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Back-to-School in a Surge: Tips for Parents

Prakash Chandran (Host): This UAMS Health Talk COVID-19 podcast was recorded on August 16th, 2021. With the new school season starting soon, and the Delta variant fueling the most recent surge of COVID hospitalizations in Arkansas, what should parents consider if their children will attend school in person? This is UAMS Health Talk, the podcast from the University of Arkansas for Medical Sciences.

And today we'll be talking with Dr. Robert Hopkins, a Professor of Internal Medicine and Pediatrics at University of Arkansas for Medical Sciences. My name is Prakash Chandran and Dr. Hopkins, it's really great to have you here today. Many schools in Arkansas, aren't going to be requiring masks. So, what exactly can a parent do to help their child keep safe if a brick and mortar school is their only option?

Robert Hopkins, MD (Guest): Well Prakash, thank you for that question. And I'm happy to be here with our audience. I think the first thing that's important for us to recognize is that our kids that are 12 and older have the opportunity to be vaccinated. If at all possible, any of those kids 12 and older should be vaccinated to reduce their risk for COVID-19. And when I think about COVID prevention, I think about layers of protection and that vaccine is probably the thickest layer we can use. Short of that, I think it's important that all of our kids going to schools, need to be wearing masks, they need to have a mask that covers them from the bridge of their nose over their chin, and they need to be comfortable wearing those masks.

So hopefully we've been practicing those mask wearing skills, you know, through the last several months of the summer, if we didn't get good at it in the last school year and then lots of good hand-washing and other good hygiene techniques.

Host: Yeah, that makes a lot of sense. And just specifically on this Delta variant, do we have any more information about how it spreads in a younger population or how severely it can affect children?

Dr. Hopkins: Well, Delta does spread much more rapidly than the traditional forms of COVID and some of the earlier variants that we've seen. In fact, we've got some data that shows that even those that have been vaccinated can spread Delta, because they do develop enough of the virus in their nose and throat to do so. And unfortunately, over this last six or eight weeks, we've seen an increasing rate of children and adolescents admitted to the hospital with COVID-19 related symptoms. And so we at least have an indication that Delta is more serious in kids than some of the earlier variants.

Host: Now Dr. Hopkins, what would you say to a parent who might be hesitant about getting their child vaccinated? You know, this is something that I have heard some hesitancy about for a while now saying that, oh, you know, it doesn't really affect kids as severely, so why should I get my child vaccinated? What might you say to them?

Dr. Hopkins: Well, Delta changes the game a bit, you know. COVID-19 can cause serious illness in kids. It can put some kids in the hospital. It can lead to, and in a number of kids, a serious condition, we call multi inflammatory syndrome. And unfortunately it can also cause persistent symptoms. What we often hear people talk of as long COVID in kids much like it can in adults. So, there's that direct protection that we get from vaccine that we don't have if you're not vaccinated. Second thing is we know that COVID-19 is easily spread from children to others. And so, I think it's important to think about that factor. And then finally we know that our vaccines are both safe and effective, primarily for prevention of severe disease, but also reduce their likelihood of transmitting COVID.

And so, for all of those reasons, I would encourage people to vaccinate their 12 and up kids. I can tell people that you know, I'm not just talking the talk, we have vaccinated our two older children and my daughter who's under 12 will be vaccinated as soon as she's able to be vaccinated.

Host: Right. Yeah, that's definitely reassuring to hear. I have also heard from some parents they're be concerned about the side effect profile. You know, there's sometimes side effects that adults experience that they worry might be more severe with their child as they get them vaccinated. What might you say to that?

Dr. Hopkins: Well, it's not uncommon for anyone following a vaccination, a child, an adolescent, or an adult to get a sore arm, to be tired for a day or two after the vaccination, to have some fever, to have potentially some headache. And so those are not uncommon symptoms in kids and adolescents, as they are in adults. The thing that people can recognize is if your health condition allows you to do so, there's nothing wrong with taking Tylenol or ibuprofen or naproxin, over the counter medications we commonly use for fever and achiness that can help with those symptoms. And so minimize the impact of that on their kids.

Host: Okay. You know, I've also heard that vaccinating more adults can actually help with children as well. Is that something that you can speak to?

Dr. Hopkins: Absolutely. You know, the more of our population that's vaccinated, the better level of protection we provide, not only to those of us that have had the vaccine, but also we reduce the likelihood of transmission to those that have not been vaccinated or that are not going to get optimal benefit from vaccination. So our kids that are too young to get vaccinated, our adults who may have immune suppression and not get as good a level of protection from the vaccine. They get secondary benefit if we get a high enough proportion of our population vaccinated.

