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| Pilar Villarraga had spent much of the summer counting down the days until her daughter Sophia’s birthday. In early August, Sophia would turn 12 — and become officially eligible for a Covid-19 vaccine. “I didn’t want her to start school without the vaccine,” said Ms. Villarraga, who lives in Doral, Fla. | 皮拉尔·维拉尔拉加(Pilar Villarraga)在夏天的大部分时间里一直在为女儿索菲娅(Sophia)即将到来的生日倒计时。索菲娅将在8月初满12岁，那时她将有资格接种新冠疫苗。“我不想让女儿在没打疫苗的情况下去上学，”家住佛罗里达州多拉尔的维拉尔拉加说。 |
| And then, in late July, just two weeks before the milestone birthday, Sophia caught the coronavirus. At first, she just had a fever, but on July 25, after four quiet days convalescing at home, her ribs began to hurt. The next day, Ms. Villarraga took her to the emergency room, where chest X-rays revealed that Sophia had developed pneumonia. She soon began coughing up blood. | 然而，在7月下旬，就在索菲娅这个里程碑式的生日到来两周前，她感染了新冠病毒。起初只是发烧，但7月25日，在家里静养了四天后，她开始感到肋骨疼痛。第二天，维拉尔拉加带女儿去看了急诊，X光胸片显示，索菲娅患上了肺炎。不久她开始咳血。 |
| Sophia was promptly admitted to Nicklaus Children’s Hospital, in Miami. Her parents, and their friends, were in shock. “I didn’t think that kids could get that sick,” Ms. Villarraga said. | 索菲娅马上被迈阿密的尼克劳斯儿童医院(Nicklaus Children’s Hospital)收治，让她的父母和父母的朋友们大为震惊。“我没想到小孩会病得这么重，”维拉尔拉加说。 |
| But Sophia was one of roughly 130 children with Covid-19 who were admitted to a U.S. hospital that day, according to the Centers for Disease Control and Prevention. That number has been climbing since early July; from July 31 to Aug. 6, 216 children with Covid were being hospitalized every day, on average, nearly matching the 217 daily admissions during the pandemic’s peak in early January. | 但据美国疾病控制与预防中心(Centers for Disease Control and Prevention)的数据，索菲娅是那天住院的约130名感染新冠病毒的儿童之一，这个数字自今年7月初以来一直在攀升。在7月31日到8月6日这段时间里，平均每天有216名感染新冠病毒的儿童住院，与今年1月初疫情高峰期平均每天217名儿童住院的数字几乎相同。 |
| Hospitals in coronavirus hot spots have been particularly hard hit. On a single day last week, Arkansas Children’s Hospital, in Little Rock, had 19 hospitalized children with Covid; Johns Hopkins All Children’s Hospital, in St. Petersburg, Fla., had 15; and Children’s Mercy Kansas City, in Missouri, had 12. All had multiple children in the intensive care unit. | 新冠病毒感染热点地区的医院面临的情况尤为严重。上周仅一天时间，小石城的阿肯色儿童医院(Arkansas Children's Hospital)就有19名儿童因感染新冠病毒住院；约翰霍普金斯儿童医院(Johns Hopkins All Children's Hospital)有15名；密苏里州堪萨斯城的儿童慈悲医院(Children’s Mercy Kansas City)有12名。这些医院都有多名儿童住进了重症监护室。 |
| These numbers have sparked concerns that what had once seemed like the smallest of silver linings — that Covid-19 mostly spared children — might be changing. Some doctors on the front lines say they are seeing more critically ill children than they have at any previous point of the pandemic and that the highly contagious Delta variant is likely to blame. | 这些数字引发了人们的担忧。这场大流行以前仅有的一线光明似乎是，新冠病毒不太容易感染儿童，但情况可能正在发生变化。一些在一线工作的医生说，他们正在救治的危重症儿童人数比这场大流行此前任何时候都多，罪魁祸首可能是具有高度传染性的德尔塔变异株病毒。 |
| “Everybody is a little bit nervous about the possibility that the Delta variant could in fact be, in some way, more dangerous in kids,” said Dr. Richard Malley, a pediatric infectious disease specialist at Boston Children’s Hospital. | “大家都有点紧张，德尔塔变异株实际上在某种程度上有可能对儿童更危险，”波士顿儿童医院(Boston Children's Hospital)的儿科传染病专家理查德·马利(Richard Malley)博士说。 |
| Most children with Covid-19 have mild symptoms, and there is not yet enough evidence to conclude that Delta causes more severe disease in children than other variants do, scientists said. | 科学家说，大多数患病儿童症状较轻，现有证据还不足以得出结论，认为德尔塔变异株给儿童造成的疾病比其他变异株造成的更严重。 |
