COVID-19 may never truly go away, despite hopes for the U.S. reaching herd immunity as more people get vaccinated or recover from infections and gain natural immunity. Three things could keep us short of herd immunity: The protection from vaccines or prior infections may prove temporary; future COVID-19 variants could infect people who are immune to the existing strains; or a significant minority of the population may never get vaccinated. However, scientists believe that at some point, COVID-19 will become “endemic” rather than pandemic, meaning that it will still be around, but it will be less deadly and less common. They think that the human body will eventually adjust on its own to at least lessen the severity of an infection, so that COVID-19 becomes more like the flu: A seasonal nuisance that hits people more when they are indoors in close proximity in the winter months and during the holidays. Children in school could still pass it around, much like they do with other viruses. Plans are being developed for booster vaccines to be given as early as this fall.
Since early in the pandemic, it was clear that older adults were at elevated risk for severe COVID-19 disease and death. In contrast, Brazil’s epidemic is exhibiting elevated mortality among children and infants. A report by The New York Times describes some of the factors that could be contributing to increased pediatric mortality. Since the onset of the pandemic, Brazil has reported at least 832 deaths among children aged 5 years and younger, which likely is a “substantial undercount.” In fact, researchers at the University of São Paulo estimate that the actual total is closer to 2,200, including more than 1,600 infants younger than 1 year. For comparison, the US has reported only 139 deaths among children aged 4 years and younger. While the age range is slightly smaller than in Brazil’s tally, the US has a population approximately 50% larger than Brazil’s. Myriad factors could be contributing to Brazil’s high pediatric mortality. The P.1 variant that is circulating widely in Brazil has been linked to increased disease severity and mortality among pregnant women as well as elevated risks of stillbirth or premature delivery. A lack of testing leads to untimely or inadequate access to health care for children with COVID-19, and poor and overwhelmed health systems also could result in increased mortality among this population. Underlying health conditions—some related to poverty and food insecurity—can exacerbate the risk of severe disease in children, but Brazil’s pediatric COVID-19 mortality also is elevated in otherwise healthy children. Further study is needed to better characterize the factors influencing elevated mortality among children and infants in Brazil.
CSSE is reporting 33,079,478 positive cases in the U.S. and 589,135 deaths. DOH reported 2,304,860 confirmed cases in Florida Friday, with 36,441 deaths.