CDC Director Rochelle Walensky warned on Friday that pediatric hospitals are seeing record numbers of children with COVID-19, as the Omicron variant surges nationwide.
US coronavirus cases are currently higher than they’ve ever been, averaging around 600,000 new cases reported daily (itself an undercount), with hospitalization rates that have increased for people of all ages, according to Walensky, who briefed reporters on Friday. More than 1,200 people a day are dying of COVID-19 nationwide.
“While children still have the lowest rate of hospitalization of any group, pediatric hospitalizations are at the highest rate compared to any prior point in the pandemic,” Walensky said. “Sadly, we are seeing the rates of hospitalization increasing for children 0 to 4, children who are not yet currently eligible for COVID-19 vaccination.”
As of Jan. 1, the rate for COVID-19 hospitalizations among children under 4 was 4.3 cases per 100,000. That’s almost four times higher than it is among kids 5 to 17, who are eligible for vaccination, according to Walensky, and more than twice the hospitalization rate seen in this age group at the same time last year. She added that CDC data does show that children above the age of 4 are more likely to be in the hospital if they are unvaccinated.
Walensky pointed out that some unknown number of these cases are incidental — children who test positive when they are hospitalized for non-COVID reasons. Many of the case reports of children come from asymptomatic kids who enter the hospital for elective procedures or other illnesses, she added, complicating the picture for epidemiologists trying to figure out risks for kids.
George Rutherford, professor of epidemiology and pediatrics at UCSF, said these numbers show that COVID is widespread, is infecting children, and some proportion of them will be hospitalized. “Hospitalizations are going up. There's no reason to think that they wouldn't go up in children,” he said, adding that “children don't seem to be as unsusceptible to this as they have been to earlier strains.”
But he thinks it’s too early to say that the proportion of infected children requiring hospitalization is growing nationally, partly because the CDC data is mostly from the northeastern region. Not knowing how many of these hospital cases are incidental makes the numbers even harder to interpret. “I've seen in London, where they actually do publish these data, that a third of COVID hospitalizations are incidental findings,” he added.
Still, he said that COVID-19 is a serious disease for children, and protecting them while Omicron surges across the country is paramount.
“In 2020 COVID was the seventh leading cause of death in children in the United States,” Rutherford said. “It is a big deal. And people who pooh-pooh it and say 'oh, it's no big deal' are blind to facts.”
Masking in school and other indoor settings is helpful, he said, but what’s most important is for parents to try to ensure that everyone their child is in contact with is vaccinated and boosted (if they are eligible).
It remains an open question whether Omicron is any more likely to lead to more severe disease in kids than other variants. This did not happen with Delta, Walensky said. “We are seeing a rise in hospitalizations, both because they are coming in with COVID but also because they're screening in for COVID," she said. "[We] have not yet seen a signal that there is any increased severity in this age demographic.”
Throughout the briefing, Walensky also defended the CDC against complaints that recent changes to protocols for isolating or quarantining after an infection, down to five days without symptoms, were confusing to the public or subject to disagreement from outside experts.
“This virus has changed, and it's constantly throwing up curveballs,” Walensky said in response. As this virus changes, the CDC will have to change its guidance when working with state and local public health “to provide recommendations that are most feasible and can be implemented in communities across the country,” she said. “The past few weeks have been challenging for all of us.”