Welcome everyone.
My name is Steve Mizek and I'm a social media specialist
at Rush University Medical Center.
Thank you everyone for joining us today.
We're going to be talking with Dr. Latania Logan,
a pediatric infectious disease specialist at Rush.
Thank you so much for joining us.
Let's just start by telling us a little bit
about what you do at Rush.
Sure, thank you so much for having me.
So I am, as you said,
a pediatric infectious diseases doctor at Rush,
so I do see patients, but I also do research
and I actually do research on antibiotic resistant bacteria.
In my other roles, I'm the hospital epidemiologist,
so I'm dealing with COVID and those kinds of things.
And I am the chief of my section
and the vice chair of research
for the department of pediatrics.
Great, and so today we're going to be talking
about kids and COVID.
Our understanding of how kids are affected by COVID
has changed.
When we started out the pandemic,
we kind of thought that it was really,
young ones weren't affected so much,
and then these days it seems like that's starting to change.
Can you tell us a little bit about why that's changed
and what the situation is now for kids and COVID?
Yeah, that's a great question.
So, it's more than one reason
that this is occurring right now.
The first part of it is actually,
in some ways, a good reason.
So when we started vaccinating,
our priority was to vaccinate the healthcare workers
and the seniors, so the age 65 and older.
And now we're at the point
where 80% of seniors are vaccinated, right?
So when you see COVID right now,
you're seeing a younger age group
who's getting COVID infections.
And so the children are within that younger age group.
Now, why is it different this wave though,
than the prior waves?
And the, one of the big reasons for that
is the strain or the strains that are out
are more contagious.
So the children are also affected
by these more contagious strains,
and now we're starting to see children
who used to not have any symptoms or be affected
now are infected
and you can actually see them with symptoms.
Are we seeing hospitalization rates
similar to like what it was for adults before
as it relates to kids?
So that's a great question.
We are not seeing a ton of children being hospitalized,
there are more kids being hospitalized
in certain regions right now,
who are having, such as Michigan,
and some of the areas in the East Coast
that are seeing some very large surges
of cases of COVID in children.
But what we are seeing is about 1/3 of the kids
who are hospitalized have severe disease.
So it is enough children who are being hospitalized,
however, it's still a low fraction
of all of the children who have COVID
that actually have symptoms
that require any type of medical care.
I see.
And are you seeing that, like,
is it just because of this variant
is more infectious in general
or does it seem to have a different impact on kids
just because of how, what the variant is?
Yeah, that's a great question.
We're still learning about these variants
and there's really a few of these variants of concern
that are out there right now.
So the big one here in our region and across the US
is this B.1.1.7, which has also been called the UK variant,
as to where it started.
That strain has taken over
as the most common strain we're seeing,
and we know it overall to be more contagious.
So I don't think that it's necessarily
that it's just a kid thing,
I just think that this strain
just like if you have a bad flu season,
this strain itself is more contagious,
it's going to affect more people.
Gotcha, that makes sense.
So kids have also, not all,
but a lot of kids have gone back to in-person learning
and they're around their peers again.
Do we feel like in-person learning
is contributing to the spread
or is it just the variant itself?
Yeah, great question, this comes up a lot.
I have two kids on my own, they're age seven and 10,
and they are at in-person school
and I'm completely comfortable with them being there.
I think in-person school is not the problem.
If you look at transmission within schools
that are following the mitigation strategy,
so meaning they are social distancing,
they are doing their hand hygiene,
they have good ventilation, they are masking.
These schools are not seeing transmission rates
that are higher than a half percent, total.
So that means if you look at transmission within school
to find one transmission within the school,
you'd have to test like 200 people.
Whereas what is really contributing to it
is the events that are taking place outside of the school.
So kids on their play dates,
or kids at their youth sports, which is a big deal.
Kids who are congregating and having meals together.
Or the kids who are not using the mask etiquette.
The other thing is that now 80% of teachers are vaccinated.
That's huge.
If the teachers aren't contributing to spread
and now you're getting 16 and 17 year olds vaccinated,
the risk of the transmission in schools
is even that much more plummeted.
