Alison writes:
Hi,
In the last hour two different work colleagues told me their kids had high fevers and are getting COVID-19 tests. I’m very scared and worried for them. I’ve been thinking for a few weeks already that the next 12 weeks are going to be full of thousands of children dying. Yet I’m still shocked it could get this close for me. (It re-highlights for me the privilege my circles of people have had since the pandemic was officially recognized as being in the US. I mean my grandmother all of a sudden had received a booster already. She doesn’t fall into any of the categories you listed as being in the 3rd shot EUA. On the one hand I’m personally grateful. On the other hand, I know she has better chances the faster we can get the entire world their shots.)
When I heard about my coworkers’ kids being tested I realized I didn’t know if monoclonal antibody treatment is approved for children under 12. Since normally I can share what I’ve heard from your clinical updates to help people I knew I needed to write to you immediately. I hope this question can make it into the weekly update that will be released on Saturday.
Are any of the monoclonal antibody treatments approved or in clinical trials for people that young?
Thank you for continuing to provide me with facts I can relay to help people. Most days it is all I can muster to do to be helpful regarding this virus personally and that keeps me going.
Alison
Geoff writes:
Dear Dr. Griffin,
Thank you so much for your clinical updates – they have been a fantastic resource as my colleagues and I have worked to implement best practices at Colgate University over the last year and a half. We instituted a vaccine mandate for all students and employees, and are currently at a 96% vaccination rate. However, we have had some students, both vaccinated and not vaccinated, test positive through our arrival surveillance testing process, though almost all of these individuals are asymptomatic (as we would expect in a young, vaccinated population). Nevertheless, these students have to isolate, and therefore miss class, based on their positive test, which is problematic as we do not have the same policies for instructors to provide remote options for classes, as we did last year. We are also more limited in our isolation space this year, and worry that we could run out of space, housing a bunch of asymptomatic students. Given the data that shows a rapid decrease in viral RNA levels, as well as in the ability to detect infectious virus, in vaccinated individuals following infection, it would seem reasonable to us to decrease the length of isolation time for vaccinated individuals, as they would be unlikely to be able to transmit virus past, say, 6 days post-positive test, instead of the full 10 days. Of course, we are going to continue to follow CDC/New York State DoH guidelines for isolation, but wonder if it would be reasonable to lobby these agencies for a reduced isolation time for vaccinated individuals. I would be very interested to hear your thoughts on this issue.
Thanks again,
Geoff
—
Colgate University
Associate Professor of Biology
Ingrid writes:
Dear Dr. Griffin,
Should individuals who are vaccinated and test positive for COVID take monoclonal antibodies?
Ingrid
Queens, NY
Dan writes:
Hello
I am a pediatric pulmonologist. I retired in 2016 after 36 years in pediatric medicine. I have been an advocate of asthma education in the school and at home since. I have been following your updates at TWIV for several months and appreciate your review of the literature. I also value your pediatric overviews as well. Since the pandemic began I have followed local data in San Antonio. As a private citizen I have been confused and do not understand why pediatric data is not reported similar to adult data. The impact on children has been understated from the beginning and still is under-reported. I have used my membership in the local medical society to ask the leadership to engage the local trauma region leadership to release pediatric data and trend it over time. It has been futile. Other pediatricians in the medical society have also questioned the limited information on children. My reasoning is that parents and pediatricians need to follow trending data, in real time, to identify concerning trends to convey these concerns to their parents and children. I was also boarded in Pediatric Critical Care early in my career. You mention that one point of data does not answer questions. I would evaluate trends over time in the PICU to identify stability, response to therapy and identify concerning trends. Like the parent’s discussion of her child in the PICU experience on this week’s episode (78). This is a tragedy that impacts the whole PICU equally as well as the parents. It also exposes the tragedy of serious illness and deaths in children that are preventable by universal vaccination and masking in addition to other mitigating protocols. Here in a city that is 66% Hispanic the serious consequences of this pandemic are concentrated in areas of high poverty and ethnicity. While I follow the AAP children’s data it does not motivate local interventions. The low numbers do not reflect the tragedy at the local level. As in asthma or flu I question any death in a child as preventable.
I only have followed intermittently. If this has been discussed in the past I would appreciate the number of the podcast.
Dan Deane MD