Saving Children and Mental Health

In a recent study, Columbia University and Temple University researchers concluded the enactment of COVID containment policies resulted in a significant and sustained increase in firearm violence in Philadelphia.

In other news:

  • Our Jennifer Cabrera says Florida is outperforming lockdown states like California and New York on all metrics. Here’s the summary of all the data.
  • The evidence is clear: We can open schools safely now, says Boston University epidemiologist Benjamin Linas.
  • The gravity of COVID does not escape me. But the emerging mental health crisis is also very serious, says clinical psychology student Mane Kara-Yakoubian.
  • Double masking is a double distraction. It’s not the science nor headlines we needed, says Dr. Vinay Prasad. 

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Additionally, we just released an update on how COVID-19 is playing out on university campuses.

COVID News

San Francisco files suit to reopen schools, citing high suicide rates among children

The number of suicidal children in San Francisco has hit a record high and health experts say it is clear that keeping public schools closed “is catalyzing a mental health crisis among school-aged children,” according to a lawsuit the city filed Thursday to push its school district to reopen classrooms.

San Francisco City Attorney Dennis Herrera announced last week he was taking the dramatic step of suing the city’s own school district, which has kept its classrooms closed nearly a year. In the motion filed Thursday in San Francisco Superior Court, Herrera included alarming testimony from hospitals in the San Francisco Bay Area, doctors and parents on the emotional and mental harms of extended distance learning.

One mother, Allison Arieff, said she had recently found her 15-year-old daughter “curled up in a fetal position, crying, next to her laptop at 11 a.m.” Arieff said her daughter often cries in the middle of the day out of frustration and “is losing faith not just in SFUSD but in the world.”

Lawsuit pdf: 

https://www.sfcityattorney.org/wp-content/uploads/2021/02/2021-02-03-Filed-Stamped-Copy-of-Petition-for-Writ-of-Mandate.pdf

Firearm violence in Philadelphia almost doubles after COVID-19 lockdown measures: report

https://www.foxnews.com/us/firearm-violence-in-philadelphia-almost-doubles-after-covid-19-lockdown-measures-report

After the state of Pennsylvania implemented stringent containment measures in an attempt to mitigate the spread of the COVID-19 virus, firearm violence in the city of Philadephia increased. 

A new report from Columbia University’s Mailman School of Public Health and Lewis Katz School of Medicine at Temple University showed that measures taken in an effort to stop the spread of the virus compounded inequities and exacerbated problems already prevalent in low-income communities — some with fatal consequences.

In a Feb. 11 news release, researchers stated that the increase in incidents could be linked back to the enactment of a lockdown and other public health policies, as well as nationwide protests ignited by the Minneapolis Police killing of George Floyd in May of last year. 

The release noted that firearm-injured patients were presenting at higher rates to surgeons and trauma centers around the city in the wake of these events. 

The team used data from the Philadelphia Police Department’s registry of shooting victims dating back to Jan. 1, 2016, through Nov. 26 of last year.

School Reopening Pits Parents Against Teachers: “Is There a Word Beyond ‘Frustrating’?”

https://www.wsj.com/articles/school-reopening-covid-classroom-cdc-parents-teachers-union-students-11613512932

MT. LEBANON, Pa.—Patrick Cozzens had never spoken up at a school board meeting until he stood in front of a crowd of angry parents earlier this month to read a statement his 16-year-old daughter helped him to write.

“I’ve watched her go from a child that has loved school, thrived at school her entire life, to one now, using her own words, who just doesn’t care anymore,” he said, his voice breaking. “What are you focused on? Get our children back!”

Dozens of parents who live in the affluent community outside Pittsburgh erupted in applause, and the president of the school board rapped his gavel for order. Other parents, some via Zoom, and at least one teacher opposed a plan introduced by the superintendent to return the town’s 5,300 students to classrooms full-time in March, up from two days a week at most currently.

“The thought of returning to a full in-person day amid a global pandemic is so overwhelming that it could honestly bring me to tears,” said Emily Rindels, a fifth grade teacher in Mt. Lebanon, who teaches about half of her students at a time in the classroom, under the district’s hybrid model.

Commentary/Analysis

Florida’s COVID-19 response has outperformed lockdown states on excess deaths, education, and the economy

According to data released today by Florida Governor Ron DeSantis’ office, Florida is outperforming lockdown states like California and New York on all metrics. Florida has lower per-capita mortality, higher availability of in-person education, and a lower unemployment rate.

Excess deaths

  • Compared to Florida, 34 states had a higher rate of all-cause mortality from 2019 to 2020, per capita. Higher-than-average increases indicate that states probably had extra deaths resulting from lockdown policies, not just from COVID-19.
  • Compared to Florida, 38 other states rank higher for per-capita COVID-19 mortality among seniors 65 and older.

Florida has fewer pediatric COVID-19 cases while having the highest rate of in-person instruction offered.

  • Schools have been open in Florida, and Florida still has fewer COVID-19 cases among kids when compared to other large states on a per capita basis. (New York is not included because they don’t make pediatric cases publicly available).

I’m an epidemiologist and a father. Here’s why I’m losing patience with our teachers’ unions.

https://www.vox.com/2021/2/15/22280763/kids-covid-vaccine-teachers-unions-schools-reopening-cdc

Millions of students across America have now been stuck in remote learning for nearly a year. This situation, which has hurt learning and widened gaping disparities, is in large part because many teachers fear returning to the classroom in person. But in this past year, we have also learned how we can keep schools open safely.