| What is clear is that a confluence of factors — including Delta’s contagiousness and the fact that people under 12 are not yet eligible to be vaccinated — is sending more children to the hospital, especially in areas of the country where the virus is surging. “If you have more cases, then at some point, of course it trickles down to children,” Dr. Malley said. | 没有疑问的是，几个因素的汇合，包括德尔塔变异株的高传染性，以及12岁以下的人还没有资格接种疫苗，正在将更多的儿童送进医院，尤其是在美国的病毒肆虐地区。“如果有更多的感染病例，当然会在某个时刻传染给儿童，”马利说。 |
| Climbing cases | 不断上升的感染病例 |
| Many children’s hospitals had been hoping for a quiet summer. Several run-of-the-mill childhood viruses are less common during the warmer months, and national Covid rates had been declining through the spring. | 许多儿童医院曾希望会有一个平静的夏天。在温暖的月份，几种感染儿童的普通病毒不是那么常见，而且整个春季，全美国的新冠病毒感染率一直在下降。 |
| But last month, as Delta spread, that began to change. “The number of positive Covid tests started to climb in early July,” said Marcy Doderer, the president and chief executive of Arkansas Children’s Hospital. “And then that’s when we really started to see the kids get sick.” | 但上个月，随着德尔塔变异株的传播，情况开始发生变化。“新冠病毒检测呈阳性的人数从7月初起开始攀升，”阿肯色州儿童医院院长兼首席执行官马西·多德若尔(Marcy Doderer)说。“那之后，我们的确开始看到孩子们被感染患病。” |
| The vaccines are effective against Delta — and provide powerful protection against severe disease and death — but children under 12 are not yet eligible for them. So as more and more adults get vaccinated, children make up an increasing share of Covid cases; between July 22 and July 29, they accounted for 19 percent of reported new cases, according to the American Academy of Pediatrics. | 现有疫苗对德尔塔变异株有效，而且提供针对重症和死亡的强有力保护，但12岁以下的儿童还没有资格接种疫苗。因此，随着越来越多的成年人接种疫苗，儿童在染病患者中占比越来越高；据美国儿科学会(American Academy of Pediatrics)的数据，在7月22日至29日的一周里报告的新确诊病例中，儿童患者占19%。 |
| “They’re the unvaccinated,” said Dr. Yvonne Maldonado, a pediatric infectious-disease specialist at Stanford Medicine and chair of the A.A.P. Committee on Infectious Diseases. “That’s where we’re seeing all the new infections.” | “他们都还没接种疫苗，”斯坦福医学院(Stanford Medicine)的儿科传染病专家、美国儿科学会传染病委员会(A.A.P. Committee on Infectious Diseases)主席伊冯娜·马尔多纳多(Yvonne Maldonado)博士说。“我们看到的所有新感染病例都发生在这些人身上。” |
| From July 22 to July 29, nearly 72,000 new pediatric Covid cases were reported, almost twice as many as in the previous week, according to the association. At Johns Hopkins All Children’s Hospital, 181 children tested positive for the virus in July, up from just 12 in June. | 据儿科协会的数据，7月22日至29日的一周里报告了近7.2万例儿科病例，几乎是前一周的两倍。在约翰霍普金斯儿童医院，7月份共有181名儿童的新冠病毒检测呈阳性，远高于6月份的12名。 |
| Most of those children have relatively mild symptoms, such as runny noses, congestion, coughs or fevers, said Dr. Wassam Rahman, the medical director of the pediatric emergency center at All Children’s. “Most of the kids are not very sick,” he said. “Most will go home and be treated with preventive care at home. But as you might imagine, families are scared.” | 这些儿童中的大多数症状相对较轻，比如流鼻涕、鼻塞、咳嗽或发烧，约翰霍普金斯儿童医院儿科急救中心的医学主任瓦萨姆·拉赫曼(Wassam Rahman)说。“大多数孩子的症状不严重，”他说。“大多数人不需要住院，只需在家中休息，防止传染他人。但你可以想象，患儿的家庭都很害怕。” |
| A small share of children do develop severe disease, showing up at the hospital with pneumonia or in respiratory distress. | 一小部分儿童的确出现了严重症状，来医院看病时已患肺炎，或出现了呼吸窘迫。 |
| Some hospitalized children have other chronic conditions, like diabetes or asthma, that may make them more vulnerable to Covid, but doctors said that they also have seriously ill patients without any obvious risk factors. | 一些住院儿童患有其他慢性疾病，如糖尿病或哮喘，这可能让他们更易感染新冠病毒，但医生说，他们也看到了没有其他明显风险因素的重症患儿。 |
| Sophia, who was on her school’s track and cross country teams, was healthy and active before getting Covid, her mother said. Her parents were surprised by how quickly she deteriorated. “From one minute to another, she got super bad,” Ms. Villarraga said. “I said, ‘You know, I could lose my child.’” | 索菲娅的母亲说，女儿是学校田径和越野队队员，在感染新冠病毒之前身体健康，十分活跃。父母对女儿病情恶化的速度感到震惊。“她的状况从这一分钟到下一分钟恶化很快，”维拉尔拉加说。“我说过‘我可能会失去孩子’的话。” |
