COVID surge for children renews fears for medically vulnerable children

Whenever someone tells Jamie Chong that COVID-19 isn’t a serious threat to children, she reminds them that a cold can land their child in the hospital.

Their son Asher, who is approaching his third birthday, has cerebral palsy and problems with his respiratory and gastrointestinal systems, putting him at higher risk from the coronavirus.

Chong has been caring for him at her Simi Valley home during the pandemic and has severely restricted who can enter. Sometimes, when cases have increased, she has even decided to turn away his home nurses.

“It’s scarier than it was at the beginning,” Chong said. “When things were very bad before, the children didn’t go to school. People worked from home. Now they say it’s much more contagious – and everything is open.”

There’s the idea that, “‘If you’re vulnerable, you have to stay home.’ Well we do. But how much longer can we go?” asked Chong. “My son deserves a life outside of home.”

According to federal data, infants — those younger than 5 years old — are hospitalized with COVID-19 more often than at any point previously in the pandemic. Health officials say the rising numbers among children are the result of the rapid spread of the Omicron variant, which is much more easily transmitted than previous variants of the coronavirus.

The recent surge has been particularly alarming for many families with children who are medically vulnerable and under the age of 5 – the age group still ineligible for COVID vaccinations. Federal approval for a vaccine for the youngest children is expected to be months away.

“We don’t have a vaccine. We have very few treatments for this age group. And we’re not telling people to be careful and cautious around young children,” said Dr. Jorge A. Caballero, anesthetist and co-founder of the volunteer organization Coders Against COVID.

“We can’t just ignore the needs of an entire group,” Caballero said, but “we do essentially the same thing with people with disabilities of all ages.” Disability groups have recently denounced statements by the director of the Centers for Disease Control and Prevention, in which he called “encouraging” that people with comorbidities suffered a disproportionate number of deaths.

“The public health response to COVID-19 has treated people with disabilities as disposable items,” said the American Assn. of people with disabilities and dozens of other groups wrote in their letter.

Young children and adolescents do not usually end up in hospital because of the coronavirus: Less than 1% of infected children and adolescents were hospitalized and 0.01% died, according to cumulative data collected by the American Academy of Pediatrics from states and the Children’s Hospital Assn.

But with a massive spike in infections, even a small percentage of children being hospitalized has left many more children in hospital beds than before. In the seven days ended January 12, the US counted an average of 881 newly admitted children and adolescents with COVID-19 per day; The rate of new hospital admissions in this group is six times higher than two months ago.

Recent federal data shows that children too young to be vaccinated were being hospitalized with COVID-19 at rates close to those of young adults, although they are still well below rates for middle-aged and elderly people lay.

Los Angeles Children’s Hospital had more than 40 pediatric patients who tested positive for the coronavirus early last week — nearly six times the number in November, according to a hospital official. About a quarter of children admitted with COVID-19 go to the intensive care unit, and some have had to be intubated, said Dr. Michael Smit, its Medical Director of Infection Prevention and Control.

“We used to have the luxury of saying, ‘It’s bad, but for most kids it’s really not that bad,'” said Dr. Garey Noritz, Professor of Pediatrics at Ohio State University and Chair of the Council on Children with Disabilities for the American Academy of Pediatrics. Since the numbers have skyrocketed, “it doesn’t feel like it anymore.”

The risks of COVID-19 are much more pronounced for children who are immunocompromised or medically vulnerable, including children with cancer, lupus, and other conditions.

Because older children and adults have been able to get vaccinated, “it feels like we’ve been left behind,” said Matt Heidrick of Fresno. “My son is still unvaccinated – and we have to be careful around him.”

Betsey and Matt Heidrick have kept 3-year-old Arthur in virtual preschool throughout the pandemic. Her son has Type 1 Spinal Muscular Atrophy and uses a BiPAP device to help him breathe at night.

He has ended up in intensive care due to a respiratory virus in the past. Even before COVID-19, the couple had to take care during flu season to protect him. If one of them felt sick, they masked themselves and isolated themselves from the others.

When the pandemic started, it felt like, “Oh, the rest of the world is in our boat now,” Betsey Heidrick recalled. But as they approach a third year of COVID-19, she feels invisible when people suggest the virus is no longer a threat.

Before the Omicron wave, the Heidricks would occasionally venture out on short trips to Target with Arthur when the shop wasn’t busy. A few times he has visited the zoo during quiet hours, staying outside and masked.

