Consider This from NPR - Uncharted Territory: Back To School Meets The Delta Surge

Episode Date: August 11, 2021

In the next few weeks, millions of children will head back to school. Many of them are too young to be vaccinated. At the same time, children are being hospitalized with COVID-19 in small but growing numbers — and approaching rates higher than the winter surge. Dr. Marcos Mestre with Niklaus Children's Foundation Hospital in Miami told NPR's Weekend Edition Sunday many of the children his hospital is treating come from families with unvaccinated parents or caretakers. Unlike last year, many schools will have no remote learning option this fall. While some may have mask mandates, a handful of Republican governors — including Florida's Ron DeSantis — have issued executive orders banning those mandates. NPR's Pien Huang surveyed experts about how to keep children safe during the delta surge. Read more coverage from the NPR science desk here.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

I pledge allegiance to the flag of the United States of America. Over the next few weeks, millions of kids will be going back to school in person, and many of them are too young to be vaccinated. Welcome to this special meeting of the school board. Which means a lot of parents and caretakers This is particularly scary to me. feel like they are in a no-win situation. The Delta variant is not sparing

our children. These kids will get sick. They will bring this home to their families. I never thought we'd live in such a bizarro world where I'd have to come here and plead with the school officials responsible for my children's health and safety. Now this could be any number of school board meetings around the country in the last few months. It's from this week in Manatee County near Tampa. Just one day before kids went back to school, the board was hearing from parents as it debated whether to implement a mask mandate. If you're scared, stay home. We have options. Not everyone supported the idea. My right to choose what is best for the health and well-being of my children is granted to me by God and not the government.

What about my kid's choice to come to school in a safe environment? Ignorance is the thought that we have the ability to stop a virus. We are watching Florida burn. Just make it optional. It's not, it's no different. In the end, the school board voted to keep masking voluntary. And that happens to be as far as Florida's Republican governor says they can go. I can tell you in Florida, the parents are going to be the ones in charge of that decision. Ron DeSantis, along with the governors in a handful of other states, have banned mask mandates in schools.

Though some districts have defied those bans. Lawsuits and threats of lawsuits are flying back and forth. Meanwhile, COVID hospitalizations in Florida are at record highs, even worse than last winter. And while children face a far lower risk of getting sick, for one of those parents in Manatee County, sending her son back to school with only a voluntary mask policy was a call she didn't want to make. I would estimate that at best, on back-to-school night, I saw 5 to 10 percent of people in the entire school wearing a mask. You've left me with an impossible choice. My son's health or his education.

Consider this. Kids back in classrooms during the Delta surge means the pandemic is about to enter uncharted territory. Some parents and public health experts are worried. We'll explain why. Plus, we'll have some advice from those experts. From NPR, I'm Adi Cornish. It's Wednesday, August 11th. This message comes from NPR sponsor Audible. Chasing Ghislaine is a new investigative podcast series from executive producer James Patterson and hosted by veteran journalist Vicki Ward, who has been covering the Jeffrey Epstein saga for nearly 20 years. Epstein's story intertwines with the disgraced heiress Galane

Maxwell, Epstein's ex-lover, former employee, and alleged co-conspirator. Chasing Galane is available exclusively on Audible. To start listening, go to audible.com slash chasing. NPR's Planet Money Summer School is now in session. Everything you want to know about investing from expert guest professors. New classes every Wednesday till Labor Day in the Planet Money podcast feed. It's Consider This from NPR. Masks aren't the only debate of the new school year. There's also the question of whether

vaccines should be mandatory for teachers. On Wednesday, California became the first state to say yes. All of our staff, not just teachers, credentialed staff, paraeducators, custodial staff, the bus drivers. Governor Gavin Newsom said this fall all K-12 teachers and staff must be vaccinated. So will more states follow? Yeah, I'm going to upset some people on this, but I think we should. I mean, we are in a critical situation now. That's the president's chief medical advisor, Dr. Anthony Fauci, this week on MSNBC's Morning Joe. Two of the nation's largest teachers unions have signaled that they aren't opposed to vaccine mandates,

though they also say the vast majority of teachers are already vaccinated. Fauci predicted teacher mandates may get more traction soon if the FDA grants full approval to coronavirus vaccines, which he expects will happen this month or early next. Remember, right now, they're still just authorized for emergency use. You're not going to get mandates centrally from the federal government. But when you're talking about local mandates, mandates for schools, for teachers, for universities, for colleges, I'm sorry. I think we're in such a serious situation now that under certain circumstances, mandates should be done. In plenty of private schools and colleges, mandates are already being done.

