The Daily - Children and Covid: Your Questions, Answered

Episode Date: August 23, 2021

As the number of coronavirus infections in the United States surges, and school districts begin to reopen for in-person learning, some parents are apprehensive and full of questions.Recently, The Daily asked parents to send in their queries about children and Covid. We received about 600 responses.With the help of Emily Anthes, a reporter who covers the coronavirus, we try to provide some answers.Guest: Emily Anthes, a health and science reporter for The New York Times. Sign up here to get The Daily in your inbox each morning. And for an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. Background reading: With the spread of the Delta variant of the coronavirus, classrooms are opening their doors to a different pandemic. Here is how to think about risk.What was supposed to be a new, relatively normal year has become a politicized, bewildering experience for many parents, students and educators.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. 

From The New York Times, I'm Michael Barbaro. This is The Daily. Hello, Michael, and everyone at The Daily. My name is Colleen Marshall, and I am speaking to you today from Bethlehem, Pennsylvania. Hello, my name is Trenton Foster. We live in San Juan, Puerto Rico. This is Eric Schreiber from Broward County in Florida. As school districts across the country begin to reopen for in-school learning amid a surge of infections. I have two little ones

ages 8 and 11 who are about to return to school. I have two young kids who are in daycare. One is one year old and one is four years old. No, I'm three. Oh, sorry, he's three. He's almost four. Parents are anxious and apprehensive. My mommy anxiety is at an all-time high. And they have questions. How dangerous is COVID to young kids? What symptoms should I be looking for in my kids? Should I be more or less worried if my children are unvaccinated,

but they're under the age of five? Today, Kevin Roos spoke with our colleague, Emily Anthes, about the answers to those questions. It's Monday, August 23rd. Hello. Hello. I like your closet. Yep. We were just saying it's a closet slash podcast studio. I'm familiar.

Yours is much better organized than my makeshift podcast studio, which was just like a bunch of shirts constantly hitting me in the face. Well, you're only seeing a select portion of the closet. This is the curated closet? Yes, this is the presentable part of it. I'm honored. Emily, every parent I know has basically one thing on their mind right now, which is how to navigate this virus around their kids and the return to school. And so the team at The Daily started asking around the staff of

The New York Times looking for the person who was best equipped to answer questions from parents about COVID. And the answer kept being that it was you. Well, thank you. I am flattered and honored by the vote of confidence from my colleagues. I've been a science journalist for 15 years now. And since I came to The Times in March, I have been covering this pandemic day in and day out. And lately, that has meant diving into a lot of the research on COVID and kids. And when The Daily asked listeners to send in questions about COVID and kids, we got a ton of responses, something like 600 people sent in questions. So I have a big ask for you today, which is answer all of them. No, just kidding.

We've basically organized them into themes, and we're going to play a few of them and ask you to answer them as best you can. Does that sound okay? Let's do it. Hi, this is Alex from Lakeland, Florida. My biggest concern as a parent of two young kids right now is the fact that they can't get vaccinated. I am wondering why it is taking so long for the vaccine to be approved, even on an emergency basis, for children under the age of 12.

Are there problems with finding enough people to participate in the study? Are there problems with the kids who've gotten the vaccine? What I'm pleading for is just some sort of compass from Moderna and Pfizer and when we will be able to protect our little ones. Well, unfortunately, I'm not going to be able to provide some magic date that everyone can circle on their calendar, but I think I can provide a little bit of clarity. So what's happening now is that the clinical trials for children who are between 5 and 11 are still ongoing. So the reason the vaccines haven't been authorized yet is because Pfizer and Moderna have not yet released the data from the trials or officially applied for authorization to the FDA. Pfizer, which seems to

be in the lead, the closest to being ready, has previously said that they plan to apply for authorization for 5 to 11-year-olds sometime in September. There is a bit of a wrinkle, though, because recently the FDA asked Pfizer and Moderna to expand their clinical trials for kids. Why? What's the story there? You may have seen some reports that some of the vaccines have been associated with potentially serious side effects. And the FDA takes that really seriously. The good news is that the side effects are rare. The bad news is that that means that in order to really get a sense of how much risk there is and how likely these side effects are, you need to include more people in your trials.

