Canadian Medical Association

In a little more than two weeks, children from coast-to-coast-to-coast will start their new school year, donning school supplies and looking to reconnect with friends. As a mother, I know the importance of this milestone for children and families. But as a pediatrician, I can’t help but worry about the current pandemic projections and how our children will again bear the brunt of our leaders’ decisions.

The combination of the rapid rise of Delta variant-related cases and back-to-school for thousands of unvaccinated children could yield our most challenging wave yet. Not only are thousands of children under 12 unvaccinated, but many who are tasked to care for our children choose to remain unprotected making themselves a transmission threat.

I have it heard before: children are not as affected by COVID-19 as those with co-morbidities; children can wear masks; children will recover much quicker; children should not be subjected to vaccine experiments; children will not die.

Some have suggested that ‘children won’t die of COVID-19’. Mortality is a crude outcome measure in pediatrics. What about disability, medical trauma, impact on families and mental health?

As a pediatrician, I’ve had the opportunity to work in children’s hospitals, on Medivac teams and now in the Yukon. As we see cases rising as a result of the rapid spread of the Delta variant, I believe this new wave could become an incredible foe and test the limits of our healthcare system. What I don’t understand is that we seem to be approaching the inevitable like we don’t know the consequences. We have now experienced this pandemic in three waves, why have we not yet applied the lessons learned? Why are we so determined to play the waiting game when we know it will only leave us to play catch up afterwards?

It is clear this fourth wave of COVID-19 will be the result of misinformation, under-vaccination and premature abandonment of public health mitigation strategies. With the virus still very present in our communities, why are we removing masks? As we know the virus is airborne, why are we not addressing school ventilation on a priority basis? With two more weeks prior to the start of schools across the country, why are we not mandating everyone who poses a risk to our children to get vaccinated or tested? The effectiveness of asking nicely or encouraging people to do the right thing has plateaued and the health of our children is on the line.

Critical care for children is limited and only available in major centres and many of our resources are maxed out. Medivac is complex and resources are limited. I have personally spent many long nights waiting bedside to move a critically ill child from the north to a pediatric ICU in an urban centre. What makes us think this will get any easier?

As we look at the next two weeks, we have the solutions that we could apply today that could help avoid the worst-case scenario. We need to increase the number of fully vaccinated Canadians with all the levers we have and the lessons we’ve learned. Let’s reinstate masks indoors. Time to get the ventilation inside schools done properly. Nothing should be off the table.

When it comes to this pandemic, let’s remind ourselves how dangerously close we came to a health system collapse. This variant is more contagious and aggressive and we are still learning about the long-haul effects. Political strategy and indecision could become the key determinants on how we will ride this new wave.

Preventable death and disability are not acceptable consequences. As the denominator of children with COVID increases, so will the adverse outcomes. It’s simple math.

And those who could pay the biggest price will be our children. The time is now to step up and be the adults.

Dr. Katharine Smart, CMA President-elect

This op-ed appeared in The Globe & Mail on August 16, 2021

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