COVID hospitalizations up for state's children

Apr. 13—TRAVERSE CITY — As many older people have been vaccinated against COVID-19, health care officials are focusing on another vulnerable population — children.

Hospitalizations are at an all-time high for Michigan's children under 16, for whom vaccines are not yet approved.

Children with COVID-19 often have no symptoms or very mild symptoms. Some get severely ill, however, and the state is seeing several cases of Multisystem Inflammatory Syndrome in Children (MIS-C), which develops three to four weeks after an initial infection.

Because so many children are asymptomatic, many of their parents don't even know they had COVID, said Dr. Christine Nefcy, chief medical officer for Munson Healthcare.

"It's a serious illness and certainly these are children that don't have an option right now of getting vaccinated, so everything we can do to protect our most vulnerable ... I'd say it's important for us to do," Nefcy said.

In Michigan there are 28 children with MIS-C, Nefcy said, with a handful of local cases. Their average age is 8 and more than 60 percent require a bed in an intensive care unit, she said.

One 10-year-old boy in Shelby had both hands and both legs amputated after developing the syndrome, according to news reports. In all there were 50 Michigan children hospitalized with COVID-19 as of Tuesday.

The two-week average of those in the Munson Healthcare region testing positive for COVID has also reached an all-time high of 17.5 percent.

"It's hard to imagine that it's been almost exactly 13 months since our first case in this area and we're as bad as we've ever been," said Dr. Christopher Ledtke, an infectious disease specialist with Munson. "This is really raging right now."

Despite the prolonged surge in cases, Michigan announced Tuesday that it would follow CDC recommendations to pause administration of the Johnson & Johnson vaccine as it investigates six women who developed cerebral venous sinus thrombosis — clots in the veins that drain blood from the brain.

The J&J vaccine received emergency use authorization in late February, but it makes up a small fraction of the doses administered in the U.S., with Pfizer and Moderna vaccines making up the bulk of those administered both nationally and closer to home.

In Michigan, 2.85 million of vaccines given were Pfizer, 2.37 million were Moderna, and about 209,000 were J&J, according to the state's vaccine dashboard.

Area health departments were able to pivot to the Moderna and Pfizer vaccines after learning of the state's pause.

Those who were scheduled to receive the J&J vaccine Tuesday and Wednesday from the Grand Traverse Health Department were encouraged to keep their appointments as they would get the Pfizer vaccine instead, a press release said.

Those who have appointments at the county's first satellite clinic in Fife Lake Township on Friday will also get the Pfizer vaccine, with a second-dose clinic set for May 7.

"The pause on J&J administration does not change our vaccination efforts and goals," Lisa Peacock, health officer for the Benzie-Leelanau District Health Department and the Health Department of Northwest Michigan, said in a press release. "We will continue with the use of Pfizer and Moderna, adjusting our plans to administer vaccine available with our current allocations."

District Health Department #10 will also continue to provide the Moderna and Pfizer vaccines at clinics as previously scheduled.

The women who developed clots after receiving the J&J vaccine were all between the ages of 18 and 48 and reported symptoms 6-13 days after vaccination. One has died and another is in critical condition, according to news reports.

As more than 6.8 million doses of the J&J vaccine have been given, that's about one person in 1 million. To compare, women who are taking oral birth control have 1,000 times more risk of developing a blood clot, said Dr. Nick Tourney, an infectious disease pharmacist with Munson.

Some studies suggest that patients hospitalized with COVID-19 have a much higher chance — one in five — of developing a blood clot.

Tourney said while a correlation between the clots and the vaccine has been established, causation — the evidence that one caused the other — has not.

Symptoms include severe headache, abdominal pain, leg pain and shortness of breath occurring within three weeks of the vaccination.

On Tuesday Munson reported 85 hospitalizations across its healthcare system — a few more than one week ago — with 51 at Munson Medical Center in Traverse City.

Hospitals continue to see the numbers of younger people go up, while the average age of the COVID patient has gone down, something that is attributed to the success in vaccinating those in the 65-and-up age category.

Michigan also has the second highest number of variants in the U.S., with the B117 or UK variant the most dominant. Tests for the variant are done by the state, which only tests a small percentage of positive cases, Ledtke said. Because of that it is not known how widespread the variant is, he said. The variant is 50 to 75 percent more contagious, he said.

"We suspect that it's very widespread," Ledtke said. "In some ways it's almost like a new pandemic."

Michigan has been hit hard with the latest surge because of a number of reasons, including the prevalence of the variant, the low number of cases early on, and the relaxing of restrictions on restaurants, bars and sports events, he said.

In the coming months the scenario in Michigan will likely spread throughout the country, Ledtke said. He encouraged everyone who is eligible to get the vaccine.

State statistics show that 51 percent of people in the northwestern Michigan 17-county Region 7 have received at least one dose. For those 65 and over that number is 76 percent.

Statewide, about 42 percent of Michigan residents have been vaccinated.