Kids and the Delta Variant: Should you Act Differently?

Emily Oster

9 min Read Emily Oster

Emily Oster

Kids and the Delta Variant: Should you Act Differently?

Emily Oster

9 min Read

My most asked question these days, by far, is about kids and the delta variant.

We thought it was the summer of fun! Camp! Popsicles! Followed by the fall of normalcy: back to school shopping, full school days, maybe even no masks. And now…delta.

There is a lot to unpack with the delta variant, including how it interacts with unvaccinated adults, its contribution to global cases, its intersection with the question of whether we should donate vaccine doses, and on and on. I want to mostly focus today on one specific question: How much does this change how we think about kids (if at all)?

Before we get into that, though, I wanted to briefly talk about vaccine efficacy. The vaccines we have remain highly effective against the delta variant. Estimates of efficacy after full vaccination (two doses) with Pfizer in the UK and Canada were 88% and 87%, respectively. Data from Israel has seemed to suggest lower efficacy (64%), but many experts have questioned this given the UK and Canada data. It’s difficult to calculate these numbers in a real-world setting, and the Israel number may simply be too low.

In general, though, the efficacy numbers against any infection are slightly below the wild type. But they are still very effective and extremely, extremely effective against serious illness and death. The presence of the variants is an extra reason to get vaccinated, not a reason to not be vaccinated. Virtually all COVID deaths in the US at this point are among unvaccinated individuals. Bottom line: vaccines work — they still work — and if you are fully vaccinated, you still do not need to worry very much about infection and, especially, serious illness from COVID.

However: kids under 12 are not eligible for vaccines yet. So, what about them?

Kids & Delta

When we turn to the question of kids, we need the right frame. Which is, to me:

What, if anything, does this change?

We have been living with COVID-19 for over a year now. We grappled with questions about how much to engage our kids in the world, how we wanted to mask, what case rates we wanted to respond to. At this point, for better or worse, you have probably made those choices.

When we introduce the delta variant into the equation, then, it would be a huge mistake to undo all this work. I think we are sometimes falling victim to the idea that this should cause us to completely re-evaluate everything. But you did so much work to make these decisions before! Do not throw it away!

Instead, we want to simply ask whether this should change what we do. The value of this frame is that it really narrows what we need to know. There are two reasons that our behavior might change in response. One is if this makes kids more likely to get COVID-19. The second is if it is more likely to lead to serious illness in kids. Let’s deal with these in turn.

Is Infection More Likely?

The Delta variant is more contagious; exactly how much is unclear, but it seems in the range of 60% to 100% more. (100% more contagious = twice as contagious). This means that if an interaction with an infected person had a 10% chance of leading to infection with the original COVID-19, that same interaction has a 16% to 20% chance now.

This means that everyone — kids, adults, etc — are more likely to be infected for a given interaction with an infected person. However: the data does not suggest a relatively greater degree of infectiousness for kids. That is: it doesn’t look like children are relatively more susceptible to this variant.

The best data we have on this is from the UK, where frequent sequencing and the dominance of the delta variant for months has made it possible to look at the age patterns of infection. The graph below shows infections by age group over the last months. Just as in earlier parts of the pandemic, rates in younger children remain extremely low. The most affected group in this time frame are people 16 to 24, a group which in the US has been eligible for vaccination for several months.

The group aged 2 to 11 is perhaps the most relevant here, and the rates are low and flat even though there has been unmasked in person school during this period. This should be reassuring.

It is important to note that over the next months we will continue, in the US, to see children be a larger and larger share of cases. (Not number, share). This is because older people are vaccinated. (For example: UK vaccination rates for older people are very high, and you can see that in their low rates in the graph above). In the limit, if all eligible people were vaccinated, we’d expect to see kids be a really large case share. But that’s not because the variant is more infectious in children.

Bottom line here: infection is more likely for every unvaccinated person, including children, but not relatively more so in kids.

Is infection more serious?

Serious infection or death from COVID-19 in kids is extremely rare. We know this, and it continues to be reinforced with data. Just this week, several studies out of the UK showed extremely low child death rates. Of almost half a million infections, there were 25 deaths, 15 of which were in children with serious underlying illness. Any death is tragic, and death is not the only thing we are worried about, but this reinforces the conclusion that children are extremely low risk.

