Behind the mask… and the shower curtain: COVID-19 and the plight of children
BY JOHN LITTELL, MD
During the flu season of 2017-2018, 200 children died from influenza in the U.S. During the COVID pandemic of 2020, fewer than 100 children have died from this novel coronavirus. Similarly, in every flu season, hundreds more children were sick and hospitalized than we have seen with COVID-19. When a rare systemic condition resembling Kawasaki’s disease was seen in small numbers of children in COVID “hot spots” this year, there was concern that children would succumb to COVID-19 as a result of Systemic Inflammatory Response Syndrome (SIRS). Thankfully, this did not come to fruition.
While it is now apparent to all that COVID-19 is a benign disease for the young and healthy, many have feared that children could and would become vectors for COVID-19—that is, although not getting sick themselves, they might transmit this potentially-fatal virus to others in their family and community. Hence there has been widespread reluctance to allow children to interact with each other and, most recently, to go back to school.
Last month, the American Academy of Pediatrics published an objective review article that summarized studies from several nations, best summarized by the title of the editorial accompanying this study: COVID-19 Transmission and Children: The Child is Not to Blame (Benjamin Lee, MD and William V. Raszka, Jr., MD, Pediatrics Vol 146, #2). The bottom line: Children are not only NOT getting sick from COVID to any significant degree, they are also NOT transmitting COVID to each other or to adults.
Yet it appears no one paid attention to this important review.
At my 11-year-old son’s basketball tournament, during which he and dozens of players from other teams interacted at a very physical level (elbows in the face, pulling each other up from the floor after fouling them), the players were instructed NOT to shake hands at the conclusion of each game—touching elbows, of course, was acceptable. Similarly, as schools have opened up, we see children wearing their masks dutifully while sitting at their desks—of course, socially-distanced desks—and trying to listen to their teachers who are also wearing masks or face shields. More “innovative” schools have positioned “transparent” shower curtains around students’ desks to minimize the spread of COVID among students and between students and teachers. They must walk in the hallways while wearing masks, all in the same direction.
The children then get to go to recess and P.E. and play with each other, with no similar restrictions—just no shaking hands or exchanging hugs.
I heard a report on NPR this morning about how teachers around the world are re-opening in the midst of the pandemic. One teacher from Greece commented how her small children—especially those with Down Syndrome and autism—were coming up to her to give her a hug, but she had to refuse due to fears of COVID contamination and school policy.
COVID-19 has become, with no reason, the modern equivalent of leprosy. Refusing a child’s hug?
Also on NPR was the report of a woman in Tampa who was finally able to see her mother in a nursing home (other than through the window) for the first time in 6 months—but she was not permitted to touch or hug her mother. No rational person would believe that this healthy daughter (who is not a healthcare worker) would infect her mother with COVID—as neither had been exposed to persons with COVID symptoms.
The CDC itself, this past weekend, revised testing guidelines for COVID, stating that ASYMPTOMATIC persons ought not to be tested for COVID and that only those who had been closer than 6 feet for more than 15 minutes to a SYMPTOMATIC person need to be tested. Even the CDC now recognizes that the only “asymptomatic” transmission of COVID has been during the PRE-symptomatic phase of the disease—typically 2-3 days after contact with a SYMPTOMATIC (sick) COVID patient.
Although it appears that pre-symptomatic transmission is possible, it would require significant exposure to this pre-symptomatic individual for another person to become infected with the virus to any degree. For example, a family member or a co-worker who lives or works in close proximity to the recently-infected individual could be at risk. All the patients I have treated for COVID have, in fact, been in the presence of other sick individuals for more than 15 minutes, whether in the hospital, in a nursing home or household setting, or perhaps at a large family gathering.
In my experience, the overwhelming majority of COVID transmission occurs from a sick individual to others. Prudence would dictate, therefore, that those who are caring for or are in close contact with sick individuals for more than 15 minutes ought to refrain from close interactions with others for 2 to 3 days.
Furthermore, no one, it appears, wants to consider the FACT that the risk of children getting sick from, and dying from, COVID-19 is LESS than the risk posed by influenza during a typical flu season. Nor the FACT that children do NOT transmit COVID to adults to ANY degree significant enough to warrant these draconian measures, as evidenced by the study in AAP cited above.
Hence you can see my consternation when, during a recent back-to-school exam with one dutiful mask-wearing family and their two daughters, I encountered resistance from their 5-year-old mask-wearing daughter when asked to remove her mask for the exam. She flatly replied, “I don’t want to take off my mask.”
Never in my 30 years as a family physician have I seen patients so willing to trust what they hear from the talking heads on TV or from fear-mongering, politically-driven county commissions, more than they trust the advice of their physician, based on their individual risks of acquiring or transmitting an infectious disease.
We have indeed become a nation of zombies, it would appear. COVID-19 was, in fact, a cause of death (but not the ONLY cause of death) for over 100,000 Americans (and, as we now know, many of those deaths—especially in nursing homes—were easily preventable had we implemented strategies such as the use of Vitamin C, Zinc, Vitamin D, and especially early use of hydroxychloroquine, rather than waiting for residents to become so ill that, by the time they reached the hospital, it was too late to implement effective treatment.
Yes, indeed, we have had a pandemic—a pandemic of fear, of distrust. People are compliantly choosing to obey mandates rather than exercise their ability to reason independently and to exercise their basic freedoms—including the decision to wear or not wear a mask, the right to provide our children with a decent education, and the right to give each and every child, teacher, or parent a much-needed hug. And, please, get rid of the silly shower curtain dividers in the classroom!
Dr. John Littell is a family physician in Ocala, FL.