Kids’ vulnerability to omicron probed

Although early data suggests the omicron variant is associated with milder illness compared with other versions of the coronavirus, there still aren’t solid answers, especially regarding how the mutant affects different age groups.

But emerging evidence shows children are getting infected and being hospitalized at alarming rates relative to pre-omicron days, particularly those who are unvaccinated. Kids younger than 5, who are not yet eligible for vaccination, are making up large portions of pediatric covid-19 surges across the globe.

Many experts advise heightened caution rather than panic.

Nationwide, more than 900 children have been admitted to a hospital as of the week of Dec. 20, up from 800 the previous week, according to the Children’s Hospital of Philadelphia.

That’s about 1.1 hospitalizations per 100,000 children, which is still lower than the rate of admission during a typical flu season.

“While it’s still early, we’ve not yet seen any data from the omicron variant to make us worry that the risk of severe illness among children has changed,” said Dr. Jennifer Nuzzo, an infectious disease expert at the Johns Hopkins Bloomberg School of Public Health.

“These relatively low risks and our ability to lower them further may help ease some anxieties over the next few months.”

On Christmas Eve, the New York State Department of Health issued an advisory to health care workers warning of surging pediatric hospitalizations.

Health officials said there was a four-fold increase in hospitalizations among people 18 and younger from the week of Dec. 5 until Christmastime. A news release said none of the 5- to 11-year-olds in the hospital were fully vaccinated, and only a quarter of those between 12 and 17 had all their shots.

“The risks of COVID-19 for children are real,” Acting State Health Commissioner Dr. Mary Bassett said in the release. “Protect your children who are five years and older by getting them fully vaccinated and protect children under five by making sure all of those around them have protection through vaccination, boosters, mask-wearing, avoiding crowds and testing.”

In Philadelphia, a study of more than 7,500 K-12 students who tested positive found a nearly five-fold increase in positive tests beginning about Dec. 13. Most were unvaccinated.

“These data support the fact that transmission is now increasing disproportionately among children compared to adults,” three doctors with the Children’s Hospital of Philadelphia wrote in a blog post. “We are seeing cases of moderate to severe disease among hospitalized children, including otherwise healthy children, particularly those who have not been vaccinated.”

The U.S. is only starting to experience what other countries have been facing for weeks, particularly South Africa, where kids younger than 12 are not eligible for vaccination.

Research based on 211,000 covid-19 test results in South Africa found children have a 20% higher risk of hospitalization when infected with omicron. Most diagnoses involve bronchiolitis and pneumonia, often coupled with severe gastrointestinal symptoms and dehydration.

Still, kids were 51% less likely to get infected with omicron compared with adults, “and, overall, the risk of children being admitted to the hospital for COVID-19 complications remains low,” Shirley Collie, chief health analytics actuary at Discovery Health, South Africa’s largest private health insurance administrator, said in a news release.

Most kids experience mild illness with short-lived symptoms such as headache, fever, sore throat and nasal congestion.

But Dr. Rudo Mathivha, head of the intensive-care unit at Chris Hani Baragwanath Hospital in South Africa, said the trends she’s seeing among kids and young adults are “concerning.”

“In the past, children [under 12 years old] used to get a covid infection … and it wouldn’t really put them down, it wouldn’t really send them to the hospital in big numbers to be admitted,” Mathivha said.

“We are now seeing them coming in with moderate to severe symptoms needing supplemental oxygen, needing supportive therapy, needing to stay in the hospital for quite a number of days.”