One of the consistent mercies of the SARS-CoV-2 “covid-19 pandemic,” even at its most virulent initial stages, has been the paucity of serious disease in children generally, and healthy children, universally. Covid-19 always was and remains a very highly age– and comorbid risk-stratified disease that targets the extremely frail elderly—especially those in congregate care—and the otherwise middle-aged to elderly with multiple (for example, ≥ 6!), severe, chronic comorbidities.
For the vast preponderance of the world’s population, and workforce, i.e., the ~94 percent under age 70-years-old, we now know that the most aggressive early variants, such as the Wuhan, Alpha, and Delta strains, conferred a very modest infection fatality ratio (IFR; covid-19 deaths/total covid-19 infections) of 0.1 percent, or 1 per 1,000 infections. This seasonal influenza-like IFR for those < 70, overall, dropped precipitously further in the pediatric age range (0-19-years-old) to 0.0003 percent, or 1 in 333,333. Such unalarming IFRs among those < 70, especially children, for the early SARS-CoV-2 variants, have been reduced by at least 3-fold more (so 0.1 percent/3; 0.0003 percent/3!) since the advent of the Omicron wave in early 2022, and its perhaps even milder related subvariants, that are continuing to emerge through the present.
During 3+ years, including the period when the most virulent early SARS-CoV-2 strains were predominant, through the Omicron wave, and till now, not a single pediatric death due to covid-19, has been recorded in Rhode Island. This contrasts starkly with the three HINI influenza (swine flu) pediatric pneumonia deaths that accrued in a single flu season, during the 2009-2010 swine flu pandemic, mirroring recent national US pediatric influenza death trends. Comparative US pediatric influenza vs. SARS-CoV-2 mortality data since 2009, underscore how both pandemic, and bad seasonal influenza outbreaks—with which we cope, appositely, minus hysteria—pose a greater mortality risk to children, than SARS-CoV-2.
We have also learned that SARS-CoV-2 transmission, like influenza transmission, is driven by persons with symptomatic infections. Both SARS-CoV-2 contact tracing studies, and an elegant experimental design tracking viral emissions from deliberately infected healthy subjects, just published in the Lancet, have reaffirmed this observation. Moreover, regardless of mode of transmission, it is also established that children did not “drive” the SARS-CoV-2 pandemic.
Complementing these irrefragable SARS-CoV-2 mortality and transmission data, a century of uniform public health evidence, bolstered over the past four decades by randomized, controlled trial findings, demonstrates that community masking (with N95 masks, as well) does not prevent respiratory virus infections (influenza, SARS-CoV-2, RSV, and others) in adults, or children.
Blithely ignoring each of these four fundamental, evidence-based considerations, on August 24, 2023, just prior to the reopening of Rhode Island public schools after summer recess, the Rhode Island Department of Health’s (RIDOH) Center for Covid-19 Epidemiology (CCE), distributed a memorandum (original pdf here; archived here) to public “School and District Leaders,” with the following cover email from CCE “team leader,” Julia Brida:
From: Brida, Julia (RIDOH-Contractor) <Julia.Brida.CTR@health.ri.gov>
Sent: Thursday, August 24, 2023 1:51 PM
Cc: COVID19Questions, RIDOH <RIDOH.COVID19Questions@health.ri.gov>
Subject: [EXTERNAL] Center for COVID-19 Epidemiology- Back to School Memo
We hope you have had a great summer! Ahead of the 2023-24 school year, the Rhode Island Department of Health Center for COVID-19 Epidemiology (CCE) wanted to share a memo to provide key updates and information regarding COVID-19. This includes:
COVID-19 key recommendations
Tracking COVID-19 in Rhode Island
COVID-19 operational updates
Outbreak reporting and support
Center for COVID-19 Epidemiology, Education Team
Senior PM | HCH Enterprises
Education Policy & Engagement Team Lead | Center for COVID-19 Epidemiology (CCE)
Division of Emergency Preparedness & Infectious Disease (EPID)
Rhode Island Department of Health (RIDOH)
The memo itself urged students and staff to: “[G]et tested when you have COVID-19 symptoms;” “If exposed to someone with COVID-19, monitor symptoms; test after day 5; and wear a mask through day 10;” and
“If you have COVID-19, isolate at home for 5 days and wear a mask through day 10.” A so-called “Covid-19 Operational Update” section of the memo declared, “Testing remains an important tool to detect infection and prevent COVID-19 spread.”
Glaringly absent from the memo (archived here) was any unambiguous statement that these recommendations were not compulsory for students (and their parents), staff, or administration, and non-compliance with them would not preclude an individual’s school attendance, limit their school activities, or affect school district funding.
This current sorry situation, vis-à-vis “covid public health policy” for schools, continues the unbroken thread of Lysenkoist mismanagement which knits together Rhode Island’s response since children returned, gingerly, in part, to “in-class learning” during September, 2020.
