COVID-19 and Its Ever-Changing Mutations: Individuals, families and parents still struggle with difficult health choices

Written by By Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP Public Health Education Specialist at the Greenwich Department of Health

COVID-19 is largely a vaccine preventable disease. Yes, we have breakthrough cases, but rarely will the fully vaccinated become very ill, hospitalized, admitted into an ICU, or die.

There are caveats to that statement; those of advanced age or with underlying immune compromising conditions may be unable to create robust antibody response despite vaccination. These people may be unable to adequately ward off a viral attack but they will have significantly improved their odds of survival if they are fully vaccinated.

General Colin Powell’s death on October 18, 2021 was an unfortunate example of those few who succumb despite vaccination. He was fully vaccinated but he was of advanced age, had an immuno-compromising blood cancer, and Parkinson’s disease. To the contrary, over 99% of the very ill and those who have died have been our unvaccinated friends, neighbors and loved ones of all ages. A death from COVID today is beyond tragic, because it is largely needless. COVID-19 vaccines are now available to anyone 12 years of age and older. The vaccination of children from 5 to 12, and possibly even as young as 6-months, is just around the bend. Clinical trials are already well underway (CDC, 2021). When pre-teens and teens became vaccine-eligible this past May, that was a game changer in our fight to beat back COVID!

It enabled us to get closer to herd immunity. The virus will continue to infect our unvaccinated of all ages. Originally the pandemic took the lives of seniors and those with underlying health conditions. Today we are watching increasing numbers of adults, young adults, and infected children across the country, being hospitalized, placed in ICUs and pediatric ICUs, intubated, and succumbing to the ravages of COVID-19. Until May 2021 our children could not be vaccinated. That is no longer true. Originally about 15% of U.S. COVID cases were children; that number has been on the rise (Mayo Clinic, 9-21-21). Fortunately most children develop mild cases and some have no symptoms at all; but some become severely ill and some die. People of all ages are equally contagious to others around them. Sadly, the American Academy of Pediatrics and the Children’s Hospital Association have documented a recent 10% increase in reported cases (Oct. 2021). Many asymptomatic child cases undoubtedly go unreported because, as with adults, an asymptomatic person is not aware they are infected.

The USA has been notoriously under-tested from the start. We tested people who had symptoms, when we should have been testing everyone to break the spread of infection. It is important to know that all infected children are just as capable as adults of spreading the disease to others even if they have no symptoms at all.

As of eleven days ago, over 6 million children in the US were COVID-positive; more than 148,000 cases were added in the past week, and more than 750,000 children had joined that group during the last four weeks (American Academy of Pediatrics, 2021). Children with underlying genetic, neurologic, metabolic and congenital heart disease, as well as those with other health conditions are at higher risk for contracting COVID-19 than children without this extra burden. These other diseases include juvenile diabetes, asthma and other lung conditions, sickle cell disease, cancer, immunosuppressive disorders, as well as children on immunosuppressant medications. This group of conditions also includes many of the rare-diseases as well as childhood obesity. If your child or grandchild has one of these conditions, they are at high risk for contracting COVID-19 and for having a worse outcome if they do contract it. They would strongly benefit from being vaccinated.

The predominant strain of COVID-19 circulating today is not the same one that first infected our town and nation just a year and a half ago. Viruses notoriously change in small ways and in significant ways. Yes, we do have mutants among us, but they are mutant viruses. The viruses of great concern to us right now are COVID-19’s Delta virus, and this year’s seasonal flu. We are closely monitoring new and upcoming COVID variants which can be more highly contagious than Delta, and may be more vaccine resistant. These are the variants of interest (W.H.O.) which public health surveillance is monitoring. All variations of COVID-19 will continue to mutate for as long as they can find hosts to invade. Those hosts will be our unvaccinated loved ones, friends and neighbors, which unfortunately includes 100% of our children under 12 who are not yet eligible for vaccination, and those who are eligible but who have not been vaccinated. ( (CDC) (WHO).

Families and parents have difficult choices to make. Vaccines, masks, and social separation have been rejected by many for both valid and unfounded reasons. We are living in risky times and in mobile communities where a few additional cases can move us from a safe zone into a red zone. Greenwich is doing well, but all of Connecticut is not. Less than 70% of Greenwich is fully vaccinated. We all need facts and evidence-based scientific data to make wise choices. The problem is that we just don’t know what we don’t know, and public opinion is molded based on accurate and inaccurate information and messaging.

Not everyone, adult or child, has the same risk-burden. I urge you, when making these tough decisions that you look not only at your risk factors, but also at those of your loved ones, your immediate and extended local families, and your circle of friends. You or they may not be lucky enough to get a second chance if infected with COVID. Consider, too, all those others with whom we interact in the course of a day. Our decisions in regard to vaccines, masks, and social distancing do not just affect us alone. Exercising our individual rights can have dire impact for others who are at risk around us. While any one of us may or may not become ill or die, each of us can unwittingly transmit the virus to a classmate, a school employee, a store worker, a colleague, another at-risk loved one, or someone with whom you merely interact, without ever knowing we are ill. We do not know who around us is immune-compromised. High-risk people are everywhere. These people should have been vaccinated long ago, but it is not too late to do it now. Those who were may not have developed a full immune response.

Please don’t wait until you’re or your loved one is ill with COVID, as it is then often too late. Don’t rely on being young and healthy, “COVID doesn’t care”. If you are pregnant or a nursing mother you should get vaccinated (CDC). Pregnancy makes you a high-risk patient. Talk with your care provider, get your questions answered, and
schedule your vaccine.

The Greenwich Director of Health, Caroline Baisley, has been our State-appointed, credentialed and Designated Public Health Authority for forty years. She urges everyone to get vaccinated for both COVID-19 and seasonal flu; wear your masks and socially distance. We do not yet know what this flu season will bring. The next Greenwich Department of Health Flu Clinic is on 10-27-21 from 11 AM to 2 PM at the Greenwich Town Hall; pharmacies and many doctors’ offices can also vaccinate you against both viruses.