Omicron Drives Covid-19 Child Hospitalizations to New Highs

In England, 576 children ages 5 and under were admitted to hospitals with Covid-19 in the week to Jan. 9, well above the previous peak of around 160 in August. Separate data, from a study that tracks admissions in detail from around half the hospitals in the U.K., show that the rise is being driven by under-ones. Admissions for those ages 6 to 17 are also at a high. By contrast, Covid-19 hospitalizations among adults are still significantly below the peaks of earlier waves, thanks in large part to vaccination.

Those numbers appear alarming, but doctors say there are no clear signs, so far, that Omicron is afflicting children worse than earlier variants. What is likely contributing to the pattern is that the unprecedented number of infections across the country means that more children have it when entering hospitals, often for respiratory diseases they commonly get in winter. In other words, the proportion of children going into hospitals with Covid-19 rather than because of the disease is likely significantly higher than in adults.

The rate of Covid-19 hospital admission among children ages 5 and under, at around 15 per 100,000 for the week to Jan. 9, is still lower than in adults, where rates range from 17 per 100,000 among those ages 18 to 64, to 179 per 100,000 in those 85 and older.

But the figures don’t say much about how much Covid-19 is responsible for sending children to the hospital. They encompass those there primarily for another reason—such as a broken leg—who have tested positive for the virus before or after they were admitted. They also include those in the hospital for other infections or illnesses where Covid-19 might have played a part.

Covid-19 vaccines aren’t routinely offered to children under the age of 12 in the U.K., but it isn’t known, doctors say, whether this plays a significant role.

“It would be rather surprising if we didn’t see large numbers of hospital admissions with the infection,” because of the high level of cases in the community, said Adam Finn, professor of pediatrics at the University of Bristol. “The tricky bit is trying to figure out how much the infection is actually contributing to the reason for the child being in hospital,” he added. “It’s not cut and dried.”

Doctors say that more children are being treated primarily for Covid-19, but no more than would be expected given the sheer number of infections Omicron is causing. Separate data show that overall case numbers in those ages 4 and below in England have quadrupled since the beginning of November.

And Omicron doesn’t appear to be leading to a surge in the most severe cases among children. Data from the U.K. Health Security Agency show that intensive-care-unit admissions for those ages 4 and below didn’t rise significantly during December, despite a quadrupling in hospital admissions among that group.

“These are not particularly sick infants,” said Calum Semple, professor in child health and outbreak medicine at the University of Liverpool, one of the researchers on the hospital admissions study. They are being admitted for shorter periods in this wave and requiring less oxygen than in previous surges of the virus, he said. The proportion taken to ICU has slowed over time and the numbers on mechanical ventilation are incredibly low and continue to fall, he added.

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