Doctors address back-to-school concerns from Manitoba parents at virtual town hall

Manitoba parents and teachers had some of their back-to-school concerns addressed Tuesday during a town hall meeting hosted by Doctors Manitoba.

About half a dozen doctors specializing in children's health and infectious diseases answered questions on common themes. Those include the health impacts and risks of COVID-19 for kids, vaccine safety and effectiveness, and preventative measures in schools and the impacts of those precautions on development and mental health.

"All of us are worried about the well-being of our children," said Dr. Jared Bullard, pediatric infectious disease specialist. 

"COVID is not a joke. It can definitely cause harm to children."

There have been three deaths out of about 15,000 confirmed COVID-19 cases in kids over Manitoba's first three waves, according to Bullard. About one in 200 ended up in hospital, one in 2,000 ended up in intensive care, and one in 1,000 experienced a condition known as multisystem inflammatory syndrome, or MIS-C, he said. 

"All of those that have had MIS-C have done exceptionally well," Bullard said.

'School is a safe environment'

The most common way kids get COVID-19 is through people they live with, not through schools, he said. 

Manitoba data also suggests that schools overall are very safe and infection patterns generally mirror the broader community — except in teachers, Bullard said.

Compared to the rest of the adult population, teachers have been about half as likely to contract COVID-19, he said.

"Being in a school is a safe environment for them," he said.

Dr. Ruth Grimes, president of the Canadian Paediatric Society, said the longer-term impacts of infections in kids aren't clear.

"We just simply don't know … but time will tell," she said.

A U.K. study published by the journal The Lancet said most who experienced symptoms such as MIS-C didn't require hospitalization, Grimes said.

Some kids can develop long COVID symptoms with fatigue the most common in teens, Grimes said.

The delta variant also changes things. It's twice as infectious as the original coronavirus strains in circulation, meaning more infections, especially among the unvaccinated, are likely on the way. With more infections, more serious outcomes can be expected, said Bullard.

Some U.S. trends suggest kids are being hospitalized at a higher rate due to delta, though data from Israel and Europe suggests the rate of severe outcomes in kids isn't as great as anticipated.

Benefits outweigh risks

Several people at Tuesday's town hall asked questions about immunocompromised children and those with pre-existing conditions.

The doctors said the benefits of in-person learning generally outweigh the risks even for those kids, but it depends on the child.

Dr. Ashley Chopek, a pediatric oncology and bone marrow transplant specialist, said some kids receiving chemotherapy or who received a bone marrow transplant may have compromised immune systems and can be at increased risk, particularly in the three months or so after treatment finishes.

Then again, some don't experience the same degree of immune system suppression from treatment, she said.

"The message … from an oncology standpoint is that we're encouraging more children to attend school and to be vaccinated if they're eligible," she said.

"The benefits of school … outweigh the risk to most children with compromised immune systems."

Dr. Marni Hanna, president of the Manitoba Pediatric Society, said for kids under the age of 12 who aren't yet eligible, it's especially important for all the adults around them to get vaccinated.

"Cocooning them … will greatly reduce the risk," said Hanna.

Revisiting the fundamentals

It's also important to revisit the fundamentals with kids ahead of school.

Going over proper hand washing and masking techniques with kids can help minimize the risk of exposure and Bullard said good-quality cloth masks are generally sufficient in the community and schools. 

Some parents asked about possible negative side-effects of wearing masks.

"There is really no evidence to support any concerns regarding masks," said Grimes. "There is no health risk to children."

Dr. Hanna said there aren't any studies showing significant effects on speech development in kids where masks are concerned.

"Children who can't see learn how to talk just as well as children who can, so that's something interesting to keep in mind."

Parents should be screening their kids every morning before school for symptoms, said Grimes. If a child has any, even if they live with allergies, parents need to keep them at home and get tested.

In terms of ventilation in schools, she said cracking a window and leaving the classroom door open helps. Schools should also facilitate outdoor learning opportunities this fall before the cold sets in, she said.

Grimes said the preponderance of evidence suggests vaccines are safe in those age 12-17. Cases of adverse effects, including myocarditis, or inflammation of the heart muscle, are rare and mostly resolve on their own.

"Bottom line is the likelihood of contracting myocarditis and pericarditis from COVID is infinitely higher than the incidence with immunization itself," she said.