Rising child hospitalizations loom large over US Covid-19 response

Washington(CNN) Public health experts have sought for months to find the right message that will resonate with the many Americans who remain unconvinced about the very real danger of Covid-19.

Nearly two years and some 800,000 deaths later, tens of millions remain unvaccinated while the use of masks and other simple mitigation measures still frequently falls along political party lines.

But that dynamic has been built on top of an early pandemic premise: Children experience Covid-19 far differently from adults. While it's true that kids rarely get seriously sick from the virus, variants have shown -- in disturbing fashion -- that they can and do feel the effects of the pandemic. And Omicron is fueling a surge in child hospitalizations in a way we haven't seen before.

Read this story from CNN's Maggie Fox and Jen Christensen. They write: A five-fold increase in pediatric admissions in New York City this month. Close to double the numbers admitted in Washington, DC. And nationwide, on average, pediatric hospitalizations are up 35% in just the past week.

Take it from the doctors on the front lines quoted in the story:

• "It's almost like you can see the train coming down the track and you're just hoping it doesn't go off the rails," Dr. Claudia Hoyen, director of pediatric infection control at UH Rainbow Babies and Children's Hospital in Cleveland, told CNN.
• "They're needing oxygen. They're needing some other assistance. Even if they're just really dehydrated, needing IV fluids, most of these kids that we're admitting for Covid are kids that have respiratory issues -- that they need oxygen and they need other support. So they're going to be pretty sick. You know, you don't see kids that are not very sick in the hospital," said Dr. Stanley Spinner, who is chief medical officer and vice president at Texas Children's Pediatrics & Urgent Care in Houston.
• "We are seeing pretty much every age group. We are seeing infants to older teenagers. It is definitely across the board," Dr. Jennifer Owensby of the pediatric critical care division at Rutgers Robert Wood Johnson Medical School told CNN.
• "It's affecting larger communities and it's certainly affecting children in a way that we hadn't seen before. And that's new compared to last year," said Dr. Juan Salazar, physician in chief at Connecticut Children's Medical Center in Hartford.

Will these grim dispatches represent a turning point in the pandemic? Could this be the inflection point wherein even skeptical Americans are convinced they need to take serious steps to protect our nation's children? That remains unclear. But, at least to this point in the pandemic, the Omicron surge has done little to shake the convictions of unvaccinated Americans.

Vaccine hesitancy portends dark winter

Since the variant was first detected in the US on December 1, vaccination rates have not increased in meaningful ways. And data about childhood vaccination concerns from last month isn't encouraging, either.

Before the Omicron variant was detected -- but still with a screaming level of Delta transmission in the US -- a Kaiser Family Foundation survey conducted in mid-November found that most parents have concerns about the safety of Covid-19 vaccines for children, and about 3 in 10 say they will "definitely not" vaccinate their children against Covid-19.

Parents who were less likely to be vaccinated themselves were also less likely to vaccinate their children, including among Republican parents, who were more likely than Democratic parents to say they would "definitely not" vaccinate their children against Covid-19 (50% vs. 7%).

Also, most Republican parents (61%) said the vaccine poses a bigger risk to their children than becoming infected with Covid-19.

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Their hesitancy preceded the holiday gatherings, like those over Christmas and New Year's, that have some health care workers specifically worried about the impact on children in the coming weeks -- especially those who are too young to be vaccinated.

"We've just had all of these kids mixing together with everybody else during Christmas," Hoyen said. "We have one more holiday to get through with New Year's, and then we'll be sending everybody back to school. Everybody is kind of waiting on the edge, wondering what we'll end up seeing."

The US Centers for Disease Control and Prevention has publicly shared information about the safety of Covid-19 vaccines for children, including data that shows serious side effects are rare. But parents' trust in the CDC dropped from 66% in July to 57% in November, according to the Kaiser Family Foundation -- a decline that comes as some experts predict the US will soon blow past its record for daily new cases.

"I think we're going to see half a million cases a day -- easy -- sometime over the next week to 10 days," CNN medical analyst Dr. Jonathan Reiner told CNN on Sunday.

President Joe Biden has framed the coming months as bleak and dangerous for those who have forgone vaccination, warning earlier this month, "We are looking at a winter of severe illness and death for the unvaccinated -- for themselves, their families and the hospitals they'll soon overwhelm."

If messages like that haven't resonated in the past, maybe the warnings from pediatric doctors will.

"Perhaps it is more widely spread now that we've liberalized our social gatherings. Perhaps some of the masks have come off -- families are tired. They are not willing to undergo some of the strict isolation policies from a year ago," Salazar said.

"And so that has allowed these new variants to spread more widely. And for that reason it's affecting kids, who at this point are the most at-risk population because they're not vaccinated, or many of them are not."