Kids across Tampa Bay are heading back to school as our state is dealt with a another surge in Covid cases, so naturally there is concern among many families. We have questions too.
We followed up with Dr. Christina Canody, the Pediatric Service Line Medical Director with BayCare, to ask her common questions from families about what they’re seeing right now in Tampa Bay when it comes in kids and covid.
We asked her about the possibility of Covid re-infection in kids and adults (yes, it can and does happen), the concern among the medical community as kids head back to school in absence of full mask mandates, vaccine questions, and more.
You can also read our recent Q and A with Dr. Allison Messina with Johns Hopkins All Children’s Hospital here.
We went into summer break feeling pretty good about where we were in the pandemic—vaccines were in arms and masks recommendations were relaxed. And then the delta variant changed all of that.
Dr. Canody: It was overwhelming how quickly this variant multiplied. It was exponential. Every week we saw a doubling…and then a majority of every variant we have right now is Delta.
We had enjoyed very low numbers in June and I think everybody took a little step back and said, this is awesome. I think we’re in a good place now. …and then Fourth of July came around, it was a a little more quiet and then boom. So pretty much this last month has been awful.
Wait times in the emergency department, stress on staffing and the number of people that are working, it’s really tough and not only that, we’ve had a record summer for other respiratory illnesses. We saw RSV come back at 10 times the rate it normally is in the summertime and severe—a lot of parents getting high fevers, a lot of older kids being hospitalized, so it felt more like it was the middle of winter with some of our respiratory illnesses in June and July,
And then you put Covid on top of that and now we’re heading back to school. I’ve been calling it a perfect storm and it truly is.
We’ve seen reports that there is an increase in pediatric patients being hospitalized in this most recent wave of Covid. Is one age range more susceptible to hospitalization than others?
Dr. Canody: Still in general, kids under the age of 4 and over the age of 15 have higher hospitalization rates. And then just like every other wave of Covid we’ve seen, those kids between 4 and 14 are the ones that have the higher rates of multi-system inflammatory syndrome (MIS-C) and we see that follow by about 3-6 weeks (after covid infection), so we’re about a month in and we’ve started to see an uptick on those cases as well.
As Covid cases surge, are you noticing that more kids 12 and older are getting vaccine?
Dr. Canody: I feel like there’s been a little uptick in that, especially in the last three weeks. Parents who have really been considering it, they see the numbers going up, they see the hospitalization rates going up.
I feel like there’s a little bit of complacency even among those who are vaccinated because they go, “Oh, I’m vaccinated, I don’t have to wear a mask. I can do what I want to do”, but the truth be known…delta isn’t going to be the last variant, it’s very likely it won’t be and pandemic cycles on average last about three years, so we may only be halfway into this thing.
If we are, we have to wait to see what variants emerge and for now, we’re pretty good because our vaccinations are protective against the variants we’re seeing. Yes you can still get hospitalized, but we’re not seeing death. The people who are in the hospital that are vaccinated are most likely the higher risk individuals.
Delta has put a lot of people in the hospital who have felt like ‘I’m young, I’m healthy, it shouldn’t cause a problem in me so I’m not worried about it”, but now you’re seeing a lot of people back peddling and going “I wish I would have gotten my vaccine.”
What else can parents do to protect our children who are not old enough to receive the vaccine as they head back to school?
Dr. Canody: We always do the five: cover your face, stay in your own space, wash your hands, don’t share things with your friends, and sneeze or cough into your elbow.
We truly believe that masking along with doing those basic hygiene things are still very protective for kids. We know it works. We do it in our environment every day.
I have to be honest—here in an ambulatory clinic where we see patients on a daily basis who are sick, masks keep us from getting sick as well. Washing our hands, wearing a face covering…I deal with a lot of younger children that have viral illnesses who are too young to wear a mask, but yet it still helps protect us from all of those things.
The mask is really our first line of defense when children are too young to be vaccinated.
What would you say to people who continue to refuse to wear a mask or mask their children?
Dr. Canody: We have to realize we’re not just doing it for ourselves, but those around us. Not only our loved ones and our family members, but for our community. It’s a combination of slowing down the numbers, protecting ourselves, protecting those around us, and making sure we’re not promoting the emergence of even more severe variants.
I was in a meeting a couple of weeks ago when we started to see the numbers climb and you could just feel—just that heavy feeling in the room. Everybody felt like we had taken all of these giant steps forward and now we just took several major steps back because of all of the progress we have seen. We understand that there’s a balance- that we want to keep our economy open, we want to keep everybody’s behavioral health in check and foster the socialization of everybody’s relationships, but there has to be a balance and wearing a mask is a really easy thing you can do to protect yourself and those around you.
Is there concern the next variant could be worse?
