There can be no doubt that in the United States we have gained the advantage in our battle against COVID-19. Never before in modern history has victory against a biological enemy been so uncertain. Biotechnology has been challenged to do something which we thought impossible until now, to defeat or at least contain an easily transmissible upper respiratory virus.
In the United States only 35% of the population has received at least one dose of a vaccine against COVID-19. However, this does not fully portray the scope of our success. In many regions of the United States those who are most at risk of dying have already been immunized, and a continuing decrease in mortality is inevitable. In Los Angeles County 70% of the population who are 65 and older have received at least one dose of a vaccine.
For all of those who have spent the last year sheltered in their homes the thought of freedom is intoxicating. Older people dream of seeing their grandchildren and teenagers desperately want to visit their friends.
A sobering fact in the face of this euphoria is the spread of the B.1.1.7 strain of SARS-CoV-2. The CDC has announced that the B.1.1.7 strain is now the predominant variant both in California and the United States. Evidence has shown that the B.1.1.7 strain is generally susceptible to the immune response elicited by all three vaccines which are currently approved for use in the United States as well as to treatment with monoclonal antibodies in recently infected patients.
However, here is also bad news, there is a growing body of scientific evidence that the B.1.1.7 strain spreads more easily and is more likely to cause hospitalization among children and young adults than the previous strains of SARS-CoV-2 we have encountered.
Early on in the course of the epidemic I reassured people that based on available scientific evidence COVID 19 is generally less severe in children and that we need to focus on the older people. I now stand corrected. As the B.1.1.7 strain spreads across the nation and the world the average age of hospitalized patients with COVID-19 is dropping. Surges in Minnesota and Michigan have shown that spread is occurring in group settings such in schools, child care facilities and team sports.
Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who previously advocated for opening schools, has changed his mind. He has commented on the surge in Minnesota, Michigan and Wisconsin and warned of the dangers in school attendance right now “All the things that we had planned for about kids in schools with this virus are really no longer applicable. We’ve got to take a whole new look at this issue.”
Of course, all of us desperately want to return to normal life. However, it is important not to refuse to accept known facts. Published studies show that more than 40,000 children in the United States have lost a parent to this disease and a far higher number have lost their grandparents.
Many of the children in the hardest-hit areas of Southern California live in high-density multigenerational households. While we are most certainly in the final days of the epidemic, prematurely reopening classrooms in the face of B.1.1.7 will inevitably result in more orphans.
There are powerful political and economic forces determined to reopen the schools immediately. While delaying reopening would doubtless save the lives of parents and grandparents living in high density low-income areas, many different levels of government and education have already committed funds and resources to early re-opening and it is unlikely they can be convinced to delay until everyone is immunized.
Faced with forces beyond our control I urge every family with school age children to immediately do whatever it takes to immunize all household members over age 16. There are online sign-up websites for city-run sites, pharmacies, and a large number of non-profit and public community health clinics.
Immunizations for children under 16 should become available over the summer. Take matters into your own hands and find a way to get the vaccine for all household members as quickly as possible. Do not delay. Your children need you to do this.
Dr. Ruth Lindo is a practicing pediatrician at Clínica Monseñor Oscar A. Romero in Los Angeles.