Doctors say ‘health is more than the absence of COVID-19’ for children
If there’s anything parents have learned from the COVID-19 pandemic over the past two years, it’s the importance of in-person learning for kids. “Remote learning has exacerbated existing educational inequalities and harmed academic achievement for students of all ages and has compounded the growing mental health crisis in children and adolescents,” according to the American Academy of Pediatrics.
As new COVID cases decline rapidly across the country, hospitalizations peak and deaths continue to rise, according to the Centers for Disease Control and Prevention.
In November 2021, a vaccine approved for emergency use in children aged 5 to 11 was going to help restore some semblance of normality for children when it comes to school, extracurricular activities or dating again. . But Omicron had other plans.
Dr. Lucy McBride, a Washington, D.C. physician and Yahoo News medical contributor, is one of 13 medical experts who developed the “Children, COVID, and the Urgency of Normalcy” toolkit as a guide for help restore a sense of normalcy to children in schools after the Omicron surge.
(Some answers have been edited for clarity.)
Yahoo News: At this point in the COVID-19 pandemic, why is there an urgent need to restore a sense of normalcy for children?
Dr. Lucy McBride: The Surgeon General along with the American Association of Pediatrics and other expert groups have declared a pediatric mental health emergency because there is evidence that levels of anxiety, depression, thoughts suicide attempts, emergency room visits for suicide attempts, substance use disorders and general hopelessness among children 18 and under are at high levels.
This is happening at the same time as we are living through a pandemic where children have been deprived of their normal social and emotional coping skills, or tools, and deprived of the normalcy of being in school. It is important to recognize that some children suffer from COVID-19 itself. Some are grieving from having lost a loved one to the virus. Some children, however, suffer from the loss of safety and security in their daily lives.
Returning to school will not heal the wounds of all children, nor will it be an overnight solution for 22 months of living through a pandemic. But getting back to normal is a fair, just, and smart way to help children begin to heal the wounds of having been through a traumatic experience.
How are healthy children typically affected by COVID-19?
COVID poses very little threat of serious illness to students in highly vaccinated communities and to students who have been vaccinated themselves. COVID is a flu risk for unvaccinated children, and new data show us that even unvaccinated children under the age of 5 are at very low risk of serious outcomes. That’s not to say we haven’t lost children to COVID-19. Tragically, we have. This means that the vast majority of children who contract COVID-19 make a full recovery.
What are the risks of children getting “long COVID”?
Long COVID is a rare complication of a COVID-19 infection and is clearly a concern for children. Studies, however, consistently find that post-infection symptoms are similar in children who have had COVID-19, compared to children who have had other non-COVID infections. Long COVID is an area where we need a lot more research. But most public health officials and doctors I talk to don’t think we should organize schools and restrictions around the potential for this very rare complication.
What should the big picture of child health look like?
Children need to start getting back to more normalcy, and ideally better normalcy, because COVID is just a threat to their health and well-being. Tragically, children can get COVID, they can get very sick. Tragically, children have died from COVID-19. But there is more to health than the absence of COVID-19. Health involves social and emotional connections. Health involves going to school, feeling safe and, in many cases, being fed. It is therefore important that as we move gradually and in different parts of the country at different times towards endemicity, we adjust our policies according to the evolution of the pandemic.
What are the possible political solutions?
Thirteen public health and medical experts [including McBride] across the country have created an “Emergency of Normalcy” School Advocacy Toolkit to help school decision makers and anyone making decisions about schools understand the facts in order to make balanced, nuanced decisions and understand that the Health is more than the absence of COVID-19 for school children.
Our recommendations are:
1) Continue to encourage vaccination for all eligible children, especially where vaccination rates are lowest.
2) Continue to upgrade school ventilation systems. We know that crowded, poorly ventilated spaces are where the coronavirus likes to spread the most.
3) We recommend stopping asymptomatic testing and contact tracing. There is ample evidence that this does not significantly reduce school transmission, and this data is supported by the recommendation from the Policy Lab at Children’s Hospital of Philadelphia.
4) We also recommend bringing children back to normal lunchtime socialization. Free time is essential for children’s social, emotional and interpersonal development, and after two years of virtual learning and social distancing, it’s time to nurture childhood friendships and strengthen the bonds of our school community through socialization.
5) We recommend removing mask mandates in schools after the Omicron surge and when local hospitalization rates are low. For example, less than 10 per 100,000, and in the meantime, continue to encourage vaccination, encourage sick people to stay home, and encourage people who want to continue wearing a mask to wear a well-fitting N95 respirator, which protects the wearer and don’t rely on the behaviors of other people around them.
6) Finally, we recommend expanding mental health services in schools. Coming out of two years of trauma will require significant resources, including support animals and compassionate leadership from school counselors. This would minimize the long-term impact on students’ mental and physical health.
The toolkit is intended to help anyone who needs to make important evidence-based decisions in schools, whether they are teachers, mentors, school administrators or school decision-makers. It is intended to give people a framework with which to make complex decisions. As physicians and scientists, our goal is to inform people with accurate data and put it into context and provide advice, not to tell people what to do. We hope people will take this information and bring it to their own communities and share it with others as we navigate this complex time together.