Educators’ anxiety is based on reasonable concerns. Covid-19 is a serious illness. And schools are an indoor group setting with the potential to spread infection. But schools, it turns out, with a few basic safety measures, including masks and reasonable distancing, are not a high-risk venue for Covid-19 transmission. In fact, they appear to have far lower rates of the virus than their surrounding communities. Still, some education union leaders are beginning to lay the foundation for schools remaining shuttered into the 2021-22 school year.

For the better part of the past year, I’ve been living inside the tempest that is Covid-19 and schools. I am a father of three girls, ages 11, 13, and 17, all of whom go to public school. I am also an infectious diseases physician and epidemiologist. I understand teachers’ fear — it is real and I have felt it myself as a front-line doctor. But I also know that America needs to have its schools open for in-person learning and there are safe, affordable ways to do this — right now.

And if educators and their unions don’t embrace the established science, they risk continuing to widen gaps in educational attainment — and losing the support of their many long-time allies, like me.

Salvaging Mental Health Amid the Covid-19 Pandemic

Mental health is health is an aphorism with which young Canadians have grown familiar over the past decade. The sentiment has been reiterated by high school teachers, professors, counsellors, family doctors and the media for years, particularly on the annual Bell Let’s Talk day, when telecommunications company Bell Canada donates 5 cents to mental health programs for every social media post that uses the #BellLetsTalk hashtag.

But the campaign felt cynical—even sarcastic—this year. If there was concern about a mental health crisis before the pandemic, surely today we should be more worried than ever. Mental health is sharply deteriorating around the world. Many have found themselves with precarious finances, confined to their homes, separated from loved ones, reliving the same dull, colourless day over and over again. For the past year, our governing bodies have neglected the toll the pandemic and the measures to combat it have taken on our psychological well-being. While mainstream media is eager to report terrifying stories about the virus, it has far less to say about the severe psychological problems developing behind the scenes.

Depression, anxiety, substance use and suicidal ideation are on the rise among younger adults. Toronto’s Hospital for Sick Children has reported that approximately 70% of children experienced a decline in their mental health during the first lockdown. Although buzzwords like resilience are liberally thrown around, Ontario’s children have not yet recovered from the psychological toll of the first lockdown, and entered the second lockdown less resilient than before. SickKids hospital has reported an unprecedented increase in eating disorders among children. Kids Help Phone, an organization that offers 24/7 support to children, was contacted over 4 million times in 2020, more than twice as many times as the previous year.

The mental health toll is very real. But those of us who speak out about it are frequently demonized on social media and dismissed as anti-science, anti-lockdown buffoons. But, by November 2020, there had been more than 1,500 deaths from opioid overdoses in British Columbia—surpassing the number of Covid-19 fatalities. That month, the province reported an 89% increase in illicit drug toxicity deaths compared to the previous year: most of the victims were men aged 30–59. This alarming trend is not unique to Canada. The pandemic and the accompanying economic recession are associated with a 10–60% increase in “deaths of despair” (illicit drug overdoses, suicides, alcoholism) in the United States.

Op-Ed: Double-Masking Is A Double Distraction

https://www.medpagetoday.com/blogs/vinay-prasad/91221

Last week, the CDC announced results showing that when dummy heads were fitted with a cloth mask over a surgical mask, or when a surgical mask had a knot tied near the corner of the mouth, more particulates were captured when the head emitted an aerosol from its plastic mouthpiece during a simulated cough than were captured by a surgical mask alone.

Headlines rang out:

CDC Says Double-Masking Offers More Protection Against The Coronavirus

CDC Updates Coronavirus Face Mask Guidance, Endorses ‘Double Masking’

CDC Report: Double-masking Can Block More Than 90 Percent of Viral Particles

I have no doubt the CDC’s result is accurate. A cloth mask over a surgical mask is better than a surgical mask alone when a mannequin sprays aerosol from its mouth in a simulated cough. I would even wager that an additional mask will outperform just two masks in this test. Yet, I struggle to understand the value of the research question at this moment. This is not the research, nor the headline we need.

Research

Changes in Shooting Incidence in Philadelphia, Pennsylvania, Between March and November 2020

https://jamanetwork.com/journals/jama/fullarticle/2776537

Firearm violence occurred more frequently in US cities in 2020 compared with previous years. Two major events of 2020 may explain this increase: enactment of containment policies to reduce the spread of coronavirus disease 2019 (COVID-19) and a national reckoning with systemic racism, including widespread protests sparked by the police killing of George Floyd. This study evaluated independent associations between COVID-19 containment policies and the killing of George Floyd on firearm violence in one US city, Philadelphia, Pennsylvania.

Charts and Graphics

International News

Romania’s Economy Outshines Rest of EU After Shunning Lockdown

https://www.bloomberg.com/news/articles/2021-02-16/romania-s-economy-outshines-rest-of-eu-after-shunning-lockdown

Romania’s economy outperformed the rest of the European Union last quarter as the government opted not to impose the kind of harsh lockdown that shuttered most of the continent.

Output not only grew from the previous three months, but surged more than 10 times what analysts had expected. The expansion of 5.3% puts it ahead of all other EU members to have reported data so far.

The fourth quarter was good for other parts of eastern Europe too: Hungary and Bulgaria both unexpectedly recorded growth from the previous three months, according to numbers published Tuesday. Lithuania looks set to be the EU’s best performer last year.

Romania has officially dodged a recession during the pandemic by only notching one quarter of economic contraction, between April and June. Despite struggling with one of the bloc’s widest budget shortfalls, it’s managed to boost public investments to the highest in a decade, buoying construction while IT remained strong.

Prime Minister Florin Citu hailed the fastest rebound in his country’s history.

“Everyone will need to revise 2021 GDP forecasts to the upside,” said Ciprian Dascalu, an economist at Erste Group Bank in Bucharest.