So I don't think that schools
are going to be a big factor going forward.
I'm sure that's very reassuring to parents.
You mentioned youth sports when you were talking.
And I understand that I've heard it said
that youth sports have been a big contributor,
and not necessarily because of when they're playing,
but because when they're traveling or stuff like that
can you talk to about that at all?
Absolutely, yeah.
So that's exactly right.
So people are wondering,
why would the kids be getting infected in these sports?
You know, of course, being inside those sports
are going to be at a higher risk.
Because you're in these settings where it's closed off,
maybe the ventilation isn't as good,
the children are in contact with each other.
One of the big things is,
where they are when they are next to each other
in spaces like the bench, right?
Let's say you're outside and playing baseball
and you're in a dugout.
You're right next to each other.
I mean, that's the way it was, it's still like that.
So we have to work on the spacing of those children
and their masks.
You know, some kids are very good,
there are athletes around with basketball
where the kids wear the mask the whole time.
There's not any transmission that's going on in those areas.
However, there are several
where the kids are not as good at that.
Neither are the coaches, we see that sometimes.
And that is where you're going to start
to see this transmission happen.
Additionally, kids do things like share water bottles.
So you have to be willing to put in the effort
to make sure that the children are following the strategies.
If they are, then I think some of them can be very safe.
But I do think that the contact sports
are going to be a lot more difficult to control,
particularly because the kids are so used
to being next to each other,
and then they let their guard down a little bit easier.
Sure, that makes good sense.
So I've heard it said the only way
for us to reach herd immunity as a society
is to vaccinate kids.
What's your opinion about that?
Yeah, so it's so funny, Dr. Fauci just came out
and he's like,
"I'm done talking about herd immunity."
And part of the issue
is that we really just want to get people vaccinated.
But we have to think about it like this,
vaccination is not mandatory,
and there's a whole section of the country, of society,
that doesn't want to get vaccinated,
they are not willing to do it.
In this case, the children are very important.
Because there's going to be a whole area of people
that may live near each other that aren't vaccinated.
And that is going to put that whole community at risk.
So herd immunity is important
in terms of not just overall immunity for US,
but pockets of people all over the US
that need to be vaccinated are not getting vaccinated.
In those areas, kids would be helpful.
In our area, if all the adults are vaccinated,
then the kid vaccination is less important
because we're not going to spread it to the kids.
But overall, I think that the kids
are going to be super important
because they're going to be the only ones left
not to be vaccinated.
And then the last thing I'll just say about that is,
if you think about herd immunity,
what really is important is the global immunity.
We travel, we all go outside, come to the country,
this kind of thing. So we really need to think about it
from that more of a standpoint of,
we need to get everyone vaccinated,
not just here in the US, but around the world.
Right.
So many parents were eager to get vaccinated themselves
as soon as they possibly could.
But when it comes to vaccinating kids,
sometimes people are a little bit more hesitant or worried,
they have concerns.
Obviously it's still not available yet to kids.
But what would you say to parents
about thinking about vaccinating their kids for COVID?
Well, the first thing I would say is that,
the minute the vaccine's approved
and I've looked at all this data,
and I'm convinced
that these are going to be very safe in children,
that I will get my children vaccinated.
The other thing I'd like to bring up is that,
if we really think about vaccines
in the hundreds of years that we've been giving them,
most of the vaccines are given in childhood,
from the time we're born until we're 100 plus,
we're getting vaccines.
And these are safe.
The side effects that we see from vaccines are very rare,
and most commonly the mild things like getting a sore arm
or whatever, they're short-lived.
They start at the very beginning of the time
which you got it,
and they end very quickly
after the time of which you got it.
They're not in a lot of long-term issues
that ever been associated with any of these vaccines.
So I wouldn't look at this vaccine any different
than the childhood vaccines that we give
that have saved millions and millions of lives.
This one also will do the same thing.
So like I said, you can come in line with me and my kids
when it comes out, 'cause we'll be there.
Great, well, that's a ringing endorsement
if I've ever heard one.
