Thread by @rebekah_diamond

I keep seeing hot takes on how covid affects kids + if it’s dangerous for them.

But amazingly there’s still a striking shortage of pediatrician voices given the opportunity to provide our nuanced and expert opinion.

What would we say if you asked us?

A thread 🧵

Pediatricians have a lot to say about the covid in kids, how to balance the risks and benefits of exposure, and how to make personal + public health decisions that prioritize the needs of children.

What would we say if asked how dangerous covid is for kids?

We’d ditch glib mortality statistics that dress up data as science + paint a more complicated picture.

We’d reassure you that children continue to mostly do well with acute covid. We’d then explain that deaths + hospitalization from acute covid are just part of the equation.

We’d dive into conversations about the known and unknown long term effects of covid, what we’ve seen and what we worry about.

We would explain how statistics are percentages, how small percentages of large numbers are large numbers.

We would take a necessary detour to explain the limitations of our healthcare system. We would describe how children only do so well with so many illnesses, including covid, because of the modern medical resources we have to care for them.

We would explain how uncontrolled covid surges threaten children’s ability to receive life saving medical care from any condition, how their ability to survive any of the world’s dangers and diseases can be jeopardized so easily.

We would detail our firsthand experience seeing to the endless downstream consequences children have suffered from this pandemic. We’d recall the harms of isolation, loss of loved ones, lack of services, + endless social disruption is that we see daily, that haunt us.

We would walk through how ongoing transmission prolongs our collective crisis, leads to infectious variants that escape vaccination, threatens to undo the progress we have made.

We would reassure parents in impossible situations, remind them that excess risk of covid exposure to their children is society’s failure, not theirs. We would empower parents to make the personal risk decisions that make sense for their family, even if the choice is unfair.

We’d decline unhelpful statistical comparisons between covid + accidents, RSV, influenza, and other childhood tragedies. We have years of research and clinical experience into treatment and prevention of all of these conditions. We would pass on comparing apples + oranges.

Instead we’d compare the risks covid exposure to its own benefits. We know that medicine, like parenting, means mitigating risk when possible, and accepting risk when the benefits exceed it. We’d focus on the risks of covid infection + transmission to the harms of containment.

And we would ask those in charge of pediatric public health decisions to sit with experts— the people who have spent careers helping make decisions that appropriately balance the risks from infectious disease with the risks of measures to control it.

We’d demand conversations that accept + mitigate the full spectrum of covid risk to kids. We’d remind everyone how they’ve suffered, bear an unjust burden during, how we owe it to them to translate concern for their well-being into actions that actually put their needs first.

With everything we’ve been through it’s hard to avoid becoming cynical. But I still believe that we can learn, grow, redirect. Pediatric medicine, pediatric public health, pediatric policy— this is what pediatricians are here for. What would we say about covid in kids? Just ask.

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