- The high transmissibility of the Omicron variant increases the risk for children who attend in-person school.
- However, vaccination can help prevent hospitalization from the coronavirus.
- Several factors, such as local transmission rates and your child’s vaccination status, can affect their degree of risk.
- Your pediatrician can help you evaluate whether you should keep your child at home during the surge.
According to a Jan. 7 statement by Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky, the number of cases of children being hospitalized for COVID-19 is now at an all-time high.
COVID-NET data for the week ending Jan. 1 indicates there were 5.3 hospitalizations per 100,000 children from ages 0 to 4 years in the United States.
For that same period, 1.4 per 100,000 children between the ages of 5 and 17 were hospitalized.
Adults were still more likely to be hospitalized, however. People ages 18 and older experienced hospitalizations at the rate of 8.6 per 100,000 people.
Among this group, adults 65 and older had the highest rate, with 18.3 hospitalizations per 100,000 people.
According to earlier CDC data, an average of 378 children were admitted to hospitals each day during the week ending Dec. 28.
This represents an increase of more than 66 percent from the week before that.
This number also breaks the previous record average of 342 daily hospital admissions from the end of August and early September.
In response to these high numbers, many school districts around the United States have opted to return to remote learning to keep their children safe.
But just how great is the risk for children attending in-person school? And how can parents best protect their children until the number of cases declines?
How severe is Omicron?
We are still learning about the severity of Omicron in children, Walensky said.
However, CDC data collected from the beginning of the pandemic to Oct. 31 of last year indicates that COVID-19 generally affects adults worse than children.
Among hospitalized children ages 0 to 4 years, 6.1 percent were placed on mechanical ventilation, 25.1 percent spent time in intensive care units (ICUs), and 0.8 percent died.
Children ages 5 to 17 fared similarly, with 6.5 percent being placed on mechanical ventilation, 28.7 percent spending time in ICUs, and 0.7 percent dying.
In contrast, the overall rate of mechanical ventilation was 12.5 percent, with older adults being ventilated the most frequently (14.2 and 14.1 percent for the age groups 50 to 64 and 65-plus, respectively).
The rate of ICU stays was not all that different among the various age groups. Overall, 24.9 percent of all people hospitalized for COVID-19 were admitted to the ICU.
The disease was more likely to be fatal for adults, however, with the rates rising from a low of 2.8 percent among adults 18 to 49 to a high of 16.8 percent for adults 65 and older.
How risky is in-person school?
Dr. Andrea Berry, infectious disease pediatrician at the University of Maryland Children’s Hospital and assistant professor at the University of Maryland School of Medicine, said that Omicron transmission is high throughout the entire country.
“The CDC defines high transmission as greater than or equal to 100 new cases per 100,000 in the past 7 days, and/or greater than or equal to 10 percent positive NAAT tests (PCR tests) in the past 7 days,” she said.
“Currently cases range from 450 to 2,667 per 100,000 and, for a majority of states, test positivity is greater than 25 percent,” she added.
Berry explained that since the overall risk of getting COVID-19 in the community has increased during the Omicron surge, this means that the risk of contracting the virus in school has also increased.
However, the actual risk level depends on several factors, she said.
“Individual behavior is one of them. Some kids will be in more contact with other kids at school,” she said.
She also pointed out that a child’s “school mitigation measures are another variable.”
“In Maryland, those measures include masking, improvements to ventilation in school buildings, encouragement not to come to school if feeling ill, and notification if there are COVID-19 cases in the classrooms, schools, or in contacts,” she explained.
“For some communities, school mitigation measures are more comprehensive than measures taken at other community gathering spots,” Berry added.
How vaccination helps reduce risk and illness severity
Walensky said in her statement that we are still learning about what is driving the increases in hospitalizations among children.
It could be a reflection of the fact that there are more cases in the community overall, or from the lower rates of vaccination among children.
“Currently just over 50 percent of children, 12 to 17 are fully vaccinated,” she said, “and only 16 percent of those five to 11 are fully vaccinated. We know that vaccination prevents severe disease and hospitalizations.”
Walensky noted that the rate of hospitalizations in unvaccinated adolescents was about 11 times higher than that in those who are fully vaccinated.
On the week ending Nov. 27, 2021, unvaccinated children between the ages of 12 and 17 years were hospitalized at a rate of 2.2 per 100,000. In contrast, vaccinated children were hospitalized at a rate of only 0.2 per 100,000.
In Walensky’s opinion, parents should get their children vaccinated if they are eligible or boosted if they are 12 or older.
Walensky said that a review of more than 26 million vaccine doses given to this age group had been conducted, and it showed the “overwhelming safety” of vaccination.
“Please,” said Walensky, “for our youngest children, those who are not yet eligible for vaccination, it’s critically important that we surround them with people who are vaccinated to provide them protection.”
Evaluating your family’s personal risk
“Kids face many of the same risks as adults, only vaccination rates among pediatric populations are lower,” said Dr. S. Wesley Long, a researcher at Houston Methodist Hospital in Houston, Texas.
“In-person learning involves indoor spaces where distancing can be difficult and mask wearing may be variable,” he said.
As far as whether you should choose remote or in-person schooling for your child, Long said it depends on your situation.
You should look to see what is going on in your own geographic area, said Long.
“It is important to consider local COVID numbers and measures of transmission more than national averages, as the local numbers really tell you what is happening in your community,” he said.
You will also want to consider whether your child or someone else in your household is high risk.
Long suggests talking with your child’s pediatrician when making your decision since they will know best the health status of your child and can help evaluate local conditions.
In addition, you will want to consider whether your child is vaccinated and how high local vaccination rates are, he said.
“Vaccinating and boosting eligible children is their best defense, combined with mask wearing and distancing as much as possible,” Long said.