-CDC said last week adolescent hospitalizations due to COVID were on the rise, media picked up the message Not true: child cases and hospitalizations down 84% and 69% since Jan
-CDC failed to highlight that 20% of hospitalizations in their study Jan-March 2021 were psychiatric
-Mental health (MH) effects hard to study since healthcare utilization down & MH services for children already has gap
-Only way is to look at ED visits & suicides. Data from Children's Hospital Oakland: 66% increase in 10-17 screening yes for active or recent suicidal ideation
-CDC said last week adolescent hospitalizations due to COVID were on the rise, media picked up the message Not true: child cases and hospitalizations down 84% and 69% since Jan
-CDC failed to highlight that 20% of hospitalizations in their study Jan-March 2021 were psyc
-Similar data, CO and Connecticut
- California DPH public records data shows a 24% increase among children < 18 who died from suicide in 2020 than 2019 (with 10% decrease in adults, speaking to more stressors than that of pandemic on kids). 134 vs 108 suicides
And California, this is my LAST paper I will write on school openings (I address CA because I live here & we have lowest return of kids to in-person learning among 50 states). It is the 13th and the saddest. Our adult vax+community rates can return our kids to normal life now.
CA did great job with vaccines! My 3 concerns: 1) Our school closures -worse in SF than surrounding counties & worse in CA than any other state 2) We closed outdoors in December, virus disperses effectively outside 3) Adult vaccine + pop immunity for unvax work better than masks
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I am interested in increasing trust in public health. 4 things we can address now to increase that trust: 1) Natural immunity: Real, don't know duration of immunity from either route; 1 dose only? Acknowledge natural immunity, our knowledge limits
2) Vax in kids: Acknowledge that adult vax massively reducing community transmission in US, kids less at risk of getting sick. Acknowledge risks vs benefits of vax in kids under study. 1 dose, lower dose to reduce risk of myocarditis? If low rates, can kids have normal life?
3) PCR test: Acknowledge limits of PCR especially after vax. PCR picks up "dead virus" or low virus in nose because very sensitive (can tell if must cycle the machine a lot; CT >30 is low viral load). Don't isolate someone with high CT (use Ag; no asymptomatic testing after vax)
Thanks to @NYT for publishing this guest essay by @TracyBethHoeg, @DrDanielJohnson (Pediatric ID) by me saying we must fully reopen schools this fall and here's how. Main points: 1) Full in-person learning need not be tied to child vaccination status nytimes.com/2021/06/08/opi…
given falling cases & hospitalizations in children with adult vax (61% & 40%, respectively in just last 6 weeks; 80% since January) 2) Hand-washing great for rotavirus, noravirus, rhinovirus; excessive hand sanitation, cleaning not needed for COVID; 3) No plexiglass barriers
4) No mass asymptomatic testing unless community transmission high (won't be anywhere by September - 200/100K) 5) Test symptomatic individuals 6) Don't close class for a child testing positive; unvaccinated teachers follow CDC I&Q protocols
MYOCARDITIS after 2nd dose of COVID vaccine after 2nd dose mainly among 12-17 year olds in US. Data from Vaccine Adverse Events Reporting System (VAERS). Remember, vaccines can cause myocarditis. The rate of myocarditis from smallpox vaccine was 1/12,000: jamanetwork.com/journals/jama/…
Mechanism unclear (handwaving paper says "antibodies & T cells"). Now remember, only Pfizer is approved for 12-17 year olds and the dose of the vaccine (30 micrograms) is the same dose used for adults (the trials among kids 6 months-11 years uses lower dose, 10). Publicly
available data from VAERS up to 5/28/21 shows myocarditis rate post vax for16-17 yo is 0.0016% (so comparable to smallpox). In fact, hospitalization for myocarditis post-vax among 12-17 year olds is currently 12x greater than hospitalization for COVID with low cases among
Good to see that 45.7% of adolescents in this study did not have primary reason for admission be related to COVID-19 which is consistent with careful work done by our Stanford & Northern California colleagues that 40% admissions in children not for COVID cdc.gov/mmwr/volumes/7…
That work is summarized here in a commentary I wrote with @DrAmyBeck - careful chart review find reasons for 40% hospitalizations in children during pandemic linked to other reasons (consistent with 45.7% in this study) hosppeds.aappublications.org/content/early/…
These days in U.S., asked what end of epidemic would look like & I wanted to explain why COVID - once controlled- will be more like measles (where public doesn't think about every day) than influenza (where public does think about in winter). COVID has highly effective vaccine
like measles does - the effectiveness of the measles vaccine is high like the effectiveness of the COVID-19 vaccine - one dose 93% effective and two doses 97% effective per original studies. We give measles vax fda.gov/consumers/cons…).
two doses in childhood & then high exposure populations like healthcare workers/international travelers often given booster - schedule is here. We have already discussed that T cells from measles vaccination last a long time -remember paper cdc.gov/vaccines/vpd/m….
With 0 deaths across England from COVID today, I am reminded that on April 22, 2021, England downgraded its epidemic to "endemic" status when an infection no longer is causing morbidity/mortality to justify extreme measures adopted earlier without vax news.yahoo.com/covid-pandemic…
Now the UK is at 58% 1st dose and we are at about 50% 1st dose because they adopted a 1st dose first strategy so going faster than we - please see World Vaccine tracker here. And UK does a lot of testing & has seen B.1.617 but has not changed 0 death mark ourworldindata.org/covid-vaccinat…
You can see and track cases/hospitalizations/deaths here at Worldometer across regions & this is what UK rate looks like. When hospitalizations/deaths become DECOUPLED from cases with vax, not prudent to track cases as metric of re-opening (or variants) worldometers.info/coronavirus/co…