So as the summer approaches,
many parents are starting to think about sleep away camps.
And you know, what guidance would you give parents
who are trying to navigate whether or not that's feels safe
or whether that's the right thing for them and their kids?
Yes, this is a hot button topic, I will say.
I get this a lot, it's a very good question.
And I think it's going to be dependent
on where your kids are at the time,
where they live, where is the camp?
What research have you done to look at this camp
to know that they're following the mitigation strategies?
What happened last summer?
Did they have a camp?
There've been some summer camps
that we know had lots of outbreaks within them
that were in the sleep away camps.
The day camps on the other hand,
have not had a substantial problem.
So I think that each camp is going to have
to have a really solid plan
as to how they're going to keep their staff
and their children from getting infected.
The other thing that I will say that will be helpful
is if you know whether or not their staff are vaccinated.
You want to know if the staff are vaccinated.
And we know that hopefully Pfizer,
who is already filed for an amendment
to get their vaccine approved for 12-to-15 year olds,
if your kid is going to get that vaccine in May or June
then that child is actually even more,
likely somebody who would be okay
to go to the sleep away camp.
So I think that overall,
during a time where there's a surge, it's hard to say,
"Yeah, I would really send my kids anywhere."
For me, I couldn't do it.
But I think that some parents will have that option
particularly if they have a break camp
that has these mitigation strategies in place,
they have high vaccination rates,
and they're going to have these children
who possibly are also vaccinated at camp.
So what's the timeline looking like
for being able to vaccinate younger ones,
than who are currently available to get it now?
It's a great question.
So 12 to 15,
Pfizer put in the amendment a couple of weeks ago.
So we actually think by May or June,
that Pfizer will get that approval,
because it was by their statement,
it was 100% protective in children.
So I think that they will get their approval
and that'll be great.
So then those kids be okay from May and June
and going into the summer.
The littles, as I call them the six month to 11 years
where my kids are in that cohort,
they've started the trials.
Pfizer has started their trials,
Moderna has also started those trials,
they've been a little bit slow on the front end,
while they're just getting, make sure everything's in place.
But we anticipate that those trials will be done,
and that hopefully those children in the youngest age group
will have a vaccine by the end of 2021
or the beginning of 2022.
I see.
Do we know anything if Johnson & Johnson
is going to be participating for kids as well?
Well, yes, they did.
They actually, Johnson & Johnson also
has been doing 12 to 17 year olds.
I think everything's on pause right now for them,
but yes, they have also started their trials in 12 to 17,
which will be great,
'cause that's a one-shot vaccine for the kids.
Can you, I know that many of us know
what's been going on with Johnson & Johnson,
why it was paused,
but would you mind just filling us in,
just 'cause for someone who maybe doesn't know?
Oh sure, absolutely.
So what had occurred is,
basically what we've learned is that the system works.
There's something called VAERS,
which is basically a system where people, anybody,
can enter in side effects that they have from vaccines,
including doctors, you as a person,
anyone can enter this in,
it's been working beautifully. And how do we know that?
Because there were six cases
of people who had had blood clots
after the Johnson & Johnson vaccine that had occurred
between about a week or two
after they've gotten the vaccine.
That's six people out of over 7 million.
So the rate of this occurrence is very, very low.
And there may be something about these particular people
that has allowed them to have these low platelets
where they're having these low platelets,
normally cause bleeding,
but are associated with clotting.
So that vaccine, the Johnson & Johnson
and also the AstraZeneca vaccine,
which is not approved here,
but they're a very similar type of vaccine,
they are also looking at it
in the other countries that use that.
And all of that collated data is being looked at by ACIP,
which is our immunization practice body
that works with the CDC
that validates whether or not we should use this.
They will be meeting Friday
and we will know whether or not
we're going to resume the vaccine.
We believe that they will likely resume at this point.
It's really looking at these last couple of weeks
and seeing if they have more cases.
Right, and I know that one of the things
that I've heard a lot said is that,
birth control causes blood clots
at a higher rate than this does.
