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Students line up on the first day of school in Montreal on Aug. 31.Graham Hughes/The Canadian Press

New research published on Monday shows the majority of Canadian children and teens were spared the most severe health outcomes of COVID-19 in the first phase of the pandemic. But health experts worry the increased transmissibility of the Delta variant could expose high numbers of vulnerable young people to the virus and lead to more serious cases.

The study, released after millions of unvaccinated children returned to school, sports and social activities, found that pediatric hospitalizations linked to COVID-19 were low from March to December, 2020.

About 44 per cent of children who were in hospital with COVID-19 had been admitted for reasons unrelated to the coronavirus, according to the study, published in the Canadian Medical Association Journal. For instance, some cases were detected through routine testing before a planned procedure.

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Children and teens who were hospitalized for severe illness linked to COVID-19 often had existing health problems, such as obesity and chronic neurologic or lung conditions other than asthma.

Charlotte Moore Hepburn, a pediatrician at Toronto’s Hospital for Sick Children and one of the lead investigators of the new study, said only a small number of children without existing health conditions developed severe illness as a result of COVID-19.

With the highly transmissible Delta variant of the coronavirus now accounting for most cases in Canada, and no vaccine yet available for children under 12, more needs to be done to protect young people from the virus, she said.

“Everyone, regardless of underlying health conditions, should do everything they can to protect themselves and their community,” she said.

A report published by the U.S. Centers for Disease Control and Prevention earlier this month found that the Delta variant has not led to a significant change in the overall rate of children and teens who become severely ill as a result of COVID-19. But research is continuing to determine whether the variant does hit certain age groups harder.

But the fact the Delta variant spreads so easily means larger numbers of young people will become infected, with a small subset experiencing serious illness. According to the Public Health Agency of Canada, people 19 and under account for about 20 per cent of all COVID-19 cases in Canada, and they make up about two per cent of all hospitalizations related to the virus.

“Where we see lots of COVID transmission, we’re going to see lots of cases [in children],” said Laura Sauvé, an infectious-disease specialist at B.C. Children’s Hospital. “It’s possible that in the places where there’s lots of COVID circulating now, there will be some more severe cases.”

Weeks into the school year, experts say it’s imperative for adults to do whatever is necessary to keep transmission rates low, not only to protect kids from the virus, but to allow them to benefit from in-person learning and other social activities.

“The biggest way we can protect children is to get everybody around them vaccinated,” Dr. Sauvé said.

No COVID-19 vaccine has been approved for children under age 12. Last week, Pfizer-BioNTech reported positive results from a trial involving five- to 11-year-olds, suggesting that approval of a vaccine for that age group could be a few weeks away. But even then, it will take time to get vaccination campaigns organized and get good coverage rates among that age group.

With more students meeting face to face, Dr. Sauvé also highlighted the fact that common respiratory viruses could also pose challenges this year.

“We’re definitely watching for, not just COVID, for other respiratory viruses as well,” she said.

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