Glossary

• Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
• Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines. Variants that substantially increase harm are now listed by Greek letters, the most troublesome one now is Delta.

• Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
• SARS-CoV-2– the specific name of the new coronavirus
• COVID-19-the name of the illness that the new coronavirus is causing
• Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
• Epidemic– a sudden burst of an illness that comes and goes over a limited time
• Pandemic– an epidemic that bursts across the world not just one region
• Spreadability– how contagious is the disease, how many people will end up infected
• Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
• Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
• Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
• Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
• Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
• Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
• Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
• Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
• Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
• Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.
• Vaccine Terms
• Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
• Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
• mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
• mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
• Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

The Delta Children’s Epidemic

Readers of Real Answers, and nearly everyone, know that one of the tragic differences with the Delta variant of COVID is that it far more readily infects, spreads, and sickens children.

You will recall that Delta has 3 key differences from the original COVID:

1. Delta is far, far more contagious.  Some talk it being 2x more contagious, but in reality, if you are unimmunized, there is a very good chance you will COVID now from Delta, unless you take very strong precautions.
2. Delta can infect the immunized who can spread it, but who are vastly less likely to die from COVID than the unvaccinated.
3. Delta infects children who are then far more contagious than with the original COVID.

Together, these differences put all children under 12 years of age at risk from Delta, and they will remain at risk until they are immunized against COVID.

As long as our children under age 12 cannot be COVID vaccinated, the risk of large outbreaks in children, including the chance that some of our children would suffer severe infection, has hovered over all of us in our community here in NE Ohio, around Cleveland.

Initial trends suggested that our roughly 50% immunization rate just might keep our region from suffering a full deluge of Delta as seen in Southern states with immunization rates in the high 30%tiles.

But today, I am very grieved to share my impression that the Delta Children’s Epidemic appears to be threatening full force now right here in our communities.

The Worrisome Trends

There are a number of real numbers that indicate that we in NE Ohio will be seeing significant outbreaks of Delta COVID in all unimmunized children.  We do not yet know the scale that Delta will reach, and so of course we hope very fervently that it doesn’t rage too hotly.  Here are the trends:

1. The numbers of Delta cases in Ohio is accelerating ominously.  The key number is the # of people with COVID diagnosed each day per 100,000 in the state.  Remember, if that number is under 5, there is little transmission, that is where we were in May and June.   We get worried as that number rises from 10-20.  Ohio went from 10 to 20 from Aug 3-13.  That was enough to raise concern and that concern was shared.  But now we see the numbers really climbing.  We have gone from 20 to 43 from Aug 13-Sept 2.  But even more worrisome, that curve is turning vertical, looking more like the rate of climbs seen in the South last month.
2. Today we heard far, far more reports from families about actual outbreaks in their day care centers and schools than we ever have.  Even at the peaks of COVID in 2020, we never heard of major outbreaks in schools, some isolated cases, but no major outbreaks.  We heard of high school sports teams having major outbreaks, but not classrooms, even when students largely returned to in-person learning.  Today, we heard of one day care center with 6-8 confirmed cases of COVID, of many schools with many cases, and increasing numbers in the schools as well, from elementary to high schools.
3. Some days ago we learned that the number of children being admitted to a local, major medical center for COVID pediatric ICU has far exceeded the pace seen all last year.

The Setting for this Delta Children’s Epidemic

Tragically, in the context of this very real threat to all our unimmunized children comes these features of our current reality, each of which could be preventable, but there appears little indication those changes are about to happen soon:

