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Why Children With COVID-19 Swamp Pediatric Hospitals – Infection Control Today

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Omicron is going hard after the pediatric population, many of whom are too young to be vaccinated and whose vital organs, which COVID-19 attacks, are still in development.

The current surge in COVID-19 cases hits children particularly hard, as pediatric hospitals across the United States report a huge influx of patients. That surge is fueled mostly by the Omicron variant, which accounts for 95.4% of new cases in the country, according to the Centers for Disease Control and Prevention (CDC). (See chart below.) There has been a 400% increase in child hospitalizations at Texas Children’s Hospital in Texas, the largest pediatric hospital in the country, since the holidays, CNN reports.

Jim Versalovic, MD, the pathologist-in-chief at Texas Children’s Hospital, tells CNN that “we have staggering numbers here from this Omicron surge already. We shattered prior records that were established during the Delta surge in August.”

There has been much hope (perhaps false hope) pinned to early data about Omicron that suggest that it affects upper airways, and not the lungs, as did Delta and earlier iterations of SARS-CoV-2. A COVID-19 variant that produces mild symptoms and can knock the deadly Delta variant out to the way to become the dominant strain could possibly be a way to end the pandemic. But the surge in pediatric COVID-19 gives pause.

“The pediatric population is more fragile,” reminds Linda Spaulding, RN-BC, CIC, CHEC, CHOP, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board. “We’re seeing children as young as 5 days old getting COVID. And we don’t know what the long-term effects on that population will be because their lungs aren’t fully developed, their brains are still growing, their hearts are still fragile.”

As Spaulding noted in an interview with ICT® in February 2021, one of the possible long-term effects of COVID-19 on children is multisystem inflammatory syndrome (MIS-C). As the CDC explains, the condition, which can also affect adults and is called MIS-A in those cases, “is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.”

Spaulding says that vaccines aren’t the answer for many pediatric patients because there are no approved vaccines for children 5 years old and younger. “When we are dealing with the pediatric population, we have to deal with getting them through the illness and monitor them for developing MIS-C afterwards,” says Spaulding, of the current COVID-19 surge.

Even children who can get vaccinated aren’t getting vaccinated as much as adult are. According to the CDC, about 61.2% of the total U.S. population have been fully vaccinated. Children are the least fully vaccinated: 53% for those from 12 to 17 years old. Only 14.7% of children from 5 to 11 years old have been vaccinated.

Edith Bracho-Sanchez, MD, a primary care pediatrician and assistant professor of pediatrics at Columbia University Irving Medical Center in New York, agrees with Spaulding that the fact that Omicron affects upper airways and not the lungs isn’t good news for pediatric patients.

“We cannot treat the airways of children like they are the airways of adults,” Bracho-Sanchez tells CNN. “It’s just not the way it works. And for us pediatricians, we know that respiratory viruses can lead to … croup and bronchiolitis, that inflammation of the upper airways that does get in children in trouble.”

Spaulding adds that “during their early years, a lot of children have asthma and COVID-19 is not a friend to asthma.” Spaulding urges parents to “do their job of protecting those children and not taking them out in the community and around crowds. I see parents all the time at stores with masks on and the baby in the stroller with no mask.”

In the debate about whether schools should be open for in-class instruction, Spaulding believes that now—during a massive COVID-19 surge—is not the time to reopen schools.

“The schools are open and we’re seeing a large increase of children coming home from school positive with COVID-19 and once again people seem surprised by that. And the consequences is that we’re going to have more children admitted to the hospital.”

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Why has BC stopped doing contact tracing for coronavirus? – Dawson Creek Mirror

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Contact tracing is no longer an effective tool in the province’s fight against surging cases of the Omicron coronavirus variant, says B.C.’s top health officer. 

The province has adapted its strategy to prevent transmission of the highly-infectious COVID-19 strain, Provincial health officer Dr. Bonnie Henry told reporters in a press briefing Friday (Jan. 21) morning.

And while contact tracing has been an effective mechanism for public health intervention in the past, Henry noted that is an increasingly difficult process due to the infectious variant. 

