How mask mandates, high vaccination rates could protect Quebec children from the delta variant
While pediatric hospitals fill up in parts of the U.S., Quebec's kids are headed back to school unmasked
In parts of the United States, particularly in areas where vaccination rates are low and public health measures are non-existent, hospitals are filling up with kids sick with COVID-19.
Now, with the delta variant quickly spreading in Quebec, parents here are preparing to send their children back to primary and high school with no masks required in class.
The decision, announced last week by Education Minister Jean-François Roberge, is worrying some medical experts.
"Masks did work at preventing transmission in previous waves," said Dr. Olivier Drouin, a pediatrician at Montreal's Sainte-Justine Hospital and a public health researcher.
"I think we should err on the side of caution: have kids start the year with masks[in class], and then remove them if we see we are going in the right direction."
Roberge said last week students would only be required to wear masks in common areas, and teachers will also not be required to wear masks if they can maintain a two-metre distance. Students will no longer need to stay in their classroom bubbles throughout the day.
The policy is subject to change, depending on the epidemiological situation. On Wednesday, Roberge said he has once again asked for advice from the province's public health officials.
Drouin said the provincial government should be doing everything it can to keep kids in school because it's such an important part of youth development. He said masks would help prevent the school-closing outbreaks that ultimately force students to learn from home.
Vaccinations prevent transmission
Drouin said the next step is to get every eligible person vaccinated.
"The lower vaccination rate, the more community transmission there is going to be," he said.
In Quebec, 85 per cent of the eligible population (age 12 and up) has received one dose of vaccine, and 74 per cent have received two doses. Among 12 to 17 year olds, 84 per cent have received a first dose, while 59 per cent have received two.
The number of hospitalizations has gone down drastically in areas where vaccination rates are high. In Quebec, the vast majority of people getting seriously ill these days are not adequately vaccinated.
Drouin said children's hospitals in Montreal are ready for a spike in pediatric patients, but noted this could slow emergency services even more.
"For parents, it's going to mean a very long waiting time. We only have two children's hospitals in the city," he said.
Health-care workers at those two hospitals are already under pressure, according to Dr. Nathalie Gaucher. She specializes in emergency pediatric medicine at Sainte-Justine.
"Staff are exhausted across the board," she said on Twitter Wednesday. "There are very few clinics that parents can consult with their children for viral symptoms, on top of the critically ill we already care for."
The pediatric EDs have been swamped for weeks. Staff are exhausted across the board. <br><br>There are very few clinics that parents can consult with their children for viral symptoms, on top of the critically ill we already care for. <a href="https://twitter.com/urgencehsj?ref_src=twsrc%5Etfw">@urgencehsj</a> <a href="https://twitter.com/ChuSteJustine?ref_src=twsrc%5Etfw">@ChuSteJustine</a> <a href="https://t.co/4QmhVP8HOT">https://t.co/4QmhVP8HOT</a>—@nat_gaucher
Adults should get vaccinated to protect kids, doctor says
Because they are still ineligible for vaccines, kids under 12 make up the largest group of unvaccinated people in the country, said Dr. Laura Sauvé, chair of the Canadian Paediatric Society's infectious diseases committee.
"Having the adults around them protected by vaccination will help protect kids who are too young to be vaccinated," said Sauvé.
In addition, Sauvé said, it's critical to keep up other public health measures, such as wearing masks indoors, especially where community transmission is high.
But as important as masks are, medical experts and scientists around the world agree that masking goes hand-in-hand with vaccination when it comes to protecting kids.
"The higher our community vaccination rates, the lower the burden of illness will be in children," said Dr. Jeff Burzynski, a pediatric intensive care physician at Winnipeg's Children's Hospital.
Delta's rapid transmission worries expert
Dr. Earl Rubin, director of pediatric infectious diseases at the Montreal Children's Hospital, said the delta variant appears to transmit among unvaccinated people as fast as chicken pox.
Somebody with chicken pox can infect six to eight people who do not have immunity, he said. That's something to watch for once delta infiltrates Quebec schools, Rubin said.
He suspects the delta variant will be the predominant strain in September.
While high school students are largely vaccinated, Rubin said he is concerned that sending young, unvaccinated students back to class without masks in class or bubbles will lead to entire schools being shut down.
While he hasn't seen compelling evidence that delta causes more severe symptoms, the issue is the transmissibility, he explained. The more people infected, the more patients require hospitalization.
It's still possible for people who are double vaccinated to catch and transmit the delta variant, but they are much less likely to get severely ill or die, he said.
The level of vaccination rates in Quebec will likely reduce the strain on the medical network, he said, but with kids still unvaccinated, "masking, especially at the elementary school level, is as important, if not more important than before."
Rubin said parents can still encourage their kids to wear masks regardless of the education minister's decrees, but masks are most effective when everybody wears them.
"My hope is that the minister will decide to be more proactive, thinking about this and the delta variant, rather than reactive," said Rubin.
with files from Sabrina Jonas