How COVID-19 is affecting the physical-mental health of children: pediatric ER chief

Dr. Christopher Sulowski, interim chief of the pediatric emergency department at McMaster Children's Hospital in Hamilton, spoke with the CBC's Conrad Collaco about how COVID-19 is affecting children, and why it's still safe and important to get emergency care ifrequired.

You can read an edited and abridged transcript below, or hit play above and watch the entire interview.

Dr. Christopher Sulowski, interim chief of the pediatric emergency department atMcMaster Children's Hospital

The American Academy of Pediatrics sayschildren represented 22.4 per centof new cases reported in theweek endedApril 29. Why are we seeing so many more kids with COVID-19 right now?

It's good that people are getting vaccinated. And it's going to get us out of this.As we vaccinate the older generation first, the younger ones will make up a larger percentage of those that are positive or newly positive.

What does COVID look like for young people?

For the majority of the patients we're seeing in the McMaster Children's E.R., COVID looks like your common cold. Looks like a fever. Looks like a runny nose. There's often some vomiting or diarrhea, maybe a bit of a cough. In most cases, it's not very severe. We look at every child, and examine them and make sure of that. And that's one of our main jobs right now. And in many of those, kids are getting swabbed and ultimately going home.

More childrenare coming in with stress-related symptoms

Are there any other differences between how young people and older people are responding to the virus?

We hope that families leave the pediatric ERfeeling a little bit more reassured, a little bit more empowered, and certainly feel like we've done our best to help them and their families and their children through this pandemic and difficult time.

We have a comment coming in to us from Ruth over email. She says, 'My daughter and her husband are both in their 30s. They've decided not to get the vaccine. They have a young daughter who is one year and three months old. It's very upsetting that they would take this risk. Her husband goes into work and has travelled to Texas twice since the pandemic started. They do isolate and are being careful. How can I convince them to get the vaccine?'What advice would you have for Ruth?

So that is a tough question and it is ultimately a personal choice. We encourage families to reach out and get some information about vaccines, get some reputable information. I know that at the hospital we've had a great uptake of vaccines. And I believe that all of our staff are vaccinated or certainly we've had the opportunity to get a vaccine. And we definitely encourage that. I think reaching out to your primary-care physician, if they're in their thirties, it would probably be their family doctor and talking about their individual concerns that the vaccine hesitancy is, as we call it, or I guess refusal, if that's the decision that they've made. But I know that the Canadian Paediatric Society has done a lot to empower pediatricians and physicians to address vaccine hesitancy and to try and explore what's behind that personal decision. I can imagine it's not one that they took lightly. We would love for them to reconsider. But everyone makes that decision for themselves.

COVID-19 and babies

Back to social media, where we have a question from Brenin, who says, 'If I get the vaccine, can I still pass COVID onto my baby?'A few people are asking that question, and I'm sure there are a lot of people who are concerned about that. What do you say?

We're still asking everyone, while we learn more about what it means to be vaccinated and transmission, to keep isolating, to keep staying in your bubbles, to keep wearing your masks when you're in public. So, I'm sure that time is coming. I wish I knew when that would be. I'm sure we're all looking forward to that date. So if the question is, 'Am I vaccinated, could I still pass it to my child?' I think at this point there's no clear answer to that. But I would not say that it's an impossible scenario. So keep being careful, and keep wearing your mask, and keep doing and following what public health is asking us all to do,as difficult and as stressful and isolating as it is.

And Jessica has a child with severe asthma that lands him in the ICU. She asks, 'Should I be more concerned about exposure because of this?'

COVID-19 precautions at emergency

Now, Jessica might be one of those parents who's a little concerned about bringing her child to emergency at this time. What would you say to parents who are concerned about having their kids exposed to COVID while visiting emergency? Should we be worried about bringing the kids in?

I think that's a great question. And we've done a lot at McMaster Children's Hospital right from the moment you come through the front doors, when you're met with screeners, whether it's in the parking garage or the front door. We've got universal masking and eye protection for all of our physicians. You'll see a lot more Plexiglasaround. And we've changed the flow of patients through the hospital. And really we're doing a lot of virtual visits. So you'll actually see fewer families and children at the hospital. But if you're worried about your child, we do encourage you to come to the pediatric ER. I think it's important that families know that we've got extra screening questions from the first individuals that you meetat our front door in the ER. Our clerks are asking extra questions. If you're COVID positive or high risk for having COVID because of an exposure, we try to triage you differently and move you into a room as quickly as possible to limit exposure to other families. Our waiting room looks very differentseating has been spread out.

A lot of people are wondering when a vaccine for children might be ready. And I know that the CEO of Pfizer has suggested they're planning, at the very least, for September in time for the beginning of school. What do we know right now about when that vaccine might be ready?

I don't think I have any extra information on that. I think we're all waiting. There are trials going on with younger and younger kids in those trials. And we're all very optimistic, including myself, that we can get the vaccine to kids before that fall start date. But I don't have any information about that other than to say that when it's approved, I'll definitely get my kids vaccinated. And we just have to wait for those proper tests and trials to be completed and show that they're safe.

(Ed. note:Health Canada announced on Wednesday May 5 that it had cleared the Pfizer-BioNTech COVID-19 vaccine for use in people as young as 12 years old.)

What happens in September?

What would you think we need to make sure happens before September if we are to hope that our kids can get back in front of teachers and beside their fellow students and friends?

Well, I think certainly getting teachers vaccinated, which I know is happening already, is a great big step, and that's already happening. So that's great. Whether or not they go back to school with or without masks, I don't know. I know my kids, fortunately or unfortunately, did get used to it and still enjoyed seeing their friends. And after a while, the masks just kind of became second nature. At least they were there and socializing. So will the masks still be there in September? I really don't know. That's a tough question to predict. And I'm not really sure what percentage of children, what percentage of herd immunity is required to be safe.

We certainly have seen an increase in eating disorders. We've seen an increase in visits for patients with mental health concerns. They were at school a few months ago with masks on and smaller classes. Maybe that is the answer to helping with those issues that we're seeing right now already in the pediatric ER. What would it take to go back to our normal, larger classes without masks? I really don't know. But certainly getting kids vaccinated would be a huge step in that direction.