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‘Back to Normal’ Is Bringing a COVID Crisis for Children

The group Urgency of Normal published a National Post article that misinforms, denying grave risks from lax school protections.

Dr. Christopher Applewhaite, Kerri Coombs, Dr. Susan Kuo and Protect Our Province BC 21 Nov

Dr. Susan Kuo is a Richmond family physician. Dr. Christopher Applewhaite is a Salt Spring Island family physician. Kerri Coombs is a communications consultant. They are members of Protect Our Province BC, whose steering committee contributed to this analysis.

Just weeks after schools reopened this fall, the National Post published an opinion piece titled "Let the old normal reign in schools without the threat of COVID restrictions.”

Two of the four authors of the Sept. 23 piece, Dr. Jennifer Grant and Dr. Martha Fulford, are associated with the Urgency of Normal, a movement pushing to end all pandemic protections for children. The group finds an eager audience in those who have largely been spared the worst of the pandemic.

As journalist Melody Schreiber describes Urgency of Normal, “this movement to drop pandemic precautions is about something else entirely — a potent mix of pandemic fatigue, politics, individualistic thinking, and, if both polling and pandemic statistics are to be believed, a persistent divide based on class and race."

In our opinion, the Urgency of Normal group appears motivated by factors other than the desire for public health policy to be based on the best available evidence. We read most of the statements in the National Post opinion piece as either clever manipulations of data or completely unsubstantiated by current scientific knowledge about COVID-19. All can easily be countered.

The opinion piece begins by wrongly claiming COVID "was never a major threat to children,” that "the very small threat that was present early in the pandemic has shrunk considerably" and "the severity of COVID in children is less than influenza.”

In reality, the risk of a child dying from COVID is six to nine times higher than the risk of a child dying from influenza. In the U.S., the Centers for Disease Control and Prevention data showed that 600 children died from COVID in 2021, six times higher than the number of influenza deaths in a typical year. Additionally, hospitalizations for COVID-19 of children from the ages of 12 to 17 in 2020-21 was greater than for influenza during the three years before COVID, and according to U.S. CDC statistics; in July and August, there were more COVID hospitalizations of infants age zero to five months than in adults ages 65 to 74.

Unlike colds and most flus, COVID can cause long-term serious medical conditions in children, even children who initially experienced "mild" symptoms. A CDC Morbidity and Mortality Weekly Report found that after a COVID infection children under 17 years of age had a higher incidence of Type 1 diabetes and myocarditis, or inflammation of the heart, and an increased risk of developing kidney failure, clots in lungs or limbs and cardiac arrhythmias. Prior to COVID, all these conditions were rare in children.

These are only the problems we know of so far, two-and-a-half years into the pandemic. We don’t yet know the potential for future impacts on people who experienced one or more COVID infections in childhood.

German Health Minister Karl Lauterbach has stated: “It is incompatible with my job as health minister that children are falling ill in large numbers. Infecting an entire generation is irresponsible. We don’t know yet what this infection does to the children’s immune system when it occurs repeatedly. As a society we cannot take the risk of mass infection in schools.”

Although the Urgency of Normal group downplays the risk and impact of long COVID in children, in reality long COVID impacts six per cent of infected children. Multiplied by large numbers of infected children, 80 per cent or more in many communities, and we have an enormous number of children and their families suffering from long COVID.

The authors of the opinion piece cite poor quality, cherry-picked evidence to support their bold claim that the risk of long COVID in children is negligible. For example, they reference a self-reporting tool where the authors simply assumed that a lack of self-reporting indicated a complete resolution of symptoms, and make a meaningless comparison of symptom frequency between children with and without a prior COVID infection, rather than a comparison of the quality of life of the same children before and after COVID infection.

They also claim that “teachers are not at a higher risk than the general community.” This is directly contradicted by WorkSafeBC’s data on COVID claims. As of Sept. 30, 2022, education workers submitted 2,457 claims, second only to the 9,213 claims registered by health care and social services workers.

The majority of these claims were registered in 2022, after the arrival of Omicron. With the more contagious Omicron BA.5 subvariant circulating and most schools having dropped COVID protections, we will see many more WorkSafeBC claims from educators unless pandemic protections in schools are reintroduced.

The authors claim that “schools are not primary drivers of community transmission,” but we’ve known since schools reopened in 2020, based on several studies, that unprotected children in schools become major vectors of COVID transmission for their family and community. This has been confirmed in Quebec, B.C. and Alberta, despite each provincial government claiming otherwise.

The National Post op-ed pushes many more misinformation and dubious claims throughout the piece, such as the theoretical concept of “immunity debt.” Published in May 2021 in a French medical paper, the hypothesis suggests that the human immune system loses its efficiency if not routinely infected with contagious diseases. In reality, infection with COVID-19 does not confer long-term immunity, and the virus may continue to inflame multiple organs and disrupt the immune system long after the initial infection.

The op-ed indulges in hand wringing about the impact of protecting children from COVID-19 on their mental health, despite the fact that child mental health visits to the ER actually declined during the pandemic.

On the other hand, the number of children grieving a parent or caregiver lost to COVID-19 is now 10.5 million worldwide. As Dr. Tyler Black states “likely the best way to protect our kids’ mental health is to have less people dying by COVID.”

The most ludicrous claim in this opinion piece is that there is no compelling evidence for masking in schools. After two-and-a-half years, the evidence that masks substantially reduce the transmission of COVID-19 is absolutely overwhelming. Data from Arizona shows clearly that, when implemented early, masks in schools dropped risk of COVID infection 3.5-fold when compared to schools without a mask requirement. There is no evidence to support the op-ed’s suggestion that mask wearing impedes the development of speech.

One should question anyone who suggests, “Let the old normal reign.” The “old normal” gave us a pandemic, a climate crisis, a war, systemic racism and social inequities, including inequitable COVID illness, disability and death. To suggest a return to the “old normal” shows an inability to look beyond one's own privilege.

We suggest a reframing from Urgency of Normal to Urgency of Equity is in order.

We worry what will become of the next generation who have been saddled with the long-term effects of COVID-19 by governments around the world who were willing to sacrifice children and families in the mistaken belief that allowing a dangerous infection to run rampant in our communities is good for the economy.

We cannot sit by while the opinion of the Urgency of Normal is spread widely, lulling folks into believing that there is no need to take simple, effective and reasonable steps in order to prevent death and disability in our children.  [Tyee]

Read more: Coronavirus

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