'Hitting kids hard': What to know about children and the omicron COVID-19 variant

Nicole Villalpando
Austin American-Statesman

Every day, more and more children are coming into doctors' offices, urgent care centers and pharmacies to get tested for COVID-19. 

The omicron variant "is really hitting kids hard," said Dr. Stanley Spinner, vice president and chief medical officer at Texas Children's Pediatrics & Texas Children's Urgent Care. "This is the highest number of kids infected we've seen."

Nationally, pediatric COVID-19 cases are more than 20% of all COVID-19 cases.

With other variants, including delta, Spinner said, "we were managing to keep our head out of water. With omicron, we're trying to keep our head from being under water. ... We're trying to keep from drowning from this."

Of the demand for testing, office visits and urgent care visits, Spinner said, "we haven't seen it like this before."

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Why is omicron affecting kids more?

It comes down to who is vaccinated and who is not. The virus needs somewhere to go, and it is mainly going to the unvaccinated, Spinner said.

"Clearly a lot of our kids are not yet vaccinated," he said.

In the U.S., 22% of children ages 5-11 have received at least one dose of a COVID-19 vaccine. It became available for that age group in November. 

Among kids ages 12-17, 62% have had one dose and 52% have had two. Those 12-15 could get vaccinated beginning in May, and all 16- and 17-year-olds could get it by March. 

In Texas, 17% of kids 5-11 have had at least one dose; 63% of youths ages 12-17 have had one dose, and 51% have had two.

Total vaccination rates, which include everyone 5 and older, are higher, with 71.53% having had one dose and 60.95% with two doses of an mRNA vaccine or one dose of the Johnson & Johnson vaccine. The 65 and older population has even higher rates, 93.17% with one dose and 83.17% fully vaccinated.

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How is omicron affecting kids?

Omicron for many people stays in the nose and upper respiratory tract, rather than settling into the lower respiratory tract and lungs, as previous variants did, Spinner said.

Often it can be confused for typical colds or allergies with runny nose, scratchy throat and coughing. Though the symptoms might look the same as a cold or allergies, because of the amount of omicron spreading throughout the community, you should assume you and your family have been exposed to it, unless you truly have not left the home, Spinner said.

If you're having any cold or allergy symptoms, you should get tested. 

Just like adults, kids who have been vaccinated might still get COVID-19, but they tend to have mild or even no symptoms, Spinner said. 

The kids showing up in the hospitals are those who have not been vaccinated, Spinner said.

For the unvaccinated, omicron isn't more serious than other variants, but the sheer number of pediatric cases is the reason children's hospitals are seeing a rise in COVID-19 hospitalizations. 

Nationally the number of kids hospitalized for COVID-19 rose 50% in less than a month in December.

At Texas Children's Hospital in Houston, Spinner has seen the number of kids hospitalized with COVID-19 quadruple.

Austin's numbers remain low, with 10 children hospitalized last week for COVID-19, compared with Houston's 76. The Dallas area had 76, and San Antonio had 17.

"The hardest hit are the under 5," Spinner said, "because they can't be vaccinated." 

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Dr. Allison Lopez gives Oliver Howell his first dose of a COVID-19 vaccine Nov. 11 at a mobile clinic in Austin.

How can omicron be treated in kids?

For youths 12 and older, treatment options include a monoclonal antibody called sotrovimab and the new Food and Drug Administration-authorized Pfizer pill, which can be given early in the course of the disease. Like many places, Texas has run out of sotrovimab because of the demand for it. The Pfizer pill has not yet been available at pharmacies or doctors offices. 

No COVID-19 treatments have been approved for the 11 and younger population. Instead, doctors work on managing symptoms with known treatments for those symptoms.

For parents at home, that's managing fever, cough and congestion with over-the-counter medication..

Omicron treatments:Texas runs out of monoclonal antibody treatment to fight omicron

What parents need to do right now to protect kids from omicron

This isn't the time for big gatherings or even taking kids to grocery stores — especially if they are too young to be vaccinated. 

Wear a mask when you leave the house, especially if you go somewhere indoors, or outdoors where it is crowded. 

If your kids can be vaccinated and haven't yet been, make that appointment right now. If your 16- to 17-year-old kids are six months past their last vaccination, get them a booster. Be on the lookout for news soon about boosters for 12- to 15-year-olds.

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Students work on classwork at Norman-Sims Elementary School on Thursday, Sept. 23, 2021. The Austin school district, which was the first in the area to require face coverings in defiance of Gov. Greg. Abbott’s order banning districts from mandating masks, has counted the fewest cases per 1,000 people.

What about going back to school during omicron?

Even if your school district does not require it, Spinner advised everyone to wear a mask. It's better if those around your child are also wearing masks, but if you can't control that, you can at least reduce the risk by having your child wear a mask. 

Don't send children to school if they have symptoms. Instead, get tested through your pediatrician's office, a pharmacy or an at-home test.

In January, the Austin school district is offering free testing from 8 a.m. to 2 p.m. Monday through Friday at Akins, Eastside, Navarro, Northeast and Travis early college high schools; McCallum High School; and Cunnigham, Kiker, Norman-Sims and Pillow elementaries. The district also has after-hours testing from 3 to 7 p.m. Monday only at its central office, 4000 S. Interstate 35. This testing is for Austin district students and staff members only. Not in the Austin district? Check with your school district to see if it has set up testing hubs.

What about at-home tests and quarantining?

Even at-home tests and rapid tests, which are not as good as PCR tests, have value. If you get a positive result, you can feel safe assuming that you have COVID-19. If you get a negative result but still have symptoms, continue to isolate and retest a couple of days later. 

The Centers for Disease Control and Prevention issued new quarantine guidance. Instead of advising people to isolate for 10 days after testing positive, the CDC is recommending you isolate for five days if you are asymptomatic. 

If you have symptoms, continue to quarantine until you test negative.

If you've been exposed and are vaccinated with a booster, you do not need to quarantine, but you should wear a mask for 10 days after the exposure.

If you are unvaccinated or are more than six months out from your last vaccination and have been exposed, quarantine for five days and wear a mask for five days after that.