Is the Omicron variant less dangerous for children?

Almost four weeks after school masks ended, do we have to worry when we see child contamination at such high levels? As of last Friday, almost 3,000 classes were still closed due to Covid-19, according to the Ministry of National Education, and 88,722 students had become infected within a week.

Two years into the pandemic, we know more about the severity of Covid-19 in children. And especially with the Omicron variant, which is responsible for 100% of the contamination today.

The contaminations exploded in January

We sometimes heard that the Omicron wave was “carried” by children in January. “It was much more contagious than the previous ones,” admits François Angoulvant of the Department of General Pediatrics at the Robert-Debré University Hospital (AP-HP). But that applies to all age groups. I don’t think he has any greater tropism for children than for adults. Omicron’s explosion begins during the Christmas holidays, it’s evident in the turns. »

This chart from Covid Tracker shows that contamination is affecting the over 6 year olds more than the youngest, and after a rebound in March, numbers have started to fall in recent days.
This chart from Covid Tracker shows that contamination is affecting the over 6 year olds more than the youngest, and after a rebound in March, numbers have started to fall in recent days. -CovidTracker

With contamination levels rising again for the past two weeks, CovidTracker’s latest graphs give hope that cases are starting to fall.

Hospital admissions rose in January but then fell

Beginning in August 2021, at a time when the Delta variant was in the majority, we saw an increase in child hospitalizations for Covid-19. François Angoulvant then launched a study with colleagues to collect all entries in the country’s 41 pediatric intensive care units. “Since August 30, 2021, 700 children with severe Covid have been admitted to pediatric sheaves,” he explains. A third had acute Covid, a third had PIMS and a third had ‘accidental Covid’, meaning for example a child who is hospitalized with a broken leg will end up testing positive. “These are the patients who were hospitalized ‘with Covid’ and not ‘for Covid’. “Of the acute Covid children in Garben, 60% had comorbidities, after 2 years it was 80%,” assures the pediatrician.

Graphic by Santé Publique France on admissions to children's intensive care units since the start of the Covid-19 pandemic.
Graphic by Santé Publique France on admissions to children’s intensive care units since the start of the Covid-19 pandemic. – Public Health France

And more generally on the hospitalization side? The peak appears to have been reached in January. They have since declined, as shown in this chart by Santé Publique France. Even though there has been a slight increase with the rebound in contamination over the past two weeks…

Chart showing hospitalizations of under-18s since the pandemic began.
Chart showing hospitalizations of under-18s since the pandemic began. – Public Health France

Does this mean that Omicron was more dangerous? “No,” replies the pediatrician. As there was more contamination, more children were hospitalized. Most children will have very mildly symptomatic Covid. »

PIMS have declined drastically since March

Besides the emergence of an acute Covid, which almost exclusively affects children with comorbidities (disability, respiratory disease, trisomy 21, sickle cell anemia, etc.), the second risk of Covid-19 is PIMS (for Pediatric flammatory Multisystem Syndrome).), these “pediatric multisystem inflammatory syndromes”. “The good news is that there was much less PIMS with Omicron than with the previous variants, about 10 times less,” emphasizes the pediatrician. Before Omicron, the risk of doing a PIMS was about 1 in 4,000. For Omicron, the order of magnitude is closer to 1 in 40,000. So yes, Omicron gives less severe forms. »

Here is the chart from Public Health France showing that cases of Pims have been declining since early March.
Here is the chart from Public Health France showing that cases of Pims have been declining since early March. – Public Health France

Equal relief from Public Health France, which published its latest point on these serious pathologies last Friday. Since the pandemic began, pediatricians have reported 1,005 PIMS related to COVID-19 to the Public Health Department. One child died within two years and 39% of the affected young patients had to be admitted to the intensive care unit. “Given the very high incidence of cases during the 5th wave in children and the observations during the 4th wave, there was concern that the number of PIMS cases would increase much more than that observed. However, since week 08 there has been a significant decrease in PIMS incidence [début mars]. »

More good news according to Santé Publique France: “Despite an initial illness that can be severe, the data show that during the six-month follow-up of PIMS cases, very few sequelae are observed and it is not excluded that the clinical Forms of PIMS associated with the Omicron variant appear to be less severe. » How do you explain it? “No element allowed us to predict this,” the pediatrician acknowledges. We suffer this epidemic like the weather. However, what we do know is that Omicron also causes less severe cases in adults, even if they are unvaccinated.

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