Coronavirus cases rise among children in South African hospitals

JOHANNESBURG – The children had gone to the hospital for various reasons: one had jaundice, the other had malaria. A third had a broken...


JOHANNESBURG – The children had gone to the hospital for various reasons: one had jaundice, the other had malaria. A third had a broken bone. But once admitted, they all tested positive for the coronavirus, a worrying trend in South African hospitals that hints at just how transmissible the new variant, Omicron, can be.

Doctors in pediatric wards at two large Johannesburg hospitals say they haven’t seen a spike in admissions, and they still don’t know if the children have Omicron. But the increase in the number of people who test positive after arrival may provide some insight into the behavior of the highly mutated variant that was discovered last month, and of which little is known.

“Our suspicion is that the rates of Covid positivity in the community setting are very, very high right now and increasing,” said Dr Gary Reubenson, pediatrician at Rahima Moosa Mother and Child Hospital in Johannesburg.

Young children under 12 are not yet eligible for Covid-19 vaccines in South Africa, which also makes them more vulnerable.

Although it is still too early to draw any conclusions about the severity of the illness caused by Omicron, modeling and analysis suggest that it can move twice as fast as the Delta variant.

“What is frightening now is that the proportion of positive patients among those admitted is very high,” said Dr Sithembiso Velaphi, who works at Chris Hani Baragwanath Hospital in Soweto. “Overall, the number of admissions has not increased.

And although the number of young patients is relatively small, doctors have noted that few children so far have required oxygen.

The number of coronavirus cases in South Africa continues to rise exponentially in a fourth wave of infections which epidemiologists say is piloted by Omicron. Since the variant was first sequenced and announced by South African doctors on November 25, it has become the dominant version among samples tested in the country.

At Rahima Moosa Hospital, a public hospital that serves the working-class areas of central Johannesburg, Dr Reubenson said he had not seen a peak in admissions but a higher proportion of pediatric patients and pregnant women tested positive for the coronavirus.

But, he warned, it’s still too early to draw any conclusions about the variant. As of Tuesday, there were 10 patients in the Covid-19 pediatric ward, but very few had respiratory symptoms. Only one child, who was diagnosed with pneumonia, needed oxygen, said Dr Reubenson, who also works as a pediatric infectious disease specialist at the University of the Witwatersrand School of Medicine.

The relatively low number of Covid-19 patients requiring oxygen was in line with the findings of a first report doctors from Steve Biko Academic and the Tshwane District Hospital Complex in Pretoria, currently the epicenter of the epidemic in South Africa.

At Chris Hani Baragwanath Hospital in Soweto, Dr Velaphi observed a similar pattern in the Covid-19 pediatric ward. On Tuesday, 12 children were admitted, three of whom needed oxygen.

It is still too early to say whether children will develop a potentially more serious condition, multi-inflammatory syndrome, which has been found in some children who test positive for the virus. It can take around six to eight weeks after infection for it to develop, Dr Velaphi said. Symptoms usually include stomach pain, diarrhea, and vomiting, among others.

In both hospitals, it was not known how many children came from homes whose parents or guardians were vaccinated. In Rahema Moosa’s delivery room, it was also unclear how many pregnant women had been vaccinated.

But data from the National Institute of Communicable Diseases showed that many children who tested positive for the coronavirus had parents or guardians who were not vaccinated.

While preliminary studies show that a previous infection may not protect Against the new variant, the easing of regulations such as mask wearing and social distancing in late October most likely played a role in increasing the positivity rate, Dr Reubenson said.

In the previous wave of infections, driven by the Delta variant, children accounted for 12% of positive coronavirus cases, according to data from the Institute of Communicable Diseases.

Then, during the South African winter, when children went to school on a staggered schedule, more teens were infected and admitted to hospital, said Dr Waasila Jassat, a public health specialist at the National Institute of Communicable Diseases.

South Africa vaccination extended to children as young as 12 in October, with over 652,000 vaccinated to date. The South African government has cleared one injection of the Pfizer-BioNTech vaccine for the 12 to 17 age group, with the second dose available from January.

To bypass guardians and hesitant parents, teens do not need permission from their parents or guardians to get vaccinated at free public vaccination stations.

This may explain, according to Dr Jassat, why there are more younger children who test positive than adolescents. It is not yet clear whether the South African health products regulator will allow the use of vaccines for children under 12.

As of last week, vaccine makers had yet to apply for permission to administer vaccines to children under 12 in South Africa, officials said.

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