17th February 2022 – (Hong Kong)  A COVID-19 infected 3-year-old girl who was hospitalised in the Paediatric Intensive Care Unit of Hong Kong Children’s Hospital passed away on 15th February due to aggravation of her condition. She replaced the 4-year-old boy who tested preliminary positive earlier to become the youngest patient to pass away of COVID-19 in Hong Kong. The 4-year-old boy passed away at Pok Oi Hospital on 11th February after preliminarily tested positive.

Meanwhile, it was announced today that a 4-month-old baby infected with COVID-19 is in critical condition. It is unknown if the baby has been infected with Omicron or Delta variant.

In Hong Kong, 3 to 4 years old can receive CoronaVac vaccination and 5 to 11 years old can be vaccinated with Comirnaty. Children under 3 years old are still exposed to the risk as evident by the 4-month-old baby who is currently in critical condition.

Meanwhile, in U.S. according to data by American Academy of Paediatrics, reported COVID-19 cases among children spiked dramatically in 2022 during the Omicron variant surge, almost 4.5 million child cases were reported since the beginning of January. For the week ending 10th February, nearly 300,000 additional child COVID-19 cases were reported, down substantially from the peak level of 1,150,000 reported the week ending January 20th. Since the first week of September, there have been nearly 7.3 million additional child cases.or the week ending 10th February, children were 21.9% of reported weekly COVID-19 cases (children, under age 18, make up 22.2% of the US population). 

For the second time in less than a week during early February, a Mississippi child has died from COVID-19, bringing the state’s paediatric death toll to eleven over the last twenty-three months from the virus. While most of those deaths came as a result of the Delta variant last year, new information from researchers in South Africa shows greater hospitalisations among young children from the virus than any other variant, meaning potentially more kids in Mississippi could follow suit.

The odds of a person infected with COVID-19 dying from the disease increase once they’re hospitalised, State Health Officer Dr. Thomas Dobbs has said in recent months. “What we’ve really been seeing here at the paediatric clinic with Omicron is a lot of younger children getting infected. A lot of children in daycare, a lot of children in schools, and they are catching it from siblings, from parents, from other people. And so it’s really hard. It’s really sad,” said Dr. Anita Henderson, a paediatrician who practices in Hattiesburg.

According to the Centers for Disease Control and Prevention (CDC), new hospital admissions for kids with COVID-19 have increased 66 percent on average for the week ending 1st January.

The alarming statistic has parents wondering what they can do to keep their kids safe, particularly children under 3 years old who are not yet eligible for a vaccine.

The CDC published a report on 8th January that outlines a link between diabetes and COVID-19 in children. Researchers found that children who had been diagnosed with COVID-19 were 166 percent more likely to later be diagnosed with diabetes. A similar trend has been found in adults and some scientists believe it could be caused by the way the virus attacks a person’s organs, in this case, the pancreas. Much more research is needed to determine the cause and identify ways to protect children moving forward.

This research does highlight a risk that while children may not suffer severe symptoms or require hospitalisation at the rates adults do, there could still be long-term damage to their health. Researchers also noted that they do not yet know if the condition will be reversible or not. One author on the paper Dr. Sharon Saydah, told the New York Times that these findings highlight the urgency in getting children vaccinated. Dr. Saydah also noted that parents should be aware of the symptoms of diabetes which include “Increased thirst, frequent urination, unintentional weight loss,” to be able to get their children diagnosed if they present.

Data collected by UNICEF as of January 2022.

 

According to UNICEF, gains in child survival are dependent on the continued provision of essential health services to women and children around the world. While the full extent of COVID-19’s impact on economies, movement, and child health is not entirely clear, if life-saving interventions are disrupted, many more children could die of treatable and preventable conditions. This is a call to not only invest in women and children by continuing to provide critical services and supplies, but also to provide the evidence base for sound and informed decision-making. More data and research are urgently needed to foster a more nuanced understanding of how and why child mortality has changed since the pandemic began, and to ensure children and adolescents do not succumb to preventable deaths.

What is the risk for children under age 5 to develop COVID-19? How has Omicron affected the young and unvaccinated?

“Omicron seems to be much more contagious than previous strains of COVID-19. The number of hospitalisations due to COVID in children is definitely increasing; however, this is largely due to the fact that such a large number of children are getting infected,” said Dr. Gopi Desai, pediatrician at NewYork-Presbyterian Medical Group Queens and an assistant professor of clinical pediatrics at Weill Cornell Medicine.

