COVID-19 Risks and Kids

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Rebeca Ibarra: It's the Brian Lehrer show on WNYC. I'm Rebeca Ibarra, the local host and producer for NPR and WNYC's Consider This. I'm also a host in the WNYC newsroom and I'm filling in for Brian today. It's been great to be here with you. Last Friday, the Centers for Disease Control and Prevention updated their COVID-19 guidelines for schools. The guidelines state vaccinated students and teachers don't need to wear masks inside school buildings, emphasis on vaccinated.

Unvaccinated students and staff should continue wearing masks indoors, but they don't have to wear them outdoors. The CDC also recommends three feet of social distancing for everyone, but the agency says distancing shouldn't get in the way of kids coming back to class and distancing is not required among fully vaccinated students or staff.

The updated guidelines reflect the urgency to get students back to in-person learning. It's an urgency that shared from local governments all the way up to the White House. New York city and New Jersey have said there will be no remote option this coming school year and this, despite the fact that students younger than 12 are still ineligible for the COVID-19 vaccine.

That's making some parents anxious, especially as we see a rise in the more contagious strain of COVID-19, the Delta variant. Here to help address some of those anxieties is Dr. Daniel Griffin. He's an infectious disease clinician and researcher at Columbia and chief of the Division of Infectious Disease at ProHEALTH Medical Group. Dr. Griffin, welcome back to WNYC.

Dr. Griffin: I'm happy to be here. I don't know if you could hear me right now.

Rebeca: I can hear you. You sound great.

Dr. Griffin: Fantastic.

Rebeca: Dr. Griffin, first give us your thoughts and reaction to the updated CDC guidelines for schools.

Dr. Griffin: I have to say, I think it's a fantastic update and really it's right at the start of it. That gets me the most excited. They really have said that schools are a priority. Students really do benefit from in-person learning and the virtual learning is not the ideal setting. We need to prioritize our schools. I think that's the most critical thing. Then they've given us a lot of guidance on how do we make sure that can happen?

Rebeca: The guidance does seem to be at the end of the day, each school can figure it out on their own, or am I misreading that?

Dr. Griffin: No, I think that is one of the concerns that, that we all have, and I say we as physicians, as people with training in public health, but also as parents. It's really going to come down to the schools taking the responsibility to make sure this is done right.

Rebeca: Because I believe the CDC isn't requiring schools to ask people- well, children over 12 to actually be vaccinated. Isn't that so?

Dr. Griffin: That is true. There are some wrinkles here and as positive as I want to be about this, they've made comments about if you're not vaccinated, you should be wearing a mask indoors, but yet it's not clear that there's really any system in place for doing anything other than an honor system for these decisions. You may be the parent who's doing all, we're going to say the right things, your child's vaccinated, your child maybe decides to wear a mask in school. You're avoiding a lot of large gatherings. You're doing everything inside and outside school, but then you send them to school and they may be sitting there three or two feet away from an unvaccinated child, not wearing a mask and that is going to be a challenge for us as parents.

Rebeca: I know. This does seem a bit like a logistical nightmare. You have a classroom where some kids are vaccinated, some are not, teachers are vaccinated, others aren't, and then who gets to wear the masks. I guess you could understand how some people are a little bit confused by this.

Dr. Griffin: I certainly understand that and, boy, the last 18 months, 24 months here have been a very difficult time. Then I think the other is that there's the CDC guidance and then each state is going to have its own local guidance and you always wait for those two to either mesh or conflict. Then now as you're pointing out, I think maybe some of our people who call in will comment, what's going to happen in my school? I think there's going to be a lot of concern and fear, is probably the right word, that my school will not be doing the right thing or my school will be doing something that I consider too restrictive.

This is not being done as well as it could be done. These are difficult times and we live in a country where ultimately it comes down to the state, it comes down to the community and there are rules here. There's guidance.

