COVID-19 Mortality Rate Among Children Is Even Lower Than Previously Thought

We’ve known since the early weeks of the pandemic that age is the single best predictor of COVID-19 mortality, and that the risk of death for young people is vanishingly small.

A letter in the New England Journal of Medicine reported that zero Swedish children aged 1–16 died of COVID-19 up to the end of June 2020. And only 15 were admitted to the ICU, of whom four had a serious underlying health condition.

Of course, England is a much larger country than Sweden, and it’s been a whole other year since those Swedish data were collected. So how many English children have died of COVID-19?

In an unpublished study, Clare Smith and colleagues sought to identify the number of COVID-19 deaths among people aged under 18 between March 2020 and February 2021. They examined data from the National Child Mortality Database, which was linked to testing data from Public Health England and comorbidity data from national hospital admissions.

The structure of their dataset allowed the authors to distinguish deaths that were plausibly from COVID-19 and deaths that were merely with COVID-19.

3,105 under 18s died from all causes in England during the relevant time period. Sixty one of these involved people who had tested positive for the virus. However, the authors determined that only 25 were actually caused by COVID-19. And of the 25, 76% had a serious underlying health condition.

Given that an estimated 469,982 under-18s were infected with the virus up to February of 2021, the survival rate in this age-group (the inverse of the IFR) was 99.995%. What’s more, 99.2% of total deaths were caused by something other than COVID-19.

Smith and colleagues’ findings underline just how small a risk COVID-19 poses to young people, and hence – I would argue – why a focused protection strategy was preferable to blanket lockdowns.  

As early as 10th April 2020, Martin Kulldorff – co-author of the Great Barrington Declaration – published an article on LinkedIn titled ‘COVID-19 Counter Measures Should be Age Specific’.

Based on the data that were then available, he estimated one would need to stop 3.5 million children being exposed in order to prevent the same number of deaths as one could prevent by shielding 1,000 people in their 70s. He argued, therefore, that Covid counter-measures must vary by age.

A similar argument was made by George Davey Smith and David Spiegelhalter in a piece for The BMJ last May. These authors called for “stratified shielding”, while noting that this would “require a shift away from the notion that we are all seriously threatened by the disease”.

According to the medical researcher Russell Viner, who spoke to Nature, “There’s a general feeling among paediatricians that probably too many children were shielded during the first wave.” And the epidemiologist Elizabeth Whittaker said that efforts to shield children “have probably caused more stress and anxiety for families than benefit”.

In addition to “stress and anxiety”, there’s also the learning losses associated with months of online teaching. All this compared to the marginal impact closing schools had on the spread of COVID-19.

When we look back at the response to Covid, serious questions will have to be asked about the costs of lockdown, not only to society in general, but to young people in particular.