Roundup: COVID

Over the past two years, I’ve written a lot about COVID (understatement). Unlike with pregnancy or parenting, much of this writing is relevant in the moment. COVID data moves fast, and updates on vaccination from January or August of 2021 are much less useful now. Rounding up all the COVID posts from this newsletter might be an interesting reflective journey, but most would not be action items. However: some of them remain quite relevant, especially with a bit of updating. So below is a collection of writing on several hot-button topics — vaccines, risks for kids, masks — including what I’ve covered before and a few updates. I’ll also talk through a couple of the more general decision-making posts that I believe are still relevant as we move through this pandemic phase. A few recommendations, first, for where to look outside this newsletter (or at least where I go) for COVID content: Case/death/hospitalization rates: New York Times Excellent science-based explainers on current COVID news (especially but not exclusively about kids): Your Local Epidemiologist Daily news roundup of what is going on with COVID and schools: COVID-19 Policy Update Data reporting from the U.K., which both seems to get COVID waves before we do and has much, much better reporting: John Burn-Murdoch at the Financial Times and Alasdair Munro I trust those can sustain you for the times when I’m looking at topics other than COVID. For now, let’s turn to vaccines. Vaccines For adults and adolescents in general: At this point, my guess is that most adult readers of this newsletter are either fully vaccinated or never will be. But if you’re still on the fence about a booster, this post from early December makes the case. Updates: Over the past two months, we’ve seen that boosters provide significant protection from Omicron, especially for older people. We’ve also learned that efficacy seems to wane after a few months. I think we’re likely to see a more universal push for a fourth dose for high-risk individuals. For kids 5-11: Here’s my original summary of the trial data. And here’s the late-December update on safety after millions of doses. Updates: Vaccination rates in this group remain fairly low — around a third, though with variation across locations in the U.S. — but the safety data is reassuring if you’re still contemplating. For kids under 5: You know vaccines are delayed, but if you missed the details, here’s the rundown from last week. Updates: Over the weekend, we got additional answers on what happened. It sounds like last Thursday, Pfizer submitted new data from the Omicron-wave time period that indicated that the vaccine was less effective at preventing symptomatic infection than it had hoped based on the Delta wave. These new results made the FDA less confident in doing a review without data from a third dose. Risks for kids Many months ago, I wrote about the comparison between unvaccinated kids and vaccinated adults. You can read that original piece, in The Atlantic, here. There were valid criticisms, but the underlying comparison was, if anything, conservative. David Leonhardt pointed that out with updated data this fall. I wrote more about the overall COVID risks to young children here. The underlying message in all of this is that the risks of COVID to young children — even unvaccinated young children — are on average very low. Updates: I field a lot of questions about immunocompromised children and about long COVID. To the former, it is absolutely correct that children who are immunocompromised are at higher risk of COVID, and other illnesses, than those who are not. For this group, even with vaccines, they remain at risk, and additional precautions (high-quality masking, avoiding high-risk areas) may be necessary. In terms of long COVID, increasingly we are seeing that high-quality studies suggest extremely low rates of long COVID in kids. Here’s a rundown on this, and here is probably the most comprehensive academic review. A key issue in reading these studies is to keep the focus on studies that include a control group. Since symptoms of long COVID are many, it’s important to include a control group to adjust for the base rate of things like runny nose or headache. There are other concerns about the risks of the pandemic to kids aside from COVID. Some of the concerns raised are real — like the test-score losses I’ve documented in my academic work here. Others are less well-supported in the data, like the scary but not well-done study out of the CDC on COVID in kids and diabetes risk. Updates: Not so much an update, but I wanted to flag one area where we are still working through the data, which is whether babies born during COVID are behind developmentally. I talked through and rejected the claims in at least one study on that (see here), but more have cropped up. For now, I’ll just say that the question deserves its own newsletter, which will be coming soon. Masks I have not written much about masks. There’s one post, here, on the possible downsides for children. I’ve also got a working paper on masking in schools, using data from the last school year. And just yesterday, I discussed (and dismissed) the most recent study of masking in California. Clearly, there is space for writing more about this, likely focused on our current moment, when mask mandates are coming down whether we like them or not. But until then, here’s some other reading: The value of one-way masking (i.e. your mask protects you) The Atlantic’s case against masks at school The AAP still thinks masking in schools is necessary Conclusion: This area is fraught! Decision-making and moving on Among the early posts in this newsletter was this one, on a five-step system for deciding what to do about grandparents and child care, way back in May 2020. The precise questions we have now may be different, but my argument is that the approach of framing a question, evaluating, and making a final decision is still very valuable. Indeed, that system is at the core of The Family Firm’s “Four Fs,” which I wrote more about here. When it comes specifically to thinking about decisions in the next phase of COVID, I’ve pulled out a few posts about moving on, here: When will COVID be over? From September. Suggestion: never, or when you decide. I think this post is even more true now than it was then — ultimately, as individuals we may have to actively decide when we are ready to move toward normalcy, accepting that it may be a challenge. Is it always going to be like this now? From December. Most relevant, I think, is the point that there is always going to be uncertainty, COVID or not, and you can still make plans. I had COVID. Am I done now? Late January. In a way, the same message. From an individual standpoint, vaccines are our ticket out. But we shouldn’t expect them to eliminate COVID.

This Post Is for Paid Readers Only