As waves of coronavirus swept across the United States, parents of young children could take comfort in knowing that COVID-19 tends to have milder effects on children and that most — but not all — children who become infected are fine.
But while it’s low-risk, many parents don’t want to gamble with their children’s health. And others may be more concerned that their children will pass on COVID-19 to elderly or immunocompromised loved ones who may not be doing as well.
Now the highly contagious Omicron variant is driving up case numbers, and most young children are unvaccinated. Children under the age of 5 are still not eligible for vaccinations, and as of December 29 in the United States only 23% of children 5 to 11 years old and 53% of 12 to 17 year olds are fully vaccinated.
With so many unknowns, how do we manage to protect our families and maintain a sense of normalcy?
We asked experts how parents of unvaccinated children should deal with the Omicron wave. Acknowledging that this is a difficult situation, they stressed that many of these decisions will differ based on each family’s vulnerability and risk tolerance. Here’s what they advise.
What has changed at Omicron?
Omicron is much more contagious than previous variants, but appears to be less severe so far. “The case numbers are just so high, really everywhere,” said Tara Kirk Sell, a senior researcher at the Johns Hopkins Center for Health Security. “And if they’re not high yet, they will be high. It’s incredibly transferrable.”
As a result, more children are being hospitalized with COVID-19. However, experts believe the spike is correlated with the skyrocketing number of people becoming infected rather than the severity of the disease the variant causes in children.
This follows the natural spread of viruses, explained Dr. Catherine Le, infectious disease physician at Cedars-Sinai Medical Center. Viruses mutate to survive, but they will not survive if they kill their hosts. So, over time, they generally evolve into more contagious but less dangerous ones.
The symptoms with Omicron can be slightly different. “The Omicron pandemic is still in its early stages, but it looks like we’re seeing more upper respiratory symptoms, including croup, in children,” said Dr. Grace M. Aldrovandi, professor and chief of infectious diseases at UCLA Mattel Children’s Hospital. “In general, symptoms in children are less severe than in adults, and they may have more gastrointestinal symptoms compared to adults with COVID.”
dr Priya Soni, a pediatric infectious disease specialist at Cedars-Sinai Medical Center, said that symptoms of Omicron typically include fever, dry cough, sore throat, body aches and night sweats. “These are really hard to spot in young kids though,” she said. “So mostly I see high fevers and kids with runny noses.”
There’s more we don’t know. With children, “we’re talking about a group that may not be at higher risk, but to tell you the truth, the jury is in agreement,” said Dr. Neha Nanda, medical director of infection prevention and antimicrobial responsibility at USC’s Keck Medicine.
For example, a report by the Centers for Disease Control and Prevention showed that children with COVID-19 were twice as likely to be diagnosed with diabetes after contracting coronavirus than children who didn’t have the virus.
We also don’t know if it’s related to childhood multisystem inflammatory syndrome, known as MIS-C, which is “rare but scary,” Le said, because it can lead to organ failure weeks after a coronavirus infection.
It is also too early to have data on whether Omicron causes long COVID in children. A national survey in England found that up to 14% of children with COVID-19 had persistent symptoms more than 12 weeks after diagnosis before developing Omicron.
“These kids were having an impact of fatigue, headaches, insomnia, trouble concentrating, and that was really, really limiting their quality of life and school attendance,” Soni said.
What hasn’t changed?
All the protective measures we have taken since the beginning of the pandemic are still important now. When there’s less COVID-19 in the community, there’s less risk and more room for relaxation, but the surge is a good time to step up your masking, social distancing, handwashing and other safety protocols, experts say.
This is especially true for children, because if they hang out with other children — say, at school or daycare — there’s a good chance they’re hanging out with children who aren’t vaccinated.
Which children are most vulnerable?
“Children under the age of one year, children with chronic diseases — neurological, immunological or respiratory diseases — and obese people are at higher risk of contracting SARS-CoV-2 disease,” Aldrovandi said.
That includes children who have leukemia, are receiving chemotherapy, or are transplant recipients, Soni said.
dr Kawsar R. Talaat, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health, encouraged concerned parents to speak to their pediatrician. “There are some children who may need to stay home and be protected from others until the surge subsides,” she said. “It’s a very individual conversation between the parents and the doctors: what risks they have and how best to protect their children.”
What Can Concerned Parents Do?
Make sure everyone who is eligible around your children is vaccinated and updated. If you have a meeting, it’s less risky if all the adults around them are masked, vaccinated, and boosted. This creates a protective cocoon around them, Talaat said. If you’re sending your children to daycare, it’s important to know that staff are vaccinated, refreshed, and masked – and that they don’t have to come to work if they’re sick.
Having a support system of people who are vaccinated and refreshed also means you may have help should you test positive and want to isolate yourself from your children, said Kirk Sell, who encourages parents to make plans for different possible scenarios.
Mask yourself even when you are outside. “We are now recommending that children, even if they go back to school, remain masked in heavily populated outdoor areas,” Soni said.
This includes playgrounds where many children are in the same area.
Parents should also transition to higher-quality masks for children — like surgical masks or KN95s — if they haven’t already, Aldrovandi said. As a resource, she recommends the website cleanaircrew.org/kids-masks.
Experts do not recommend masks for children under the age of 2 because of the risk of suffocation, so parents of children in this age group may opt for more social distancing depending on their comfort level.
Avoid crowds. Suellen Hopfer, an assistant professor of public health at UC Irvine, recommended avoiding places where large numbers of people gather, especially indoors. She also recommended postponing travel plans.
have children tested. Kids get a lot of colds, so it’s important to test when they have symptoms to see if it’s COVID-19, Soni said.
Tests in children are generally the same as in adults, but the challenge is getting the child to cooperate. “Even before COVID, we were performing nasopharyngeal swabs on children, including babies, to diagnose respiratory viral infections,” Aldrovandi said. “The virus is the same in children and adults, so rapid tests can be used in children.”
Testing sites can vary in terms of safety, she said. “This virus is airborne so it’s important to get to a testing location with good ventilation – outside or in your car – [and where] People wear high-quality masks and keep their distance.”
The pediatric practice should also be able to test.
If they are suitable, get them vaccinated. As COVID-19 is unpredictable, experts are urging parents to vaccinate their children. A Moderna pediatric COVID-19 vaccine for children ages 6 months to 5 years could be approved in late March or early April, and Pfizer and BioNTech are expected to submit data to regulators to support approval of their vaccine in the first half of the year .
“They prevent the possibility of a long COVID and MIS-C,” Soni said. “We should be very confident in the safety of this vaccine to give to these children of this age.”
Also, you make it less likely that your child will spread the coronavirus. “It’s just a lot less worrying,” Kirk Sell said.
Try to stay calm “Parents’ fear can be felt by young children,” Aldrovandi said. “It is important that parents try to model how they react to stressful situations. Parents should try to reduce their own anxiety by focusing on the present and not overly worrying about worst-case scenarios. Establishing routines can help both parent and child.”
“There is no such thing as a zero-risk scenario,” Kirk Sell said. Instead, she said, it’s about going low-risk and living a life that works for you.
All of these experts reiterated that if they contract the coronavirus — Omicron or otherwise — most children will be fine. “We hope they don’t have to experience it,” Talaat said. “But don’t panic.”
https://www.latimes.com/science/story/2022-01-10/how-parents-with-kids-too-young-to-vaccinate-can-navigate-omicron How parents with very young kids can navigate Omicron