Rebeca: Emphasis on guidance. Listeners, we can take your questions for Dr. Griffin, especially parents of kids under 12. Do you have any questions on the CDC school guidance around masks? Is it confusing to you at all? Call 646-435-7280 and as the city and the whole country really is pretty much open now, do you have questions on how to keep your unvaccinated kids safe from COVID 19, or have people pretty much drop their masks indoors where you are? How is that affecting the things you do with your kids? Give us a call now with your COVID questions for Dr. Daniel Griffin. 646-435-7280, or you can always tweet us @BrianLehrer.

Dr. Griffin, because children under 12 are still ineligible for the COVID-19 vaccine, parents are having to navigate this parallel world in which vaccinated people are maskless and free but young children are not. On top of that, you have rising cases of the Delta variant, which spreads twice as fast as the original variant. How worried should parents be around this variant?

Dr. Griffin: This is really a challenge. For 18 months, the early part of the pandemic, we just did a tremendous job of keeping kids safe from the virus. There were certainly other consequences of those measures, but we protected the kids. We ended up having very low infection rates in children. We ended up with only, I'm going to put the word only, because people do say only maybe 500 children died during the early days with everything we did. Now we've basically said, okay, the only reason we did that was to protect our older, more vulnerable, and we are letting children get infected at higher rates.

I would say children are at low risk, but they're not at no risk. This has actually become quite a problem for children who are not eligible for vaccinations, because now when they go to, take a summer camp for instance, there may be an adolescent there who's working as a counselor who has made a decision not to get vaccinated and now the child ends up getting sick with COVID. Maybe the minimum is they miss 10 days of this, what was going to be a wonderful experience after 18 months of lockdown, or worst case, there is a certain percentage of children who are going to get more serious disease, and a certain percent of those children who are going to not be better for a couple [inaudible 00:07:28]

I think this is really challenging for parents until maybe the end of August, September, when we're hoping that there will be enough information, knowledge, safety data to extend that vaccination opportunity down. This is really a challenging time for those parents.

Rebeca: You mentioned summer camps. Summer and it's activities are well underway. You have travel, you have summer camps. What kind of precautions should parents be taking? What is some advice?

Dr. Griffin: One of the tough things for parents is that not all the camps are taking this measure, the COVID safety precautions as seriously. Also I've heard lots of, "Well, we have challenges hiring so we have to put unvaccinated individuals in these camper-facing, in these vulnerable population facing roles." Parents have to make decisions about how they can keep their children safe because a lot of the camps, a lot of schools as we'll see in the fall, may not make the same risk calculations that a parent might want to make.

Rebeca: You're saying really with so much out of your control if, for example, a parent has a kid under 12 who isn't able to get vaccinated with a preexisting condition, would you urge them to really, really consider the risk of going to, say a summer camp, or of traveling or getting on a plane?

Dr. Griffin: I want to keep this in context. Children are at low risk. This is not like sending your 80 year old mother to to the same setting where, boy, if she gets COVID, a 25% chance she'll end up in hospital. Then if that happens a 25% chance she'll never come back out. Children are at lower risk. We also know that keeping them at home has been associated with a lot of harm.

What I think the CDC is saying in their guidance and I really think I want to emphasize this, is that is really important to our children that we get them in camps, that we get them in school, that we let them have these opportunities, but parents need to be vocal to the camps, to the schools and need to say, like, "I do not want my child put in a risky situation just because you're having staffing challenges. Just because there's a vocal minority saying that they don't like something." I think we need to prioritize our children and I said early on, open the schools, close the bars, we need to focus our priorities on our children.

Rebeca: Let's go to a caller. We have Vijay in Queens. Vijay, thank you for calling WNYC. What is your question or comment for Dr. Griffin?

Vijay: Hi. Thanks for taking my call. I definitely support the reopening of schools in September. I'm the president of the Community Education Council for District 28 in Queens, New York here. We have an overcrowding issue in our schools. Our schools on a regular day, there's a lot of kids in the school. My concern is if we're going to have these guidelines with distancing to go back in September, where are the kids going to go and how are they going to be safe? That's a huge concern that we in Queens, New York here have for the CDC and for the City of New York DOE.

