A now-deleted video shared by NHS England on its Twitter and Facebook accounts on 3 February 2022 contained claims about children and Covid-19 that were not accurate. The video was widely shared before being deleted, but at the time of writing, NHS England has not published a correction to explain why the video was deleted.
In the video, a consultant respiratory physician, Dr Binita Kane, spoke about the risk of hospitalisation for children who catch Covid, and the number of children who have died of the disease.
Based on what we know, her claims on the number of deaths and the risk of hospitalisation were almost certainly overstated.
The death or serious illness of a child is a terrible event in any circumstances, but it is important to understand the real level of risk as accurately as possible.
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Do one in 100 children with Covid go to hospital?
During the video, Dr Kane said: “One in a hundred children will actually get sick enough [with Covid] to be admitted to hospital.”
NHS England told Full Fact that it believed that Dr Kane’s statistics came from the website of a campaign group called Long Covid Kids (LCK), and Dr Kane has confirmed this with us.
Specifically, it comes from a chart on the LCK website, which shows that the number of Covid hospitalisations in 0-17-year-olds was often around 1% of the number of reported cases until the second half of 2021. More recently, it has been roughly 0.5%, which Dr Kane told us she thinks is a more up-to-date estimate.
Even so, both figures still overstate the proportion of children who get ill enough with Covid to be admitted to hospital.
How many admissions are for Covid?
A number of the hospital admissions in this data will be so-called ‘incidental Covid’ admissions—meaning that the children in question were in hospital for other reasons, but tested positive for Covid at the same time. Some incidental Covid infections may have an important effect on someone’s health. Others may have little effect. However, it would not be true to say that these children were necessarily “sick enough” with Covid to be admitted.
NHS England publishes regular data on this subject, which shows that at the end of January and beginning of February, about half of all hospital patients with Covid were being treated primarily for the disease. We don’t have data to show whether this rate would be higher or lower in children specifically, but it does suggest that adjusting for incidental admissions would make a significant difference to the hospitalisation rate.
How many children catch Covid?
The number of reported Covid cases also does not reflect the total number of infections actually happening, because many people do not get tested, or their results are not reported.
There is clear evidence for this in the Office for National Statistics (ONS) Infection Survey, which estimates that the number of people catching Covid in England in December 2021 and January 2022 was about two and a half times higher than the number of positive tests being reported. Again, we can’t say confidently whether this reporting rate would be different for children.
Dr Kane partly acknowledged this second point in a message to Full Fact, saying: “I should have said 'symptomatic' children, as of course asymptomatic infections will dilute the data.”
What’s the real risk of hospitalisation?
Since the number of child Covid cases is higher than reported, and the number of children who “get sick enough [with Covid]” to be admitted to hospital will be lower than the total number admitted, the real risk will be lower than lower than 1% or 0.5%. The true risk is hard to estimate precisely.
However, if the 1% rate was adjusted to assume that there were 2.5 times more children being infected than reported (using the rate for all ages), and 50% of hospital admissions of children with Covid were primarily for Covid (using the rate for all ages), the hospitalisation rate would be more like 0.2%.
If you took Dr Kane’s updated estimate of 0.5% and applied the same adjustments, you’d end up with an estimate of roughly 0.1%. A paediatric doctor reached a similar figure with a series of calculations on Twitter.
In short, the claim in the NHS video that one in 100 children with Covid get ill enough to need to go to hospital may have overstated the real risk significantly.
How many children have died of Covid?
In the same video, Dr Kane also said: “Sadly, 136 children in the UK have died of Covid-19 since the beginning of the pandemic.”
In a message to Full Fact, she said that this figure also came from the LCK website, where it now appears to have been updated to 138.
We have asked LCK how this figure was calculated, and it told us that it was based on deaths within 28 days of a positive test. As a result, this figure includes some cases where people tested positive for Covid, but died for other reasons. Dr Kane also told us that the figure reflects deaths in those aged under 20, which includes 18-19-year-olds, who do not meet the General Medical Council’s definition of children.
As we have said before, the latest ONS data shows that 50 deaths “due to” Covid in under-18s were registered in England and Wales from the start of the pandemic to the end of December 2021. This means that Covid itself was listed as the underlying cause of death on their death certificates. (The total would be 62 if we include all deaths “involving” Covid, meaning that Covid was either the underlying cause or was mentioned as a contributory factor.)
We do not have the comparable data for Scotland and Northern Ireland, but those nations account for about 10% of the children in the UK, so the numbers would probably increase slightly if they were included.
Sadly, more children may have died of Covid in January 2022. We do not yet know how many, but the total is very unlikely to rise to 136.
The NHS response
In answer to our messages asking if it agreed that the figures in the video were not accurate, NHS England said: “The post has now been removed given this data is no longer the latest on record.”
The deaths figure and the hospitalisation rate were never accurate, however. We therefore think this is a misleading description of what happened.
Photo by Adam Nieścioruk on Unsplash