Host: And just regarding the vaccine itself, you know, because we now are experiencing this Delta variant and there's kind of talk out there about adults getting boosters. What can parents, or what might parents expect for their child? Is this one out of many vaccinations that they'll have to get for them?

Dr. Hopkins: Well, there's certainly that possibility. Right now, we are starting to give a third dose of vaccine to our adults and our kids down to 12 that have severe immune suppression because those folks don't mount as good an immune response to the COVID-19 vaccine. Much like they don't respond as well to other vaccines. It is possible that others are going to need additional doses. At this point, the data is that kids 12 to 15, even on up to 18 that are vaccinated, get actually a more robust response to the vaccine than older adolescents and adults do. So, we're less likely to have to worry about boosters in those kids than we are in those of us who are a few years older shall we say.

Host: Right. You know, one of the other things I wanted to cover is just kind of how we return back to school in a healthy way. You know, I know certainly for adults after they've gotten vaccinated, some of us have felt almost invincible. Like, hey, you know, I'm vaccinated, no problem. Let's return to life as normal. And I imagine that for children, it's the same way. THey might go back to playing with their friends, you know, touching surfaces and doing all of the things that they were used to doing. So, what advice might a parent give their child just around good health practices as they return to school?

Dr. Hopkins: You know, as I mentioned earlier, you do have a layer of protection when you're vaccinated, but unfortunately, that layer is not a hundred percent. Particularly in light of this Delta variant, we've got a very transmissible virus. And so I encourage people that are vaccinated, just like I encourage those that are not vaccinated, to wear their mask when they're around others. To try to maintain that social distance, to give additional layers of protection. We don't want anyone to get COVID-19 that we could prevent it. And so vaccination, masks, social distancing, all of those practices are important for all of us, particularly while we're in a situation of a highly transmissible variant and lots of disease in our communities.

Host: And just one final question, just regarding maybe families at home with a potentially a more at risk or elderly family member if they're sending their child to school; and their child is vaccinated, but they're obviously still potentially getting exposed. Do you have any best practice ways around how that child might interact with that family member when they return home?

Dr. Hopkins: That's a really challenging situation. I think it's probably good advice in those settings for when that young person comes back in the house for them to go and do a good hand and face wash when they come in, let's take that soiled mask and either throw it in the wash if it's a cloth mask. Or throw it away, if it's a paper mask. Let's do everything we can to avoid bringing something home to that family member. It's also important that if you have any symptoms related to potentially a respiratory infection, whether it be a stuffy nose or a cough or a fever, you need to get tested and you need to stay in isolation until you get the results of that test. So that we know that you don't have COVID before you're around others, particularly around that immune compromised member of your family.

Host: Yeah. So, Dr. Hopkins, you mentioned the importance of getting tested, especially if you are feeling some of these symptoms. What's the testing situation like these days and how can we ensure that our children can get tested quickly and effectively?

Dr. Hopkins: So, I think there are a couple of points that are important for us to think about. Number one, if you have any symptoms of a respiratory illness, stuffy nose, runny nose, cough, fever, achiness. It's really important that you get tested. For those symptoms, you also need to do what you normally would do. Contact your healthcare provider, use symptomatic measures, but you need to stay isolated until you get the results of that test so that we know that you're not carrying COVID.

Similarly, if you're exposed to somebody, it's important that you stay isolated and generally the advice of the CDC is you should be tested three to five days after that exposure and need to stay in isolation until we know the results of your COVID test.

Host: Yeah, that makes a lot of sense. So, you know, you have obviously experienced and seen a lot of people that have had COVID-19 and potentially helped them through it. What's one piece of advice that you would really like to leave parents with as they listen, or as we end this conversation?

Dr. Hopkins: We've got to all be pulling together in this battle against COVID-19. I think it's important that we encourage anyone who can be vaccinated to be vaccinated. I think it's important for us as parents and family members to ensure that we put a cocoon of protection around our kids. We help those kids to understand why masks are important. We help them to understand why maintaining that social distance is important. We keep demonstrating as well as talking about using hand-washing techniques. All of those pieces are parts of our layers of protection that protect us, that protect our families and protect our communities.

If we all are putting those things in place, we're all going to be helping fight this disease and hoping to get back to a more normal existence in the future.

Host: Well, Dr. Hopkins, I think that is the perfect place to end. Thank you so much for your time.

Dr. Hopkins: Certainly it's been a pleasure speaking with you.

Host: That was Dr. Robert Hopkins, a Professor of Internal Medicine and Pediatrics at University of Arkansas for Medical Sciences. Thanks for checking out this episode of UAMS Health Talk. For more information on this topic and to access the resources mentioned, please visit uamshealth.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

My name is Prakash Chandran. Thanks again for listening and we'll talk next time.