The Omicron Covid-19 variant is leading to record numbers of reported infections across many countries, but evidence shows the variant is less likely to result in an admission to a hospital. However, within England, there have been various media reports of many admissions to hospitals for children with Covid. So what does the data show on child hospital patients?
Admissions of children with Covid-19 to hospital are rising in recent weeks
We should first start with the definition of a Covid-19 admission, which is anyone admitted who either tested positive for the virus in the 14 days before their admission or during their stay in hospital. So someone admitted to hospital for a non-COVID reason but then later tests positive, becomes an admission.
Daily admissions among children (aged 0 to 17) with Covid-19 since September last year have fluctuated in line with the prevalence of Covid-19 in the community. With children having high rates of Covid-19 since the summer of 2021, daily admissions with Covid-19 to hospital have fluctuated around 40 per day. However, since the middle of December, as the Omicron variant spread significantly in England, the average daily numbers have increased. In the seven days to Boxing Day, there were on average 73 admissions to hospital of children with Covid-19.
More people admitted with Covid but not because of it
As more people get infected with Omicron, we would expect to see more people admitted to hospital with Covid-19. At the extreme, if 100% of the population had Omicron, then every admission to hospital would be with Covid-19 and every death in the country would be someone with Covid-19.
At this stage in the pandemic, with a more transmissible but less deadly variant, it is more important to understand how the virus is affecting health. Therefore, the focus needs to shift to those admitted to hospital for Covid-19 and not those with it. NHS England updates each week the number of patients in acute hospitals with Covid-19 but also how many have Covid-19 but are primarily in hospital for other reasons, and the virus alone would not have led to an admission.
Up until mid-December, around 1 in 4 patients (25%) were in hospital with Covid-19, but not being treated primarily because of it. Since the middle of December, this has risen to around 1 in 3 patients (33%) a clear indicator that Omicron is adding people to hospital admission numbers who would have been in hospital for other reasons.
These numbers only include acute hospitals, where a patient receives active, short-term treatment for a condition. There are patients with Covid-19 in other hospital settings, such as maternity beds or those having treatment for mental illnesses. It is likely that many of these are not in hospital because of Covid-19 and if all patients fell into this category, it would mean around 42% of patients in English hospitals have Covid-19 but are primarily in wards for other reasons.
Decline in children in pediatric beds in recent weeks
I asked NHS England if the information on who is in for other reasons was available by age group, but it is not. But throughout the winter, NHS England publishes a report on the daily situation of patients in various wards. Within this is a count of pediatric beds available for children and how many are occupied.
If we look at the average admissions per day from early December, the total number of children in hospital remained flat until the middle of December and has since fallen, no doubt linked to the Christmas period and fewer admissions for some planned medical procedures. This gives a strong suggestion that the rise in children with Covid-19 in hospital is among many children who would be in hospital but who have a positive Covid-19 test. This will be clearer as we move into the first week of January.
Conclusion
Children obviously get admitted every day for a wide variety of reasons and the surge of Covid-19 through the Omicron variant has not led to an increase in the overall numbers of child hospital patients. If we look at beds available for new patients, those too are unaffected, with around 36% of beds being vacant in the 7 days to Boxing Day, as the numbers of children with Covid-19 rose sharply.
As more people catch Omicron, it is important we distinguish between those admitted because of the virus and those who have Covid-19, but the reason for hospital treatment is something else.
While there will be instances where Covid-19 is causing serious illness in children, the evidence through the pandemic points to this being rare. Thankfully, at the moment we are not seeing any increases in the total number of child hospital patients on pediatric wards.
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