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COVID Crisis Post 32: Essential Workers FAIL & Kids.


Sometimes it seems pointless to try and educate others on the importance of social distancing and the seriousness of this pandemic.


Such as seeing dozens upon dozens of people waiting for the 7 train, many who I am sure were not essential workers. Or learning today that Florida is allowing beaches to reopen but with "social distancing measures" in place even though infection rates are still on the rise ๐Ÿ™„๐Ÿคฆ๐Ÿฝโ€โ™‚๏ธ.


But when you realize those who should be doing the educating and setting the example are hypocrites themselves, well then, it really seems pointless.


On my way to work yesterday, I witnessed a large gathering of the NY police department, fire department, and ambulances outside of a hospital. I found out later it is organized on a daily basis to applaud those healthcare workers on the frontline during the COVID-19 crisis. The gesture is obviously very sweet.


But the execution was pathetic. If the goal as healthcare professionals and safety personnel is to model what we expect of our fellow citizens, they failed miserably.


There were police officers and members of the fire department within 6 feet of one another not wearing masks. You had DOZENS of healthcare personnel who gathered in MASSIVE groups taking pictures and videos of the spectacle. There were even some who were not wearing masks.


This was an epic fail.


I understand when we work in the hospital, it is almost impossible to keep our distance because we are in such restricted quarters dealing with many patients. We share that risk together due to our profession.


But when we fail as healthcare providers to set an example for others in such a public setting, we are doing a massive public disservice. And those individuals should not get to complain when others do not follow suit. Applause is nice, but these sorts of demonstrations greatly diminish what we are trying to accomplish.


It is no different than people congregating in public in front of capitals to express their dissatisfaction with quarantine measures because the end result is the same.


End rant.


On a kinder note, I miss taking care of kids.


Do not get me wrong, I have really enjoyed my time in the ICU. It has been a great challenge, and I have even considered doing a fellowship in it in the future (still to be determined). But taking care of children warms my โค.


Kids were mentioned early on during the COVID-19 crisis but have since fallen to the wayside since they did not seem to be a significant proportion of those succumbing to serious illness, which has been true.


But I do not want to minimize those children who HAVE fallen significantly ill.


There have been a small handful of deaths around the world in children likely related to COVID-19. And it seems children aged 1 and younger tend to have more severe disease compared to their older counterparts. This is likely due to an immature immune system that puts them more at risk for significant respiratory illness in general, and leads to a greater rate of hospitalization as a result.


A story recently described a 22 month old toddler in Michigan and his 4 month old brother, both previously healthy, who both eventually tested positive for COVID-19. The 22 month old spiked a fever as high as 107 (!!!) degrees and was hospitalized for some time, and when it was deemed he was no longer in danger, he was discharged home. But he is still struggling with fevers at home, along with his baby brother who has not needed hospitalization at this point.


So please, watch after your kids. Do not put them at unnecessary risk. It is always hard to see any loved one get ill, but a child is especially heartbreaking.


There have been multiple theories discussed in the past for why children seem to have a milder course of illness or result in being asymptomatic carriers for COVID-19 (SARS-CoV-2), many that contradict one another in regards to their immune responses, the role of the ACE2 receptor, etc.


But one theory which still continues to be considered very plausible is children's exposure to multiple different types of coronaviruses could offer a degree of cross-immunity. Now, this theory is not novel, and it has been discussed ad nauseam anytime there is a discussion about the differences between children and adults.


The common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, such as the common cold.

229E and NL63 are both alphacoronaviruses, whereas OC43, HKU1, SARS-CoV (SARS), and SARS-CoV-2 (COVID-19) are all betacoronaviruses. Those in the same genus share more similar characteristics.


I was speaking with one of my pediatric colleagues about this recently. And I have been wondering, as a result, how many of us who are relatively young and healthy (lower-risk cohort) and work with children on a regular basis, or know someone who fits this description, if they have become ill with COVID-19. Because I do not.


*BIG KNOCK ON WOOD* - I have not been sick, nor know anyone who has become sick who fits the above description. No one in my entire pediatric anesthesia team has become ill. And given many of us are working with known COVID-19 positive patients and have been likely exposed to asymptomatic patients, children or adults, this is surprising.


When I first started taking care of children, I used to get sick periodically as would be expected of most people during cold and flu season. But over the years, this has decreased dramatically to the point of where if I get sick at all, it is a surprise.


I am curious, from an anecdotal perspective, if this is something others have noticed as well. If teachers, pediatric healthcare professionals, day care staff, etc, were shown to make up a smaller proportion of those infected with COVID-19 than what would be expected for their respective age/co-morbidities group, it would lend support to the theory of cross-immunity since we should also be able to develop the same cross-immunity as a result.


This seems worthy of thought, at least in my tired post-overnight ICU shift mind. And if it is not worthy, then apologies.


But at least Ralph Wiggum would be proud.


#covid19 #nyc


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