So this was a precautionary measure the FDA took so that they could make sure that the trials were big enough to detect any rare adverse events that might pop up. And what would those side effects be? Well, so the biggest concern, I think, when it comes to kids is something called myocarditis, and that's inflammation of the heart muscle. And it's been seen a bit in vaccinations for adults. It seems to be most common, though, in young males, so young men in their 20s as well as teen boys. And because of that profile, because it's more common among the younger adults that have been getting it, I think there's some concern that it might also be a side effect that pops up in kids. And so I think regulators and companies and everyone just really wants to be sure that they have a handle on

whether this is a risk or not. And all of these trials, they're covering kids of all ages or just certain ages? Who is actually being studied right now? Well, so the trials happen in sort of a step-down fashion. So that's why we have data and approval for 12 and up right now. So when that data came back good, these companies then moved on to 5 to 11-year-olds, which is likely to be the next category of children that we have data for and the next category that have authorized vaccines. And then the companies will continue moving downward to younger and younger ages of children. Got it. So maybe for kids between 5 and 11, they will have an answer about the vaccine in the next few months, maybe this fall. Younger children may need to wait longer until

that sort of step of studies has been done. So it seems pretty safe to say from what you're telling me that it might be months or maybe many months before parents will have peace of mind about vaccinations for their kids. Am I reading that right? Yeah. I mean, unfortunately, I think that's the case because the other thing is even once these companies release the data, of course, the FDA has to review it. I think that's expected to take at least a month, if not more. And then, of course, you have to roll the vaccines out. If there are going to be two doses again for kids, there's a waiting period while you wait for the second shot and for immunity to kick in. So it is safe to say that we are months away

from widespread immunity in young children. Got it. Which I think gets us into this next batch of questions. Hi, my name is John Leslie, and I live in Roatan, Connecticut. And my question simply is, how dangerous is this virus to children under 12 years old? How many have gotten it? How many have been hospitalized? And how many have died? Hi, my name is Cassandra, and I live in Minneapolis. I've seen several articles lately about children's hospitals

being overrun with patients, but I haven't seen any clarification on whether the surge in kids is due to Delta being more severe for them, or whether the high numbers in children can be attributed to the fact that the majority of the child population is unvaccinated at this point. And I'm just wondering how concerned we need to be about the Delta variant versus the original COVID variant. Thanks. So these two questions and a lot of others like them basically boil down to how dangerous is this virus for kids and how scared should parents be for their kids right now? Well, I don't want to tell parents how scared they should or shouldn't be, but one of the very few silver linings of this pandemic and this virus is that it does seem to largely spare children.

Most children, especially young children, have mild or even entirely asymptomatic cases. There was a recent study that showed that most kids recovered on their own in less than a week. And symptoms, when they do appear very often, seem like a cold or a respiratory bug, some other kind of common childhood illness. Serious and severe cases in children are rare, but they do exist. So far, about 1% of children who get infected with the virus end up in the hospital, and 0.01% end up dying. So those are very low numbers. Those are low odds. But of course, if that 1% or 0.01% includes your kid, that's not much consolation. So there can be serious, severe disease in children. So just to be sure I understand, of the kids who get the virus,

understand, of the kids who get the virus, roughly one out of 100 ends up in the hospital, and roughly one out of 10,000 actually dies from it. Yes, based on the data that we have, that's right. And what do we know about the Delta variant in all of this? Is the Delta variant worse than other variants? The Delta variant is clearly more infectious. It is believed to be about twice as contagious as the original version of the virus. And so a lot more people are catching it. That includes kids. And in fact, it may be disproportionately affecting kids because no children under 12 are vaccinated. And this virus and Delta is really mostly seeking out unvaccinated people. Right. The question of whether or not it causes more severe disease

is a little bit harder to say. Scientists think it is certainly possible that Delta is causing more severe disease. We just don't quite have the data to back that up yet. Okay, I want to move on to the next set of questions we got, which were about long COVID or the kind of long-term effects of this virus in kids. Hi, I'm Heidi Geiberson and I live in Astoria, Queens, New York. I'm a mom of a four-year-old and long COVID is what keeps me up at night. So I'm wondering if there's any data that shows how likely a child will develop long COVID if they're infected with COVID-19. Thanks.

