Michael Smit, MD, MSPH, Hospital Epidemiologist and Medical Director of Infection Prevention and Control at Children’s Hospital Los Angeles, spoke with CHLA.org to share what we know about Omicron—and what families should do to stay safe.
The spread of Omicron is so significant, it feels almost impossible to avoid. What can families do to keep safe?
Although it seems overwhelming, we need to transition to living our lives in the presence of SARS-CoV-2 and the Omicron variant. Due to the failure of many Americans to accept COVID-19 vaccines, we will continue to have transmission of the virus in the foreseeable future. To keep reasonably safe, families should avoid large indoor gatherings outside of their household if possible. If indoors, maintaining physical distance of six feet from others and wearing a well-fitting mask are recommended. If someone has cold or flu symptoms, they should get tested for COVID-19 if testing is available. People should also follow local public health guidance regarding isolation if infected, and quarantine if exposed.
What kind of masks should children wear outside and to school?
If you are outside and able to physically distance from others, then masks are not needed outdoors. For indoor situations or crowded outdoor settings, the Centers for Disease Control and Prevention (CDC) recommends wearing masks. Masks should:
- Have two or more layers of washable, breathable fabric
- Completely cover the nose and mouth
- Fit snugly against the sides of the face without gaps
- Have a nose wire to prevent air from leaking out of the top of the mask
Should parents keep their children out of certain activities like sports for now?
Currently Los Angeles is experiencing a surge with the Omicron variant. Parents should thoughtfully choose what activities are safe at this time. If a child is eligible for and up to date on their COVID-19 vaccination, then participating in outdoor sports may be reasonable. For indoor sports, the risk of catching COVID-19 is higher. Parents should have an understanding of school and local guidelines, as well as the rules regarding isolation and quarantine so that if their child is exposed, the family is prepared to follow public health guidance.
What should families do if their child—or another member of the household—gets COVID-19?
If your child has any symptoms, you should discuss it with your health care provider.
- CDC guidance states that infected household members should separate from others, if possible, or wear a well-fitting mask if they are at least 2 years old.
- It’s helpful to designate a “sick room” or an area of the home and have a dedicated bathroom for the infected member if household space allows.
- Current isolation recommendation is for five days from symptom onset or positive COVID-19 test, whichever is first, as long as symptoms have subsided.
- After the five-day isolation, infected family members should continue to wear a well-fitted mask around others for an additional five days.
What symptoms should lead parents to seek medical care for their child who has COVID-19?
In general, if your child is feeling or appearing unwell you should contact your pediatrician or health care provider. If there are any serious concerns such as the conditions listed below, then you should seek immediate medical attention in the Emergency Room.
- High fevers
- Difficulty breathing
- Persistent chest pain or pressure
- Severe belly pain
- Severe diarrhea
- Confusion or sluggishness
- Unusually pale, gray or blue-colored skin or lips or nail beds
Should families be resigned to getting COVID-19 at this point?
During surges like we are seeing with Omicron, you should do your best to keep yourself safe and prevent virus transmission and spread. We hope that eventually the dominant variant circulating in the world will be less contagious and less deadly, much like the flu. We likely will eventually have seasonal protocols that balance the safety concerns of living with COVID-19 with everyday life. We are not there yet.
First we had Delta, then Omicron; what’s next? How often do variants happen and what else might we expect?
New variants are identified on a regular basis. This will continue as long as we have transmission of the SARS-CoV-2 virus. This is one of the reasons it is so critically important to vaccinate as many people as possible. This mathematically reduces the risk of new and potentially more deadly variants entering the population.
What about boosters: If you aren’t eligible for a booster because your second vaccine shot was too recent, are you less protected from Omicron?
The data we have now shows that vaccine protection appears to decrease with time. Initial studies with Omicron show that boosters provide additional protection. Specifically for the pediatric population, I suspect we’ll get more data in the coming weeks or months.
Is there any data on how Omicron impacts children? Do children between ages 5-11 who have recently been vaccinated have some protection against this variant?
Because the variant is still so new, we don’t have enough data yet to show if the Omicron variant will impact children differently than past variants of COVID-19. Vaccination remains a very important strategy for reducing the risk of COVID-19 infection and transmission in children. High vaccination rates also help keep our hospitals from being overwhelmed.
Should kids aged 12-15 years old get the booster?
Yes. The CDC, the Western States Scientific Safety Review Workgroup, and the State of California now recommend COVID-19 boosters for children aged 12 and older. This is based on scientific data that shows that booster provides a significant increase in protection from catching COVID-19 and from getting severely ill if infected.