We are now close to entering the third year of this COVID-19 pandemic. While I don't know too many people who aren't completely COVID-beleaguered/exhausted, I think that parents of young kids, health care workers (and those, like us, who are both) are truly close to the end of what we can reasonably handle. My sister-in-law Katherine recently sent me this article which nails it.
We have been shielding our kids from "normal" childhood things for almost two years now, avoiding socializing outside of school/work, travel (with few domestic exceptions), activities, birthday parties, and more. Iver had asked me, after he got vaccinated in November, whether he'd be able to attend a friend's future January birthday party, and I was so thrilled to say "Yes, that sounds great!" (all the while, still thinking, "but we'll just have to see..."
And now, almost predictably, there's Omicron.
We really are at a point where we feel that someone in our family contracting COVID in the near future is probably inevitable, despite our best precautions and luck in having dodged it so far. We are trying to walk a very fine line between freaking out too much, and not enough, "letting go" and still being "safe" (which is obviously relative). (Note: regarding the birthday party this week, we’re letting him go. It’s outdoors and he’ll mask when inside with other kids).
Many people (some of my health care worker friends included) have questioned the evidence behind the recent CDC guideline change to shortening isolation/quarantine periods for COVID (to five days with subsequently mask-wearing five more/quarantine to 10 days from 14 ideally with testing on day 5 after exposure if possible). Some people fear it will lead to irresponsible behavior and unnecessary exposure risks for others (some very vulnerable) in the community and was changed just to benefit corporations at the expense of workers. However, in this house, we rejoiced. In our three-quarters vaccinated household, we are not scared of the health risks of COVID, but we are terrified of the implications and threats of missed school/work, and we feel like we are missing out a lot on normal life because of it (while I, the introvert, don't miss large gatherings at all and am super comfortable with being socially restrictive, I grieve for my kids). We follow the news and are NYT subscribers (and I am about as liberal as they come, politically), but we do feel that the media is currently over-representing the absolute risk of COVID morbidity to individuals like ourselves and to most Americans.
I am hopeful that some day in the not-too-distant future with the tools of widespread immunity (acquired or natural), masks, and therapeutics, the period of isolation or quarantine will be eliminated altogether and that people in the world can and will accept the small (but real) risks of COVID like we have done for influenza, pneumonia, and other respiratory pathogens which, while they can cause severe illness and death, do not for the vast majority of the population. Lest you peg me for a COVID dismisser or minimizer (which, I assure you, I am not), there are common sense things that, in our opinion, would well balance the emotional risks of living with prolonged pandemic restrictions (which I have seen in my own patients and family) while still still avoiding excessive death/hospitalizations in this country (obviously, there's no way we can prevent them all). *Note: these our my personal views alone, and may differ from those of my organization or hospital system.*
I am FOR:
- Vaccination including boosters for all eligible, at the very first available opportunity (I’m also for vaccine mandates)
- Schools staying open (we still maintain that they should have never been closed even in 2020), even in light of variants (thankfully, Omicron seems to cause milder disease than previous COVID strains and COVID morbidity is rare, even in unvaccinated kids)
- Masks in indoor public places or at large gatherings for as long as public health officials feel is prudent (masks are a very minor inconvenience that doesn't impact my life in any meaningful way; in fact, sometimes I like the anonymity of wearing masks indoors while out and about in our small town! My kids are also extremely used to them at this point and masks are a small price to pay for being able to do "normal things")
- Keeping kids (and adults) home when they're sick or febrile or feeling too ill to work and masking for the immediate and 10-day period after clinical illness and avoiding socializing during this period "in case" COVID is present
- Clinic-based COVID testing and evaluation for patients who are moderately ill, and appropriate testing/management for patients requiring hospital care (which is mostly the unvaccinated; it’s really hard to do this with grace, empathy, and without “I told you so”s)
- The option of at-home COVID testing for anyone with mild or no symptoms or who wants to be tested prior to gathering socially with vulnerable people, including people who obstinately refuse to get vaccinated or who are elderly or immunosuppressed (with hope and with help from the federal government, these tests become more available/affordable than they have been for people in the US, compared to Europe and other countries, and offloading the burden on our medical providers, who are sick of doing COVID testing all day long instead of other also important clinical work that creates its own downstream health problems)
- People at high risk for severe illness (like the elderly, immunocompromised) avoiding socializing unmasked during COVID surges whenever possible
- Tracking hospitalization and death rates (especially in relation to local, state, and national ICU capacity)
I am AGAINST:
- Tracking and sounding the alarm about rising COVID case counts (which, by in large, are like "bad colds" [or less] for the majority of the population, especially those who have responsibly been vaccinated and boosted)
- Routine and regular "surveillance" for asymptomatic COVID testing for "peace of mind" of employees or community members (especially those who have refused vaccination). I have always opted out of this testing when the clinic has offered it. Iver was required to have weekly testing in his school's after-care program (as they mix kids from different grades) until he was vaccinated and we've suggested he opt now now that he's had his shots.
- Wasting resources/time/manpower performing clinic-based COVID testing (especially multiple rounds) for patients who refuse to be immunized and who call with non-severe COVID symptoms but with panic about what this means for them and their lives
- Closing classrooms, schools, offices, stores, and businesses or lockdowns to "reduce the spread" of COVID, especially to the eligible-but-still-unvaccinated (lack of staffing is it's own issue but I think you need to just make do the best you can, just as health care workers and other essential workers have done and continue to do throughout this whole pandemic)
- Isolation periods for employees and people who are well (yet incidentally COVID positive) and who faithfully wear well-fitting masks while at work and comply with avoiding socialization for the infectious period
- Barring masked birthing partners or restricting (by a capped/arbitrary number) doulas from supporting laboring patients or creating barriers to being present for one own child's birth (our hospital policy was currently changed just prior to the New Year to restrict visitors to only one [ideally vaccinated,] masked & presumably non-infectious partner to accompany the birthing patient; the operating room is sometimes even more strict). I have seen firsthand how negatively lack of emotional and labor support during pregnancy and around the time of birth affects birth routes, outcomes, and creates long-lasting trauma
- Mandatory masking outdoors
I know not all educators/doctors/public health professionals/people agree with all of the above; however, as Kelvin is finding with all his COVID clinic research and work, the CDC and public health guidelines and messaging are adapting exceptionally slow given the state, length, and other social costs of the pandemic, and it really is time for some more common sense. Something has to give, so life (for those of us, especially exhausted parents, who feel we've done all we can) can go on.