Yeah, well, so we are getting more and more data on this, and it does seem to follow the same general pattern as acute COVID in the sense that long COVID does seem to be somewhat less likely in children than in adults. Estimates vary wildly from study to study, and some studies define long COVID in different ways. But I've seen estimates that range anywhere from 2 to 15 percent of children still have symptoms at least a few months after recovering from COVID. We don't have a lot of long-term data simply because this is a new virus that hasn't been around very long. I guess the other thing that's worth saying is that what we're lumping together as long COVID can be a bunch of very different symptoms and conditions. So one kid with long COVID might just be a little fatigued for a few extra months. On the other hand, you might have a child who's struggling with what we sometimes call

brain fog or difficulty concentrating for many months. And so those are quite different manifestations. And there's still a lot to learn about what long COVID is and what it looks like over the long term. We'll be right back. So, Emily, we also got a lot of questions about schools. We got questions about whether schools would open this fall, whether they would stay open, what kind of policies schools are putting into place. And I know you're not an education reporter, but what does the science of this virus indicate about schools, especially this fall? Yeah, so I know in some ways it seems like we're right back where we started and that nothing has changed since we were facing these same questions about schools last fall. But we actually really are in a very different place. And part of that is because we have a whole year's worth of research and knowledge

about schooling and the safety of schooling during a pandemic. Schools can be safe when they take precautions, particularly when they take several different precautions. So maybe they mandate masking and they have daily symptom screening and they have regular testing programs or they have some physical distancing or if they upgrade ventilation. If schools do a couple of these things or layer some of these precautions, they can not only be safe, but are often even safer than the surrounding communities. There have been some studies that showed that even when the virus seemed to be raging in an area, transmission rates were very low in schools. On the flip side, of course, is Delta. So the studies we have about school

risks last year were conducted before this highly contagious variant was spreading across the U.S. And so it's not quite clear yet what the risk of in-school transmission will be now that Delta is the dominant version of the virus. Right. And I think that the piece that's tricky is, you know, ideally we would live in a world where schools were taking all of the precautions you mentioned, but there are many schools that are not making masks mandatory or even recommending them, that they're not upgrading their ventilation, that they're not putting in place the measures that one might hope they would. And so in those situations where parents are deciding whether or not to send their kids in person to a school

that may not be doing its best to prevent the transmission of COVID, do you have any advice for those parents? have any advice for those parents? Unfortunately, I think those are not only tough decisions, but really personal ones for families that depend on a lot of factors. So if there's someone who is super high risk or immunocompromised in your family, you might decide that you would rather pursue a remote schooling option for your child. It may depend on the level of transmission in your community. Do you live in a place where the virus is really surging right now? It may depend on how much vaccination coverage there is at your school. There are a lot of factors to take into account, and so I'm not sure there's any one answer that applies to all families. I want to switch gears here to a series of questions we got about a subset of much,

much younger kids, kids who are not yet in school. I'm Mia. And I'm Ellen. And we're twins from Massachusetts. I have a four-month-old. And I have a two-month-old. We were both vaccinated while we were pregnant. And we're both breastfeeding. How much protection do our infants have from COVID-19?

Thanks. What do you think, Emily? Well, I have a cautiously optimistic, but perhaps slightly unsatisfying answer, which is we do know that women who are vaccinated while they're pregnant make antibodies to the virus and they pass those antibodies on to their children through the placenta. to their children through the placenta. We also know that women who are vaccinated while they are lactating make antibodies and that those antibodies turn up in their breast milk and remain elevated for weeks, if not longer. So both of those things are really promising pieces of evidence. What we're not quite sure about yet is how much protection those antibodies offer children and how long that protection might last. I know there's been some concern from some women who have had anxiety or fears about whether it's really safe to get vaccinated while they're pregnant or while they're breastfeeding. pregnant or while they're breastfeeding. And the CDC recently formally changed its guidance for pregnant and lactating women, and it now officially recommends that they go ahead and get vaccinated.

And there are likely a couple of different factors that went into that decision. One is that we have an increasing amount of research that indicates the vaccines are safe during pregnancy and lactation. And two is just as Delta spreads and the risk of becoming infected increases, it's important to remember that COVID-19 itself poses all sorts of risks to women and children. And so vaccinating against it becomes even more important. Okay, so now I want to ask you about this batch of questions we got that I would characterize as being pretty specific. My name is Joe Duncan. Hi, my name is Lauren. I live in Raleigh, North Carolina.

