National U.K. Study: 56.2% of RARE Pediatric “Covid-19 Deaths” Were INCIDENTAL, i.e., NOT “Covid-19 Deaths”, With an Infection Fatality Ratio (IFR) of 0.7/100K, Through December 31, 2021

RES IPSA LOQUITUR

“Between 01 March 2020 and 31 December 2021, after excluding two stillbirths, there were 185 deaths within 100 days of a positive SARS-CoV-2 test in CYP aged <20 years in England, of which 81 (43.8%) were due to COVID-19 (Figure 1). The remaining deaths (104/185, 56%) were due to unnatural causes (26/104, 25%) or due to causes unrelated to COVID-19 (78/104, 75%)…During the 22-month surveillance period, COVID-19 was responsible for 1.2% (81/6,790) of all deaths in CYP aged <20 years (Table 2). Over the same period, there were 2.9 million confirmed and 11.6 million estimated SARS-CoV-2 infections in CYP aged <20 years in England, giving an IFR of 2.8 per 100,000 confirmed SARS-CoV-2 infections and 0.70/100,000 estimated SARS-CoV-2 infections, “

Downloaded full paper pdf link: UK pediatric Covid-19 deaths reveal 56pct were incidental

 Bertran, Marta and Amin-Chowdhury, Zahin and Davies, Hannah and Allen, Hester and Clare, Tom and Davison, Chloe and Sinnathamby, Mary and Seghezzo, Giulia and Kall, Meaghan and Williams, Hannah and Gent, Nick and Ramsay, Mary E. and Oligbu, Godwin and Ladhani, Shamez, “COVID-19 deaths in children and young people: active prospective national surveillance,” March 2020 to December 2021, England (May 9, 2022). Available at SSRN: https://ssrn.com/abstract=4125501

 

METHODS

(CYP= “Children and Young People”)

“As part of the public health response to the global COVID-19 pandemic, UKHSA has been conducting enhanced national SARS-CoV-2 surveillance in CYP, including detailed follow-up of all fatalities since March 2020. UKHSA routinely receives reports of all laboratory-confirmed SARS-CoV-2infections in England through the Second-Generation Surveillance System (SGSS), an electronic database used by National Health Service laboratories to report significant infections to UKHSA. Confirmed SARS-CoV-2 infections in healthcare settings (pillar 1) and in the community (pillar 2) during 01 March2020 and 31 December 2021 (21 months) in CYP aged <20 years were extracted from SGSS and linked to electronic registrations records provided by the ONS to UKHSA for public health surveillance and to the Personal Demographic Service (PDS), a real-time electronic database of patients registered with the NHS, with information on demographics, name and address of their general practitioner, and current status (alive/dead and date of death).Cases were also linked to Hospital Episodes Statistics (HES),an electronic administrative database containing details of all admissions, outpatient appointments and emergency department attendances at NHS hospitals, to obtain further details on medical history and cause of death.29Additionally, the general practitioners of children who died were requested to complete a short surveillance questionnaire –online using the Snap Survey software [Snap Surveys, Portsmouth, New Hampshire] or on paper–requesting information about the reason for SARS-CoV-2 testing, symptoms, underlying conditions, hospitalizations, intensive care admission and cause of death. We also requested copies of hospital discharge summaries, death certificates and post-mortem reports if performed. Unreturned and incomplete questionnaires were followed up by phone and email. Where general practitioners were unable to provide sufficient information to ascertain the cause of death, we contacted hospital clinicians, the local designated doctor for child death and, where post-mortems were performed, pathologists and coroners for more information, as needed. Data for individual cases were reviewed independently by at least two authors and any conflicts were resolved through discussion with other authors. A COVID-19 death was defined as any fatality in a CYP with a positive SARS-CoV-2 test who died within 100 days of the test where the virus contributed to the death. Non-COVID-19 deaths included deaths that were not related to SARS-CoV-2 infection and had a clear alternative cause, as well as deaths in CYP who survived their infection but died later due to a different cause, including their underlying medical condition. Where there was insufficient information to ascertain whether the SARS-CoV-2 infection contributed to the death, the authors discussed the case with the clinician responsible for the CYP’s care to decide the most reasonable classification. Sudden deaths with no other identified cause of death were included as COVID-19 deaths. Stillbirths with a positive SARS-CoV-2 test at post-mortem were excluded.”