Canody: Absolutely. The virus gets smarter. It wants to continue multiplying and infecting as many people as possible so it’s going to mutate to keep going. I think the biggest concern is seeing a variant that does not respond to our vaccines.
There is hope that kids under the age of 12 will be able to get the vaccine in the near future. What are you hearing?
Dr. Canody: What we really anticipate is Pfizer to get complete (FDA) authorization —and that should come sometime in the next month or early September. Right after that, it looks like they should have enough data to apply for emergency use in kids—somewhere in the less than 12 and down to somewhere around 2-5 years old. I don’t know if it will go down to 2. They feel like at 5, they may have a little more data. We’re really hoping to have that no later than the first of October.
One argument from families is that if they, or their child has already had Covid, they have immunity and don’t need the vaccine. What would you tell those people?
Dr. Canody: There’s two parts—the delta variant, most people who have already had covid before this summer, before June did not have the delta variant. The immunity is different. That’s like saying, I got Flu A, I won’t get Flu B this season—that’s not true. You can still get several strains of the same virus and that’s how viruses come back year after year after year. Covid is no different.
There are particular viruses like chicken pox and measles, once you have them you develop a different type of immunity, but in general when we’re looking at coronaviruses, that kind of immunity is not long lasting-you can get several different versions of them.
So I can say—yes, you may be partially protected, but you may not be as fully protected if you are vaccinated, because it works against multiple variants of the spike protein within the virus.
And number two—even if you get a mild infection or are asymptomatic, you can still spread it to others. You can still spread it. You’re not completely immune and you’re immunity is not as good if you were vaccinated.
If I suspect my child may have Covid, what’s the best way to go about getting a test?
Dr. Canody: If somebody is really mild, there’s no reason why they can’t ulitze a walk-in testing facility or even now—some of the tests are actually available over the counter at some of the local pharmacies and drug stores-you just have to be careful that you’re doing it the right way. It’s an unpleasant test and if it’s pleasant, it hasn’t been done correctly It really should irritate the nose. If you don’t trust you can do an accurate test, then reach out to your provider and be seen by a provider.
We do have monoclonal antibody therapy available for children over the age of 12 who are increased risk for severe infection, so that is a good option for those higher risk individuals.
Are there different symptoms in kids with delta variant compared to last year’s strain?
Dr. Canody: With the delta variant, we’ve seen a lot more symptoms that resemble sinus infections and cold symptoms -scratchy throats, sore throats, cough, nasal congestion. Some have reported changes in their hearing —we’re not seeing as much changes in smell or taste. It is still there in a large proportion, but not as overwhelmingly as we saw with the previous variants.
As a pediatrician, do you think masks hinder learning?
Dr. Canody: Is it optimal, no. We would love to be without the masks at this point, but is it going to protect them? Yes. It’s going to keep kids in school. It’s going to prevent major outbreaks and the last thing we want to see is 2-3 weeks into the school year, a massive outbreak and shutting down schools for cleaning or because there has a been a major uptick in cases.
I’ll be honest with you, the way numbers are right now, we’re concerned because staffing is going to become a major issue and I know that is true of all of our hospitals.
What is the concern about staffing in hospitals?
Dr. Canody: Healthcare is not exempt from the pandemic work shortage. The same thing you are seeing in your restaurants and the retail industry, healthcare is the same way. A lot of people changed jobs during the pandemic. A lot of people decided they wanted a different lifestyle or they retired early.
I think we’re all holding our breath a little bit. Praying for the best and totally expecting the worst and hoping we’ll be pleasantly surprised.
We’ve talked about pandemic fatigue before. We know it’s real, but there are steps we can take as families to protect each other like wearing a mask and getting a vaccine if eligible, right?
Dr. Canody: The one thing I would share-in general, this vaccine has proven to be safe and effective. But a lot of people have come forth with concerns about the vaccine and I give them a seat belt analogy. If you’re in an accident, wearing a seat belt is the safest way to go. Most of the time it’s going to save your life. There is a rare instance where you could be stuck in the car and it could be a more difficult to get out, but in general it’s going to save your life.
The vaccine was designed to decrease hospitalizations and decrease the risk of death. We have been very lucky that we haven’t seen an increase in pediatric death, but we have seen an increase in pediatric hospitalizations.
There was concern among some parents that the vaccine could cause birth defects or fertility issues. It’s pretty clear at this point that you haven’t seen any of that and can debunk this myth.
Dr. Canody: I would say a majority of newborns I’m seeing, mom was vaccinated during pregnancy and so they’re hopeful not only does that immunity transfer across the placenta but also through break milk so they’re hoping that’s helpful for the young infants as well
And actually it’s been the opposite. When you look at some of the studies, there have been increase in infertility in people post-Covid. So a decrease in sperm counts and more difficulties getting pregnant and difficulties with ovulation have been seen post-Covid.
*Cover photo by Drazen Zigic, iStock Getty Images.