I live in Kentucky. Hi, Zach name is Lauren. I live in Raleigh, North Carolina. I live in Kentucky. Hi, Zach Bowman from Lancaster, Ohio. And I have two little girls. My oldest is four and my youngest is 16 months. We're considering enrolling our daughter in preschool for the first time. She's three. She's very excited about it. We have a 17-month-old who is unvaccinated. And my main question is regarding how to assess risk and decisions around her because she can't mask. She's missed out on many things because of COVID,

but because of the Delta variants and the extra risks that are coming with that, we're just concerned that maybe now is not the right time. Our oldest, she's great with masking. We feel comfortable sending her back to preschool, but are starting to second guess whether it's safe to send our little one to daycare. Because when she's not going to be in preschool, she'll be watched by her grandmother and grandfather, who has recently recovered from lymphoma, is in remission. But even though he's received vaccine, he actually cannot produce antibodies. Sort of leaves us in a limbo, not totally understanding the risk factors and just making us less confident in our decision making about

moving forward with our life. So we're just worried that by jumping back into school, that we might be putting our family at risk by doing so. Any clarity on that would be wonderful. Thank you so much. So let's acknowledge right up front that no two family situations are the same. No two school districts are the same. No two situations are the same with respect to making decisions about this virus. But I guess what I heard in these questions, aside from, you know, what do I do about my specific situation, is some version of a question like, how the heck am I supposed to even make decisions about my kids right now? Is it possible to look at the data

and listen to the experts and make a good decision that you can have a lot of confidence in? Or are parents just supposed to kind of fumble their way through it? Well, I guess the first thing I want to say is to validate these and all the other parents who didn't have their questions make it on that these feel like excruciating decisions because they are excruciating decisions. And these are often situations in which there is no great solution or answer. So I feel for these parents and I understand the fear and anxiety. I guess the guidance I would provide is that I think the most helpful approach is for families to decide together what their top priority is. Is their top priority to keep their child from getting infected with the virus at all costs? Or maybe their top priority is to keep their child from getting infected with the virus at all costs. Or maybe their top priority

is to keep their child from bringing the virus home or passing it on to an elderly or immunocompromised relative. Or maybe their priority is just to make sure that their kid doesn't fall farther behind in school this year. And once you decide what that priority is, the rest of your decisions can follow from there. It's not that the answers then become easy at that point, but I think they become a bit easier if you have a framework like that. That feels like really helpful advice, not necessarily in giving people a sense of what they should be doing, but in giving parents a sense of the process of making a decision. Because ultimately, there's a lot we still don't know, but even finding a shred of clarity in the form of a priority could be very helpful. clarity in the form of a priority could be very helpful. Absolutely. And I think one reason all these decisions are so hard is because they all involve trade-offs. And so you are balancing

one risk or one unpleasant outcome against another. And so I think the best we can do right now is to figure out what matters to us most and to try to follow that. Emily, on behalf of me and on behalf of the people who send in their questions and probably many more at home listening who have some of those same questions. Thank you so much. Thanks for having me. We'll be right back. Here's what else you need to know today. On Sunday, as the Biden administration scrambled to evacuate Americans and U.S. allies from Afghanistan, it ordered six commercial airlines to participate in the operation.

the airlines to send 18 passenger jets to bases across the Middle East, where they will pick up civilians who have already been airlifted out of Kabul. The order comes as conditions at the Kabul airport worsen. Dangerously large crowds of Afghans trying to flee the Taliban continue to surge around the airport, leading to at least seven deaths, including a toddler. Let me be clear. The evacuation of thousands of people from Kabul is going to be hard and painful no matter when it started, when we began. It would have been true if we had started a month ago

or a month from now. During a briefing on Sunday afternoon, Biden defended the pace of the U.S. evacuation, saying the military has gotten nearly 28,000 people out of Kabul in the past week. But he warned that the process remains complex and dangerous. There is no way to evacuate this many people without pain and loss of heartbreaking images you see on television. It's just a fact.

Today's episode was produced by Michael Simon Johnson, Sydney Harper, Chelsea Daniel, and Annie Brown, with help from Soraya Shockley and Robert Jemison. It was edited by Dave Shaw and Lisa Chow, and engineered by Chris Wood. Original music by Dan Powell and Marion Lozano. Special thanks to the hundreds of parents who sent us their questions.

That's it for The Daily. I'm Michael Barbaro. See you tomorrow.