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A Review of the Science

Exercise and vitamin D3 are beneficial, omicron is mild in children, asymptomatic spread with Omicron is significant

Covid-19: Omicron variant is linked to steep rise in hospital admissions of very young children BMJ(Published 14 January 2022) BMJ2022;376:o110

Highlights:

  • The overall conclusions of this article do not match the fearful messaging of the title.
    Hospital admissions of children under 1 year old have risen steeply, coinciding with transmission of the omicron variant
  • The alpha and delta variants were also associated with increased cases in children, raising concerns that children would be more vulnerable to these variants and would become sicker. But this turned out not to be the case.
  • And the indications are that children admitted to hospital with omicron are even less sick, as they require less support than children admitted earlier in the pandemic and are discharged earlier.
    • Oxygen use by children aged under 1 admitted in the past four weeks for whom data are available was 12%, compared with 22.5% in the first wave of the pandemic.
    • Admission to intensive care was 9.9% (v 14%),
    • Use of mechanical ventilation was 2% (v 5.8%),
    • Use of non-invasive ventilation was 2% (v 7.2%), and mean length of stay was 1.7 days (v 6.6 days).
  • A rapid review by NHS England of 55 babies admitted to hospital with omicron found that most were aged under 3 months and that around half were admitted for observation and received no treatment, “Clinically, this picture is incredibly reassuring,”
  • Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said, “As pediatricians, we are accustomed to having busy winters where we see lots of particularly under 1s, typically, with high fevers, often with some kind of respiratory distress.”
  • She noted an increase in babies testing positive for omicron but lots of other respiratory viruses also circulating. “The presentation of these babies very much fits in with a mix of what we would expect to see in a busy winter in the UK,” she said.
  • Kingdon added that South Africa had also seen a sharp rise in hospital admissions of under 5s associated with omicron but that most had not needed supportive care and had required a shorter length of stay.
  • The CDC explained that many children were admitted with covid-19 rather than because of it.

High Rate of Asymptomatic Carriage Associated with Variant Strain Omicron medRXiv January 14, 2022 (not yet peer reviewed)

Highlights:

  • Findings of this study strongly suggest that Omicron has a much higher rate of asymptomatic transmission (infectivity) than other variants and this high prevalence of asymptomatic infection is likely a major factor in the widespread, rapid dissemination of the variant globally, even among populations with high prior rates of SARS-COV-2 infection.

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