RIDOH and the rest of Rhode Island’s “covid brain trust” have always enacted uncritically the policies hectored at the public by national covid leadership figures, such as former “Covid-19 Response Coordinator,” Dr. Deborah Birx. Dr. Birx was fêted at the University of Rhode Island in the fall of 2020, where she aggressively pushed mass, unselective covid testing because, “her main concern is (was) asymptomatic spread.” This misbegotten testing policy and the false construct of asymptomatic spread, were of course both rubber-stamped by RIDOH and its then generalissima, Dr. Nicole Alexander-Scott. Dr. Scott, as proof of her overzealous endorsement of the factitious mass testing/asymptomatic spread paradigm, had RIDOH issue an “early warning” asymptomatic press release, and a subsequent release crowing about the state’s completion of its “millionth covid-19 test.”
Nearly a year later, despite the well-established futility of community masking, generalissima Scott angrily remonstrated, “Masks work,” in response to a query by independent journalist, Pat Ford. Ford’s preamble to his question raised the issue of potential harms of masking to children, which Scott ignored.
RIDOH Covid-19 Medical Director (later RIDOH Acting Director), Dr. James McDonald lied under oath in Rhode Island Superior Court claiming three RI children had died “as a result of covid-19.” Still under oath, about a week afterward, Dr. McDonald was allowed to “correct” this act of perjury, and only then did he acknowledge indeed there had not been any primary cause of pediatric covid-19 deaths in Rhode Island. McDonald also conceded, candidly, during this latter testimony, that a 16-year-old male admitted to a Rhode Island Emergency Department with an ultimately fatal gunshot wound to the head, who as part of his admission testing, coincidentally “tested positive” for covid-19, would be designated a “covid-19 death,” by RIDOH recording methods, since “it meets the definition of the CDC.”
At a subsequent deposition, as Acting RIDOH Director, Dr. McDonald was questioned about a comprehensive Pediatric Infectious Disease Journal review—a journal that he claimed to be familiar with as a pediatrician—entitled, “The Role of Children and Young People in the Transmission of SARS-CoV-2.” The review concluded,
“[T]here is no convincing evidence to date, 2 years into the pandemic, that children are key drivers of the pandemic.”
McDonald while acknowledging he had not read the review nevertheless, defiantly, if (tragi-)comically proclaimed, “I don’t agree with that assessment.” The good Dr. McDonald predictably could not supply any published data to support his dogmatic contention.
Last December (2022) RIDOH’s Dr. Philip Chan helped gin up hysteria over a Rhode Island so-called “tripledemic,” the alleged confluence of covid-19, influenza, and RSV infections, affecting children, in particular. Dr. Chan’s claim proved to be contrived. Hard data showed minimal primary pediatric covid-19 admissions, a significant fall outbreak of RSV, accompanied by RSV hospital admissions, and to a much lesser extent, pediatric influenza infections, and influenza hospital admissions, driving total pediatric respiratory viral hospitalizations.
Once again, a tocsin of potential looming calamity is already being sounded, now, for another so-called tripledemic this fall by the new director of the Centers for Disease Control and Prevention, Dr. Mandy Cohen. Sadly, if inevitably soon, such overwrought “tripledemic” messages, with a repeat inappropriate focus on pediatric covid-19, are almost certain to be echoed by Rhode Island’s disingenuous local RIDOH public health brain trust.
RIDOH’s newly minted “back to school” covid policy recommendations will have no ameliorative impact, especially in light of covid’s near nonexistent threat to children. But their socioeconomic effects might continue to wreak unnecessary havoc on our communities, albeit not as extreme as lockdowns. How do we Rhode Islanders extricate ourselves from this hysterical, anti-scientific “covid school policy” morass? There are general, evidence-based templates we can cite.
In Sweden, open primary schools with teachers providing face-to-face education, and no masking throughout the covid-19 pandemic, were associated with “No learning loss during the pandemic” vs. closed schools, “distance learning,” and mask mandates, in the US, yielding “historic learning setbacks for America’s children,” including Rhode Island schoolchildren. Furthermore, there were no covid-19 deaths among Swedish schoolchildren during the most virulent spring 2020 covid-19 wave, while teachers as a profession had similar or even lower serious covid-19 morbidity, vs. all other Swedish workers.
Dr. Tom Jefferson is an internationally recognized evidence-based medicine research scholar whose ongoing pooled analyses of community masking for the potential prevention of respiratory viral infections extend back almost two decades. Responding to Dr. Anthony Fauci’s recent incoherent, vacuous “critique” of Dr. Jefferson’s 2023 Cochrane Review reestablishing the lack of randomized, controlled trial evidence supporting community masking, Jefferson noted,
“So, Fauci is saying that masks work for individuals but not at a population level? That simply doesn’t make sense. And he says there are ‘other studies’…but what studies? He doesn’t name them so I cannot interpret his remarks without knowing what he is referring to. It might be that Fauci is relying on trash studies. Many of them are observational, some are cross-sectional, and some actually use modelling. That is not strong evidence. Once we excluded such low-quality studies from the review, we concluded there was no evidence that masks reduced transmission.”
We can also restate the evidence that mass asymptomatic testing, since SARS-CoV2 transmission is driven by symptomatic persons, are conjoined fool’s errands, made worse still if these practices are attached to punitive school policies.
Finally, concerned Rhode Island parents must demand, unequivocally, that RIDOH issue an immediate clarifying memo to “School and District Leaders.”
This memo must state plainly that none of RIDOH’s covid-19 policy recommendations are mandatory, and failure to implement or comply with them will not result in any children or staff being barred from school, or school activities, nor will such failure jeopardize any school or district funding.