RESULTS

“Between 01 March 2020 and 31 December 2021, after excluding two stillbirths, there were 185 deaths within 100 days of a positive SARS-CoV-2 test in CYP aged <20 years in England, of which 81 (43.8%) were due to COVID-19 (Figure 1). The remaining deaths (104/185, 56%) were due to unnatural causes (26/104, 25%) or due to causes unrelated to COVID-19 (78/104, 75%). The deaths occurred throughout the 22-month surveillance period, mainly during the peaks of the three pandemic waves due to wild-type, Alpha and Delta variants.”…

Of the COVID-19 deaths, 61 (75%) CYP had an underlying condition, especially severe neuro-disabilities (n=27; 44% of comorbidities, 33% of COVID-19 deaths) and immunocompromising conditions (n=12; 20% of comorbidities, 15% of COVID-19 deaths). Among the 22 CYP with other non-immunocompromising conditions, 11 had a congenital syndrome (18% of comorbidities, 14% of COVID-19 deaths), including Down syndrome (Trisomy 21) and Edward syndrome (Trisomy 18) (≤5 cases each) and seven had chronic heart disease (12% of comorbidities and 9% of COVID-19 deaths). Of the five COVID-19 deaths in infants (aged <1 year), four had been born prematurely (29-36 weeks gestation.)” …

“During the 22-month surveillance period, COVID-19 was responsible for 1.2% (81/6,790) of all deaths in CYP aged <20 years (Table 2). Over the same period, there were 2.9 million confirmed and 11.6 million estimated SARS-CoV-2 infections in CYP aged <20 years in England, giving an IFR of 2.8 per 100,000 confirmed SARS-CoV-2 infections and 0.70/100,000 estimated SARS-CoV-2 infections, with an overall mortality rate of 0.61/100,000 CYP. When assessed by variant wave, IFR was lowest during the Delta variant wave but there were more COVID-19 deaths (45 during the Delta wave vs 36 deaths during the wild-type [n=21] and Alpha [n=15] variant waves) and a greater contribution of COVID-19 deaths to total deaths during the Delta wave than the whole pandemic period prior to the Delta variant wave (Table 2).”

DISCUSSSION/CONCLUSIONS

Two years into the pandemic, there are still limited data on severe and fatal COVID-19 in CYP, mainly because these are uncommon outcomes of infection in CYP…. COVID-19 contributed to only 1.2% of all [pediatric] deaths until the end of 2021, with most deaths occurring in adolescents. Of the confirmed COVID-19 deaths, nearly all fatalities occurred within 30 days of a positive SARS-CoV-2 test, similar to the previous English study. Even within this period, however, only 63% of deaths in CYP with a positive SARS-CoV-2 test were attributable to COVID-19, indicating that 28-day or 30-day infection fatality rates substantially overestimates the risk of death in CYP… Some death registrations documented “SARS-CoV-2” or “COVID-19” to be contributory even when the cause of death was unrelated to any infection.”…

Overall, our study confirms the very low risk of death due to SARS-CoV-2 in CYP, irrespective of variant. IFR based on confirmed SARS-CoV-2 infections overestimates the risk because there was very limited testing for the virus until June 2020…. The estimated IFR of 0.7/100,000 was four-fold lower than the 2.8/100,000 calculated using confirmed infections in England.”…

Ongoing national surveillance continues to demonstrate a very low risk of death in CYP with confirmed SARS-CoV-2 infection. Because of the high rates of asymptomatic and mild infections, deaths within 30 days of infection and death registrations both substantially over-estimate fatalities in CYP, highlighting the critical importance of individual case reviews to assess such rare outcomes.”

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