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Australia: Paediatric doctors brace for more child cases in hospital amid Queensland's COVID-19 Omicron wave

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The Queensland Children's Hospital yesterday had 12 inpatients with COVID-19, including one in intensive care. (ABC News: Marc Smith) © Provided by ABC News The Queensland Children's Hospital yesterday had 12 inpatients with COVID-19, including one in intensive care. (ABC News: Marc Smith)

A Brisbane-based children's infectious disease specialist, who studied COVID-19 patients in London, has moved to allay parental fears as Queensland's expected Omicron variant peak looms over the coming few weeks.

Dr Julia Clark spent more than two months late last year embedded in St Mary's Hospital in London — considered a centre of excellence in paediatric infectious diseases — where she observed COVID-19 patients and their treatment in preparation for the Queensland wave.

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Dr Clark also gained experience in diagnosing and treating a rare post-COVID condition in children — known as paediatric inflammatory multi-system syndrome (PIMS) — that is potentially fatal without appropriate medical care.

As of yesterday, the Queensland Children's Hospital at South Brisbane had 12 inpatients with COVID-19, including one in intensive care.

Dr Clark said most of the child COVID-19 patients had been admitted to hospital for other conditions, not because they had the virus.

"We're not really concerned that we're going to be looking after lots of children with severe COVID, because we're not," she said.

"Most children have fairly good outcomes with COVID — they get a very mild illness. When they get COVID acutely, they hardly ever get really unwell."

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Post-COVID inflammatory condition

However, Dr Clark said, parents should be alert for a potentially severe post-COVID illness — paediatric inflammatory multi-system syndrome — which could develop in children between two and six weeks after having the virus.

Symptoms can include fevers, rashes all over the body, red eyes and red lips.

"The thing that's dangerous … is they get an inflammation of their heart, they get a myocarditis, and their blood pressure drops," Dr Clark said.

"That's when parents get worried that there's something very wrong with their child and they come in."

Dr Clark said the condition occurred in about one in 5,000 COVID-19 cases in children, commonly aged between six and 12.

"We need to make sure that we're messaging to health care professionals and to parents that this is a possibility," she said.

'Continuous learning experience'

St Mary's Hospital in London was one of the first centres in the world to describe the syndrome.

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In the early days of the COVID-19 pandemic, some children died of the condition.

But, Dr Clark said, better recognition of the syndrome, and the development of successful ways to treat it, was saving children's lives.

"If you treat quickly, then you stop the progression of the inflammatory condition and the outcome is much, much better," she said.

"That was one of the reasons that I was pleased I went to London.

"Being a doctor is a continuous learning experience — we all read, we all talk to our colleagues and go to conferences — but it's not the same as seeing a patient.

"That just makes a big difference in how comfortable you feel and how confident you feel about being able to treat them.

"The more you see, the easier it becomes and the more you understand that you are doing the right thing and you can do it quickly."

Dr Clark said so little was known about the Omicron variant that it was unclear how it would impact on case numbers of the post-COVID inflammatory condition in children.

She said it was also too early to know whether the COVID-19 vaccine in children aged five to 11 would reduce cases of PIMS.

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"That's something that people are really, really interested in," Dr Clark said.

"I think the expectation is that a vaccine will decrease the chances, but we haven't been vaccinating children under the age of 12 until now, so we don't know — that will be monitored."

'Next three weeks will be tough'

Queensland's Omicron peak is expected in late January-early February.

Chief Health Officer John Gerrard yesterday defended the decision to push the start of primary school back to February 7 to help hose down transmission of the virus, and take pressure off the hospital system, when modelling suggests cases would be at their highest.

"I'm not talking about lots of children being admitted to hospital," Dr Gerrard said.

"We just know that when schools return to normal functioning, you get a lot more transmission of virus in the community in general."

Yesterday, 529 patients were being treated in Queensland hospitals with COVID-19, with 27 of them in intensive care and six patients on ventilators.

"I think we're doing reasonably well, but the next three weeks will be tough," Dr Gerrard said.

"There will be a lot of people admitted to hospital and there will be significantly more intensive care admissions than what we're seeing now."

Queensland Health has more information about the post-COVID paediatric inflammatory multi-system syndrome on its website.

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Will Omicron Protect Us From Future Waves? .
A variant that spreads comprehensively won’t necessarily protect comprehensively.The close of Omicron’s crush, then, should bring the country one step closer to hitting a COVID equilibrium in which SARS-CoV-2’s still around, but disrupting our lives far less. In the most optimistic view of our future, this surge could be seen as a turning point in the country’s population-level protection. Omicron’s reach could be so comprehensive that, as some have forecasted, this wave ends up being the pandemic’s last.

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