And so I think that's something
that's good for people to know, have that context,
that this isn't necessarily statistically that important
relative to the abundance of concern that's being put in it.
Or looking at it
as it's happening in less than one in a million people.
So, call yourself one in a million,
you know, that's a good thing in some ways,
but this and this side, it's one of those rare side effects.
Right.
We've had a couple of questions from the audience.
The first one, babies,
are babies susceptible to getting COVID
if they're not wearing masks? This is a great question.
So, what's really cool about the vaccines
is pregnant women have been getting vaccines,
and pregnant people have been getting vaccines.
And we found now that the antibodies
can actually pass on to the baby.
So similar to the other vaccines that we use,
the infant will have antibody protection
against the COVID for maybe up to six months.
So for those babies whose moms are vaccinated,
they're probably in pretty good shape.
Once you get where the they lose the maternal immunity,
that protection that we give them,
then that's where the baby's at risk.
And that baby is at just as much risk
as the toddler or the older kid.
I don't think that babies have been spared through this.
I do think that they have been sheltered more through this.
And now if people are more likely
to be coming around each other,
then it will be likely that babies,
we will be starting to see the babies come in with COVID.
We do see some of them now.
I will also say that we're starting to see
some of the cold viruses
that we didn't see during the winter,
now starting to see them at this point of the year,
because people are starting to come back together.
So the babies are not just going to be
necessarily sick with COVID,
they may catch RSV or the cold virus rhinovirus
or any of these other flu, just the same.
Great.
That actually makes me wonder about the flu in general,
like as someone who is a specialist,
since we had very low flu cases because of the pandemic,
do you anticipate there being a rise in cases this year,
because as things get back to normal?
It's really interesting.
So in Australia, that's what happened.
In the off season when people were getting back together,
and during, their summer and our winter
are at the same time.
So they started to see the increases
in the cases of these things during the off season.
It is quite possible that we will also see that occur.
So an off season flu, basically a summer flu,
or that kind of thing that may occur.
We have not seen it yet.
That was in western Australia where they had these problems.
So it's possible that we will,
we hope that that doesn't happen.
The other thing we should realize is that,
next winter we have a chance of a very difficult season.
Particularly if we stop masking,
if we don't do this anymore, then
we're going to be at risk for all the rest of the viruses.
So, time will tell.
We actually like this because we've seen less of these cases
but we know this isn't forever.
Right, absolutely.
So talking about masks,
there's been a lot of questions
about guidance as it relates to wearing masks outdoors.
How necessary it is to wear masks
when we're walking on the street, or,
so I just wondered,
do you have any guidance for like,
how people might want to make the decision themselves,
if they want to wear a mask when they're outside?
Well, I will say that, depends on if you have a mandate.
If there's a mandate like we have here,
then you're supposed to wear your mask wherever you are.
Let's say you're though somewhere else
where you don't have to wear the mask,
you have a choice in wearing the mask.
I think there's a lot that goes into that decision.
How comfortable do you know the people who you're with?
Do you know if they're vaccinated?
So some of these games, we're seeing these ball games,
baseball games stadiums full of people,
and you think, wow, how is this going to work?
But I think, if you know that the people you're around
are relatively safe, you're in a kind of bubble of place
because you have all these vaccinated people,
then it's probably okay.
I think that the issue
is that we tend to let our guard down again,
if we let our masks down.
We might be starting to hug people,
we might start to share these bottles,
we might do these things.
So I think if there's less risk,
if you're just walking your dog,
but if you're about to go meet somebody,
you really have to think of, have some pause
about having that mask down when you're outside,
'cause you just don't know what they have at that point.
Right, thank you for that guidance.
So I will certainly apply that myself.
Well, we have to wrap it up,
but thank you so much, Dr. Logan, for appearing with us
and talking to us today about kids in COVID,
and it's been very enlightening,
I'm sure everyone else got a lot out of it as well.
And please visit rush.edu/vaccine
for any questions about vaccine,
or rush.edu/COVID for our latest updates around COVID.
And please stay tuned for more great Facebook Lives
from Rush University Medical Center.
Thanks everyone.