Pediatricians offer back-to-school advice for parents anxious about COVIDAug 23, 2021
The number of children hospitalized for COVID-19 in Michigan nearly doubled over the last week from 11 to 20. That’s a small fraction of the pediatric hospitalizations for the virus across the country, which reached a peak on Saturday at 19,000.
Despite a relatively low number of severe COVID cases in children in the region, parents may be feeling uneasy as schools prepare to return to in-person learning as the more contagious delta variant increases infectious rates. Michigan Radio reached out to several pediatricians to talk through questions and concerns that parents might have as they think about the risks posed to children by COVID-19.
Are hospitals prepared for a potential surge in pediatric COVID-19 infections?
Michigan Radio reached out to hospitals and health systems across the region and found that none have seen a significant increase in pediatric COVID cases. But that hasn’t stopped them from bracing themselves for a potential influx of cases in the coming months.
“We are following very closely other states which are surging a little bit ahead of us that have seen a substantial increase,” Dr. Christine Nefcy, chief medical officer at Munson Healthcare said in a call with reporters on Tuesday. “This is something that we're very concerned about, especially as we head into the fall and winter.”
Nefcy said that most of the pediatric COVID cases seen during the state-wide surge in April saw hospitalizations due to MIS, which is a serious condition in which organs such as the heart, lungs, and brain become inflamed.
How likely is it that a child can contract “Long COVID?”
There are a lot of unanswered questions when it comes to “Long COVID,” including the likelihood that anyone – adult or child – who has contracted COVID-19 will have extended symptoms. One recent study from the United Kingdom, however, found that about 4.5% of children who contract the virus continue to have symptoms beyond four weeks.
Dr. Carey Lumeng is a pediatric pulmonologist at Michigan Medicine's C.S. Mott Children’s Hospital. He heads one of the few clinics focused on pediatric Long COVID in the country, which hs seen about 70 cases since it opened in May.
Lumeng said that many of the symptoms have been persistent respiratory issues, although he’s also seen a cognitive impact on young patients. “It definitely has effects on mental capacity and learning,” he said. “I would say we’re mainly seeing fatigue and brain fog. For some of our patients we’re supporting accomodation in school, as we get closer to the school year, to help them be able to function.”
And it’s not just children who had severe cases of COVID who are experiencing those persistent symptoms; in fact, Dr. Lumeng said that the majority of children he sees with Long COVID were not hospitalized for the infection itself. He did note, that children who have underlying conditions that impact their respiratory system or heart, or those who are obese, tend to be more likely to experience extended illness after contracting COVID.
What are doctors saying about mask mandates in schools?
Mask mandates have been hotly debated in school districts across the country.
Dr. Bishara Freij is a pediatric infectious disease specialist with Beaumont Health System who said the science is clear that masking helps reduce transmissions of COVID. “I am 100% in support of a mask mandate,” he said. “I don’t think this is something that should be left up to individual preference. We are in a pandemic and your decisions affect me and my decisions affect you.”
Freij said that he believes there are significant benefits to sending children back to school in person both in terms of academic outcomes and mental well-being, and he said ensuring that everyone in school wears a mask will help slow the spread, especially since young people may be more likely to transmit the virus to adults.
“We all have to do what we have to do to help our family, friends, coworkers, and everyone else to finally put a lid on this thing,” Freij said.
What evidence is there to suggest that masking will actually slow the spread of COVID?
“A preponderance of studies show reduction in transmission when you wear masks in the context of school or work,” Freij said.
He admitted that some have shown different results, but said that’s because there are more factors than just a mask involved in studies, including whether people who participate are masked, the sort of ventilation in the rooms under review, as well as how effectively people wash their hands.
One recent study considered how long it would take to have a 50% chance of contracting in classrooms and found that it would take 120 hours if everyone wore a mask, and only 3 hours if no one wore a mask. At the high school level, those numbers shift down to 89 and 2, respectively.
Freij emphasized that masks are not a “holy grail” to stopping transmission, but that they are one tool in the arsenal to defeating COVID-19.
What advice do doctors have for parents who might be feeling anxious about sending their kids to school in person?
All of the pediatricians who Michigan Radio spoke to for this article were unanimous in recommending that students wear masks to school. Dr. Kevin Dazy is a pediatrician at Children’s Hospital of Michigan but he’s also the father of a 6-year-old and an 11-month-old. He said he’s had honest conversations with his older daughter about the importance of wearing a mask, and told her that wearing one is key to her getting to see her friends at school. He said that even though she’s just a kindergartener, she understands.
Beyond talking to kids about masking, Dazy said he would urge parents to “just be extra cautious” in monitoring their kids for any health changes. “[If your child has a] fever [or] runny nose,” he said, “you should contact your primary care physician, your pediatrician about that, and contact your school.”
He said children who have flu like-symptoms should stay home and only go back if they’ve tested negative for COVID-19. “It comes down to parents to make sure that we're keeping our kids safe and doing what we have to do to teach our kids to socialize and do the things we've always done in our entire lives as adults.”