Miscellaneous
Remember when everyone thought things would be back to normal by September? Instead, children are returning to classrooms with caseloads climbing. So how should parents prepare kids for the return to in-person schooling? Is it safe? Would they be better off being taught virtually? And when should we expect vaccines to be approved for those who are under the age of 12? For guidance, we turned to a pair of Medcan experts: Dr. Janice Weiss, director of child and youth, and Dr. Jack Muskat, clinical director of mental health. Episode 81 webpage. LINKS Dr. Janice Weiss provides further guidance for parents in this short YouTube video. Here’s the Ontario COVID-19 Science Advisory Table brief that suggests, “barring catastrophic circumstances”, that kids should be educated with in-person learning. Learn about Medcan’s Child & Youth Assessment, designed to provide parents with tailored strategies to help children reach their potential. Dr. Weiss and Dr. Muskat’s guidance, that children are better off in school compared to virtual learning, is supported by Sick Kids’ president and CEO, Dr. Ronald Cohn. “Schools should not only open in September, but need to stay open,” says Dr. Cohn. More here. Some good context on the risks to children of attending in-person schooling in the fourth wave in this Globe and Mail story by Wency Leung. Virtual schooling is thought to have contributed to the doubling of youth depression and anxiety during the pandemic, according to new analysis from JAMA Pediatrics finds. This CNN story spells it out in language for laypeople. “One in 4 adolescents globally are "experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms." INSIGHTS Dr. Weiss and Dr. Muskat both believe that children should return to in-person schooling. Like many experts they approach the question from a cost-benefit perspective. “The issue really boils down to, what are the real physical risks of being at school versus what are the mental health issues from virtual learning?” Dr. Weiss asks. Children 12 and over have had the opportunity to be vaccinated. And statistics show that the vast majority of children under 12 who catch COVID-19 will be either asymptomatic or will have mild cold- or flu-like illnesses. Less than 1% of children who get COVID require hospitalization, according to Dr. Weiss. Serious complications, such as multisystem inflammatory syndrome in children (MIS-C) are extremely rare, at less than 0.03%. Comparing the low physical risk with the much larger likelihood of mental health problems caused by virtual schooling (anxiety, depression, eating disorders, social isolation), Dr. Weiss and Dr. Muskat both conclude the analysis suggests children should be physically present. [01:35] One suggestion from Dr. Muskat: During back to school, recognize that kids pick up their anxiety from their parents. Children will benefit if parents can convey a strong, confident approach toward back to school. One approach? Be straight with them. Life has risks, but we can take precautions designed to minimize danger. Analogies can go a long way toward assuaging the anxiety of young people. The sort of risk-benefit analysis that suggests kids are better off with in-person schooling is applied in many other settings as well: We go swimming in lakes, even though there exists a risk of drowning. We go for a bike ride, wearing helmets to minimize risk of injury from a fall. “We cannot create 100% safety, nor should we, because life has risk,” Dr. Muskat says. “But what we want to do is go in with knowledge. And with confidence.” [08:35] To ward off the “re-entry anxiety” that some kids feel over back-to-school (similar to the anxiety that some adults feel over back-to-the-worksite), Dr. Jack Muskat suggests creating low-stress situations where you and the child rehearse what will happen on school days. Walk them to the school ahead of time. Set up “buddy” relationships with older family members or friends. Make a school lunch so that the child has a better idea of what they’ll be eating on that first day. Pack the backpack in advance with the water bottle and mask in appropriate pockets. The idea is to reduce the uncertainties that swirl around back to school as much as possible. Make these experiences fun, so that the positive atmosphere spreads to the act of in-person school attendance. [10:11] When will vaccinations be available for children under the age of 12? The medical community expects news to come in the fall on that front, says Dr. Janice Weiss. Efficacy and safety data is expected to be published for Pfizer and Moderna toward the end of September or in October. Depending on the results there, health authorities may elect to make the vaccine available to the next younger age bracket, which would be for children aged 5 to 12 years old. So vaccinations could be coming for more children before the school year is out. [16:32] Some parents are reluctant to send children to school if schools are just going to close down again anyway. Does Dr. Janice Weiss expect schools to shut down during the Delta variant’s fourth wave? “It depends on the virulence and the seriousness of the variant of concern,” says Dr. Weiss. “So if you get a variant that escapes the vaccination, then that would be concerning. If we see huge trajectories upwards of community infection, hospital admission, ICU admission, that would be a concern. So I think you have to look at local transmission variance of concern. It's a multifactorial decision.” With those qualifications in mind, Dr. Weiss believes that a shutdown is unlikely in the next few months. “I think that for what we're seeing so far, prediction wise, yes, schools will stay open,” she concludes. “When the community transmission and rates are low, the general infectivity raised within the school will remain low. And that's why we're really strongly encouraging everybody... get your vaccination, that is the best protection for society for your children.” [18:24] Finally, Dr. Jack Muskat suggests going a bit easy on your children over the next little bit. The situation is evolving, the world is a bit strange with everyone in masks, so consider not putting the usual amounts of pressure on children over things like performance in school. Dr. Muskat uses himself as an example. “I'm finding it's taking me twice as long to get things done when I'm wearing a mask,” he says, “because I don't have as much peripheral vision. I'm finding that I want to do four things in a day. And I can only get two done.” There’s a fatigue factor as well, he says. “One of the reasons people quit habits and routines — they set goals too high in the beginning.” Apply this to the school year by making things comparatively easy for children. Then, once they’re settled, you can focus on things like homework and good grades. [21:17]