This latest wave of the pandemic is forcing us to collectively redefine the priorities that will make it possible, to the best of our knowledge, to ensure a good follow-up. We now know that the health situation that we wanted to be temporary represents a potentially lasting state that we will necessarily have to come to terms with.
Posted at 11:00 a.m.
The deleterious effects of the measures imposed on children, adolescents and their families are no longer to be demonstrated. In the early days of health emergencies, the fears we had as pediatricians were more a matter of experience and intuition; today, many writings unfortunately support most of our concerns: psychological distress, demotivation, eating disorders, school delays, obesity, pathological use of screens, family distress …
Soon, young people will have spent half of their adolescence restricting their social contacts when it is usually with their peers, exploring beyond the family nest, that they define and build for their future. It won’t come back, we don’t grow up any other way. Yet we continue to deprive youth of key developmental elements that we can never give them back. The return to school in person last September was accompanied by a marked improvement in the mental and emotional health of adolescents. It is now essential to consider continuous school attendance, as well as all of its attributes, as an essential service, a fundamental value which builds the public good.
We do not deny that the situation of the hospital network is extremely precarious, that what we take for granted – accessibility to quality health care – is openly threatened. We must resolutely support the fight against the tsunami caused by Omicron. Vaccination, barrier measures, reduction in contacts will continue to punctuate our daily lives. But the tribute thus exacted from our children is currently disproportionate and must in no way be tolerated any longer.
We must protect the most vulnerable against COVID-19, but our responsibility, which is also that of Public Health, is also to protect the new generation from a situation that can no longer last.
In the waves encountered so far, schools have never been the main driver of the pandemic, but have been a reflection of community transmission, which they will not cease to be with their reopening. Now is not the time for illusions or rainbows. Furthermore, the most recent data on the Omicron variant tell us that while it is substantially more contagious, it is also less virulent than its predecessor Delta. Symptoms in children reach the upper respiratory tract more, with a force comparable to many other winter infections, very rarely with other complications. More children are currently hospitalized in Quebec with COVID-19, but especially because of the very large number of children affected by Omicron. Half of these children are not hospitalized because of symptoms of COVID-19, but rather because of a chance finding on screening or an underlying condition that requires increased monitoring.
Viruses of the pre-COVID era
Before the arrival of SARS-CoV-2, many viruses already punctuated seasonal pediatric hospitalizations. In summer, enteroviruses cause hand-foot-mouth disease, regularly causing viral meningitis and, more rarely, myocarditis in young babies. In the winter season, gastroenteritis spreads blithely in the classrooms and invades our pediatric floors. The respiratory syncitial virus and influenza cause hundreds of hospitalizations each year, several dozen children requiring intensive care, and between one and three influenza-related pediatric deaths are reported annually in Quebec. Adolescents get mononucleosis all the time and many of them develop the prolonged form of the disease, with severe fatigue and absenteeism for many weeks at school.
Even though COVID-19 is a dangerous virus to be wary of, it is clear that its effects on the pediatric population are similar to many of our common viruses.
After 23 months of pandemic, in this long war which opposes us to COVID-19, we must withdraw from our arsenal the possibility of interrupting the school, social and sports life of our children. We owe them a real return to normal, without compromise, from January 17, despite the load shedding and hospitalizations on the rise.
Better availability of rapid tests will allow symptomatic children and their positive contacts to be tested and removed, while keeping classes open. The five-day isolation period will have less impact for infected children. The continued priority vaccination of school personnel, as well as that of parents or siblings at risk, will provide imperfect but optimal protection.
After two years without regular schooling or in suboptimal conditions, life must resume its rights to survival, education its place of choice beyond adaptation, for the sake of children, for their future, which is also ours.
* Co-signers: Marie-Claude Roy, peditor, member of the Association des paediatres du Québec; Jean-François Chicoine, doctor and pediatrician, CHU Sainte-Justine; Alexander Sasha Dubrowsky, doctor and secretary of the Association des paediatres du Québec