Epidemiologist Theresa Chapple brought us an out-of-the-box perspective on this week’s Kids And COVID Conversation, starting with the consequences of comparing childhood COVID to the adult experience.

“When we’re looking at asthma, we really focus in on childhood asthma and what that means, and the impact childhood asthma has on missing school and quality of life for children,” Dr. Chapple said during First Focus on Children’s conversation about physical health and vaccinations. “It makes really good sense to have these conversations where we’re drilling in on children and not comparing them to adults but comparing them to what a healthy childhood is like.”

This unfortunate comparison set off a cascade of events, Dr. Chapple said, including low child vaccination rates, underestimates of COVID’s social, emotional, and physical impact on children, misinterpretations of educational outcomes, and a host of other challenges for children.

Questions we should be asking:

  • What happens when kids gets COVID? What are the specific physical impacts? How does fear of the disease — and of infecting people they love — affect their well-being? COVID is now among the top 10 causes of death in children. “That does not get said enough,” Dr. Chapple said. “Children with COVID can have life-changing events.”
  • Are we measuring the right things? “Deaths and hospitalizations are the tip of the iceberg,” Dr. Chapple said. “We need to drill down further – what happens before death? What happens before hospitalizations?”
  • What is our goal as a community? As the United States? “From a public health perspective, I wonder why our goal isn’t to prevent transmission, to keep people from getting the disease,” Dr. Chapple said, citing arguments of personal choice about vaccination and other mitigations. “Do we want to focus on individual protections? Or should we be focusing on protecting the health of our communities? These are real conversations that need to happen.”

Recommendations:

  • Overhaul data collection: Home tests, lack of household transmission numbers, and the persistent view that COVID is not a big deal in kids have created a lack of documentation for core data that could help medical experts evaluate developmental delays and other residual effects years from now. “Policies that encourage appropriate data collection and testing among children is the number one thing we need,” Dr. Chapple said.
  • Make system-level mitigations: Every car has airbags. Every school, child care center, bouncy house, indoor play space, and other child-centered venue should have adequate ventilation.
  • Reduce class sizes: Individual attention is among the many reasons that smaller classes benefit children, Dr. Chapple said. Inhibiting the transmission of COVID is just one more.

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