New School Year, Masks, Vaccines, and Delta

Want to Hear the Podcast Episode Instead? Check it out at the Kids and COVID podcast page or search for it on your favorite podcast player.

The following is information utilized from a recent talk given by Dr Alice Sato, an epidemiologist with Childrens Hospital and Medical Center in Omaha, NE.

What is Going on With COVID Right Now?

If you talked to me in the middle of the summer, you would have seen me optimistic.  New cases were coming down, vaccine rates were starting to increase, masks were coming off, and it seemed like we were getting closer to normalcy.  My how times have changed.

Unless you are living under a rock, you most likely have heard that new case rates are rising secondary to the Delta variant of COVID.  Across the country we are seeing a sharp increase in new cases, hospitalizations, and ICU stays secondary to COVID infection. Every day those values continue to rise locally. 

I currently reside in Omaha, Nebraska.  The last time I looked at the case rates, 15% of testing was found to be POSITIVE for COVID.  That is more than double from a week ago.  The two groups that we are seeing these rates increase in is the 5–17-year-olds AND the 30–49-year-olds (the parents of these kids most likely).  This is BEFORE we have even gone back to school. 

Photo by Olya Kobruseva on Pexels.com

How is the Delta Variant Different?

If you look across the country, case rates are going up as well as the % of that being the Delta Variant.  In Douglas County, where I reside, it is almost ALL Delta variant.  This is concerning, as with new variants comes new infectivity rates, new rates of severity of infection, and new complications. 

At this time it appears the infectivity rate of Delta is significantly higher than that of the original strain.  The original COVID strain had an R0 (rate of infection from one individual to others) of around 2-2.5. That means that without measures like social distancing, masking, cleaning the air within buildings, etc, that one sick person could get another 2 people sick, increasing the risk for spread. The goal with utilizing the discussed measures (including VACCINES) is to get that R0 value below 1. Based on recent data, the Delta variant appears to have an R0 of 6-9.  That means for every person infected with Delta and no masks, spacing, or vaccines involved, they could potentially infect up to 9 people around them.  For reference, the R0 value for Influenza is 1.5.  So no, this is not “just the flu.”

Just last week the COVID unit at UNMC was hitting capacity.  If you aren’t familiar with UNMC, they were one of the early hospitals who took COVID patients from the cruise line early 2020 before COVID truly hit the United States.  They are built to take on these patient loads, but now are becoming filled.  Where do we start to send patients when there are no more beds? For reference, ALL of the patients admitted at the time of this data collection were UNVACCINATED.

Studies out of Canada, Singapore, and Scotland are showing the Delta variant as having increased risks for hospitalization, ICU stays, and deaths.  I am in several physician groups online, and they are starting to see the strain as well.  Many ER’s are seeing large influxes of patients secondary to COVID which is filling hospital and ICU beds.  Then, other patients who NEED these beds (surgical or other health issues) are being sent to other facilities.  Staffing is low in certain areas due to staff furloughing last year.  If we do not get a hold of this soon, you will see a major testing of your local health system’s capabilities. 

Photo by Andrea Piacquadio on Pexels.com

How is This Affecting Our Kids?

One of the common “mantras” this last year has been “kids don’t get THAT sick from COVID.”  Recently, Texas Childrens Hospital announced that about 10% of positive COVID pediatric patients have led to hospitalization.  In relation, the original COVID virus was about a 1% hospitalization rate.  Now, we don’t know if that rate of 10% will stay that high, but there is obvious concern. 

COVID is now one of the TOP 10 causes of deaths in kids.  COVID deaths has surpassed that of the 2017, 2018, and 2019 flu seasons.  Considering most kids did not start contracting COVID till after about 6 months of it in our country, that number is concerning. 

Many people will look at these numbers and still say they are much less than adults so there is no concern.  Let’s use an analogy.  Let’s imagine someone builds a brick wall in a lane on the highway.  We obviously see it in the way; however, some people fail to avoid it.  One car collides with it and a person dies.  However, the rest of traffic keeps going.  Then a second person dies.  Then a third.  Yet, many still state, “Well I haven’t hit the wall yet and three people is much less than the typical number of traffic deaths in the Unite States annually, so who cares?”  How many deaths would it take for someone to finally say, “Hey, we should probably move that wall.” 

