What are the signs and symptoms of BA.2?
Upper respiratory issues are more common with BA.2 than with previous variants, according to Christos Karatzios, a paediatric infectious diseases specialist at Montreal Children's Hospital. "We're seeing congestion, sore throats, hoarseness, and loss of voice—but not as much loss of taste and smell as with previous variants," he says. Coughing and fever are still prevalent.
Anecdotally, McCready has heard of gastrointestinal symptoms occurring much more frequently in both children and adults with BA.2, and doctors are seeing a lot of croup caused by COVID in children under the age of two. "Sometimes they need a little help breathing," she explains. "Really, it's a spectrum—some people just have a runny nose, while others are extremely tired."
Doctors are also seeing lesions such as hand, foot, and mouth disease, which includes sores on the palms, soles, and mouth.
McCready recommends that parents test their children for COVID if they exhibit any of these symptoms, with or without more obvious red flags such as coughing, a runny nose, or a fever.
What is the significance of BA.2 for children?
In general, BA.2 is associated with a lower percentage of severe outcomes than previous COVID-19 variants such as Delta, but it is far more transmissible than any previous variant. While more research is needed, preliminary findings indicate that the dominant BA.2 variant is 30 to 40% more contagious than the original Omicron. The emerging variant (XE), which is a cross between BA.1 and BA.2, is 10% more contagious than BA.2.
This evolution of more transmissible variants has resulted in an increase in case numbers in many communities—"a tsunami rather than a wave," according to Karatzios. While the likelihood of your child contracting a severe infection from COVID remains low, it does occur, and child hospitalizations are at alarmingly high levels, particularly among those too young to be vaccinated. As of April 12, 75 children aged four and under had been hospitalized in Ontario with COVID in the previous 14 days. In comparison, only 15 children aged 5 to 11 were hospitalized during the same time period. According to a CHEO official, emergency room visits are at an all-time high, with approximately 65 percent of visits being for COVID-like symptoms.
How safe are fully vaccinated children?
Initially, vaccines provided very high levels of protection against both infection and severe outcomes (in some cases, over 95 percent). Many adults and teenagers were able to get vaccinated during this time period, but by the time vaccines for children under the age of 12 were approved, we were dealing with the early stages of Omicron. Our protection against infection is significantly reduced with these new variants (Efficacy against current variants is approximately 50 to 65 percent, according to Dr. Karatzios), and the further we get from our last immunization date, the less protection we have.
Fortunately, being immunized still provides very strong protection against severe COVID-19 outcomes. So, if your child recently got COVID despite being vaccinated, it doesn't mean the vaccine didn't work—it very likely reduced the severity of the illness.
Children who have recently received COVID will have additional immune protection for some time—McCready isn't seeing much reinfection before the two-month mark, and Karatzios believes immunity may last several months. This immunity is enhanced if your child is also immunized.
Managing Pandemic Fatigue
Despite our best efforts, the pandemic is not over. While it is understandable to want to "live with COVID" in the future, this does not imply abandoning all preventative measures or throwing caution to the wind.
"There's a way to live with COVID by making changes to our normal activities that make everything safer for everyone, and then when we get cases, it's less disruptive," McCready says. "We need to do basic things like improving ventilation, masking when cases are high and staying home when sick.
"I'm very disheartened to see us raise the white flag," Karatzios says. "I understand that everyone is tired, but letting it rip through society isn't going to make it go away." Instead, he fears that as the virus spreads unhindered, we'll see more and more mutations.
"The public message was muddled. However, BA.2 is not a common cold, and allowing it to spread through society will not result in herd immunity."
We can reduce risk and disruption in the future by normalizing protections in high-risk settings and staying at home when sick. And, yes, it will help us finally end the pandemic.