1. There are too many unimmunized people 12 years old and older.  The choice of anyone 12 and up not to be immunized, is very frankly speaking, fueling this current Delta Children’s Epidemic.  The furious contagiousness of Delta means that if millions of people are not immunized, the virus will spread, and the virus will kill.  One look at two states will tell all.  Vermont is about 75% fully immunized, NYC is 75% fully immunized.  The Delta epidemic has been held to about 24 cases per 100,000 in both states as Ohio sails up beyond 40.  If NY and VT stay at 24, they may very well avoid the tragedies of a Delta Children’s Epidemic.  Ohio could have too, but chose not to.
2.  In the face of a far, far more contagious variant, that now can harm children, we all decided to let our guard down.  Across the US, 32 million unvaccinated children have been gathered into indoor rooms for many hours a day, 5 days a week, school.  And many schools have dropped precautions:
3. Many schools no longer require a child with COVID to be quarantined the full 10 days of symptoms.
4. Many schools no longer require everyone who has been within 6 feet of a known COVID infected child for 15 minutes to stay home in full quarantine.
5. Many schools let immunized contacts avoid quarantine all together even though we know the immunized can get COVID and spread it.
6. Many schools have dropped mask requirements.
7. Many schools have dropped social distancing.
8. There are no programs to offer rapid testing to all students daily before school to find out who is infected each day.

In fact, many schools consider a child quarantined the recommended interval after infection or contact to have an unexcused absence if the school does not have a policy to follow such quarantine recommendations.

The Danger

In the face of a wildly contagious COVID variant, that can infect and spread from the immunized, that spreads far better amongst children, the choice to not immunize, to drop safeguards, has created all the signs of a very serious, very dangerous Delta Children’s Epidemic.

That Epidemic is in full force across the United States now.  Fully 22% of all COVID cases in the US are now in children!  This is a staggering change from last year, staggering.

And the numbers and trends all suggest that this Delta Children’s Epidemic is here in our local communities right now.

The danger is that as the number of children with Delta COVID rise, the number who will get gravely ill and end up suffering a terrible time in the ICU will climb too.

The only good news is that as the number of cases of COVID in children rise, and the pediatric ICUs fill with COVID infected children, the number of children actually dying of COVID remains surprisingly small, but that could change.  As of August 26, 2021, a total of 425 children have died of COVID.  But it used to be about 10 deaths of children a week, the last two weeks reported showed 20 deaths a week, the number is increasing.

What to Do

First, Get Everyone You Can Immunized, TODAY. 

If our population can get fully COVID vaccinated that would clearly stall the Delta Children’s Epidemic.

So make sure everyone in your child’s home who can be, gets vaccinated, NOW.

Second, Do Everything in your Power to Keep the Virus from Spreading to Your Child(ren)

1. It is time to limit gatherings.  Stay at home as much as possible, avoid indoor gatherings all together.
2. If you do go out, wear a mask.
3. If you go to school, to wear a mask, find a way to rapid test before school if you can.
4. Observe good quarantine practice for contacts, and surely for the infected.  That means staying in quarantine a full 10 days after last contact with someone known to be infected.  And for the infected, staying out 10 days after start of symptoms, or after a positive test.
5. Move your school to mandate masks, to support good quarantine practice, to establish good ventilation, to help find paths to rapid testing before school days begin.

Bottom Lines:

1. It appears a very serious Delta Children’s Epidemic, raging across the US, is erupting here at home, in our neighborhoods.
2. We know that Delta is wildly contagious, infects the immunized and spreads from them, and infects children who spread it well now.
3. Just this week we are hearing reports of serious outbreaks in day care centers, schools in our area, and hospital trends are worrisome for children too.
4. This epidemic is very frightening for all our children, we are seeing real dangers of ICU level of illness in children.
5. The threat is real, is growing, so the time is NOW to take action to protect your children:

• Make sure all members of your household who can be COVID vaccinated gets vaccinated NOW, go to any drugstore and get vaccinated, NOW
• Wear a mask
• Re-think gatherings all together for now
• Make sure your school mandates masks, keeps social distancing intact, supports and enforces full quarantine practice for all infected, and all direct contacts.
• Begin to explore approaches to regular rapid COVID testing before school to identify those infected and contagious even if they have no symptoms.

My One Takeaway Sentence:

The tragic Delta Children’s Epidemic is in full force in the US, now appearing to arrive here, now is the time to act.

To All Our Health,
Dr. Arthur Lavin