It is the same when it comes to kids.  Masks.  Continued social distancing.  Cleaning the schools. All of these were not easy last school year.  However, they worked.  Schools did a GREAT job at preventing spread within the classrooms and keeping kids in person as much as possible.  We learned from last year that kids NEED to be in person for school.  Obesity, mental health, academic development, etc – all of these was negatively affected when kids were stuck doing mainly virtual learning.  But now we have a new tool to help keeps kids in school – and that is VACCINES. Getting yourself vaccinated and your child (if they are age-eligible) will be a huge boon to curbing the spread of the delta variant as well as keep our kids in school.

Photo by Anna Shvets on Pexels.com

Why Wear Masks at School?  Should We Wear it Somewhere Else?

You may have seen the recent changes to the AAP and CDC recommendations, stating that kids 2-years-of-age and older should wear a mask at school.  A month ago it was optional.  Why the change?  The biggest reason is that cases are going up.  When your location hits 50 new cases a week per 100,000 population (or above an 8% positivity rate on testing), you are thus in a higher zone to require further masking.  Same will be said for other locations around town.  Want to go to the store without a mask?  Probably not going to happen here soon.  As cases and positive tests go up, the need for masking and other restrictions returns.

We saw a big reduction in respiratory infections, flu, and significant COVID cases in kids last year during school.  It really took the last 3-4 months to see how reducing masking restrictions, removing social distancing indoors, and other more relaxed measures have led to an increase in numbers again.  Masking is only a part of the solution, but it still plays an important role.  If your kids are going to school this year (vaccinated or not), I ABSOLUTELY recommend they wear a mask to school.  Both of our boys will be. 

With that said, please please PLEASE get your child tested if they have symptoms.  I have had many families refuse testing recently with no explanation why.  This does multiple things:

  1. We don’t know how truly widespread the infection is getting without accurate testing.  We may be missing cases that could be isolated at home to prevent this from getting worse.
  2. If we are only testing the REALLY SICK kids, then the positivity RATE is going to go UP, thus put us all into a higher risk zone leading to more restrictions.  Don’t want to have to mask everywhere you go or lead to a partial shut down again?  Then get tested when it is recommended and help us all out. 
Photo by CDC on Pexels.com

Should My Kid Get the Vaccine?

If they are old enough, then absolutely YES.  As mentioned above, there are various ways to help prevent the spread and complications from this virus.  Vaccination is one of them. The risk for ANY kind of adverse reaction to the vaccine is significantly LESS than the risk of contracting COVID, even in kids.

What If I Had the Illness Already?

Great question.  My question in return – when did you have it?  Was it early on during COVID or last week?  If it was very recent, then you most likely had the Delta variant and thus should be protected from it.  If it was 6 months ago, then you most likely were exposed to a different variant, thus minimizing natural immunity to the Delta variant.  What we DO see is that the vaccine is doing a good job at preventing significant risks for hospitalization and death from delta. 

The vaccine has been shown to greatly reduce risk of illness from COVID.  There is an 8-fold reduction in disease incidence, 25- fold reduction in hospitalization, and 25-fold reduction in death.  That is HUGE. Based on studies out of England/Scotland, Canada, and Israel, the effectiveness of the Pfizer 2-dose vaccine ranges from 93-100% at preventing hospitalization or death from delta.  Yes, some people got sick from it (Israel numbers were the lowest at 64% for symptomatic illness), but still significantly protected against hospitalization and death (93%). 

Conclusion

In the end, I recognize we are all having a sense of deja vu when it comes to schools and masking. We all wanted to be done with this. Yet here we are, and this is the situation we are presented with. We continue to ask people to do what you can not just for yourself and your family, but also the people around you. We will NOT get out of this if only part of the group is making an effort.

Get vaccinated.

Get your kid vaccinated if you can.

Follow local guidelines when it comes to masking and other restrictions.

Stay healthy

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