“The chance of hospitalisation is still relatively low, however with such a large number of children getting infected, a significant group of children are still ending up hospitalized,” Desai said. “Since these children do not have the benefit of vaccination to protect them, they remain amongst the more vulnerable groups.”

Why are hospitalisation rates rising for children?

According to Dr. Jennifer Lighter, hospital epidemiologist at NYU Langone Health and paediatric epidemiologist and paediatric stewardship director, children still represent only 2 percent of COVID hospitalisations.

That said, there are a variety of reasons why hospitalisations for children are rising amid the surge of Omicron.

“Our hospitalization rate is higher for children less than 1 years of age than it is for children between 5 and 11, and that is because there is a lower threshold to admit babies with COVID. Also, if a baby under 2 months of age has a fever, they are automatically admitted,” said Lighter, as one of the reasons for a higher hospitalization rate. 

Another, of course, is that the virus targets the unvaccinated, and kids under 3-5 years old are still highly vulnerable because they’re not yet vaccinated.

Should kids be going to daycare or staying home? If going to daycare is OK, what measures should be in place?

“There is no right answer to this question that will apply to every family. Each family will have to consider the risks and benefits of their childcare options to determine what is best for them,” said Desai.

“For the majority of families with children in daycare, this is a necessity to allow caregivers to work. This risk of daycare will depend on a number of things — the size of the classroom/center, whether caregivers are vaccinated, and whether masks are worn correctly by caregivers and children,” Desai added. “The more of these protective measures that are in place, the lower the risk of COVID transmission.”

“Children should be in daycare [if it’s possible],” Lighter said. “They should be wearing face masks, the same as kids in school have to wear. Daycares should upgrade their ventilation systems and if they cannot, they should pop up the window. Kids should eat outside if possible. And, again, every child over the age of 2 should be wearing a face mask.”

Should parents with young kids avoid traveling in settings like airplanes or buses? What measures should be in place if traveling is necessary?

According to Desai, “Any situation involving crowds and strangers in close quarters is going to put you and your family at a higher risk of being exposed to COVID, given the high positivity rates around the country and the highly contagious nature of this strain.”

“If it is possible to avoid crowded modes of transportation during this wave, that is the safest,” Desai said. “If travel is necessary, make sure to keep a surgical mask on everyone older than 2 years old and to wash hands frequently. Keep your distance from other households when possible.”

“COVID-19 is nothing like the flu in adults,” noted Lighter, meaning that for adult patients, COVID is much worse than the flu. “But in children the viruses are analogous. If a parent puts restrictions on traveling for the flu, then it makes sense for traveling for COVID. It really has the same health impact in children — both the flu and COVID. It is not the same in adults.”

What are some of the questions you’ve received from concerned parents? How have you answered them?

“The most common question that I get is, ‘My child tested positive for COVID, what can I give him/her?’ For young children who test positive for COVID, there aren’t any special medications that they can get at this time. It is a good idea to speak with your child’s doctor to discuss their individual case, especially if they have any underlying medical problems,” said Desai.

“The best advice I generally give is that COVID is a virus just like so many others that children get, so focus on giving the child plenty of fluids and ensuring they get lots of rest. Watch out for any signs of difficulty breathing or dehydration and call your pediatrician if you have any concerns,” Desai added.

What are your biggest recommendations for keeping families with kids under age 5 safe and healthy?

“The best thing to do is to make sure everyone in the home who is eligible gets vaccinated and boosted. The best way to protect infants from COVID is for moms to get vaccinated and boosted during pregnancy. High levels of antibodies transfer over to babies and keep them protected for the first few months of life,” said Lighter.

“I recommend avoiding large gatherings, a surgical mask for children over the age of 2, and washing hands frequently,” Desai added. “Stay outdoors if possible/weather permitting. And importantly, stay home if anyone in the family is sick and make sure that others that you are seeing are not sick.”

“We have a lot more information now than we did at the start of this pandemic, and we can see that the cases go in waves. We should use this knowledge to our advantage and be cautious during surges so that we can take advantage of the times when cases are low to enjoy time with our friends and family,” Desai said.

Part of the article appears in Healthline.com.

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