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COVID-19 in Cuban Children and Adolescents. Second Report. Epidemiological Weeks 12 to 30. July 2020

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COVID-19 in Cuban Children and Adolescents. Second Report. Epidemiological Weeks 12 to 30. July 2020 COVID-19 in Cuban children and adolescents. Second report. Epidemiological weeks 12 to 30. July 2020. Luisa Iñiguez Rojas. FLACSO-Cuba. University of Havana. Edgar Figueroa Fernández. CEPDE-ONEI. Laura Almora Andarcio. CIPS. CITMA. Angel Miguel Germán Almeida. IPK. Ministry of Health. Antonio Herrada Hidalgo. FLACSO-Cuba. University of Havana. Lorenzo Somarriba López. Director. Centre for Health Surveillance. Ministerial Management Centre. Ministry of Health. CONTENT 1.1. Characterization of children and adolescents diagnosed with COVID-19 (by sex and age) | 03 1.2. Provincial distribution of children and adolescents (aged 0-18 years) confirmed with COVID-19 | 06 1.3. Municipal distribution of children and adolescents (aged 0-18 years) confirmed with COVID-19 | 08 1.4. Distribution of children and adolescents (aged 0-18 years) confirmed with COVID-19 by human settlements | 10 1.5. Spatial clusters and sources of transmission | 13 General conclusions | 16 References | 17 The first report (June, 2020) on the epidemiological COVID-19 in children and adolescents in Cuba and characteristics and spatiality of COVID-19 in Cuban its territories. children and adolescents included 223 positive cases between March 21 and May 30 (Íñiguez Rojas, et al., 1.1. Characterization of children 2020). After 126 days of the epidemic’s evolution in and adolescents diagnosed with Cuba, 278 children and adolescents had been confir- the COVID-19 (by sex, age). med with COVID-19. Four of them were Cubans li- The evolution in epidemiological weeks 12 to 30 shows ving abroad, two were tourists and one was a Cuban an increase in notifications from week 13 onwards. resident who had returned to the country with her The maximum number of confirmed cases is reached mother. in weeks 15 (55), 16 (34) and 17 (39). In the following At the time of writing this report, a number of stu- weeks, notifications are reduced, with slight increases dies have been published around the world discus- in weeks 23 and 27, as shown in Figure 1. The percen- sing manifestations and possible effects on children tage representation (Figure 2) of children and adoles- (UNICEF, 2020) (LunaA-Bazaldua & Pushparatnam, cents of the total number of confirmed persons in the 2020) (CDC, 2020) (Ballarini, Arriola, Santagapita, & country varies from less than 5 % to more than 40 % of Bonnin, 2020). Some relevant, and sometimes contra- the total in week 27. dictory, points in the debate focused on the relatively Cases low confirmation of cases in children and adolescents 300 with COVID-19 in relation to the adult population, or the under-detection of cases due to slight or inexistent 250 symptoms, or viral load. Other working hypotheses 200 related to lower susceptibility to infection, the ability 150 to transmit the virus, and the low rates of hospitaliza- tion and death of children compared to adults. 100 This second report follows up on the pandemic, 50 including the findings of the first one, and inclu- 0 des the epidemiological and spatial characteristics 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 between May 31 and July 25 (epidemiological wee- Epidemiological weeks ks 23 to 30)1 to provide an evolutionary picture of Cases per week Cumulative cases Figure 1. COVID-19 in children and adolescents by date of 1 Generally, in order to analyse the behaviour and evolution of confirmation (cases per week and cumulative). diseases, especially communicable ones, epidemiological wee- Source: Ministry of Health’s daily briefings. Department of ks that follow an international calendar are used. Health Surveillance’s Database. -3- COVID-19 IN CUBAN CHILDREN AND ADOLESCENTS. SECOND REPORT. EPIDEMIOLOGICAL WEEKS 12 – 30 JULY, 2020. Percentage Cases 50 160 43.5 140 40 120 100 30 80 60 20 40 10 20 3.4 3.3 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 0 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Epidemiological weeks Epidemiological weeks Female Male Figure 2. Cuba. COVID-19 cases in children and Figure 4. Cuba. Cumulative cases of COVID-19 by sex and adolescents by date of confirmation (percentage of cases epidemiological weeks. aged 0-18 years of total cases in the country). Source: Ministry of Health’s daily briefings. Department of Health Surveillance’s Database. Source: Ministry of