Nearly 700 college campuses will have vaccine requirements this fall. That's according to a count by the Chronicle of Higher Education. Many have classroom mask mandates as well. But the battleground over mandates right now is in public schools, especially those with children too young to be vaccinated. The best way to protect those kids, Anthony Fauci said, aside from vaccinating the adults around them, well, it's masks, which the CDC recommends indoors, in school, for everyone. We know how that can be uncomfortable, but you'd rather have a somewhat uncomfortable situation with a well child than temporarily comfortable in a child in an ICU.

And children in small but growing numbers are winding up in the hospital with COVID. While most children who get sick with COVID-19 have mild symptoms, right now an average of 229 children a day nationwide are being admitted to hospitals with the disease. And that's up nearly 30 percent over the previous seven-day average. Child hospitalizations from COVID have been this high just once before, back in January, and they're trending higher, even with more than half the U.S. population fully vaccinated. Yeah, so we've definitely seen an increase in visits to our emergency departments and our urgent care centers. Secondary to that, we've seen increased hospitalizations due to COVID-19 infections. Dr. Marcos Mestra is chief medical officer of Nicholas Children's Hospital in Miami,

where he told NPR that children with COVID-19 appear to be a little sicker than they were before the Delta surge. He spoke to NPR's Lulu Garcia Navarro. Why are kids getting more sick this time around? Is it something specific to the Delta variant? Do we know? Yeah, we're not exactly sure. And in terms of the severity, we're still trying to determine. It does seem that the children are a little bit sicker, requiring more oxygen, perhaps needing more respiratory support than we were initially. And what about the ages? I mean, when you say, obviously, these are children, what ages are we seeing coming in? So we've seen the gamut. We see folks from two weeks old, typically they present with just fevers. Now, those that seem to have the greatest

complications are those that are adolescents, and especially those adolescents who are overweight or increased BMIs. Dr. Maestre, can you take me into the wards? I mean, this must be enormously distressing to see young kids now coming down with this in this fourth wave. Most definitely, and not only for the families, but also for our staff. Imagine having gone through this. We were getting ready to come out of this in early June. We were even having discussions about peeling back some of the restrictions that we had, and then we were hit with this Delta wave. It's well known that there's a nursing staff shortage across the country, and we're no exception to that. And then in addition, you're 100% right in regards to the families that are being affected by this. But again,

99% of them are not going to require hospitalization, but that 1% will. Dr. Mestre, do we know how these kids got infected? I mean, are they in families with vaccinated parents or caregivers, or are they in families with unvaccinated parents and caregivers? So it's a mix. Definitely those children that have come in that are older, 12 and older, that would have qualified for the vaccine. None of our patients have received the vaccine. So even though they could have had the vaccine, they didn't. And for those that are younger than 12 years of age, as we do see plenty of times that the parents may have not been vaccinated. So that's going to be the most common place where you're going to get infected is in the home. Dr. Marcos Mestra with Nicholas Children's Hospital. That's in Miami.

For some parents and caretakers, the decision to get vaccinated and to protect their young kids may be an easy one. Soon, it might be easy for kids under 12 to get a shot, too. But what won't be easy in the meantime is navigating another fall of temporary shutdowns and remote learning. Plus, in many places, unlike last year, there will be no remote option at all. So given all that, NPR's Ping Huang has been surveying some experts about how to keep kids safe during back-to-school and the Delta surge. Ping is a health reporter on NPR's Science Desk, and she's here now. Hey there, Ping. Hey, Adi. Thanks for having me. Masks or not, no matter how many little gold arrows and footprints you paint on the hallway floors,

we know that germs spread when young children get together. So what do people think is the right approach if a child does wake up, say, with the sniffles? Well, Seema Laktawala, she's a flu researcher at the University of Pittsburgh, and she went through this recently. Her eight-year-old woke up sneezing with a runny nose. Step one, she said, was to keep her home. And step two... I will call the pediatrician and just talk through where we've been. If we were traveling, I think I would be more concerned if we'd been on a plane recently than I would, you know, definitely want to try to go get her tested. In this case, she and the doctor thought that it was allergies and,

