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Omicron pushes covid-19 children’s hospitals to new heights

Omicron pushes covid-19 children's hospitals to new heights

Omicron pushes Covid-19 child hospitalizations to record levels in US and UK Doctors say: the infectiousness of the variant— and not increased severity — is probably largely responsible.

During the pandemic, children are much less likely than adults to suffer from serious illness from Covid-19, and doctors say the same appears to be true for Omicron. But skyrocketing case numbers mean more children end up in hospital, both with Covid-19 and because of the disease, underscoring how a probably milder variant can do even more damage simply by infecting more people.

In England, 576 children aged 5 and under were admitted to hospital with Covid-19 in the week to 9 January, well above the previous peak of around 160 in August. Separate data, from a study that follows in detail the admissions of about half of the hospitals in the UK, show that the rise is driven by minors. The admissions for ages 6 to 17 are also high. By contrast, Covid-19 adult hospitalizations are still significantly below the peaks of previous waves, largely due to vaccination.

Those numbers seem alarming, but doctors say there are no clear signs so far that Omicron affects children more than previous variants. Probably contributing to the pattern is that the unprecedented number of infections across the country means more children are getting it when they enter hospitals, often for respiratory conditions they often get in the winter. In other words, the percentage of children hospitalized with Covid-19 rather than because of the disease is likely to be significantly higher than adults.

Hospitals across the US struggle to staff medical facilities as a spate of Covid-19 cases sideline health workers. Some hospital administrators are forced to take measures of last resort to guarantee the quality of care. Photo: Joseph Prezioso/AFP/Getty Images

The Covid-19 hospitalization rate among children aged 5 and under, about 15 per 100,000 for the week to January 9, is still lower than in adults, where the rate ranges from 17 per 100,000, ages 18 to 64, to 179 per 100,000 in those 85 and older.

But the numbers don’t say much about how much Covid-19 is responsible for sending children to hospital. They include those who are there primarily for another reason — such as a broken leg — who tested positive for the virus before or after they were admitted. They also include those in hospital for other infections or illnesses where Covid-19 could have played a role.

Covid-19 vaccines are not routinely offered to children under 12 in the UK, but it is unknown, doctors say, whether this plays a significant role.

“It would be quite surprising if we didn’t see large numbers of hospitalizations with the infection,” said Adam Finn, a professor of pediatrics at the University of Bristol, due to the high number of cases in the community. “The tricky part is figuring out how much the infection actually contributes to why the child is in the hospital,” he added. “It’s not cut and dried.”

Doctors say more children are mainly being treated for Covid-19, but not more than would be expected given the sheer number of infections Omicron causes. Separate data shows that the total number of cases aged 4 years and below in England has quadrupled since early November.

And Omicron doesn’t seem to lead to an increase in the most severe cases in children. Data from the UK Health Security Agency shows that the number of intensive care admissions for children aged 4 and under did not rise significantly in December, despite a quadrupling of hospital admissions among that group.

“These aren’t particularly sick babies,” said Calum Semple, a professor of pediatric health and outbreak medicine at the University of Liverpool, one of the researchers on the hospital admissions study. They are absorbed in this wave for shorter periods and require less oxygen than in previous outbreaks of the virus, he said. The stock brought to the IC has declined over time, and the mechanical ventilation numbers are incredibly low and continue to fall, he added.

A 15-year-old receives a Covid-19 vaccine in Glasgow.


Photo:

Jane Barlow/Zuma Press

Edward Dallas, a pediatric emergency consultant at a London hospital, said he may be seeing more children with Covid-19 in this wave than at any time in the pandemic, but he didn’t think it was because Omicron is affecting children more seriously. , but only affects more children.

He added that the most common symptoms of an Omicron infection in children seemed to be a runny nose and cough, but it usually didn’t lead to a lung infection.

“It’s just a pure numbers game,” said Chethan Sathya, a pediatric surgeon at Northwell Health’s Cohen Children’s Medical Center in New York, where the number of cases is also on the rise. “If you look at the positivity rates, they’re through the roof.”

Another complicating factor is that in the winter it is common for young children to go to hospitals for respiratory diseases and test positive for several viruses, making it impossible to determine what is causing it.

“Over time, we are seeing more co-infection with Covid,” said Ronny Cheung, a pediatrician at a London hospital. “Anyone Who Tries to Say” [the illness] is because of Covid or some other respiratory infection that makes it up along the way.”

Staff at a school in Halifax, northern England, process Covid-19 rapid tests.


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oli shalf/Agence France-Presse/Getty Images

Infant hospitalizations are particularly in line with the background infection rate, as the threshold for admission is low in very young children. For example, children six months and younger who were admitted to the hospital with a fever are usually admitted for routine testing and monitoring as a precaution. The hospital admissions survey found that infants accounted for a higher proportion of infant hospitalizations, about 42%, in the past four weeks, compared to about 30% during the Delta wave.

“We know that Covid gives you a fever and when you have a fever and have a baby, you go through a cycle of research,” said Damian Roland, an honorary professor of pediatrics at the University of Leicester. “It doesn’t necessarily mean that Covid is worse or particularly harmful.”

“Like any other virus, if you have more of it, you’ll see more kids come in, and more will raise the threshold for admission,” said Jane Bayreuther, president of the British Association of Pediatric Emergency Medicine. There is no increase in overall severity, she added.

Still, it’s too early to tell the full extent of the new variant’s impact on children, according to Chinedu Nwokoro, a respiratory and general pediatrician at a London hospital.

An “omicron-sized blip” in every condition linked to Covid-19 infection in children, including long Covid and multisystem inflammatory syndrome, or MIS-C — a rare inflammatory condition that affects some children about six weeks after being infected with the virus — is “a problem in itself,” said Dr. Nwokoro.

“Datum [MIS-C cases] tend to present several weeks after the initial infection, we’re bracing for a bigger surge in the coming weeks,” said Dr. Cheung. “The question is, is Omicron going to do something different?”

Analysis of the health records of more than 14,000 children under the age of 5 in the US, comparing those infected with Omicron with those who had had Delta, found that the newer variant was significantly less likely to lead to severe outcomes. The study, by researchers at the Center for Artificial Intelligence in Drug Discovery in Cleveland, was not peer-reviewed.

At Advocate Children’s Hospital, which does not have two locations near Chicago, Covid-19-related hospitalizations have more than tripled in the 30 days to Jan. 6, according to medical director Frank Belmonte. About a quarter of patients end up in pediatric intensive care units on average per day, he added, an increase of about 10% on average in previous waves.

Some of the children in Advocate’s intensive care unit had no previous risk factors for Covid-19, according to Nekaiya Jacobs, a pediatric intensive care physician at the hospital. “There is still the misconception that Covid is always mild in children or teenagers or that children just don’t get sick,” she said.

write to Denise Roland at [email protected] and Joanna Sugden at [email protected]

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