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Inside Pediatrics Podcast

To the Editor:

Since the beginning of the school year, some Children’s of Alabama pediatric offices have seen significant increases in COVID-19 Delta variant cases in schools that are not requiring students to wear masks compared to those that have a mask requirement. These schools not requiring masks are not fully considering the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), and Alabama Department of Public Health (ADPH) recommendations on how to keep children safely in school during the pandemic. Some of these same schools have already had to temporarily cancel some of their in-person instruction.

It is a well-known fact that there has been a dramatic rise in the number of COVID-19 Delta variant cases in Alabama, especially among children and adolescents. As practicing physicians of Pediatrics East-Trussville and Pediatrics East-Deerfoot in Pinson, we feel compelled to remind school systems and parents of the proper, suggested protocols to keep our communities safe and healthy. While monitoring our cases in our clinic, we are seeing higher numbers of COVID-19 cases in school systems that are not requiring masks compared with those that have some mask requirement in place. Schools having to temporarily close due to rising COVID cases are putting strain and stress on the mental health of children. Many children have already had to quarantine multiple times due to COVID-19 exposures in school and at home on top of these school closures. We believe that masking, social distancing and vaccination are the most effective ways to prevent the spread of the virus within classrooms and to keep our children in school. A number of scientific studies back up what we are seeing in our clinic: that masking is, in fact, a safe and effective method to prevent the spread of SARS-CoV-2.

The following are reminders from Children’s of Alabama and the CDC for schools and school activities. Children’s recommendations to help keep students in school, learning and healthy:
• Masking for students in the in-person school setting, regardless of vaccination status
• All others, especially unvaccinated adults, should wear masks inside buildings at all times, especially around children younger than 12 years of age, who are not yet eligible for vaccination
• Full vaccination for all those who are 12 and older
• Avoid large crowds and socially distance to the extent possible
• Handwashing and/or the use of hand sanitizer

The CDC’s recommendations for K-12 schools include:
• All students, teachers and staff who are eligible (12 years and older) get vaccinated
• All teachers, staff, students, and visitors should wear masks indoors, regardless of vaccination status
• Schools should maintain three feet of physical distance between students within classroom and indoor settings
• Students, teachers, and staff should stay home if they have signs of any infectious illness and be referred to their health care provider for testing and care

While COVID-19 does not cause nearly as many deaths in children as it does in adults, COVID-19 does affect children. We are seeing patients in our clinic being admitted to Children’s for complications from COVID-19. As pediatricians, there is nothing more disheartening than to having to admit a child to the hospital because necessary precautions were not taken seriously and then to see the stress that hospitalization causes on a family. We have seen children have lingering symptoms, including chronic fatigue and exercise-intolerance, for months after having COVID-19. Children are having to stop sports because of persisting COVID-19 symptoms or complications. We hope and pray that the pandemic will soon end, and we can move forward without these concerns. Until then, it is vital that we take the necessary steps to protect all children from this virus while still allowing them to be safely in school.

Diane Patricia Dietlein, MD
Phillip W. Harmon, MD
Diane Kutny, MD
J. Mark Lytle, MD
Michael Miller, MD
Angela Redmond, MD
Katherine Rochelle, MD
Peily Soong, MD
Rebecca Webster, MD
Garland Youngblood, MD
Ann-Katrin Wilson, MD