School children in U.S. are much more likely to be hospitalized with COVID than in U.K. — and doctors aren't sure why

School children in U.S. more than twice as likely as kids in U.K. to end up in hospital with COVID

Children going to school in England are far less likely to end up in the hospital with COVID than kids in the U.S. despite the U.K. hitting the peak of another virus surge — a trend that has puzzled the medical community on both sides of the pond.

The most recent statistics comparing the rate of infections per 100,000 in both countries show that for one week in October, the U.S. had over 10 times more hospital admissions for children under 18 than England. At the same time, the pandemic is currently much worse in the U.K., which has the 16th-highest incident rate for the past seven days, according to OSCOVIDA, the Open Science COVID Analysis website. The U.S. ranks 35th.

Masks do not seem to play a role here. They may be a hot-button issue in the U.S., but they're not required in the U.K. The lack of masks may even have contributed to an outbreak of infections at Abi Schroeder's school.

"They're sitting close together in a classroom. They weren't wearing masks," her mother told CBS News' Charlie D'Agata. "I think it is probably very likely that actually that is why there was such a rapid rate of infection."

Britain's latest surge of COVID cases is fueled by elementary-school children, with those under 15 accounting for more than a third of all recent cases.

Abi was among those cases.

"I didn't have that many symptoms," she said. "It was just like a bad cold, kind of, and it was just annoying because I couldn't see my friends."

Abi's case is typical as very few kids in the U.K. become sick enough to be hospitalized.

The uptick of vaccines isn't the main factor, either. The percent of people under 18 years old who are fully vaccinated is lower in Britain than in the U.S.

That leaves medical experts to consider environmental or behavioral differences such as diet, nutrition and whether childhood diabetes or obesity are driving up hospitalizations among kids in the U.S.

"We're seeing those biologic differences country to country," CBS News medical contributor Dr. David Agus said. "There are certain behavior differences because we're all different. Our genetics are different, our lifestyle is different, what we're exposed to is different, our prior viruses are different and they all go into the formula."

One major difference in the two countries is mass testing. Most schoolchildren in the U.K. test at home every week or even twice a week in some cases.

"When you do at-home testing, you test people and find them with high viral loads and they don't go to school, whereas in the United States, they may, and when you present and spread with high viral loads, sometimes those people can be hospitalized," Agus said.

In the end, it may be a combination of all of those factors, though Agus said doctors "just don't" really understand the biology behind this trend.

Despite the surge of cases in both countries, it's still extremely rare for a child to be hospitalized with COVID. Hospitalizations may become even more unusual once U.S. health regulators approve Pfizer's vaccine for children 5 to 11 years old. An independent advisory panel for the U.S. Centers for Disease Control and Prevention was set to consider the move Tuesday morning.

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