“Strange how paranoia can link up with reality now and then.”
― Philip K. Dick, A Scanner Darkly
The decisions are mostly made now, but circumstances are likely to unmake some of our school openings. I have never seen a version of what I wrote below and I think it’s critically important. Death is far from the only factor to reckon with in opening schools. Below: About the scariest post I have ever written, and the reason why I favor virtual learning for many geographic areas.
Update October 16, 2020: https://www.msn.com/en-us/health/medical/a-rare-covid-19-complication-was-reported-in-children-now-it-s-showing-up-in-adults/ar-BB1a5H2v?ocid=msedgntp: “We were seeing patients who admitted to the ICU with organ failure,” Dr. Hugh Cassiere of North Shore University Hospital on Long Island said. “They would test negative for Covid-19, but test positive for Covid-19 antibodies, suggesting they’d been infected previously.
“You look back, and they probably had this multi-system inflammatory syndrome,” Cassiere said. “We didn’t have all the pieces to put together.”
The multisystem inflammatory syndrome in children is well-known now. What’s becoming more clear is that this syndrome is not limited to children. Look up MIS-A.
https://www.forbes.com/sites/robertglatter/2020/07/09/can-covid-19-trigger-the-onset-of-diabetes/#37e3b7017a08 In addition to pneumonia, clots, kidney failure, arrhythmias, and heart attacks — there’s growing fear that COVID not only aggravates diabetes: In a subset of people, it may cause the onset of Type 1 diabetes.
Update September 3, 2020: Penn State’s Director of Athletic Medicine just said cardiac MRI scans revealed that approximately1/3 of Big Ten athletes who tested positive for COVID-19 appeared to have myocarditis, an inflammation of the heart muscle that can be fatal. It’s a major cause of death in the young and “healthy.” (Since this article, that 1/3 has apparently been amended to 15% — but that’s still 3 out of 20, and helps emphasize how little we know.)
This is not an either/or, well/sick disease.
A young, former Starbucks employee who has currently left college is at the center of the following article: https://www.huffpost.com/entry/kids-long-haul-covid-parents_l_5f5b81cec5b6b48507ff886d :
“In mid-March, Amy Thompson’s daughter, Amber, called her from a shift at Starbucks and told her mom she felt a tickle in her throat she couldn’t get rid of. Within hours, the college freshman had a fever and a nonstop cough. After some struggle to find a site that would take her, Amber tested positive for COVID-19…”
Amber has spent the last six months in bed. She’s still sick — too sick to work, and sick enough to be in a wheelchair some of the time due to extreme pain in her hands and feet. What happened to Amber is rare — but rare or not, Amber’s struggle is real, and she is not alone.
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The long haulers are real. The inflammatory syndrome being seen in children is real. Inflammation follows this virus on little cat feet in some cases. In others, it moves in like the proverbial 400-pound gorilla. People get sick. An unknown percentage of those people stay sick. The current estimate is that there are tens of thousands of long haulers, people who have recovered from the initial virus attack but who have lingering symptoms. These people are “over” COVID and can be expected to pass their COVID test – but they are not well.
“Few formal studies have hinted at the lingering damage that COVID-19 can inflict. In an Italian study, 87 percent of hospitalized patients still had symptoms after two months; a British study found similar trends. A German study that included many patients who recovered at home found that 78 percent had heart abnormalities after two or three months.” (https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/)
I suggest reading the above articles. We may end up with hundreds of thousands of people suffering from this post-COVID condition. One intimidating fact: Many long haulers had mild cases. They were never hospitalized or, in some cases, even tested.* These people are still struggling six months after their illness. Symptoms are variable. Extreme fatigue is common. Brain fogginess and unusual heartbeats combine with breathing difficulties and other simply miserable, lingering symptoms. This condition can be disabling.
In pediatrics, doctors are seeing a “multi-system inflammatory syndrome in children, which appears to occur not typically with acute infection, but following the acute infection by a short period of a few weeks… multiple systems are involved with inflammation, including skin, joints, kidneys, lungs and heart. And some of these kids can be very sick, with rare deaths.” (https://news.berkeley.edu/2020/07/08/from-lung-scarring-to-heart-damage-covid-19-may-leave-lingering-marks/) As CDC statistics indicate, these unlucky kids are unlikely to die – but death is not the only risk from COVID-19.
Risks to long-term health should not be ignored because we don’t yet have a number to pin on this phenomenon. The data is still flowing in, data corrupted by testing problems. False negatives can range from 20 – 30% according to healthline.com, and tests may also come back negative if a person tests too late into their recovery. More importantly, children often don’t get very ill and frequently end up never being tested.
In fact, in the absence of a hard numbers on long haulers and pediatric inflammation, we should be extremely careful right now. What are the long-term effects of inflamed hearts, kidneys and lungs? As of July 29, there had been a total of 570 U.S. cases of multisystem inflammatory syndrome in children (MIS-C), according to research published in the Aug. 7 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report — a very tiny percentage of the 338,000 kids estimated to have gotten sick. I’m sure there have been more MIS-C cases since, still representing a tiny, tiny percentage of total cases. But what about milder cases of inflammation? Milder cases of fatigue or shortness of breath that never make it into the pediatrician’s office? Or don’t get flagged because fatigue is not rare in children, and that gastrointestinal illness that was COVID never got diagnosed?