“Disease characteristics that make contact tracing effective are things like having a longer incubation period because you have to have time to find people after somebody has been tested,” she explained, highlighting that the Omicron variant has a signifcantly shorter incubation period.

As COVID-19 strains “become more and more infectious,” it is more challenging to find people through contact tracing, added Henry. 

A disease such as measles, on the other hand, has a two- to three-week incubation period. The health officer said contact tracing for diseases with longer incubation periods like this allows time to identify and reach a high proportion of contacts and take measures to prevent the spread of the virus. 

Earlier in the pandemic, individuals infected with the Delta variant typically had a five- to seven-day incubation period, Henry noted. This period allowed public health teams to locate the individuals and prevent them from spreading the virus to others before they developed symptoms. 

Individuals infected with Omicron may also “have mild or asymptomatic infections and not even realize that they are affected,” she emphasized. Further, at this juncture in the pandemic, the majority of B.C. residents are vaccinated. Some adults with mild to moderate COVID-19 who are at high risk of progressing to serious disease will have access to Canada’s first oral antiviral COVID-19 treatment

“So with the emergence of these more transmissible variants are shorter incubation periods, COVID-19 is no longer an infection for which contact tracing is an effective intervention,” Henry underscored. 

“We now need to shift our management and think about the things that we can do across the board to prevent transmission and to prevent ourselves from being exposed.”

While vaccination is the most effective way to prevent transmission from COVID-19, individuals should also manage their symptoms and stay home if they feel ill. 

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Patients with COVID in Fraser Health may now share hospital rooms with uninfected – Chilliwack Progress – Chilliwack Progress

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A policy introduced to hospital staff last Friday by Fraser Health means some COVID-19 positive patients can share rooms with fully-vaccinated patients who are not infected with the virus.

Black Press received a copy of the memo issued Jan. 14 to staff at Chilliwack General Hospital (CGH) announcing the revised recommendations “for COVID-19 patient placement in acute care settings.”

The memo states that due to evolving epidemiology of the Omicron variant, and that “this virus generally causes mild disease,” areas for COVID patients will be reserved for only those with significant respiratory symptoms.

“A single occupancy room… is the preferred accommodation for any patients with respiratory symptoms. If a single occupancy room is not available, accommodate the patient in a multi-bed room ensuring at least two metres of space from other beds.

“Place COVID-19 positive patients only with fully vaccinated roommates.”

Hospital staff are directed to follow Infection Prevention and Control (IPC) droplet precaution guidelines, and the memo made it clear that COVID-positive patients should not share a room with immunocompromised patients, patients with chronic cardiac or respiratory disease, newborns, or others with respiratory illnesses.

At a briefing Friday morning with Health Minister Adrian Dix and Public Health Officer Dr. Bonnie Henry, Black Press asked about the rationale behind this revised policy, and she made it clear it was not unique to CGH.

Henry said the increased number of people being admitted to hospitals means that space is at a premium, and this policy helps maximize space with additional precautions in place.

She said the type of COVID-positive patients who might be placed with a non-COVID patient are those who come to hospitals for other reasons, they are tested, and the positive result is considered “incidental” to the reason they are in hospital.

“That is an infection prevention control team decision made at a hospital by hospital, and actually room by room and ward by ward basis, depending on the needs in that facility.”

Dix added that yesterday there were 891 people hospitalized in the province with COVID-19, and the pre-Omicron record was 500.

“When you have a lot of people in the hospital, you have to manage within the space you have and ensure infection control stays high and that’s what our teams are doing across B.C.”


Do you have something to add to this story, or something else we should report on? Email:
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COVID-19 in Nova Scotia, Jan. 21: weekly recap, 94 hospitalized, 601 new cases – Halifax Examiner

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Jump to sections in this article:
Overview
Vaccination
Testing

There are now now 94 people in hospital who were admitted because of COVID symptoms, 13 of whom are in ICU. Those 57 range in age from 0 to 100 years old, and the average age is 68.

