(CNN) – This month the number of children admitted to pediatric hospitals in New York has quintupled. Almost double the income in Washington. And nationwide, on average, pediatric hospitalizations have increased 35% in the last week alone.
The highly communicable omicron variant is joining the busy Christmas season to infect more children than ever before across the United States, and children’s hospitals are preparing to make the situation even worse.
“I think we will have more numbers than ever,” Dr. Stanley Spinner, medical director and vice president of Texas Children’s Pediatrics & Urgent Care in Houston, told CNN.
“Cases keep increasing because of the Christmas gatherings and we’re going to keep seeing more numbers this week because of that,” Spinner said in a telephone interview.
“Now we are going to have the New Year on top of that this coming weekend, with more people gathering; more exhibitions and then those numbers will keep increasing,” he added.
More children in hospitals
Across the country, pediatricians are preparing for a busy January.
“It’s almost as if we can see the train coming down the track and hope it doesn’t derail,” Dr. Claudia Hoyen, director of Pediatric Infection Control at UH Rainbow Babies and Children’s Hospital in Cleveland, told CNN.
“It’s going to be a very interesting couple of weeks. We just had all these kids mixed in with everyone else over Christmas. We have one more party left with the New Years, and then we’ll send everyone back to school,” he said. Today in.
“Everyone is waiting, wondering what will turn out in the end.”
And while the delta variant infected more children than previous variants, omicron appears to be even worse, Spinner said.
“What’s worrying on the (pediatric) side is that, unlike adults, where they are reporting for the number of adults getting infected relatively low numbers of hospitalizations, what we’re really seeing, we think, is a growing number of children who are hospitalized, “Spinner said.
“So that’s a concern for us, especially with those under 5 who can’t be vaccinated or who aren’t fully vaccinated or who are eligible but not vaccinated at all. So that’s a huge concern.”
While Spinner sees little evidence that the omicron variant is causing more serious illness in children than previous variants, he also does not see evidence that it is milder.
“We do everything we can to keep the child out of the hospital. So if they go into the hospital, it means they are sick enough already,” Spinner said.
“They need oxygen. They need other types of assistance. Even if they are only very dehydrated and need intravenous fluids, most of the children who are admitted for covid are children who have respiratory problems, who need oxygen and other types of help. So they will be very sick. You don’t see children who are not very sick in the hospital. “
Most really sick children are unvaccinated or under-vaccinated, he said. “I can say that practically all of our hospitalized children have not been vaccinated or are not fully vaccinated, they may have received one dose but not the second and they do not have the full protection of the vaccine,” said Spinner.
The virus finds a new niche: children
Children are easy targets for the virus, Dr. Juan Salazar, chief physician at Connecticut Children’s Medical Center in Hartford, told CNN.
“It is affecting larger communities and it is certainly affecting children in a way that we have not seen before. And that is new compared to last year,” he said. Only a third of eligible children, ages 5 and older, are vaccinated in Connecticut, Salazar estimated.
“Because of that, the virus has found a niche. At least here in Connecticut, it seems that there has been a displacement of infections,” he added. Younger children who cannot yet be vaccinated, or older children who have not yet been fully vaccinated or have not been vaccinated at all, are getting infected, he said.
“Maybe it is more widespread now that we have relaxed our social gatherings. Maybe some of the masks have been removed; the families are tired. They are not willing to submit to some of the strict isolation policies of a year ago,” Salazar added.
“And that has allowed these new variants to spread further. And for that reason it is affecting children who at the moment are the population most at risk because they are not vaccinated, or many of them are not.”
Milder infections for some children, but not all
In New Jersey, most children seem to be mildly ill, according to Dr. Jennifer Owensby of the division of Pediatric Critical Care at Rutgers Robert Wood Johnson School of Medicine.
“We definitely saw an increase in children testing positive for COVID, but they don’t necessarily come with COVID symptoms,” Owensby said. Children come in for some other treatment, he said, and they test positive when tested.
This same effect is increasing the number of cases in Washington, according to Dr. Roberta DeBiasi, chief of Infectious Diseases at National Children’s Hospital. About half of the COVID-19 tests done there are positive.
And the affected children are no sicker than when the previous variants were circulating. But there are definitely more children with symptoms than before, he said.
“We just saw a surprising increase in both the volume, the number of positive tests, and the percentage of tests that are positive,” DeBiasi told CNN in a telephone interview. “We have had up to almost half of the tests – 48% of the tests – that are positive and that is much, much higher than in previous waves, where it was more on the order of, at most, 17%. And if you look at the gross numbers of positives, in the last wave, we were impressed by about 80 positives a day and we’ve had almost 200 positives in a few days. So it’s very, very contagious. “
These tests include children who come with and without symptoms, community reviews and random testing of patients who come to other types of treatment, as well as staff tests, DeBiasi said.
“If you look at the hospital admissions, they have also been more,” he added. “Thus, in previous waves we had at the peak of those waves, a maximum of about 18 children in the hospital.” Now, on some days, up to 30 children are admitted, he said.
In New York City, state Health Commissioner Dr. Mary Bassett said pediatric hospital admissions for COVID-19 have increased nearly fivefold since Dec. 11. In the week ending Dec. 11, 22 children were admitted to New York City hospitals, he said. Last week, 109 children were admitted through December 23.
Statewide, during the same period, there was a two-and-a-half-fold increase, from 70 admissions to 184.
Children of all ages are vulnerable
Pediatricians agreed that children of all ages can be affected, from infants to teens.
“We’re looking at pretty much every age group. We’re looking at babies to teens. It’s definitely general,” Owensby said.
Owensby is concerned about multi-system inflammatory syndrome in children, or MIS-C.
“We can see it in two or three weeks,” he said, but most cases start to appear between eight and 10 weeks after children are infected.
MIS-C is characterized by inflammation of the heart and other organs, and is usually seen in children who were not terribly ill with COVID-19.
“The vast majority are asymptomatic,” Owensby said. “What is scary is that before they were totally normal children. They did not have any underlying disease. They were perfectly healthy children who appeared with heart failure and in shock.”
The CDC reports 5,973 cases of MIS-C so far, and 52 children have died from it.
“You can have even mild symptoms: a runny nose, a slight cough, or even a fever, like any other respiratory virus,” Owensby said. “You have to be attentive to the symptoms: exhaustion, inability to play,” he added.
Symptoms can be subtle, but MIS-C is serious.
“That’s the thing about children. They are fine until they are not. Then all of a sudden they are seriously ill,” Owensby said.
DeBiasi said he has yet to see any signs of an increase in MIS-C cases. “We have not seen an increase in cases of the syndrome, but we did not expect it. It takes four to six weeks after the increase of any new variant,” he said.
Parents should watch over their children and take care to protect them, Owensby advised.
“Go back to due diligence. Watch your children’s social distancing,” he advised. They should wear masks when appropriate, for example when they are indoors with other people they are not related to.
“Masks don’t hurt children,” Owensby said. Younger kids can have fun wearing face masks and playing superheroes, he said.
“The whole family should get vaccinated if they can,” he added. Vaccinated parents and siblings can protect younger, unvaccinated children.
– Virginia Langmaid and Artemis Moshtaghian contributed to this report.