THE MOST AT-RISK, THE MOST FEARFUL, AND THE MOST INNOCENT
INTRODUCTION
2020 was all about protecting the most at-risk, my mom-in-law being the poster child with her severe COPD. By controlling my work environment, despite my job being essentially to violate social distancing 60-80 times per day, COVID19 never entered my personal household. However, it did impact my family sadly, finding its way into my dad’s skilled nursing facility in July taking him. Also, my wife lost an aunt this year who declined vaccination and refused to be tested when she got sick.
Now that we may be hopefully past the worst of it my office priority has shifted to ensuring that all patients entering my office feel safe and secure, protecting the most fearful. However, I see a time coming very soon in which the emphasis will need to change once again, to that of protecting neither the at-risk nor the fearful, but the most innocent, our children (in my case grandchildren).
CHILDREN
Thus far children have been less subject to infection, and when infected subject to less severe outcomes. Unfortunately, there is a general belief that children have been altogether unimpacted by COVID19. This is incorrect. Children have been hospitalized and admitted to the ICU. Some have died. In spite of these tragic outcomes, just why kids are less impacted than adults remains a mystery. I have heard of three plausible reasons. First, mitigation. By closing schools and locking down economies, since kids are never essential workers, they have less exposure. Second, biology. The ACE2 receptor that the viral spike protein attaches to in order to enter our cells exists in fewer quantities in children than in adults, so there are fewer points of entry. Third, colds. Studies have shown that a recent exposure to the cold virus, which is a corona virus itself, seems to result in milder COVID19 symptoms. Kids pass around viral-laden snot all the time and suffer colds more than adults. Of course there may be other as of yet unknown reasons. Regardless of the why it is my prediction that this is all going to soon change. There are three reasons for this change.
MY CONCERNS
First concern, the variants. The delta variant (167.2) will soon be the predominate variant in the U.S. It is some 40% more contagious and may be associated with worsening outcomes. Since it is more contagious one has to wonder if it might it be able to more effectively infect our children.
Second concern, school. I agree that we need to return to something resembling normalcy, which also means that kids need to be back in school. But putting kids back in school in large numbers means that colds and flu and every other sort of germ will be spread around from hand to hand, nose to nose, and cough to cough, including the SARS-Cov2 virus.
Third concern, vaccine hesitancy. We can’t change concern #1 and we shouldn’t change concern #2 but you and I have direct control over concern #3. I have written at length about vaccines and controversies, about risks of vaccination versus risks of COVID19. I have studied the science with the help of my daughter with her Ph.D. in Molecular Genetics. I have spent a lifetime not getting the flu shot due to its perpetual ineffectiveness. I am neither antivax nor provax. I am pro science, and I can come to no other conclusion other than the m-RNA vaccines are simply amazing technology, that they are saving lives, and that they pose the only way to get truly beyond this pandemic.
MY PREDICTIONS
I made a prediction in the 3rd quarter of 2020 that by the 3rd quarter of 2021 things would be near normal, and here we are month one of the 3rd quarter and things are…near normal…not yet normal…but near normal, at least in some communities, thankfully our community.
I have made the prediction that these vaccines will protect us for years, not months, and an increasing body of evidence suggests that I am right. We will need boosters better designed for the current and future variants, but not because our antibodies or memory b-cells are fading.
My new prediction today is that we are going to see an increasing percentage of children getting COVID19 by the 4th quarter of 2021. Compared to last year, the percentage of children testing positive, getting sick, getting hospitalized, dying, will increase. This will be due to the confluence of factors as discussed above; more contagious variants, returning to class, and a large population of young adults, many being parents, remaining unvaccinated, thereby exposing their kids who will go on to expose your kids and your grandkids.
Compared to the first two predictions, which are both positive in nature and in outcome, my prediction about children is negative. I don’t hear anyone talking about this yet in the media. I’m a bit terrified actually. There is a solution, a way to negate my prediction. If you have not been vaccinated, get vaccinated. If you have been vaccinated, encourage the people in your life to get vaccinated too. Vaccination protects you, it protects those around you, and it prevents the creation of new and more dangerous variants. If you have questions, ask them of credible resources, get answers from trustworthy people. Ask me. Read my blogs.
My final prediction is also a hope. By 2022, if not sooner, the FDA will give full approval (as opposed to the Emergency Use Authorization) to the vaccines for all ages 4 (+/-) and older. State by state laws will go into effect mandating the COVID19 vaccination for all children to attend school. This will be the day that this pandemic will be once and truly done. SARS-Cov2 will never be gone, but the pandemic will. It will happen community by community, state by state, and finally country by country. But it starts with each individual doing their part, getting vaccinated, if for no one else…for our children, the most innocent.
Good job Rick.
Thanks!