Now that cases have increased, his main trips away from home are doctor appointments. He sometimes sees other children in the neighborhood, but limits himself to waving at them from afar instead of playing along.

If he can finally get vaccinated, “at least we would have assurance that he had all the protection that we can offer him,” Betsey Heidrick said. “Maybe he can play with one of the little kids. Or he can go to school. Or he can go to the zoo – and we can’t feel so scared.”

Many doctors said it’s unclear whether Omicron, which is skyrocketing cases in children, causes more or less severe illness in children than previous variants. The new variant appears to lodge higher in the airways, which can make children susceptible to a barking cough called croup.

Because young children have small airways, “it only takes a little swelling of those airways to cause croup,” said Dr. Graham Tse, Chief Medical Officer at MemorialCare Miller Children’s & Women’s Hospital in Long Beach. “We’ve definitely seen an increased number of children admitted with clinical croup” who were found to have COVID-19.

Public health officials have also warned that children can suffer lingering effects from long-lasting COVID, which can include fatigue and breathing problems, although researchers are still guessing how common this occurs. Children infected with the coronavirus can also get multisystem inflammatory syndrome, a rare but potentially fatal condition.

Now that Omicron has taken root, “we cannot dismiss this as a milder virus,” said Dr. Colleen Kraft, a general pediatrician at Children’s Hospital Los Angeles. Its sheer contagiousness means “so many more kids are getting this and so many more kids are going to the hospital for it.”

Across LA County, there were 58 children under the age of 5 who tested positive for the coronavirus and were hospitalized on Jan. 1. Less than a month earlier, there were only four.

Pediatricians say many of the same steps recommended to take action against COVID-19 in general — including vaccinating all eligible individuals, masking and avoiding crowds — will help protect very young children who are medically vulnerable are.

“There is no doubt that it makes sense to vaccinate yourself to protect your health,” said Dr. Steven Barkley, chief pediatrician at Cottage Children’s Medical Center in Santa Barbara.

“But the greater good is trying to preserve our health environment for children – and for children who are in a position where they cannot be vaccinated and really relying on us – adults, parents, older children – do what we can to limit the spread of this virus,” he said.

Families are doing what they can to manage the ongoing risks, but many policymakers across the country are not doing enough to protect young children who are medically vulnerable, including ensuring ventilation in public spaces, requiring masks and ensuring that humans can be tested, Caballero argued.

“As a parent, it’s very frustrating. As a lawyer, it’s very frustrating,” Caballero said. “We know exactly what needs to happen … but too many policymakers and stakeholders are trapped in a mentality that children can’t get sick.”

Noritz, who practices in Ohio, argued that “if this made any sense, we would be in lockdown now” as cases have increased. dr But Alice Kuo, director of UCLA’s Center of Excellence in Maternal and Child Health, countered that lockdowns have exacerbated other problems, including child abuse and adolescent mental illness.

“If only COVID mattered,” said Kuo, a professor of pediatrics at UCLA, “then everything would shut down again. But lockdowns are unsustainable and other health concerns matter too.”

In Manhattan Beach, Devon Cordova reflects on whether anyone who might be around her daughter, Rafaella, is probably being cautious enough about COVID-19. Before she sent her daughter to a certain teacher, she was reassured by the thought that the educator had an immunocompromised relative at home.

“We can’t just say, ‘Send the kids to school and they’ll be safe.’ We have to rely on so many other people to make the right decisions,” Cordova said.

Rafaella has a rare condition that affects the brain, spinal cord and immune system. She is 6 years old – old enough to get a COVID vaccine – but Cordova said her daughter did not get the shot due to a previous reaction and medical concerns related to her condition. The rest of the family has been vaccinated, said Cordova, who serves as vice president of a national organization focused on the disorder.

The pandemic has pushed much of Rafaella’s therapy online, although when cases fell she began working outdoors with her therapists. Before the Omicron wave, the family was tiptoeing back to normal life. Rafaella had play dates at the park and had come to school in person that fall.

“And then the rug was pulled out from under us with this recent wave,” Cordova said. “I don’t really know what to do at the moment. Are we going back to school?”

Noritz said of some people who have resisted protective measures like vaccinations and masks, “There’s a very individualistic kind of mentality, ‘Well, I’ll be fine.'”

“It’s not protecting the people who are most at risk,” he said.

Times contributor Rong-Gong Lin II contributed to this report.

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