Additionally, there are:
• 73 people admitted to hospital for other reasons but who tested positive for COVID during the admissions screening or who were admitted for COVID but no longer require specialized care
• 113 people in hospital who contracted COVID in the hospital outbreaks

The 94 people now hospitalized because of COVID have the following vaccination status:
The vaccination status of those 94 is:
• 11 (11.7%) have had 3 doses
• 60 (63.8%) have had 2 doses but not 3
• 4 (4.3%) have had 1 dose
• 19 (20.2%) are unvaccinated
Note that only 9.3% of the population is unvaccinated

My very rough calculation of the rate by vaccination status of those hospitalized (based on numbers of the population in each category two weeks ago) is as follows:
• (11) a rate of 6.1 per 100K with 3 doses
• (60) a rate of 9.8 per 100K with 2 doses (but not 3)
• (4) a rate of 5.7 per 100K with 1 dose only
• (19) a rate of 18.0 per 100k unvaccinated

Additionally, the province announced 601 new cases of COVID-19 today. The new cases are people who received a positive PCR test result from a Nova Scotia Health lab; it does not include people who tested positive using a take-home rapid (antigen) test.

By Nova Scotia Health zone, the new cases break down as:
• 269 Central
• 120 Eastern
• 49 Northern
• 163 Western

Public Health estimates that there are 5,241 active cases in the province; the actual number is undoubtedly much higher.

The graph above shows the weekly (Sat-Fri) number of new cases for the duration of the pandemic.

The graph above shows the number of weekly cases (green, left axis) and weekly deaths (red, right axis). If deaths lag three weeks behind cases, we may (nothing is certain) see 10-20 more deaths in the next couple of weeks.

The graph above shows the number of weekly cases (green, left axis) and the number hospitalized on Fridays (orange, right axis) for the duration of the pandemic.

Jail outbreak

“Active COVID-19 cases at the provincial jail in Burnside are down to 11,” reports Zane Woodford:

The Central Nova Scotia Correctional Facility has had an outbreak since late-December, and Justice Department spokesperson Heather Fairbairn told the Halifax Examiner there have now been a total of 140 cases at the jail.

“As of Jan. 21, there are 11 active cases among those currently in custody at the Central Nova Scotia Correctional Facility,” Fairbairn wrote in an email.

As has been the case throughout, according to Fairbairn, none of the prisoners is in hospital and there are no cases in the jail’s women’s unit.

Fairbairn said since January 1, five people have been approved for temporary absences or early release. The population at the jail, as of January 20, was 223. That means about 63% of prisoners at the facility have had COVID-19.

Hospital outbreaks

There are two new cases at ongoing hospital outbreaks, one each at:
• Cape Breton Regional Hospital for a total of fewer than 10 in that ward
• Victoria General for a total of fewer than 10


Vaccination

Vaccination data were not reported today “due to a technical issue.”

The graph above shows the vaccination progress as captured on Fridays through the pandemic, except Thursday for this week. The yellow line is people with at least one dose of vaccine The blue line is people with only one dose. The green line is people with two doses but not three. The grey line is people with three doses. The red line is 80% of the population.

Appointments for boosters are now open to people 30 and over for whom 168 days have passed since their second shot.

Vaccination appointments for people 5 years of age and older can be booked here.

People in rural areas who need transportation to a vaccination appointment should contact Rural Rides, which will get you there and back home for just $5. You need to book the ride 24 hours ahead of time.

There are many drop-in Pfizer vaccine clinics scheduled, starting next week, several for kids five years old and older.


Testing

Nova Scotia Health labs completed 3,975 PCR tests yesterday, with a positivity rate of 15.1%.

If you test positive with a rapid (antigen) test, you are assumed to definitely have COVID, and you and your household are to self-isolate as required.

But take-home rapid testing kits are no longer widely available.

Pop-up testing has been scheduled for the following sites:

Saturday
Halifax Central Library, 11am-6pm
Alderney Gate, 10am-2pm
Glace Bay Legion, 11am-3pm

Sunday
Halifax Central Library, 11am-6pm
Knights of Columbus (KOC) Hall (New Waterford), 11am-3pm

Monday
Halifax Central Library, noon-7pm
Hubbards Lions Club, 11am-3pm

You can volunteer to work at the pop-up testing sites here or here. No medical experience is necessary.


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