COVID Update: There are few more important or sensitive topics than kids & their health.

They are being made pawns in a dangerous game. We need to be put a stop to it. 1/
There is a fairly loud camp that believes the focus on kids is overblown & mask mandates are harmful.

Much of their logic if there is any has to turn on the fact that very very few kids have died from COVID. Thankfully most indeed recover.

That argument misses a lot. 2/
Let’s start with data. There were over 130,000 reported cases of COVID-19 in kids this week. Up 4x from a month ago. But we’re just getting started & before school is back in much of the country. 3/
A number of these cases turn serious. Between 1/2%-2% of kids end up hospitalized & they are out of room for kids in much of the Southeast.

And some kids get MIS-C or any of a number of other ailments that hit adults— from kidney disease to brain issues to cardiac issues. 4/
So there are say 1-2 thousand kids being hospitalized every week. And frankly we’re just getting started.

About 1% of those stricken with the polio virus got paralysis. We used to think that was important. 5/
What’s that look like? I called a pediatrician virologist in Alabama Children’s today.

He walked me through it. Many of us have been to an ER with our kids & when they can’t be seen for hours & it’s chaos. This feels worse. 6/
If you’ve taken your child into the hospital with swine flu or RSV, you know it’s no picnic. (Our sons have had both)

If they have to stay the night, it’s generally because of their labored breathing & high fever. Being sent home because there’s no room is terrifying. 8/
Pediatricians describe kids with SARS-CoV-2 who can’t get their breath & are scared.

Doug Ducey is bribing schools now not to require masks. He should step foot for a hot second inside a Children’s Hospital & face the families there & listen for an hour. 7/
Unlike earlier respiratory viruses, pediatricians tell me that with SARS-CoV-2 & you add an array of potential mysteries, an immune system that is confused and a limited array of medicines. Generally no monoclonals. Steroids & some traditional drugs. 9/
Parents ask questions that don’t have answers. We count on the child’s immune system to be in working order. No pediatrician I’ve talked to has seen a vaccinated kid in the hospital. Many of course are under 12 & have no choice. 10/
Yet, to Ducey-DeSantis-Abbott, hospitalized kids are like school shootings— the price of freedom. And the numbers suggest most schools that don’t take precautions will have families in this situation.

11/
Because the costs are so patently low & the solutions so patently clear, its even harder to squint your eyes & imagine someone arguing a child sick enough to be hospitalized doesn’t require action.

But here we are. 12/
The basics of protecting kids @school are known to everyone.
1- vaccinate adults. Lower prevalence will keep kids the safest
2- vaccinate kids 12 & up. Very very few vaccinated kids are hospitalized.
3- require kids & teachers to wear masks.
4- Mitigate schools w 8+ measures 13/
For schools who have adopted those measures (ventilation, eating, masks, etc), studies show there is almost no spread in schools. (Delta might challenge that near zero result— we don’t know). 14/
Arguments that kids shouldn’t miss in person learning are right on.

But when they’re made by an adult who hasn’t been vaccinated & doesn’t support these measures, be clear they think it’s important enough to say but just not important enough to do something about. 15/
The idea that masks are harmful to kids (usually according to some obscure study of 14 kids in a journal no one has heard of or peer reviewed) doesn’t stand up to the science of respiratory viruses.

It’s an argument made by people who feel they shouldn’t have to bother. 16/
We are constantly reminded of the non-illness scars on kids from the pandemic. Missing school, mental health, missing friends, losing parents.

This is sadly all true but it doesn’t make the argument anti-mask/vax people think it does. 17/
Getting kids back to school safely would be maybe the one thing we might imagine everyone agrees on.

But the fact that we have the tools & don’t use them says it all. 18/
Adults should add to the list that kids can see their considerations are the bottom of anyone’s concerns— if they appear at all.

When adults won’t get themselves vaccinated even to keep kids safe, it sends a clear message to kids how little they matter. 19/
And they will have many years to remember & thank us as we age.

/end

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More from @ASlavitt

15 Sep
COVID Update: There is an amazing array of efforts, some not very visible, to tackle COVID.

If you want to know how COVID plays out, the variables are here. But there’s the fatal flaw: us. 1/
I can try to classify many of the efforts to address COVID as now (high impact progress we are working on now), med term (things underway but not immediate), and long term (potential big game changers). 2/
The now items are critical to saving lives today & reducing the odds of future variants.

Number one on that list is to vaccinate the majority of the globe by the first quarter. 3/
Read 25 tweets
14 Sep
COVID Update: With requirements rolling across the country, I called a company that implemented vaccine requirements last month.

Here is the experience & lessons for the rest of us. 1/
Background first. The company is based in the Midwest with 6000 people.

The workforce has salaried, factory workers and service center workers.

Their starting point was 70% of the staff vaccinated.

The CEO announced that by 10/1 everyone needed to be vaccinated. 2/
The first reaction was a 10% reduction in their employee satisfaction surveys— the first reduction in the history of the company.

Some people were quite upset. So the CEO began to try to understand people’s reasons for being unvaccinated & their objections. 3/
Read 24 tweets
12 Sep
This chart is interesting.
What it says is that Delta is spreading within households (that’s what Secondary Attack Rate means) at the same level as peak flu season.
Note the increase over last September.

It implies at least 3 things we should try to understand better. 1/
First, kids are getting COVID at school and infecting family members.

Policies preventing schools from protecting kids are failing the entire family including seriously at risk adults. 2/
Second, household infections are going to grow over the Fall and early Winter without more layered interventions. 3/
Read 4 tweets
12 Sep
COVID Update: Watching the reactions & meltdowns to the proposal that Americans are required to get vaccinated (or tested) to be around others.

There is so little actually controversial here but the sideshow is first rate. 1/
Real people by large majorities support vaccine requirements. We’ve had them for decades, even centuries with little controversy.

No governor has threatened to light himself on fire & blow himself up (until now). 2/
Like traffic lights, as inconvenient as they sometimes are, people are pretty ok with rules if they do things like keep kids safe, reduce deaths, and allow businesses to be open safely. 3/
Read 20 tweets
9 Sep
COVID Update: After recent FDA approval, society is moving towards, requiring vaccines at a rapid pace.

And that’s about to get another jolt. 1/
Over 5.5 billion vaccines have been administered around the world. Think about this from a safety standpoint. Rare things happen when they occur a few times per MILLION. So we’ve seen it all.

At this point the safety record would have to be called impeccable. 2/
Over 5.5 billion shots, given to people of all ages & health, you would expect everything to occur. Yet there are only very modest & rare adverse events.

Even anti-vax strategies seem to acknowledge this reality. 3/
Read 20 tweets
7 Sep
COVID Update: How big a problem will future variants be?

I got an update from several top scientists. 1/
Quick review. Viruses continually mutate but can only mutate when they replicate. And so far we’re giving SARS-CoV-2 plenty of opportunities to replicate. 2/
Most mutations aren’t worth noting. They don’t increase hospitalizations. They don’t increase infectiousness. And they don’t cause problems for prior immunity. 3/
Read 26 tweets

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