sure enough, the kid took some allergy meds and she stopped sneezing. What would prompt a doctor to say, yes, it's time to get your child tested? It could be a number of things. It could be the symptoms, if your child has a fever or loss of taste or smell. It might be the situation if your kid is exposed. And if there's just a lot of virus transmission going on in the community, they may say, let's just test for it. And experts say it helps to do some research now to know where you can get that test with a fast turnaround time. But another option is to keep some antigen tests at home. You can now get these 15-minute rapid tests from many pharmacies, and they generally cost about $25 for a box of two.

But they're considered fairly reliable for people with symptoms, so if someone has the sniffles, it could give you a pretty good read. All right. What if your child tests positive? I mean, what should a parent be thinking about? What's their first move? Well, for starters, don't panic. Dr. Cassandra Pierre, she's an epidemiologist at Boston Medical Center, and she has young twins. She says that kids are very resilient. Yes, with Delta variant, we are hearing about more cases of infection, significant infection in children, hospitalization in children. But still, we know that children are less likely to get those severe complications. Now, before it happens, come up with a household plan. Is there a room and bathroom they can have to themselves?

Laktawalla and her husband have two young kids, so their plan is to split into parent-child pairs. One would care for the sick kid, the other for the not sick. They'd stay in different parts of the house, take turns in the kitchen. But if space is tight, there are other things you can do. Everyone should wear masks, except when eating or sleeping. Open windows, run some fans, use an air filter, because remember, the coronavirus travels through the air. And after a few days, test to see if anyone else is sick. And if you think you might need backup, come up with a list of family, friends, neighbors that are fully vaccinated so they might be able to step in and help. What's the timeline on that, though? I mean,

how long would a parent or guardian be having to do that? Well, people with COVID-19 are most likely to spread the infection to others when their symptoms first appear. So 10 days later, if those symptoms are completely gone and they're not taking medicine to alleviate fever anymore, the illness is no longer considered contagious. Scientists know less about how easy it is for people who test positive

but have no symptoms to spread the virus. And the recommended quarantine period for people who are asymptomatic, if they're unvaccinated, is 10 days after they first test positive. All right, another scenario. What if a student tests positive, right, in a child's class? So your child isn't sick, but maybe they've been in close contact. I mean, would a household need to quarantine then? So the CDC definition of a close contact at school is actually pretty limited. If your kid was at least three feet away from someone who tests positive and they were both fully masked, your kid is not exposed.

But if one of them wasn't masked, then your child would probably need to quarantine, assuming that they're not vaccinated. That doesn't mean that they have to go to the room and stay there. The experts that I talked with said, be reasonable, keep some distance, especially from vulnerable or unvaccinated people. But if the rest of the family remains healthy, one expert said that she would feel comfortable sending everyone to school and work and the grocery store with masks, but she would cancel non-essential business like playdates and dinners out. It's funny, we're at this point in the pandemic where it feels like each of us is relying on the decisions that other people make. Yeah, absolutely. That's something that I heard from the experts that I spoke with as well. We know that vaccines do reduce transmission a lot, but they're not perfect.

And we're hearing about breakthrough infections right now. So it is going to be possible in school settings for even vaccinated adults, you know, teachers, bus drivers, cafeteria staff to infect children and for children to transmit the virus to others. And that's why masks are an important tool right now. You know, if you're thinking about what kind of mask the experts I spoke with said, the best one is something that your child will wear consistently and correctly. You know, some of them had cute ones with cat faces or smiley faces. You can also get one of those cloth ones with a space to insert a little filter. You can even double mask. But the bottom line with kids is comfort. So if a tight or a thick mask is going to prevent a child from wearing it consistently, just go with what's most comfortable.

That's NPR's Ping Wong. Ping, thanks so much for explaining all this. Thanks for having me. And Ping and our colleagues at NPR's Science Desk, they have answers to even more questions about how to keep kids safe from the Delta variant, and you can find a link to all that in our episode notes. It's Consider This from NPR. I'm Adi Cornish.