Turning to delta: there is disagreement about whether the delta variant leads to more severe disease in general. Some people have suggested it does, based on one study out of Scotland. However, this is generally a challenging question because in many places with good monitoring, the most vulnerable people are vaccinated already. The broad expert consensus seems to be that serious illness risks rates are similar.

When it comes to kids, though, the data doesn’t point to anything that would look like alarming increases in hospitalization rates in recent weeks.

Broadly, both cases and hospitalization rates have been declining in children over 2021 (note the hospitalization rates are on the right axis — they max out at around 1 per 100,000; very low even at their peak). Delta has not been dominant in the US in this period, but the UK data also does not show significant hospitalization spikes over the last few weeks.

The bottom line is there is nothing in the data that we have so far which suggests the variant is more serious for kids. The situation is murky enough that it is hard to rule out the idea that it might be *slightly* more serious (partly, the risks are so low that you’d need a huge amount of data to figure this out). It also might be slightly less serious. But: the fact remains that the risks of serious illness for kids remain really, really low.

(Yes, many people are worried about long COVID. But, again, this is a risk you thought about before. It hasn’t changed, which doesn’t mean you shouldn’t think about it, but does mean that you do not need to re-evaluate based on it).

What Does This Mean?

Should you do anything differently?

I revisited my calculator as a window to what changed. First: the presence of the variants may mean that case rates go up, especially if you are in an area with limited vaccinations. So you want to watch those — independent of the variants, you want to watch them. The NYT Tracker can show you rates in your state or county.

Second: the more contagious virus warrants an update of the transmission risk, which I did in the calculator.

More generally, let’s say you thought through some case rate cutoff for various activities before, under the wild type virus. Like, maybe you thought: I’m comfortable with my child in day care as long as daily case rates are below 60 in 100,000. The presence of the variant should reduce that threshold proportionality, since it’s based on an assumption about transmission risk. If the variant is twice as contagious, your new threshold should be 30 in 100,000.

And if an activity is extremely low risk — like being outside, even unmasked — this shouldn’t change what you do. Twice a close-to-zero risk is still close to zero.

In this way, you can use the decisions you made before. Don’t force yourself to remake them all.

A Final Thought

As I reflect on on our continued discussion around kids, I am recognizing a distinction in some of our thinking. It boils down to this: Do you want to think of COVID-19 for kids the way you think about other illnesses, or does the fact that it is new mean you want to treat it differently? I think at the core this distinction is what colors a lot of our continued disagreements or differences in approach.

On the observables — serious illness, symptomatic illness, mortality risk — COVID-19 for kids (variants or not) is a risk comparable or lower than diseases like RSV or the flu. Again, I know the long COVID fears are real, but the fact is that RSV, the flu and other diseases have these long tails also.

We’ve kept kids isolated to protect high risk adults, but as those groups get access to vaccines and we focus on kids, there is an argument for treating this like other diseases. Which means, in turn, accepting the risk that your kid might get COVID-19.

For some people, the residual newness of COVID-19 means they do not want to think of it this way. They may worry about the unknowns — could there be unexpected impacts of COVID-19 infection a decade from now? — and no amount of current data will help with this. If this is your take, you may want to continue to take precautions which are greater than those you would take in the face of existing diseases.

Both of these may be reasonable, but they do reflect a very different approach. And by recognizing this difference, we may be able to better understand our choices and — more importantly — the choices of others.

1

This scales up the CDC hospitalization numbers to reflect that they cover about 10% of the population and it scales them down to reflect findings that at least 40% of children hospitalized with COVID tests are incidental infections. Case rates are converted to counts based on US population by age.

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Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
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Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents

It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents
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My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor
...

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Good news: fancier vitamins are not better.  Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough. 

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better. Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough.

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips
...

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#parentdata #emilyoster #newborncare #parentingadvice #parentingtips

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips
...

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🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth
...

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata
...

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Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships
...

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Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles
...

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity
...

What's in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you.

What`s in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you. ...

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport
...

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way. 

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way.

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes
...