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Q&A: New Orleans Pediatrician On Delta’s Impact On Children, Vaccines, Schools Reopening, More

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Aubri Juhasz
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WWNO
A sign at Rosenwald Recreation Center in Central City reminds visitors to wash their hands, mask up and social distance. July 31, 2021.

As New Orleans area schools continue to reopen, Louisiana’s record breaking surge in COVID-19 cases and hospitalizations has many parents on edge. Public school families in Orleans Parish no longer have a virtual learning option and some children are already back in the classroom.

The delta variant is impacting children differently than earlier strains and while doctors are still working out the details, they do know that more children are getting sick.

While parent anxiety is likely at an all time high, there’s still widespread agreement among the medical community that when measures, like masking and social distancing, are in place, schools remain safe.

Dr. Amanda Jackson with Children’s Hospital New Orleans told New Orleans Public Radio in an interview Monday afternoon that so far, the delta variant hasn’t changed that.

“We feel comfortable with the precautions that are being taken, so I expect the schools to be open," Jackson said.

Education reporter Aubri Juhasz spoke with Jackson, a pediatrician and vice president of physician services at Children’s Hospital New Orleans, about pediatric COVID-19 cases, vaccine hesitancy and what it would take for schools to shut down again.

The following conversation has been edited for length and clarity.

Aubri Juhasz: We last spoke in mid-July. What are the most important things you’ve learned since then relative to the delta variant and how it's impacting children?

Dr. Amanda Jackson: The delta variant does appear to be impacting children more. We're seeing more cases in children both on the outpatient side, whether they're showing up with a cough and cold and a fever, but also we have more pediatric patients being admitted to the hospital, both on the floor and in our intensive care units.

Take me inside Children’s Hospital New Orleans. How many children are hospitalized with COVID-19 right now?

Over the past two weeks, we have averaged around 12 to 14 patients. Previously, during the pandemic last school year and in 2020, we saw about one to two pediatric patients. The most we've had in the hospital is 20 patients. This weekend we had 17 in the hospital, but we were able to discharge several, so those numbers are trending down again.

How sick are the children who have been hospitalized? Are there children in the ICU or on ventilators?

We are seeing pediatric patients in the ICU. Most of the patients that we are admitting are in what we call the floor before or the acute beds, which is not an intensive care level, but we have had about four patients a day in the ICU level care.

There’s been this sense that older children have been more vulnerable in the past, children with underlying medical conditions. Is that what you’re still seeing or is that picture shifting as well?

We're seeing all ages being impacted. You know, we've had newborns admitted, we've had 17 and 18 year olds admitted. The more severe cases are those in kids that have underlying medical diseases or if they're obese, just as obesity puts adult patients more at risk for the respiratory issues as well. But we're definitely seeing all ages.

Are you seeing older children who have been vaccinated? Have there been any breakthrough cases?

The data that I looked at from Friday when we had 17 patients admitted, 14 of those patients were under 12, so they could not be vaccinated. Three of those patients were over 12, none of them had been vaccinated.

I’ve heard from a lot of parents who are vaccine hesitant. In some cases they’re hesitant because of misinformation. In other cases they’re concerned that further down the line, the vaccine could prove to have adverse impacts. What do you say to those parents?

The vaccine is by far the best way to prevent COVID. I do think that there is still significant vaccine hesitancy out there. We're starting to see more and more people get the vaccine because they're seeing more and more COVID and the fear of COVID itself is overcoming their fear of the vaccine.

When we look at the data, we've administered over 351 million doses of COVID vaccine in the United States alone. We're not seeing significant side effects from that. We're not seeing major complications from the vaccine.

With what we call an N, which is the number in an experiment of how many times you do something, an N of 351 million is no longer experimental. These vaccines have been proven that they are safe and they are the best protection against COVID.

I understand the hesitancy. I'm a parent. I understand the fear. However, the risks of contracting COVID and having severe COVID illness are so much worse than the risk of a vaccine. We've shown over and over again that vaccines have side effects, all medications do, however, the risks of adverse effects from the vaccine are minimum to none. It is much safer to get the vaccine than to get COVID.

What do you say to parents who are far less focused on the short-term impacts and are worried about the potential for additional impacts further down the line? Is there any truth to the expectation that there could be side effects 5 or 10 years from now?

In all the vaccines that I’ve administered in my career, I can't predict the future and I can’t tell you what is going to happen in 20 years. I can't tell you if you're gonna get COVID or not, but what I can do is I can tell you to make the best decision you can in the moment.

These vaccines have been shown to be safe. We have used vaccines for years and years and years, and the long term efficacy and safety of other vaccines have been remarkably safe. The best thing you can do to prevent illness in your child and in your family is to get the vaccine.

I know you work with school systems advising them on how to reopen. Has the conversation shifted at all due to the delta variant?

The conversations that I've had with the schools is that they are committed to the safety and welfare of the kids, but also the education of the kids. COVID is front of mind of every school leader and school partner, from all of our cafeteria workers to the teachers to the school administrators. COVID is front of mind.

I can tell you they're watching the numbers as closely as the health care professionals and we're having these conversations. At this point, we feel confident that with the vaccine and the precautions that we're taking where the vaccine cannot be given, so masking and testing and social distancing, that we are able to keep the kids safe.

Now, again, you know, delta was a change from alpha. I can't predict the future. If things change in a different way, we may have a different conversation. But the way that we are approaching delta, we feel very comfortable and very safe with returning to school with the precautions we have in place.

I know you can’t predict the future, but I keep hearing from parents that they want greater transparency in terms of the outlook for school operations. Is there some sort of benchmark that parents can be looking for or should there just be this expectation that schools are going to be open?

As of now I would have the expectation that schools would be open. I don't run the schools, but, you know, advising them medically, we feel comfortable with the precautions that are being taken, so I expect the schools to be open.

If pediatric hospitalizations go up and all of our current trends continue, is there a point at which the conversation changes or is that just an impossible question to answer until we get there?

Option B. Like I said, I can't guarantee the future. We reassess every day and if we need to make a different choice, then we'll make that. But at this point, I think we are on top of this. We are watching the numbers every day and are very cautious with the health and the safety of the kids foremost.

Virtual education did have a negative impact on the kids last year and there's a reason why we want the kids back in the classroom safely so that they continue that social development, continue their academic performance in the classroom with the educational professionals, supporting them and helping them grow. And we're doing that safely.

If it comes to a point where we need to change that because it's no longer safe, then we'll take that. But that's a big if and those conversations have not been had. Nobody is talking about that at this point. The plan is to proceed with having school in person.

Thank you, Dr. Jackson.

Absolutely. Thank you.

Aubri Juhasz is the education reporter for New Orleans Public Radio. Before coming to New Orleans, she was a producer for National Public Radio’s All Things Considered. She helped lead the show's technology and book coverage and reported her own feature stories, including the surge in cycling deaths in New York City and the decision by some states to offer competitive video gaming to high school students as an extracurricular activity.

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