On June 14, 2021, this update reported that the USA had reached the grim milestone of 600,000 Americans dead. Over the last three and a half months we have reached 715,000 US souls lost. That number is greater than the populations of the cities of Cincinnati and Cleveland combined. The vast majority of the deaths over the summer have been due to the Delta variant and did not have to happen, because we have safe and effective vaccines. The good news is that cases, hospitalizations, and deaths are all falling. Over the last seven days cases are rising in only seven states. There has been a 44% decline in daily US cases last week when compared to the peak average daily cases in mid-September. The daily average last week was still 95,917 cases. There is also a 35% drop in Americans hospitalized with Covid-19 currently when compared to a month ago.
Although cases are decreasing, the demographics of those infected, hospitalized and dying continues to evolve toward younger individuals. One constant characteristic remains, those with severe disease and dying have yet to be vaccinated. The Delta variant has resulted in the summer rise of not only Covid-19 cases but also the MIS-C, Multisystem Inflammatory Syndrome in Children. Although most kids recover from this ailment, it can be fatal and there can be significant involvement of the heart, lungs, kidneys, brain, and digestive system. Unfortunately, the trend of Covid-19 having a disproportionate affect on people of color continues. The CDC reports 5,217 MIS-C cases and forty-six MIS-C deaths, 61% of which are in African American and Hispanic/Latino children. The majority of the children affected by MIS-C are in the 6–11-year-old age group. MIS-C cases doubled in July and August of this year. Although pre-Delta, when MIS-C developed, its average onset was six weeks after Covid-19. Youngsters who develop MIS-C after a Delta variant infection suffer the onset at roughly two weeks after the Delta infection. Recall that no COVID-19 vaccine has been authorized for this age group. Additionally, over 1.5 million children worldwide have experienced significant mental, emotional, and social health issues as a result of being left without a primary caregiver (parent, custodial grandparent, or other custodial relative) who died from COVID-19. We can best prevent additional children from joining these unfortunate ranks by eligible adolescents and adult getting their COVID-19 vaccinations!
For those children ages 5-11 years old there is help on the horizon. Pfizer has requested FDA authorization for its vaccine in this age demographic, which consists of twenty-eight million children in America. That request will be taken into consideration by the appropriate FDA panel on Oct. 26th. The shots for these youngsters will probably be available in early November and the White House is urging states to gear up to administer these injections safely and efficiently. These young children need to be vaccinated, firstly, because when they are infected, they can spread the virus to vulnerable adults and the unvaccinated. Secondly, a small but significant enough number of infected children can become seriously ill or suffer from sequelae like the MIS-C, discussed above.
The authorization and eventual approval of COVID-19 vaccines for all children under 12 years old is likely. In the meantime, we can protect them and the entire population best by the sixty-eight million eligible unvaccinated Americans rolling up their sleeves. One of the tools in this process are the federal mandates previously detailed. Specific guidance for companies employing more than one hundred people is working its way through the Occupational Safety and Health Administration (OSHA). Many companies have issued their own rules for vaccination or frequent testing as condition for in-person work. Some are allowing remote work while others are declaring compliance as a condition for continued employment. Although mandates remain controversial, an analysis by The White House has shown that 20 percent of the companies, educational institutions, public sector agencies and health systems experienced increased vaccination rate when mandates were put into place. For example, United Airlines reports over a 99% vaccination rate after the implementation of a company vaccine mandate.
Please get vaccinated! It is our ticket to normalcy and our children’s path to growing up with less obstacles.
Clyde E. Henderson, MD
Cincinnati Medical Association