Delta variant infections and long COVID in children

Name and Constituency of Member of Parliament
Dr Tan Wu Meng

Question No. 1589

To ask the Minister for Health (a) to date, what is the number of children in Singapore diagnosed with COVID-19 and what proportion have the Delta variant; (b) how many needed supplementary oxygen at any time during their illness; and (c) how does this experience compare with countries with significant numbers of COVID-19 Delta variant infections in children. 

Name and Constituency of Member of Parliament
Mr Yip Hon Weng
MP for Yio Chu Kang

Question No. 1612

To ask the Minister for Health (a) how can the safety of children be ensured before a suitable COVID-19 vaccine for them is available especially children who are immunocompromised; (b) whether the Ministry is monitoring the trend of long COVID symptoms in children; and (c) whether adequate resources are available to provide healthcare and emotional support for children who contract long COVID.

Oral Answer

In Singapore, we have had 367 COVID-19 paediatric cases to date, with 172 infected with the Delta variant.  Children below the age of 12 account for 0.6% of all local infection cases.

Amongst these COVID-19 paediatric cases in Singapore, 13.6% (50 cases) were aged 0 to 1, 22.6% (83 cases) were aged 2 to 4, 20.7% (76 cases) were aged 5 to 6 and 43.1% (158 cases) were aged 7 to 12.

Global data show that a very low proportion of COVID-19 infected children experience a severe illness, as compared to adults. The percentage of infected children who experience severe illness and require intensive care is 0.7% in Israel, 0.3% in the Republic of Korea and 0.6% in France. There is evidence suggesting that children with underlying medical conditions such as genetic, neurological, metabolic conditions, some degree of medical complexity, congenital heart disease, obesity, diabetes, asthma, chronic lung disease, sickle cell disease, or immunosuppression might be at increased risk for severe illness from COVID-19.

Fortunately, in Singapore, no child thus far has developed severe illness requiring oxygen supplementation or ICU care. So the percentage of infected children that experience severe illness in Singapore is zero.  We are however mindful that the number of cases in the community is rising and there may be more children infected with COVID-19 in the future. We will ensure that these children receive appropriate care, if their illness is more severe.

There are things parents can do to minimise the risk of their children getting infected for developing severe illnesses. All family members should maintain good hygiene and keep their home clean. When out, keep your masks on and cut back on social activities where masks are off or the interactions are prolonged, because such interactions account for the large majority of infections. When unwell, do a self-test or see a doctor immediately.
 
These effective safe management and surveillance measures have been implemented to further keep our children safe, particularly in large settings where children congregate, such as preschools and schools. These include mask-wearing, limiting group size, personal hygiene and requiring those children with higher risk to take a leave of absence. Family members should also get vaccinated, to reduce the risks of being infected and transmitting COVID-19 to the child.

Immunocompromised children are at risk from COVID-19 and other infectious diseases.  They and their family should exercise additional precautions such as avoiding crowded places and minimising the number of visitors.

As for ‘Long COVID’, it is an informal term that refers to persons who have continued symptoms of COVID-19 infection. The underlying reasons for these symptoms vary, as do the symptoms themselves.  Locally, infected children generally have not had such prolonged symptoms. But we will offer care to all patients with ‘long COVID’ if this occurs, and especially those who require support from different clinical teams depending on their conditions.