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Opinion: So B.C. children are at risk from COVID-19. Now what?

With approval of the Pfizer vaccine for children now imminent, the B.C. government is finally admitting what parents have said all along: Children are at risk. So what are they going to do about it?
Children with masks COVID
With approval of a vaccine for 5-to-11-year-olds now imminent, B.C. is finally saying that children are at risk from COVID-19. So what are we going to do about it?

Finally.

For months I’ve found myself explaining, time and again, why I’m so concerned about my child coming down with COVID-19.

Many well-meaning, thoughtful people just can’t understand why I’m so watchful of COVID-19 in schools, why I’m so protective of my healthy nine-year-old, and why my household – while watching those around us return to “normal” life – is still partying like it’s 2020. (Which is to say: Not at all.)

This week, at last, I heard B.C. provincial health officer Dr. Bonnie Henry give voice to the reason that lies at the heart of my caution.

“We know that, for the most part, children have milder illness,” she said during B.C.’s regular COVID-19 briefing on Nov. 16. “But we can’t tell which are the children, necessarily, who are going to have more severe illness or who are going to develop longer-term concerns and complications from COVID-19.”

This.

This is what’s been on my mind for months. This is what I’ve been thinking about since I read an opinion piece by Dr. Katharine Smart, pediatrician and president of the Canadian Medical Association, before the school year started.

As she wrote, in part:

“Some have suggested that ‘children won’t die of COVID-19.’ Mortality is a crude outcome measure in pediatrics. What about disability, medical trauma, impact on families and mental health? …

“Preventable death and disability are not acceptable consequences. As the denominator of children with COVID increases, so will the adverse outcomes. It’s simple math.”

Her words stayed with me because her perspective was so at odds with the situation in B.C. Here, the 2021/22 school year began with fewer protections than the year before, despite the much-higher case levels and the rise of the fast-spreading Delta variant. Here, the powers-that-be persisted in the public messaging that children are not at risk.

Now, suddenly, the public messaging is acknowledging otherwise.

Pfizer vaccine for 5-11 set for approval

The cynic in me can’t help but notice the timing of that messaging. It just happens to coincide with the impending approval of the Pfizer vaccine for five-to-11-year-olds. Since I wrote the first draft of this column, that approval has moved even closer; now, CBC is reporting that it will be approved tomorrow (Friday, Nov. 19).

That leaves health officials in a position of having to convince parents that, in fact, getting their elementary school-aged children vaccinated is a good idea – which doesn’t entirely resonate with the “it’s fine, it’s all fine, your kids will be fine” messaging we’ve been hearing for the past year-and-a-half.

To say that leaves me frustrated is an understatement.

To have parents’ concerns dismissed and downplayed for months, in a quest to keep schools open and operating with little in the way of mitigation, and now to suddenly switch that messaging? It’s rage-inducing.

But at least it gives us – by “us,” I mean, concerned B.C. parents – a chance to finally have our point heard without being patronized or patted on the head.

Let me spell this out once, and slowly:

Children. Are. At. Risk.

Yes, children can get COVID-19. Yes, children can transmit COVID-19. Yes, children can have serious outcomes from COVID-19.

They can be hospitalized. They can end up in the ICU. They can die.

As of Nov. 1, a total of 32,223 B.C. kids have had COVID since the beginning of the pandemic, according to Nov. 4 data from the B.C. Centre for Disease Control.

Of those, 221 have been hospitalized: 116 in the zero-to-four age group, 56 in the five-to-11 group, and another 49 in the 12-to-17 group. Twenty-four have ended up in critical care (12 in 0-4, four in 5-11 and eight in 12-17).

Two – both under the age of five – have died.

No, those numbers aren’t big.

It only makes sense the number of deaths in children is lower than that in adults. Children aren’t supposed to die of COVID; they aren’t supposed to die of, well, anything. It’s part of the nature of being children.

But it’s a huge leap from “the vast majority of kids won’t die” to “it’s just fine if kids catch COVID-19.”

Numbers, however small, feel a great deal heavier when you remember they aren’t just “cases.” They’re children. Like yours. Like mine.

Long COVID in children is a real fear

And we don’t know how many of the children who’ve had COVID – in B.C. or worldwide – are now facing the wild card that is “long COVID” – the primary reason I remain on high COVID alert when it comes to my child.

A study out of Israel showed that 11% of children infected with the virus suffer from long COVID. Another from the British Medical Journal said long COVID symptoms may be affecting one in seven children.

One in nine or one in seven? Take either one; that number alone is enough to explain why I will do whatever I can to prevent my child from getting COVID in the first place. Sure, she might be one of the lucky majority. But she might be that other one – with no known rhyme nor reason for her stroke of misfortune.

I take long COVID seriously because, quite simply, it’s serious.

Long COVID sufferers can be hit physically, mentally, neurologically.

Fatigue. Headaches. Brain fog. Memory and concentration problems. Depression and anxiety. Heart problems. Diabetes triggered by COVID. Don’t forget the possibility of the more-rare MIS-C (multisystem inflammatory syndrome in children) – which inflames the heart, lungs, kidneys, brain, skin, eyes and/or gastrointestinal organs.

Keep in mind that long COVID can occur in children who had mild or even asymptomatic COVID in the first place.

So that “sniffle” or “mild flu” you’re telling me not to worry about? It could turn my child’s life upside down and inside out, even if the illness itself didn’t seem all that bad up front.

