Is it new Covid strain? What we know, and don’t, about China’s child ‘walking pneumonia’ crisis

The World Health Organisation is probing a mass outbreak of childhood pneumonia in China — with thousands of cases being reported a day. Experts weigh in on what we know, and what we don’t.

Mandy Squires

3 min read

November 25, 2023 - 10:22AM

Coronavirus

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“There is nothing to suggest” an epidemic of respiratory illness in China — affecting many children and causing hospitals to be overwhelmed — is a dangerous new strain of Covid or the next global pandemic, Australian experts say.

Head of the Melbourne University School of Health Sciences Professor Bruce Thompson said there was currently too little information to draw any firm conclusions on what was causing the mass outbreak.

The dramatic rise in pneumonia cases has led the World Health Organisation (WHO) to appeal to China for more information, and ask for details on its planned response.

There are reports thousands of children a day are falling ill with what is being dubbed as “walking pneumonia”, as it sweeps through Chinese schools.

Children receiving drips in the hospital hallways. Picture: AFP

Children and their parents wait in an outpatient area of a children’s hospital in Beijing on November 23, 2023. Picture: AFP

Children receive a drip on the stairs of a Beijing children’s hospital, also on November 23, 2023. Picture: AFP

The WHO late this week released a statement revealing that from mid-October 2023, it had been monitoring data from Chinese surveillance systems, showing a sharp rise in respiratory illness in northern China, predominantly affecting children.

“Chinese authorities attributed this increase to lifting of Covid-19 restrictions and the arrival of the cold season, and due to circulating known pathogens such as influenza, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mycoplasma pneumonia and RSV are known to affect children more than adults,” it said.

“On 22 November 2023, WHO identified media and ProMED reports about clusters of undiagnosed pneumonia in children’s hospitals in Beijing, Liaoning and other places in China. Through the International Health Regulations mechanism, WHO made an official request to China to provide additional epidemiologic and clinical information, as well as laboratory results from these reported cases and data about recent trends in circulating respiratory pathogens.”

Hospitals have been overwhelmed with sick children. Picture: AFP

A man waits with an ill child at the hospital. Picture: AFP

Head of the Melbourne University School of Health Sciences Professor Bruce Thompson said there was currently too little information to draw any firm conclusions on the cause or trajectory of the outbreak.

“Spikes in respiratory conditions do occur for many reasons including seasonal variations,” he said.

“In the case of China, which was in lockdown for a significant period of time, it may simply be community acquired infections due to an increase in socialisation. The very preliminary data suggests that there is nothing out of the ordinary, as the causes of the pneumonia illnesses have been varied, including influenza, RSV etc. At this stage, there is nothing to suggest that it may be a new variant of Covid. One thing to note is that we can be reassured that the surveillance processes are working, which is a very good thing.”

Director of the Sydney University Infectious Diseases Institute Professor Ben Marais said the increase in children with respiratory virus infections in China was not unexpected and “probably reflects the ‘immune deficit’ effect of strict Covid lockdown policies that prevented exposure to common viruses (and the acquisition of protective immunity) in young children”.

“We are currently waiting for more information and updates, but there is no indication that this represents an outbreak of a novel unidentified virus,” he said.

Other international scientists have said the situation warranted close monitoring, but they were not convinced the China disease outbreak signalled the start of a new global pandemic.

Professor Robert Booy, an infectious diseases and vaccine expert at the University of Sydney and a consultant to vaccine manufacturers, said the fact that the only reported subjects were children suggested the illness wasn’t “anything new”.

“As this does not appear to be occurring in adults, that suggests that adults have prior immunity, which points to an existing pathogen as the likely cause, rather than anything new,” he said.

Vic Covid deaths, hospitalisations rise again

Covid deaths and hospitalisations across Victoria have risen again this week, with a horror 325 people a day so seriously ill they needed to be admitted to health facilities and 145 people dying in the most recent 28-day reporting period.

The number of Victorians in intensive care with Covid has also increased to 16.

Concerningly, data shows Covid deaths among middle-aged Victorians, between 50 and 64 years-old, appear to have risen over the last couple of months.

So too have deaths of people aged between 65 and 80.

Deaths in the over-80s age bracket, however, remain by far the highest percentage.

It comes as the “currently high” virus levels in metropolitan wastewater suggest the latest wave gripping the state has not yet peaked and there is more Covid pain to come.

A mix of Omicron recombinant XBB sublineages continued to circulate in Victoria this week, with mutant strain EG.5 and one of its sublineages, HK. 3, dominating but BA. 2.86 (Covid Picola) also detected.

The Department of Health on Friday morning said to protect themselves and their loved ones from becoming ill, Victorians should wear a mask, stay home when sick, test if they had symptoms, let plenty of fresh air circulate in indoor spaces and meet outside when possible. They should also get their vaccination boosters shots as soon as able.

Those at risk of becoming seriously ill with Covid should access antiviral medication, it said.