Health’s daily briefings. Department of Health Surveillance’s Database. tion of the population and the proportion of cases in In terms of weeks of the evolution of COVID-19 in each group shows the lowest incidence in the 0-5 age the country, there are no differences by sex up to group, a similar amount in the 6-11 age group, and hi- week 15. From this week onwards, the number of gher in the 12-18 age group. However, the percenta- confirmed males rises slightly, maintaining similar ge representation in total cases in the 0-18 age group values in subsequent weeks, with the exception of varies widely from 15 % to just over 70 % of the total week 27, in which 75 % of those confirmed were in week 23; no cases were confirmed in this group in male (Figure 3). week 25 (Figure 5). In epidemiological week 15 (5-11 April), the maxi- Cases 30 mum number of confirmed cases is reached in the 12- 18 and 6-11 age groups, as the 0-5 age group reaches 25 it in week 16. Until week 15, a similar behaviour is 20 observed by age groups. In the following weeks the distribution is irregular (Figure 5). 15 10 Cases 30 5 25 0 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 20 Epidemiological weeks Female Male 15 Figure 3. Cuba. Distribution of COVID-19 cases by sex and epidemiological weeks. 10 Source:Ministry of Health’s daily briefings. Department of Health Surveillance’s Database. 5 The cumulative cases per epidemiological week show 0 that, in general, the number of male cases exceeds the 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 number of female cases (Figure 4). Epidemiological weeks The distribution of children and adolescents diag- 0 a 5 years 6 a 11 years 12 a 18 years nosed with COVID-19 by age group shows the highest Figure 5. Cuba. Distribution of COVID-19 cases by age number of cases in the 12-18 age group in most epide- groups (cumulative cases per week). Source: Ministry of Health’s daily briefings. Department of miological weeks. A comparison between the propor- Health Surveillance’s Database. -4- COVID-19 IN CUBAN CHILDREN AND ADOLESCENTS. SECOND REPORT. EPIDEMIOLOGICAL WEEKS 12 – 30 JULY, 2020. As the epidemic develops, the cumulative cases per is recorded in the 12-18 age group in weeks 15 and 17, day by sex and age show a slight predominance of ma- and male infections in weeks 17 and 27. In the 6-11 age les and the increase of the cases in the 12-18 age range, group, the highest numbers of cases are confirmed for respectively (Figures 6 and 7). females in week 16 and males in weeks 15 and 23. In terms of sex and age, the distribution of cases is Incidence rates increase with age, reaching about irregular (Figure 8). The highest numbers are both ma- 15 per 100 000 in the 12-18 age group (Figure 9). The les and females. A higher number of female infections rates by sex are similar; 11.78 per 100 000 for females Cumulative Cumulative cases cases 300 300 200 200 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 Date 0 0 0 0 0 0 0 0 0 0 0 Date 21/03/2 02/04/2 10/04/2 19/04/2 29/04/2 11/05/2 23/05/2 04/06/2 22/06/2 03/07/2 21/07/2 21/03/2 02/04/2 10/04/2 19/04/2 29/04/2 11/05/2 23/05/2 04/06/2 22/06/2 03/07/2 21/07/2 Female Male 0-5 years old 6-11 years old 12-18 years old Figure 6. Cumulative cases of COVID-19 in children and Figure 7. Cumulative cases of COVID-19 in children and adolescents (by sex). adolescents (by age group). Source: Ministry of Health’s daily briefings. Department of Source: Ministry of Health’s daily briefings. Department of Health Surveillance’s Database. Health Surveillance’s Database. Cases 20 15 10 5 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Epidemiological weeks Females 0-5 years old Females 6-11 years old Females 12-18 years old Males 0-5 years old Males 6-11 years old Males 12-18 years old Figure 8. Cases of COVID-19 in children and adolescents by sex, age groups and epidemiological weeks. Source: Ministry of Health’s daily briefings. Department of Health Surveillance’s Database. -5- COVID-19 IN CUBAN CHILDREN AND ADOLESCENTS. SECOND REPORT. EPIDEMIOLOGICAL WEEKS 12 – 30 JULY, 2020. and 12.34 per 100 000 for males. These characteristics The incidence shows a remarkable interprovincial remain in an integrated analysis by sex and age group heterogeneity (Figures 11 and 12). The highest inciden- (Figure 10). ce rates in the period were registered in the provinces of La Habana, Villa Clara and Ciego de Ávila, and the Rate per 100 000 lowest incidence was reported in the eastern provin- 16 ces, particularly in Las Tunas, Granma and Guantána- 14 mo.
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