Could Omicron’s “Sting in the Tail” Threaten Children?

Today Covid-19 cases were at record levels in all Australian States and Territories except for WA. For NSW, 11201 new cases were recorded today, demonstrating that the apparent levelling cases at around 6000, over the past few days, were an artefact of reduced collections and processing of results over the Christmas period. Indeed, there were likely more Covid-19 circulating over the holiday period than revealed by the published health data (especially in NSW).

Source: https://www.covid19data.com.au/cases-last-28-days

Ever since the omicron variant started infecting students and young adults in Gauteng Province in South Africa, it has seemed to be too good to be true: a variant that is much more transmissible (so that it replaces the more dangerous delta variant) but of itself, produces mostly mild symptoms with fewer hospitalisations. Bur omicron is still Covid-19; it hasn’t magically transformed itself into some kind of more friendly disease.

Is this the sting in the tail of omicron?

Nevertheless, magical thinking about omicron has appeared. As I have reported, the new variant hasn’t received the attention it deserves from a precautionary approach. The NSW Government has flirted with the idea of removing most of the States remaining Covid-19 restrictions (only to reinstate them days later). On Christmas Eve, I reported that the new Chief Health Officer (CHO) in Queensland was saying that the spread of omicron was “inevitable” and “necessary” for the virus to become endemic.

A well-known maxim is that: “if it seems too good to be true then it probably is.” Will we find out that omicron has a “sting in its tail” that we didn’t, at first, anticipate?

Since the outbreak of omicron in Gauteng there have been reports of increased omicron infections and hospitalisations for children under 5 (Cape Times online, 4th Dec 2020).

It’s easy to forget that it’s barely a month since omicron surfaced, pushed delta into the background and became the topic of the moment. Too short a time for peer-reviewed medical or scientific literature even. There’s this article from Nature News (17th Dec 2020), in pdf, that reports increased childhood hospital admissions in South Africa from omicron infections. However, as the author of that article points out, this doesn’t necessarily mean that children are more vulnerable to omicron. Typically children have lower rates of preexisting immunity from earlier infection or vaccination than do adults.

While we lack the medical research to understand if children are inherently more vulnerable to omicron or if omicron is opportunistically exploiting a niche it finds with low-childhood immunity, Regardless, recent anecdotal reports coming from medical staff in hospitals in North America are most disturbing. Today CNN is reporting that there is a 35% increase in paediatric admissions in hospitals across the USA.

Some anecdotal reports from medical staff in the front lines are quoted from the CNN coverage are as follows:

Dr Stanley Spinner, who is the chief medical officer and vice president at Texas Children’s Pediatrics & Urgent Care in Houston, told CNN. “What’s concerning on the (pediatric) side is that unlike the adults — where they’re reporting for the number of adults getting infected relatively low numbers getting hospitalized — what we’re really seeing, we think, is an increasing number of kids being hospitalized,”

Dr Spinner added: “They’re needing oxygen. They’re needing some other assistance. Even if they’re just really dehydrated, needing IV fluids, most of these kids that we’re admitting for Covid are kids that have respiratory issues.

Dr Juan Salazar, the physician in chief at Connecticut Children’s Medical Center in Hartford said that: “It’s affecting larger communities and it’s certainly affecting children in a way that we hadn’t seen before. And that’s new compared to last year,”

Dr Jennifer Owensby of the pediatric critical care division at Rutgers Robert Wood Johnson Medical School told CNN: “We are seeing pretty much every age group. We are seeing infants to older teenagers. It is definitely across the board,”

These reports are most alarming for countries like Australia that haven’t started vaccinating children under 12 as yet (but will begin early 2022). Children under 5 are not currently being vaccinated in the USA, or anywhere else.

From what Dr Spinner told CNN, vaccination likely makes a difference in childhood infection. He was reported to have said: “Most of the really sick children are unvaccinated or under-vaccinated, he said. “I can tell you that virtually all of our kids that are hospitalized have either been unvaccinated or not fully vaccinated …

Conclusions

An important unanswered question is whether such a disastrous scenario emerging in the USA with childhood infection could be replicated in other countries? The vaccination rate for adults in the USA has been stuck at around 62% for some time. Adults that don’t get themselves vaccinated are less likely to get their children vaccinated. Additionally, much of North American has been experiencing a colder-than-usual winter and children are more likely to be home with adults for the holidays.

It could be that the omicron variant is opportunistically exploiting the advantages it has found in North America at present. On the other hand, it could be that children are more susceptible to omicron. We just don’t know enough about omicron to make this important distinction.

Nevertheless, the message is clear: get yourself and your children vaccinated when the opportunity first arises. Get your booster shot. It’s the best way of protecting our precious kids from hospitalisation and serious illness from Covid-19.

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