Positivity Rates In Decline
We continue to see a significant and continued decline in COVID-19 positivity locally, statewide and in most areas of the country. This is being driven by a combination of the seasonal nature of this virus combining with increasing vaccination rates. Below are some of the questions we have been asked in this current environment.
Is it Safe to Plan Vacations and Gatherings?
The present rates present an opportunity for you to reclaim the joy that many families have put off. Does this mean a big party in the back room of a crowded restaurant? Many of us already know that it does not. It is a good time to make decisions that are important to your family. This can include an assessment of how much your family is in need of some degree of normalcy in the face of very low summer rates of COVID. Weigh this against the risk in your activities (disease rates where you are going, indoor vs outdoor activities, sharing of food, those not vaccinated and those who have high risk medical conditions or high risk due to age).
Impact of the Pandemic over the course of the year
Some of you may be aware – I have been asking children to rate (on a scale from 1-10 with 10 being I am doing great and it did not affect me) how they have done over the course of the pandemic. I also ask them to rate how their parents have done. Thankfully, most children have reported that they have done well, but are looking forward to removing the mask and getting together with friends and family. Many, if not most, report that their parents are not doing as well as they are. They sense the stress and difficulty this has put on their parents. We have been dealing with the every day constant level of stress for well over a year. We would expect this high level of constant stress – can and did affect many aspects of your life, including your interactions and your ability to tolerate the normal stress at home and at work to name a few. Ask your children or spouse to rate how you have done during the pandemic. Perhaps it will help you with your summer planning.
What should we know about Myocarditis?
Myocarditis is an inflammation (Irritation) of the heart. It occurs in about 1 to 2 in 100,000 children (0.001-0002%), and viruses are the most common cause. Certain childhood viruses that are generally considered mild (e.g. Coxsackie Virus) can cause Myocarditis. Many children who have it are thought to have mild symptoms that resolve quickly and therefore the true number of cases are thought to be underestimated. It can be severe, but most children resolve symptoms on their own. The most common symptoms are chest pain and shortness of breath. Late last year, it became apparent that COVID-19 was causing Myocarditis with a higher incidence in young males under 30 years of age. Although most have milder symptoms, we have been monitoring our student athletes who have had COVID to be sure that they can participate in competitive sports. This is because risk elite athletes who have myocarditis may have a higher risk of poor outcomes while participating with symptoms of Myocarditis. A study  of Competitive Athletes who had COVID-19 infection, revealed that 0.31% with symptoms had evidence of Myocarditis. When further testing with Cardiac Imaging (MRI) was added, the number with Myocarditis was higher at 2.3%.
It is now becoming more apparent that the COVID-19 Vaccine may be responsible for Myocarditis. There have been 275 cases in 12 million young adults vaccinated (0.0022%). This is higher than would be expected from other known causes, and it is looking more like a link is there. If we assume that ALL the cases reported are from the vaccine, the risk would be 0.002% from the vaccine vs 0.31 to 2.3% from the disease. This means that COVID-19 infection has a 100 to 1000 fold higher risk than the vaccine (again if we assume none of the cases are from other known causes of Myocarditis). The vaccine has a clear benefit over disease and for that reason we recommend that you vaccinate. How can we be confident? The cases of Myocarditis occur within days of the vaccine. The sample size at risk is huge, and the programs in place to monitor include the most extensive program for drug and vaccine monitoring ever in place. I have said this before, but it bears repeating – we allow more natural risk and tolerate less man made risk. It turns our head and gives pause if one child is significantly harmed by the vaccine. Although COVID-19 is milder in children than adults, we still see that over 14,000 children have been hospitalized , 3 more died last week, adding to the 327 children who have died  from COVID-19, and over 4000 have had MIS-C . MIS-C from COVID can also cause a Myocarditis like picture. Please feel free to ask questions at your well doctors’ visit.
Approval of COVID-19 Vaccine for Younger Children
Vaccine studies are ongoing at the present time. Approval for younger children are estimated to occur in late 2021 or early 2022 (as best we can estimate at this time).
In the meantime – take advantage of the low rates and reclaim your joy. Thank you for the confidence in Four Seasons Pediatrics.