Why are preschoolers subject to the strictest COVID rules in New York?


One morning last week, I was walking my son to pre-kindergarten when we spotted a friend of his walking towards us with his parents, ominously away from school. A solitary sparrow chirped in warning; a distant bell rang. A classmate had tested positive for covid-19. Per city protocol, the entire class was sent home to quarantine for at least five days. I am lucky to be able to work from home and at odd hours, because when you order little children to self-quarantine, you also send their parents to semi-isolation. In the days of idleness that followed, I alternated between frustration that my son wanted so much of my attention and guilt at being cooped up with such a distracted roommate; I almost wished he was more of a viewer. Most parents remember those claustrophobic cycles of the confined first spring of the pandemic. But most of them are long gone.

It was starting to feel like children under five in New York City were the last people under strict pandemic mandates. On the day my son was sent home to Barclays Center (capacity: approximately seventeen thousand), unvaccinated basketball player Kyrie Irving played his seventh home game since Mayor Eric Adams apologized athletes and performers of the city’s vaccination mandate. Masks and proof of vaccination were not required at Madison Square Garden (capacity: eighteen thousand), where the Rangers faced the Carolina Hurricanes. A mask would not have been required of me in the New Yorker offices, if I had entered. Mayor Adams was also in quarantine, have tested positive for covid-19 after a series of unmasked social engagements, including the Gridiron Club dinner in Washington, D.C., which turned out to be a superspreader event. On Monday, the mask mandate for US domestic flights and public transportation was struck by a federal judge appointed by Trump. (The Department of Justice plans to appeal the decision if the CDC decides a warrant is still needed.) Omicron subvariants continue to spread in New York and beyond, and, in the city’s public, private and charter schools, weekly totals of positive cases more than tripled in the month preceding April 9. Yet the era of covid vigilance is over, it seems – that is, unless you are medically vulnerable or too young for kindergarten.

In the New York City public school system, only pre-K and 3-K students are still subject “close contact” restrictions: if they are exposed to covid at school, they must self-quarantine even if they produce a negative test result. They are also the only remaining students who must wear masks at school – the mask mandate for older children ended on March 7. In kindergartens and private day care centres, the stricter rules also apply children over two years old and educators. The mask mandate has drawn a lot of grumbling and, recently, high-profile protests, and Mayor Adams seems eager to lift it — at one point he even set an April 4 expiration date to roll back. “I am totally at the mercy of my health team,” he said April 8. “They said we continue to watch the numbers. Once they’re comfortable giving me the orders, I can’t wait to do it.

I contacted the New York City Department of Health and Mental Hygiene, the agency that recommends covid policies to the Adams administration, hoping to understand why the stricter rules apply to the youngest children. Apparently, there is a simple explanation: the vast majority of them are not yet eligible for the vaccine, which is only authorized for children aged five and over. As a result, daycares, preschools and pre-K classrooms “have low baseline immunization rates compared to most other settings,” DOHMH press secretary Patrick Gallahue said in an email. . (Caregivers and educators in these settings should be fully immunized.) Children who are too young for the vaccine have runny noses and are desperate about personal boundaries and prone to chewing on their masks, although Gallahue was more diplomatic “Other tools available to mitigate the spread of covid-19 such as physical distancing and hand washing are difficult to implement in young children, making these tools less effective,” he wrote. He also pointed out that the city’s hospitalization rates for children four and under were slightly higher than those for other pediatric age groups.

These numbers are still extremely low: just over two percent for the week ending April 9. “Overall, this disease is not as severe in children as it is in adults,” Rick Malley, a pediatric infectious disease physician at Boston Children’s Hospital and a professor of pediatrics at Harvard Medical School, told me. “But you can understand why some people are a little concerned when the message goes to ‘covid is not dangerous for children”, because children have died from covid. As an infectious disease clinician, I’ve seen my share of children for whom that statement would seem ridiculous, given what they’re going through. Thirty-six children under the age of eighteen is dead of covid in New York since the start of the pandemic, including a four monthsa four yearsand one five years. A child dying of covid is rare, but the rarity is irrelevant to that child’s parents, siblings, teachers, and friends.

Lingering effects – which is the terminology that Malley prefers to “long covid”—are also much rarer in children than in adults. But, he said, “it’s important in medicine, especially with a new disease, to be a little humble and a little careful about how we communicate it.” He continued, “You try to balance the risk of covid-related illness and lingering effects in a child versus all the collateral damage of what we do: keeping them out of school, having to learn through a mask, the stress of not having childcare. He suggested the idea of ​​a “test to stay” strategy for exposed preschoolers – the same regimen that applies to New York City’s K-12 students, which relies on self -administration of moderately reliable rapid home tests and, at least in some schools, operates more or less on the honor system.

There has never been a consensus on covid protocols for very young children. Until recently, the CDC recommended indoor masking for anyone aged two and over in school settings, including older children who are vaccinated. The American Academy of Pediatrics recommends masking for “all people ages 2 and older when community-level risk is considered ‘high’.” But the World Health Organization do not recommend masks for children aged five and under at all, and mask mandates in some European Union countries, including France, Spain and Italy, To start up at six years old. In February, five scholars from Columbia University’s Mailman School of Public Health and Teachers College published a open letterco-signed by hundreds of medical professionals, arguing that scientific evidence did not support ending indoor mask mandates in schools.

In March and April, however, a nascent unmasking movement gained traction in New York. A parent group filed a complaint challenge the under-five mask mandate; a state Supreme Court judge overturned it, but the rule remained in place as the city appealed. Parents staged “Unmask Our Little Ones” gatherings in front of City Hall; has a, the children present chanted “Burn your mask!” and “See my smile!” In the Theater District, the day after Adams attended the covid– a riddled dinner at the Gridiron Club, shouted a group “Unmask our toddlers!” as he arrived for a performance of the musical ‘Paradise Square’. In another demonstration at the town hall, giant inflatable babies waddled with signs that read “NYC’s toddlers have been masked for half their lives” and “Toddlers have the lowest risk of Covid but the highest risk of developmental delays”.


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