But rates of Covid-19 and hospitalizations among children have hit record levels in recent weeks. With case rates as high as they are, experts say, even small risks of severe outcomes can lead to large numbers of children in hospital.
“When you have such huge numbers of infected individuals, and even such a small probability of a serious event – which generally happens in children; they tolerate the virus much better than adults – it makes sense that you would go for it,” said Dr. Richard Malley, an infectious disease specialist at Boston Hospital. For children: “To see more children with rare and serious consequences of infection.”
“In many ways, both statements could be true. Omicron could be milder in children than previous variants, but we could still see more severe cases of Covid, even with a milder virus.”
For the new study, researchers analyzed the electronic health records of nearly 80,000 children under the age of five who first contracted COVID-19 in the United States. This age group is not yet eligible for vaccination, and the researchers note that low rates of previous Covid-19 infection also limit pre-existing immunity.
The study found a 70% reduction in hospitalizations and admissions to ICU and mechanical ventilation among children with omicron compared to those with delta. They also found a 29% reduction in emergency room visits. Data on mortality were not included, as very few were reported.
Overall, about 1% of children with omicron were hospitalized, compared to about 3% of children with omicron, according to the study.
“Despite this encouraging result, further studies are needed to monitor the acute, long-term consequences of omicron infection, the tendency to develop ‘prolonged COVID’, the speed of spread, the potential for mutation, and how prior infection alters clinical responses,” the researchers wrote.
In the last week of December, there were about 10 hospitalizations of Covid-19 for every 100,000 children under the age of five, higher than at any other time during the pandemic, according to data from the US Centers for Disease Control and Prevention. And while the results are promising across a broad population, the experience of those families with children who end up in the hospital is no less severe.
“Imagine you’re the parent,” Malley said. “Imagine being the child. I mean, this stuff is so stressful.” “A child who is admitted doesn’t know that hospitalization will be short or less dangerous. And the parent doesn’t know that either.”
In addition to their inability to be vaccinated, children face a few additional unique risk factors that can increase transmission—and the potential chances of a dangerous outcome.
“I don’t think the virus behaves differently in children than it does in adults. But I do think children are different from adults,” said Dr. Karen Raven, chief of infectious diseases at Nemours Children’s Hospital in Delaware.
“Children are children, and so they are more likely to really get close to people when they talk to them. And when they play, they kind of bring their heads together. They tend to touch everything and get close to everyone, so I think any kind of respiratory virus, obviously That puts them at a little more risk than adults who would probably be more willing to stay away.”
And with schools and nurseries now back in session, that transition is more likely, which may be why children started to account for a greater percentage of cases and hospitalizations during a delta wave than in previous waves as well.
“It’s a different playing field,” Raven said.
In addition to Covid-19 patients, hospitals are now caring for more children whose care has been postponed or otherwise avoided.
“Early in the pandemic, the hospital was pretty empty. There weren’t many injuries or other acute injuries or medical concerns. Unfortunately, with the pandemic – and this applies to both pediatric and adult patients – a lot of people sort of evacuated or They waited to get medical attention for various concerns due to the fear of the epidemic.”
“Now, we are seeing the after-effects, with a lot of patients now being admitted because of a lot of other severe medical issues and a lot of kids being admitted with Covid on top of that. So there are a lot of patients in the hospital.”
All things considered, experts say parents should not make changes to the prevention measures they have been taking.
“There are things that parents can do that they couldn’t do a year ago. One of them is to make sure that everyone in the child’s entourage is eligible for the vaccination or to promote access to that vaccination or booster,” Malley said.
“Also, maintain the same kind of preference for outdoor activities over indoor activities, and be careful about wearing masks when you’re indoors. I think these things need to be reaffirmed.”
The new study was not reviewed or published in a professional journal. It included about 7,000 affected children during a time when the Omicron variant was dominant and about 63,000 affected children when it was delta dominant. Virus samples for each child were not individually ranked, but were hypothesized based on broader sequencing data from that time. Omicron made up about 92% of the samples during the two weeks ending January 6, while Delta made up 99% of the samples between September and mid-November.
The study also found that both variants disproportionately affected black children, but particularly the Omicron variant. More than a quarter (26%) of children with Omicron were black, but less than 15% of children who encountered any contact with the health care system during the same time frame were black.