Yes, this is for real. Read this New York Times article from August if you want a more detailed and dramatic account of what is happening to real-life kids following COVID.

Those one-in-seven odds that it’ll be my kid? Yeah, that number starts to look pretty serious, pretty quickly.

The long-term effects of COVID-19 on children remain, at this point, largely mysterious. A large, long-term study by the National Institutes of Health in the U.S. has just been launched to look at that very thing. Perhaps someday we’ll have a better idea why some children end up with lifelong problems and others sail through the virus with, yes, a sniffle or a mild flu.

For now, though, caution seems the rational response.

This isn't just about my child

Look at it this way: Someone lines up 100 kids on the shore of a shark-infested beach and says, “We’re going to toss them all in the water, but it’s cool; the sharks will only get 10 or 12 of them.”

You have no way to predict in advance whether yours will be the one who just gets a little wet or whether yours will, in fact, be shark food. I mean, maybe she’ll just get a scratch, or maybe she’ll lose a finger or a limb. Or perhaps he’ll suffer a grievous and life-threatening wound. No one really knows.

Would you send your kid in?

For that matter, would you want to send anyone’s kid in? Would it be OK to throw 100 other kids in the water as long as yours was safely on shore?

The idea that, somehow, COVID-19 shouldn’t bother me because it “probably” won’t affect my child runs counter to what it means to be human. Because if I say, “Meh, it’s no big deal as long as my kid doesn’t get sick,” then what I’m really saying is: “It’s OK if someone else’s kid does.”

And that’s just not on.

I want to keep my child safe for her own sake, of course.

But I also want to keep her safe so she doesn’t pass it on to someone else – to a more vulnerable friend or classmate or, through them, to a family member or relative who’s at higher risk from COVID. I don’t know which children in my daughter’s class have asthma or diabetes or other, relatively common “co-morbidities” that make them more susceptible to serious health problems. I don’t know who has a dad going through cancer treatment, whose mom just brought a new sibling home from the NICU, who is cared for by elderly grandparents.

Are any of those people somehow less worthy of protection than my child? Do their lives matter less because their immune systems may not be as strong as hers?

Schools need to be a focus

We haven’t come in direct contact with COVID-19 ourselves yet; the closest we’ve come is one “self-monitoring” letter when there was a case in her classroom last school year.

But it’s anybody’s guess who’ll encounter it today.

In New Westminster, where I live and where my daughter goes to school, the COVID situation is relatively mild compared to some other parts of the province. This is a highly vaccinated community – 90% fully vaxxed, at last count – and local case numbers are relatively low, with 30 new cases (in our city of 82,000 or so) reported last week.

Even so, there were 42 cases of COVID-19 involving children in New West schools in the first eight weeks of the school year (up to Oct. 28).

That’s 42 kids over 35 school days. If cases continue at a similar rate, we’ll be looking at roughly 78 cases in this school district’s students by winter break. Calculate the odds of long COVID and you’re looking at roughly eight to 11 children.

Which 10 New West kids would you like to see develop long COVID by Christmas?

I’m not OK with playing those odds. Not for my kid. And not for anyone else’s.

So, while I’m grateful that Dr. Henry finally, belatedly admitted that COVID-19 is, in fact, a real concern to B.C. children, it can’t stop here.

Now that we’re admitting kids can transmit COVID to each other and that outcomes for those children can be serious, we need to do something about it.

Not just vaccines: Data, testing, tracing, ventilation

To detail that “something” would be a post unto itself – but let’s start with legitimate, comprehensive public data on COVID-19 in schools. We’re due for the next monthly B.C. Schools Situation Report pretty soon; perhaps this one can be substantially more useful than the first one, which neglected to mention how many cases had actually been seen in B.C. schools – never mind how much in-school transmission has been seen, and when, and where, and by whom.

That data might help lead us to next steps – such as, for instance, a genuinely comprehensive tracing system that quickly finds and isolates contacts, and a testing system that proactively checks for spread in classrooms once a positive case is identified. Without that level of followup, we’ll never know to what degree children in classrooms are driving this pandemic. And we’ll never stop transmission of COVID-19 if we don’t start by looking for it in the first place.

Knowing where and when transmission is occurring could, in turn, steer us towards other solutions: comprehensive ventilation improvements across B.C. schools and public accountability for air quality on a school-by-school, classroom-by-classroom basis would be a good start.

All of which, of course, promises to be complicated – and, yes, costly.

Considering how the pandemic has played out so far in B.C., I’m all but certain our powers-that-be will instead go with their current preferred strategy and focus almost exclusively on vaccinating our five-to-11-year-olds.  I plan to do that, by the way; my child is registered and will be receiving her vaccine as soon as she can.

But it’s infuriating to think that, once again, our leaders will likely shirk their duty to take any other steps to keep our children safe. They’ll download the task of protecting children onto the shoulders of individual parents and families, as if that somehow absolves those tasked with leading us through this pandemic of their responsibility to protect us from it.

We can already be certain that vaccines alone aren’t going to be sufficient to stop the damage caused by this virus; we’re already seeing that in adults, never mind in children, where vaccination rates are almost certain to be lower.

We need more than platitudes and reminders to register your child to be vaccinated.

With the Delta variant raging still largely unchecked, it’s time for the provincial government to admit what parents have been saying all along:

Our children are at risk. And it’s long past time to do something about it.

Follow Julie MacLellan on Twitter @juliemaclellan.
Email Julie, jmaclellan@newwestrecord.ca.