Children do tend to recover well from illness, but it’s worth taking a brief visit into the past as I write about this topic. In the early and mid-1900s, the U.S. was full of adults and children who limped or even needed wheelchairs or iron lungs (respirators) after contracting polio. Others made apparent recoveries. I hate to travel down dark alleys, but I’d like to point out that those recoveries did not always last a lifetime. My grandmother had a rough time in her fifties and sixties. She leaned on that cane often. Post-polio syndrome sometimes appeared “decades — an average of 30 to 40 years — after the initial polio illness.” (https://www.mayoclinic.org/diseases-conditions/post-polio-syndrome/symptoms-causes/syc-20355669) Grandmothers and grandfathers began experiencing pain and weakness in muscles and joints, fatigue, muscle atrophy, breathing problems, and sleep apnea, among other concerns.
Decades later, a seeming complete recovery can go sideways. What if COVID lungs that recover at sixteen years of age only make a 95% recovery? A young adult could recover well enough to function absolutely fine in everyday life – until he or she is not fine. Maybe “not fine” doesn’t arrive until the vaping catches up at 60 years of age instead of 70 years of age. Maybe “not fine” doesn’t arrive until diabetes and high blood pressure finally do enough damage on top of earlier, COVID kidney damage to start dialysis at 50 years of age instead of 70 years of age. Maybe without COVID, that dialysis would never have been required.
Eduhonesty: Those long haulers ought to be spooking us all. The word inflammation ought to be raising huge red flags where opening schools is concerned. The children won’t get “very” sick? How sick is very sick? What will the long-term consequences of post-COVID inflammation become? What will that short elementary school illness mean when they are fifty? Or sixty or older? What will it mean if they become regular drinkers or smokers?
I would bet that the vast majority of kids who get ill will be absolutely fine. Children have remarkable powers of recovery. I can’t say the same for their parents and older family members, but I know I am not talking about anything like bodies in the street here.
I also can’t provide a wealth of data to support my case. We are just discovering the long haulers now because we are reaching the half-year mark from when the pandemic took off. Doctors and others are beginning to realize that many voices are asking sobering questions: When will my energy return? Will the scar tissue in my lungs heal? When will my thinking clear up? Why does my heart race? Why does it skip beats? When will the fevers stop? We are in uncharted territory with the long haulers.
Yes, kids don’t seem to get very sick – but they get others sick. The data now fully supports the idea that – duhhh – you can catch this disease from your child. And those kids who do get sick? An extremely small percentage ends up with a vicious complication afterwards. But we still don’t know how many might end up with a milder version of that complication. How many might spend a year or two tired and achy, not so tired that they shut down, just tired enough so they come home from school and fall into bed regularly while taking Tylenol on bad days? “Mommy, my back hurts again…”
Because we don’t know exactly what we are up against, we should tread as lightly as possible. Schools should not be opened based on wishful thinking. We truly are balancing health against knowledge. Healthy people can always regain knowledge. The libraries of the world can be tapped from our phones today. But those kids forced into classrooms to gain a few extra mathematical processes, scientific facts and new vocabulary words? Will they – or more likely their parents and grandparents — be able to regain their health when our re-openings go wrong?
In regions with high infection rates, the schools should stay closed.
See: https://www.eduhonesty.com/when-avas-teacher-passes-away/
Coming soon: Tips for teaching remotely. Teachers are working furiously to make online learning work.
*Today’s big piece of advice: THINK YOU HAVE COVID? GET TESTED. IF YOU THINK THE LAST TEST WAS WRONG, GET TESTED AGAIN. Because if you are right and you do end up as a long hauler, a positive test will help you qualify for medical support and benefits.
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(https://medicalxpress.com/news/2020-08-cdc-info-multisystem-inflammatory-syndrome.html )
https://www.cnn.com/2020/08/10/health/children-long-covid-symptoms-intl-gbr/index.html
P.S. Food for thought:
“Dr. Nathalie MacDermott, a National Institute for Health Research academic clinical lecturer at King’s College London and London hospital physician, told CNN she had seen more cases of children affected by MIS-C(multisystem inflammatory syndrome in children) than acute Covid respiratory illness.
‘At the moment there’s no concrete data that’s been published in relation to children and long-term problems, but that’s because we are still fairly early on and children haven’t been so badly affected,’ MacDermott said.
‘It’s certainly possible that children may experience the kind of problems we are hearing about in adults such as long-term fatigue,’ she said.
‘From a clinical perspective we are only really seeing those children who were admitted to hospital so it’s very hard to know what’s going on in the community.’”
https://news.yahoo.com/coronavirus-attacks-brain-121608034.html
The above article is from Apoorva Mandavilli in The New York Times • September 10, 2020
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