Rebeca: Vijay, thank you so much for calling. Dr. Griffin, is this a concern you've heard from parents as well? They're concerned about things like overcrowding in schools? Because, of course, the CDC says three feet apart, but not if that gets in the way of bringing children back.

Dr. Griffin: This is an excellent point. This is the gray in the guidance here, is that they really want to prioritize getting kids back to school. We have a lot of data on the fact that this is not surface-transmitted, that this is something where a little bit of distance makes a difference and that three feet is a magical number, getting us about an 80% safer. 6 feet got us to 90%, so if it meant half the kids couldn't go to school. This is going to be a challenge. What if you want to put those kids less than three feet apart? Then you've got to start looking at what the CDC describes as a multilayered strategy. Then masks are involved.

The safest thing you can do in all honesty in the schools, is have a really high vaccination rate. That's not something that I think we want to force people. That shouldn't necessarily come from the government, it should come from communication. Talk to your health care workers, find out what the risks and benefits. At this point, COVID is becoming endemic, so the choice as a parent is, am I going to expose my child to the risk of vaccination or am I going to expose my child to COVID? That, I think, is a really clear decision. Getting vaccinated is much safer than getting COVID. The more of us that get vaccinated, the safer it is. It really is critical to get our kids back in school and do everything we can to make that safe, low-risk option.

Rebeca: We have another caller for you, Dr. Griffin, with a question. Marissa on Staten Island. Marissa, thank you for calling WNYC. What is your question for Dr. Griffin?

Marissa: Hi, thanks for taking my call. My unvaccinated eight-year-old is at a day camp this summer where all of the activities are outdoors. I'm wondering if we have any data yet on the safety of outdoor activities with the Delta variant. I know that with the original COVID and some of the mutations, outdoor stuff was still deemed safe, or safer. I'm wondering where we are with Delta and outdoor activities, when the children are outdoors, but they are sometimes close to each other's bodies.

Rebeca: Thank you for calling, Marissa. Dr. Griffin?

Dr. Griffin: Yes, Marissa, you make a really great comment. I hope people can think about what you're saying here is that we have based so much of what we've said on a lot of studies that were done early on with the virus, but the virus has changed. We hear a lot in the media, and I want to temper this, where the virus is now "more transmissible", which means different things to different people. Stories of someone walked past someone else on the street and, oh my gosh, they got COVID from that. That's not true.

There is a fitness advantage to the Delta variant. A lot of the studies we did not do on the Delta variant, and it is different than the original. We still have a preponderance of evidence that outdoor is incredibly safe. We're not seeing a change. We're seeing Delta spread in unvaccinated people, we're seeing Delta spread indoors. If your child is at a summer camp and they are outdoors, that is fantastic, we are not seeing issues.

What we are seeing, and I actually get calls from a lot of camps about this, it's a rainy day and that camp counselor, and it may not be an adolescent, sometimes it's a staff member who's older, has decided not to get vaccinated, has also decided not to put a mask on when they get indoors with the children, and we are seeing transmission in those settings. That's the issue that I worry about, is outdoor is great and everyone's having a great time, but then it rains, people go inside, the masks are not enforced because in too many people's mind, the pandemic is over, and then we see children get infected. I get a couple of calls a day about scenarios just like that.

Rebeca: Let's talk about the Delta variant. I understand your point. I don't want to be alarmist, but I still have questions, many people still have questions. COVID-19 cases have been increasing in New York City driven by Delta. Here are some figures from The New York Times today that found by the end of May, Delta accounted for about 8% of the cases sequenced by the City, and by mid-June, it was more than 40%. The Times also says the case count in the city, though still very low, has been somewhat surprisingly rising this month. In your opinion, should a place like New York City reconsider reimposing some restrictions?

Dr. Griffin: There's multiple ways that we can address this virus. The most powerful way is by improving access and uptake of vaccinations. That's what I worry about with the focus on transmissibility, is that the measures that we have, they work. There's an artificial timeline that we want to open up, we can open up if we have increased vaccine uptake.

