Rise in child COVID hospitalizations in New York is a warning

SAN FRANCISCO —

A jump in COVID-19 hospitalizations for children in New York is seen as a warning sign to get more children vaccinated in California and elsewhere as the Omicron variant continues to increase.

The Omicron wave hit New York off California, which has seen a surge in cases over the past week. California officials said they are monitoring the rise in child hospitalizations.

“Unfortunately, NY is seeing an increase in pediatric hospitalizations (primarily among the unvaccinated), and they have comparable [5 – to 11-year-old] vaccination coverage,” California state epidemiologist Dr. Erica Pan wrote on Twitter. “Please give your children vaccine protection as soon as possible if our case [numbers] are increasing rapidly.”

The increase is concentrated in New York City and the surrounding metropolitan area. Officials described pediatric admissions quadrupling in New York City in recent weeks.

Half of the children admitted to hospital are under 5 years old and are not eligible for vaccination. Three quarters of ages 12 to 17 admitted to hospital for COVID-19 had not been fully vaccinated, and 100% of ages 5 to 11 admitted to hospital had not been fully vaccinated.

The warning about hospitalizations for children comes as California director and health official, Dr. Tomás Aragón, warned that state modellers are predicting hospital peaks for California.

“Why? Omicron is so contagious that it finds unvaccinated/non-immune people most vulnerable to hospitalizations and deaths,” Aragón wrote.

Aragón urged people to get vaccinated and boosted; test before high-risk events, as well as three to five days after; and consider not attending or delaying risky indoor gatherings. Aragón also suggested improving ventilation and air filtration and improving the fit and quality of masks.

Health experts have increasingly urged people to upgrade their masks from just cloth masks. A more protective mask-wearing arrangement includes a cloth mask over a surgical mask, which improves fit; an even better setup involves wearing those of higher quality, such as a KF94, KN95, or N95 mask.

dr. Anthony Fauci, President Biden’s chief medical adviser, recently urged people not to go to the kind of indoor parties where dozens of people whose vaccination status you don’t know are in attendance. Fauci said it’s safer for people to gather in smaller gatherings with family and friends in homes where everyone is known to have been vaccinated and boosted, and even safer if people have rapid tests just before the event.

Fauci told ABC on Sunday that recent data from Britain shows that in the Omicron wave, a lower percentage of newly infected people need hospitalization.

“Interestingly, the length of hospital stay was shorter and the need for oxygen lower,” Fauci said on ABC’s “This Week.” But because Omicron is causing such a high number of new infections, the variant could find many, many more people who have not been immunized, and still lead to hospitals overflowing.

Unvaccinated people “are most vulnerable when you have a virus that is extraordinarily effective at reaching and infecting people like Omicron is,” Fauci said in the televised interview. Omicron “can still lead to many hospitalizations in the United States.”

While unvaccinated people are most at risk of contracting the virus and suffering serious illness, the mutations of the Omicron variant may increase the risk of breakthrough infections in those who have been vaccinated. Still, unless they have a weakened immune system, vaccinated people, especially those who get a boost, are expected to be generally protected from serious illness and death.

New cases of coronavirus rose dramatically for Christmas in Los Angeles County. 3,052 new cases were reported Tuesday; on Wednesday 6,509; Thursday, 8,633; and Friday 9,988. LA County reported no new cases on Saturday because of Christmas.

COVID-19 hospitalizations in Los Angeles County have also increased significantly since December 1, from 569 to 849 on Christmas Eve, a 49% increase. But the latest number is much less than a year ago, when vaccinations were just introduced and available in very limited supply; in LA County on December 24, 2020, there were 6,770 people with COVID-19 in LA County hospitals; increased from 2,572 on December 1, 2020. At its peak, LA County observed 8,098 COVID-19 hospitals on January 5, a time that coincided with overcrowded hospitals and overcrowded morgues.

COVID-19 hospitalizations in Southern California are increasing faster than in the San Francisco Bay Area.

Since December 1, the number of hospitalizations from COVID-19 in Southern California has increased by approximately 34%, from 7.7 hospitalizations for every 100,000 residents to 10.3.

In contrast, in the greater San Francisco Bay Area, the rate has increased by 19%, from 3.8 to 4.6. Experts say it’s a sign of concern when the rate is 5 or higher.

The Inland Empire has one of the highest COVID-19 hospitalization rates in Southern California; San Bernardino County’s rate is 19 and Riverside County’s is 15. San Diego County’s rate is 10; Ventura County, 9; LA County, 8; and Orange County, 7.

Some experts are expressing hope that areas with high vaccination and masking rates will not be devastated by an increase in COVID-19 hospitalizations.

dr. Robert Wachter, chair of the UC San Francisco Department of Medicine, wrote Friday that while the number of coronavirus cases in San Francisco is rising rapidly, the number of hospitals remains low.

The bad news, Wachter said, is that Omicron is spreading rapidly in San Francisco. The good news is that Omicron appears to lead to milder disease overall, especially in vaccinated populations, Wachter wrote on Twitter.

Wachter said he would be much less optimistic in areas with lower vaccination coverage. San Francisco has one of California’s highest vaccination rates, with 88% of the population having received at least one dose; but other parts of the state have lower rates; LA County’s rate is 76%; Orange County, 75%; while San Bernardino County is 60% and Kern County is 56%.

“I would be… much more scared if I hadn’t been vaxxed and stimulated. The unvaxxed are playing a risky hand,” Wachter wrote.

In San Francisco, Wachter wrote that he still expects hospital admissions to rise, but added that “it seems unlikely it will be overwhelming here.”

In Los Angeles County, officials have expressed concern about the rising number of cases.

“Very high case numbers can easily cause significant stress in our health care system if even a small percentage of those infected gain experience and require hospital care,” said Barbara Ferrer, director of public health. A surge in COVID hospitals could also jeopardize care for non-COVID patients, such as those suffering from accidents, heart disease and cancer.

Still, LA County can manage the rising number of cases without overwhelming the hospital system, Ferrer said, if more people are vaccinated and stimulated, wear masks in indoor public areas and crowded outdoor areas, and avoid large crowded indoor gatherings.

Ferrer has also discouraged large indoor public gatherings in light of the Omicron Gulf.

“Whatever happens, the case numbers will rise. But we may be able to manage these case numbers in a way that doesn’t burden our health care system and prevents most people from experiencing serious illness and the tragedy of death,” Ferrer said.

Unvaccinated people are most likely to become infected with the coronavirus and be hospitalized with COVID-19.

For the week-long period ending Dec. 11, for every 100,000 unvaccinated residents, there were 272 LA County residents newly infected with the coronavirus. In comparison, out of every 100,000 residents considered fully vaccinated but not boosted, 68 were infected.

Those who received their booster had the lowest risk of infection. Of every 100,000 residents who received a booster, only 12 became infected that week.

That means unvaccinated people were 23 times more likely to get infected with the coronavirus than vaccinated people who received a booster shot.

Vaccinated people were also hospitalized far less often than unvaccinated people.

For every 100,000 unvaccinated LA County residents, 25 of them were hospitalized in the week ending Dec. 11. In comparison, the hospitalization rate for people considered fully vaccinated was 1.

“Even if transmission skyrockets, vaccination remains highly protective against hospitalization,” Ferrer said.

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