| After Sophia was admitted, doctors began treating her with the antiviral drug remdesivir, as well as antibiotics, steroids and a blood thinner. “From there, it was a day-by-day thing,” Ms. Villaraga said. “Little by little, she got better.” | 索菲娅住院后，医生开始用抗病毒药物瑞德西韦、抗生素、类固醇和血液稀释剂给她治疗。“那之后是一天一天的观察，”维拉尔拉加说。“渐渐地，她好了起来。” |
| Sophia, like most children with Covid-19, is expected to make a full recovery, her mother said. (A small percentage of children may experience lingering, long-term symptoms often known as long Covid.) She was discharged on July 31 and celebrated her birthday several days later — at home, with an ice cream cake. | 索菲娅的母亲说，与大多数感染新冠病毒的儿童一样，索菲娅有望完全康复。（一小部分儿童可能会受通常被称为新冠病毒长期症状[long Covid]的困扰。）索菲娅已于7月31日出院，并于几天后在家里庆祝了生日，吃了冰淇淋蛋糕。 |
| Delta differences | 德尔塔变异株的差异 |
| Ms. Villaraga was not told whether Sophia had the Delta variant, but more than 80 percent of new cases in the United States are caused by Delta, the C.D.C. estimates, and doctors said that it is clear that Delta is behind the surge in childhood infections. | 维拉尔拉加没有被告知索菲娅是否感染了德尔塔变异株，但据美国疾病控制与预防中心估计，全国80%以上的新确诊病例由德尔塔变异株引起。医生们说，很明显，德尔塔变异株是儿童感染人数激增的原因。 |
| What remains unknown is whether children who are infected with Delta are actually getting sicker than they would have if they had caught a different variant — or if Delta, which is roughly twice as transmissible as the original virus, is just so infectious that many more children are getting sick. | 目前尚不清楚的是，被德尔塔变异株感染的儿童，症状是否真比感染了其他变异株的更严重，也不清楚是不是因为传染性大约是原来病毒两倍的德尔塔变异株更容易传播，让更多的儿童生了病。 |
| There is some emerging evidence — mostly from data on adults — that Delta may cause more severe disease. Studies in Canada, Scotland and Singapore, for instance, have suggested, variously, that Delta may be more likely to lead to hospitalization, I.C.U. admission or death. | 有些正在出现的新证据——主要是来自成年人的数据——表明，德尔塔变异株可能导致更严重的疾病。例如，加拿大、苏格兰和新加坡的研究以不同方式表明，德尔塔变异株也许更有可能导致住院、住进重症监护室或死亡。 |
| But the research is preliminary, experts said, and there is not yet enough good data on the severity of Delta cases in children. | 但专家们说，这项研究仍在初步阶段，目前还没有足够多被德尔塔变异株感染的儿童重症病例的可靠数据。 |
| “There’s no firm evidence that the disease is more severe,” said Dr. Jim Versalovic, the pathologist in chief and interim pediatrician in chief at Texas Children’s Hospital, in Houston, where about 10 percent of children now test positive for the virus, up from less than 3 percent in June. “We certainly are seeing severe cases, but we’ve seen severe cases throughout the pandemic.” | “没有确凿的证据表明德尔塔变异株造成的疾病更严重，”休斯敦得克萨斯儿童医院(Texas Children's Hospital)的病理科主任医师兼儿科临时主任医师吉姆·维尔萨洛维奇(Jim Versalovic)说。该医院目前的儿童新冠病毒检测阳性率约为10%，而6月份还不到3%。“我们的确正在收治重症病例，但我们在整个疫情期间都在收治重症病例。” |
| Although not all states report their pediatric hospitalization rates, the data that is available suggests that they have remained essentially steady for months. Nationally, roughly 1 percent of children who are infected with the virus end up hospitalized, and 0.01 percent die, according to the A.A.P. data. Both hospitalization and death rates have declined since last summer. | 虽然并不是所有的州都报告了新冠病毒儿科住院率，但现有数据表明，这个数字几个月来基本保持平稳。据美国儿科学会的数据，在全国范围内，感染新冠病毒的儿童中，大约有1%需要住院治疗，病死率为0.01%。自去年夏天以来，住院率和病死率都有所下降。 |
| It is still possible, of course, that Delta could turn out to cause more severe disease in children. Hospitalization rates, which are a lagging indicator, could rise in the weeks and months ahead. And the rare but serious inflammatory syndrome that develops in some children with Covid-19 can take weeks to appear. | 当然，德尔塔变异株仍有可能在儿童中引发更严重的疾病。住院率是一个滞后指标，在未来几周和几个月可能会上升。而且，一些感染了新冠病毒的儿童会出现罕见但严重的炎症综合征，可能需要几周时间才表现出来。 |
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