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Omicron and children: Pediatric hospitals in parts of U.S. filling fast
“We are in a difficult situation,” said Hoyen, at University Hospitals Rainbow Babies & Children’s Hospital. “With omicron, we are now having this new surge on top of what was left over from delta.”
Add to that the normal cases of the flu, broken bones, scheduled treatments for children with cancer and other conditions, and the hospital is “in a crisis,” she said.
As the United States enters its third year of the pandemic, forecasters are predicting another ugly winter, but this time, children as well as adults are being affected. Pediatric hospitalizations for covid are surging in many parts of the country, alongside the arrival of omicron – as of Monday, the dominant strain in the United States – with about 800 new admissions each day for the past three days.
This time last year, Claudia Hoyen, a pediatric infectious-disease specialist in Cleveland, remembers staring at an eerily empty hospital as Christmas approached. With many schools shut and activities canceled, most children had been sheltered from the coronavirus. Today, nearly every bed at the children’s hospital where she works is full.
“We are in a difficult situation,” said Hoyen, at University Hospitals Rainbow Babies & Children’s Hospital. “With omicron, we are now having this new surge on top of what was left over from delta.”
Add to that the normal cases of the flu, broken bones, scheduled treatments for children with cancer and other conditions, and the hospital is “in a crisis,” she said.
As the United States enters its third year of the pandemic, forecasters are predicting another ugly winter, but this time, children as well as adults are being affected. Pediatric hospitalizations for covid are surging in many parts of the country, alongside the arrival of omicron – as of Monday, the dominant strain in the United States – with about 800 new admissions each day for the past three days.
Video: How omicron is reshaping the pandemic
Ohio, Texas, Pennsylvania and New York have been hit particularly hard. As of Thursday, there were 1,987 confirmed or suspected pediatric covid-19 patients hospitalized nationally, a 31% jump in 10 days, according to a Washington Post analysis. Since the pandemic began, nearly 7.4 million children and adolescents have been infected, with 170,000 more added to that total in the last week alone, according to the American Academy of Pediatrics.
U.S. doctors interviewed this week said that while they are seeing record positive results from children’s coronavirus tests, the vast majority of cases so far have been mild and look a lot like the common cold.
Indeed, several studies, including a pair published this week from Scotland and England, suggest omicron is sending fewer people overall to the hospital – welcome news. But public health officials have been on high alert about one group, children under 5, who are the last group ineligible for vaccines in the United States. Earlier this month South Africa reported big jumps in hospital admissions for that age group. The accuracy and significance of the South African data is unclear, but on Thursday, the United Kingdom released data showing a bump in admissions for that age group, too. Hospital admissions ending Dec. 19 were at 3.64 per 100,000 for children ages 0 to 4 – three times the rate for those ages 5 to 14.
That trend is not yet evident in the United States. Doctors and officials at eight children’s hospitals in areas of mounting infections said most of their patients are unvaccinated adolescents with underlying health conditions, as has been the case for most of the pandemic, although on any given day, a wide range of ages may be represented.
Still, Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau, acknowledged colleagues are monitoring a “signal” of a possible increase in hospitalizations of children under age 2: “It’s unknown yet whether the lack of severity that seems to be present in adults will also be true in children,” he said.
Even with less severe disease projected overall as a result of omicron, pediatric specialists said they fear more children may be admitted to hospitals in coming weeks given the sheer number likely to be infected.
Adrienne Randolph, a critical care physician and anesthesiologist at Boston Children’s Hospital who leads a network of researchers studying the coronavirus in children, said that now is the time for parents who had hesitated about getting eligible children vaccinated to schedule the shots.
“Everybody is getting prepared for the worst at the moment,” she said.
In March 2020, when the first wave of the coronavirus hit the United States, the initial presentation of covid in children tended to be somewhat distinct – with many reporting a headache, stomach pain, or loss of smell or taste.
With omicron, physicians describe messier symptoms that mimic those of cold and flu. In the United Kingdom, health officials have reported that most children with omicron infections experienced headaches, sore throats, nasal congestion and fever, with those symptoms usually lasting about three days.
In Maryland, pediatrician Aaron Milstone with Johns Hopkins University School of Medicine said emergency visits are extremely high, but few of the children have been sick enough to be admitted to the hospital thus far. He said he has seen more fevers in children with omicron infections than with past variants, and urged parents who have children with “cold” symptoms to assume “it’s omicron until proven otherwise.”
“Parents have to recognize that yes, there is cold and flu and RSV,” Milstone said. “But right now the dominant cause of symptoms that look like cold is probably covid.”
Outbreaks of respiratory illnesses like the common cold and the flu famously tend to hit the very young and the very old most severely. The elderly tend to have more preexisting medical conditions which make them vulnerable. As for babies and preschoolers, they have fewer defenses to fight foreign invaders, said Patty Manning, chief of staff at Cincinnati Children’s Hospital Medical Center.
It’s not just about immature immune systems, she said, but also about how the children cough, and manage secretions and body temperature less efficiently than adults, making them more likely to be felled by colds and the flu.
With previous coronavirus variants, there appears to be something protective about that difference in the young. Why that is remains one of the biggest scientific mysteries about the coronavirus even now, two years after the World Health Organization first alerted the world to the new virus.
Most of the U.S. medical centers contacted this week said they are experiencing record volume and positivity rates among children at both their hospitals and outpatient clinics.
In Ohio, where besieged health facilities recently took out a full-page newspaper ad emblazoned with the word “Help,” and the governor deployed nearly 1,200 National Guard members to set up testing sites and help medical personnel, pediatric cases are surging.
Robert McGregor, chief medical officer for Akron Children’s Hospital, said the positivity rate has been so high that “we don’t know the ramifications.” As of Wednesday, the hospital had admitted several kids under 5, including two confirmed cases in infants and two suspected cases in nursery-age children, but most of the other 11 were teens.