natural disasters have an end, but this pandemic has gone on for over eight months, and is likely to continue to disrupt our lives for many more. We’re very concerned about how this will impact all children, including toddlers who are missing key educational opportunities, as well as adolescents who may be at higher risk for anxiety and depression.” 

The AAP believes the number of reported COVID-19 cases in children is likely an undercount because children’s symptoms are often mild and they may not be tested for every illness. The virus has had a disproportionate impact on Black and Hispanic children, who are suffering a higher number of infections, as well as other impacts of the pandemic including economic harms and lack of access to education and other critical services.   

The data are compiled each week by AAP and CHA from reports by public health departments of 49 states, New York City, the District of Columbia, Puerto Rico, and Guam. The definition of a “child” case is based on varying age ranges reported across states; see the full report for more details and links to state and territory data sources.  

The report on child COVID-19 cases is updated every week, usually on Monday.  

AAP resources include: