[Dr. Dina News] More answers on “Kids and COVID-19”

This week we cover more of your questions about kids and the effects of COVID-19

Hello friends!

I hope you had a wonderful weekend and enjoyed the warm weather!

Let’s review the bad news, the good news, the most common questions of the week, and finally, my silver lining.

Dr. Dina, what’s the bad news?

There have been over 190 MILLION global cases of COVID-19 reported and over 4.1 MILLION deaths. In Canada, 1.43 million cases have been reported, with over 26,500 deaths.

The Tokyo Olympic games started last week, while Tokyo reported over 2,000 new cases a day. This six-month high threatens the ability of infected athletes to compete. A Chilean taekwondo athlete and a Dutch skateboarder are the first Olympians to test positive for COVID-19.

Cases continue to rise rapidly in the United Kingdom. Despite this rise, pandemic restrictions have been lifted. Citizens no longer have to physically distance, wear masks or minimize gatherings. Nightclubs have reopened.

Infections in the U.S. continue to rise. Millions of Americans remain unvaccinated, and the Delta variant is spreading quickly. Most Americans who haven’t yet receive a COVID-19 vaccine say they are unlikely to get one, AND 64% of unvaccinated Americans doubt the vaccines protect against the Delta strain, despite evidence they do. According to The Associated Press-NORC Center for Public Affairs Research, among U.S. adults who have not received a vaccine, 35% say they probably will not get one, and 45% say they definitely will not. This does not bode well. The Delta variant is now responsible for 83% of new cases in the U.S. Only 56% of eligible Americans have received at least one vaccine.

In several U.S. states, there are rising cases of COVID-19 amongst kids. Dr. Barr, the chief clinical officer at Arkansas Children’s Hospital, says, “The Delta variant is different than what we were seeing. We have 12 children admitted to the hospital now with COVID, that’s triple the usual numbers we saw during the previous months of the pandemic, and they seem to be much sicker. Most of them are teenagers, and a number of them are in the ICU and have COVID pneumonia and a few respiratory failures.”

Arkansas’ state’s secretary of health, Dr. Jose Romero, says he has
“major fears” that COVID-19 will spread to schools in September. “We’re seeing outbreaks in sites that we didn’t see last year… we’re seeing closures in daycares, we’re seeing closures in summer camps, and all that leads me to believe that in a setting where you don’t have strict mitigation that it will spread very, very quickly in our schools.”

What is the good news?

A critical study was published last week in the prestigious New England Journal of Medicine that two Pfizer or AstraZeneca vaccines are nearly as effective at preventing infection by the Delta variant as the Alpha variant.

Double vaccinated Americans can cross the border into Canada for non-essential travel starting August 9. However, Canadians traveling to the U.S. by car will have to wait until at least August 21 as the U.S. extended land border restrictions.

Cases are stable or declining across Canada, but vaccination rates are slowing down, and the rapid spread of variants among non-vaccinated people leave many experts cautious about the coming weeks and months. In addition, 95% of hospitalizations and ICU admissions and 91% of deaths from COVID-19 are among unvaccinated people.

Ontario’s top public health officials caution that until more than 90% of eligible citizens are fully vaccinated, Delta strain remains a threat. Lifting remaining restrictions won’t begin until at least 80% of eligible residents have at least one dose, and 75% have received both.

Vaccine requirements may be a requirement for involvement in certain activities. For example, the Ontario Hockey League will require all staff, coaches, players, and officials to be fully vaccinated before the season begins. In addition, Seneca College has announced that vaccines will be mandated to attend on-campus classes and events. It is the first post-secondary institution in Canada to require vaccines.

The University Health Network made news this week as they will require staff to present a negative COVID-19 test or at least one COVID-19 vaccine to enter the hospital.

The European Medicines Agency is the first group to recommended authorizing Moderna’s COVID-19 vaccine for children ages 12 to 17. The Pfizer vaccine is the only COVID-19 vaccine currently approved for use in kids under 18.

Ontario’s COVID-19 science advisory table released recommendations last week suggesting a reopening of high-risk settings soon. They indicate a vaccine certificate could be used to regulate entry into high-risk locations, including schools, restaurants, gyms, sports, and cultural events.

Premier Ford has been strongly opposed to vaccine passports, saying, “We’re not going to have a split society. I’ve never believed in proof. Everyone gets their proof when they get the vaccination”.

The Science Table also recommends that barring catastrophic circumstances, schools should be open in September for in-person learning, including a re-initiation of extracurricular activities. In addition, they suggest ongoing measures to decrease infection burdens such as vaccination of all eligible individuals, hand hygiene, adequate ventilation, cleaning, and exclusion of sick students and staff.

Their framework reviews elimination measures on top, as the most effective measures to prevent COVID-19 infection: vaccination, contact tracing, and symptom-based screening.

Permanent measures will reduce transmissions such as vaccination of eligible students, exclusion of symptomatic staff and students, hand hygiene, achieving adequate ventilation and cleaning.

Temporary measures include symptom screening, masks, diagnostic testing, distancing, cohorting, and increased outdoor space use.

The Table suggests that ongoing masking and social distancing should consider student vaccination status, age, and grade.

They recommend that small cohort size and distancing be based on age and grade.

Questions of the week

If my child contracts COVID, how will it affect them?

The symptoms of COVID-19 are similar in adults and kids. The most common symptoms are fever and cough, and some have sore throat, nausea, and vomiting. If your child has any viral symptoms, please contact your healthcare provider to plan the next steps.

As a means of comparison, the CDC reported that there have been 300 COVID-19 deaths and a few thousand severe illnesses in kids infected with COVID-19 in the U.S. compared to 188 flu-related deaths in kids between 2019 and 2020. Thus, the Delta strain or other variants of concern may be responsible for more illness and death in the future.

What are the long-term risks in kids infected with COVID-19?

Although kids do not seem to get as sick as adults or suffer the same long-term consequences of COVID-19 infection, there are cases of kids with decreased exercise tolerance, poor concentration, fatigue, joint pain, and brain fog after infection. In addition, some older kids have reported more emotional lability and low mood, similar to some adults with ‘long hauler’ syndrome.

Did you miss last week’s “Vaccine Update for Kids 0 to 11 Years!“

What can unvaccinated kids do this summer?

A recent survey of 828 health experts in the U.S., such as pediatric infectious disease physicians and epidemiologists, demonstrated that the vast majority think kids should continue wearing masks and practicing social distancing while still engaging in ‘minimally risky activities’ around other kids. Kids have missed out on so much social time, and we want to counteract the mental health effects of this isolation. Outdoor activity is far safer than indoor activity and can be practiced safely with distance and masking when possible. Specific activities should depend on the local case rates and vaccination rates. When there are more cases and lower vaccination rates, a more conservative approach is best. Avoiding busy public places and crowds is wise.

Can unvaccinated children visit grandparents?

This is hotly debated and varies considerably based on where you live and the caseload and vaccination status near you. I still encourage mask use, especially when socializing indoors and if the child is exposed to other children at daycare or camp. Vaccination does not prevent 100% of infections, and there is some COVID-19 still circulating. Please do spend time with family and friends; we have all missed it!

The silver lining of the week

This week has seen a ton more businesses opening up again. I know it has been such a challenging and long pandemic for so many entrepreneurs, and I feel optimistic that many will get back on their feet and thrive again. Please consider supporting small businesses near you. It will make a massive difference for them, their employees, and their families.

I wish you a fabulous week of sun and outdoor fun,