What we're starting to see, first in Israel, we're starting to even see it locally, is as time went by, people who are vaccinated are now starting to get infected. Not only are they getting infected, but they're starting to spread it. Early after vaccination, there seems to be a herd immunity effect of vaccine, but as time goes by, we're starting to see transmission again. The Delta variant will take over. It will be the predominant variant in our country and the areas of the country, even with high vaccine uptake, if you take off the masks, if you remove all the non-pharmaceutical interventions, if you start having big parties, particularly indoors without masks, you're going to see increased cases.

I think that we have a choice as a community, and every community across the country, we can either increase our vaccination rate or in areas of the country, it really was too soon and it's too soon to take off the masks. I think as we're looking at the fall, we're looking at our children. Don't just think about yourself, think about our children, think about their ability to safely get back to school. Community rates are the biggest risk factor for kids getting COVID. If we can vaccinate, if we can do the right thing, our kids can get back to school, they can get educated, they can have healthy, wonderful social interactions.

Rebeca: If I am a vaccinated adult and I want to have a little bit of freedom, long-deserved, long-wanted freedom, but I also want to be responsible and avoid spreading the virus, because perhaps maybe I do get it and I don't have symptoms, what should I do? Should I continue masking? Should I get tested often? What would you recommend, Doctor?

Dr. Griffin: Yes. [chuckles]

Rebeca: [laughs] All the things.

Dr. Griffin: Number one, you did the right thing, you got vaccinated, that's great. The other is, the more often you are comfortable and willing to wear a mask, you're contributing to the community, that is civic virtue. If I go to the gym, which I do, if I go to the supermarket or the store, I throw a mask on. If I have the option of indoor and outdoor dining, I choose outdoor dining. Some of the people I work with are really vigilant with the masks and we talk about the fact that they have children under 12.

The masking, the making decisions, it affects everyone, because as you point out, it's not just whether or not I'm going to get COVID, it's not just whether or not I'm going to get sick. We live in a community and this has been a horrible last 18-24 months, and we can get back to normal doing as much as every individual is willing to do.

Rebeca: Let's take one more question. We have Amani in White Plains. We have about 30 seconds-ish left. You have a question for Dr. Griffin?

Amani: Yes. Thank you very much, Dr. Griffin, for answering my question. It's just I have a four-year-old. he's unvaccinated. Should I be putting pressure on my school to make sure that he's wearing a mask in his classroom and his classmates are wearing a mask?

Rebeca: Thank you so much for calling, Amani.

Dr. Griffin: Yes, great question. I'll try to answer quickly, is masks, they do both things. They protect us to some degree, the KN95's are even better, but everyone around us wearing mask protects everyone else. Yes, I would say, if we have children under the age of 12 who do not have the ability to get vaccinated, go into schools, the right thing to do is to have masking.

Rebeca: Thank you so much. Dr. Griffin, one last question. We actually do have a few more seconds left. Is there something you're really looking forward to doing that you weren't able to do last summer?

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Dr. Griffin: For me, it's really only having a little bit more time. It's spending more time with my kids, getting out sailing, doing a lot of the things that I've enjoyed. As people probably know, it's been really tough for us as far as healthcare workers. For us, it's been really hard on our family because we've tried to be there for everyone else, we've really haven't necessarily been there as much as we would like to be for our spouses, for our children. That is what I'm looking forward to. Hopefully, everyone will get vaccinated and help me continue to have that work-life balance.

Rebeca: I wish you a wonderful summer and thank you so much for coming on. Dr. Daniel Griffin is an infectious disease clinician and researcher at Columbia, chief of the division of infectious disease for Pro-HEALTH care Medical Group, and president of Parasites Without Borders. Dr. Griffin, thank you so much.

Dr. Griffin: My pleasure. Thank you so much.

Rebeca: I'm Rebeca Ibarra and this is the Brian Lehrer show on WNYC. Thank you so much for spending part of your day with me and listening.

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