UVM Specialists Share the View from the Front Lines

Parental angst about Omicron has risen in step with the variant’s rapid spread across the country and rising numbers of children sick with Covid. Getting the right information is crucial to making the best-informed decisions for your family’s health. 

A recent livestream Q&A by the University of Vermont Health System helped shed some light on how Omicron is impacting Vermont’s largest hospital. Keith Robinson, M.D., a pediatric pulmonologist at UVM Children’s Hospital, and Gil Allen, chief of critical care at UVM Medical Center, shared their view from the front lines of intensive treatment.

As a lung specialist, Robinson sees patients in the Pediatric Intensive Care Unit (PICU) and as outpatients in his practice. From a pediatric standpoint, he said it was fortunate that “Covid has impacted adults more than children.” While that is still the case, public health officials have been sounding the alarm in recent days about the rapidly rising numbers of children being hospitalized for Covid.

Masking Against Omicron

“The best way to treat a disease is to prevent it,” Robinson said, quoting a medical tenet. And, he added, “wearing a mask is a great way to prevent Covid.” Importantly, he said it’s increasingly clear that not any mask will do. A close-fitting mask with a secure fit around the nose, cheeks and chin is essential. 

Procedure masks, such as the medical masks used in hospitals, or kid-sized surgical masks “are better than cloth,” he said. For the best protection in light of the current levels of community transmission, he recommends kids wear pediatric KN95 masks in public. UVM is now requiring KN95 masks for faculty and staff, he said. 

Robinson is a parent himself. “The emails we get as parents every night of our kids being close contacts at schools are exhausting. The best thing to do is rely on the things that work. It’s going back to primary prevention: making sure your kids are vaccinated and boosted. Making sure they’ve got those really nice tight-fitting procedure masks or KN95s. That will really reduce the amount of worry we have as parents. It’s not going to eliminate it. But it will reduce the amount of worry because you’ll know that you’ve done everything you can to protect them.”

CDC’s Updated Mask Guidance

The CDC updated its mask recommendations Jan. 14. The changes clarified that some masks and respirators offer higher levels of protection than others. The agency also recommended Americans wear “the most protective mask you can that fits well and that you will wear consistently.” Specifically, it said N95 or NIOSH-approved KN95 masks (called respirators) are the most protective.

“Masking is a critical public health tool to prevent the spread of COVID-19, and it is important to remember that any mask is better than no mask,” the agency said in a statement. “While all masks and respirators provide some level of protection, properly fitted respirators provide the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher risk situations, or by some people at increased risk for severe disease.”

The Biden administration has announced plans to make high-quality masks available to Americans for free, along with home tests. Details are forthcoming.

Omicron Experience at UVM Children’s Hospital

Underscoring the importance of vaccinating children, Robinson said the sickest kids at UVM Children’s Hospital have been unvaccinated. “Aside from [having] lung issues in the hospital, some signs and symptoms persist even as an outpatient,” he said. “So we have kids who are sick in the PICU, and they also suffer longer-term impaired lung function after recovery from Covid.”

Robinson said UVM hasn’t seen many cases of Multisystem Inflammatory Syndrome in Children (MIS-C), one of the most serious complications. The CDC website tracking MIS-C lists Vermont as having 1-49 cases. The Vermont Covid dashboard doesn’t track MIS-C. In an email, UVM pediatric critical care specialist Rebecca Bell, M.D., said “MIS-C has been seen in Vermont but remains rare,” with the number of cases in Vermont so small that revealing it would raise patient privacy issues. She also said “vaccination appears to protect against MIS-C.”

Omicron Surge Strains Healthcare Staff

Seeing unvaccinated children sick in the ICU is really hard on staff morale, Robinson said. “As healthcare professionals, we’re trying to prevent illness and disease. It impacts us more when we see stuff that could have been prevented.”

Nurses and other healthcare staff are under tremendous burden, with record staffing shortages across the state. Allen said there’s been a doubling of healthcare workers infected with Covid every week. That means more staff are under quarantine and isolation, creating a “huge strain” on the system. He appealed to people to understand the burden on healthcare personnel who are on the front lines and treat them compassionately and with dignity. “People are still working really hard, they’re still compassionate, and they’re still doing what they love, which is caring for patients,” Allen said. “They are still our heroes.” 

Learn More and Find Resources

Read the CDC’s mask recommendations, which specify that not all masks are the same and higher-quality masks provide the best protection.

Watch the live Q&A from UVM exploring the latest knowledge about Omicron and how it is affecting Vermont’s biggest hospital.

Listen to an interview on VPR Vermont Edition with Agency of Education secretary Dan French and state epidemiologist Patsy Kelso. In it, the guests tried to answer questions Vermonters have regarding changes to Covid protocols in schools. 

For more on the national perspective of Covid in children, listen to this Science Friday episode on NPR: Omicron Sparks Surge in Pediatric Hospitalizations. Pediatric experts Yvonne Maldonado, pediatrician and professor of global health and infectious diseases at Stanford University, and Dr. Rick Malley, infectious diseases specialist at Boston Children’s Hospital and professor of pediatrics at Harvard Medical School, answer questions.

Blog written by Brenda Patoine on behalf of VCN/Vermont Care Partners for COVID Support Vermont, a grant funded by FEMA and the Vermont Department of Mental Health

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Find Help

Find resources and tools for coping with stress at www.COVIDSupportVT.org.

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Find your local community mental health center by visiting Vermont Care Partners.

COVID Support VT is funded by the Substance Abuse and Mental Health Services Administration and Federal Emergency Management Agency, managed by Vermont’s Department of Mental Health, and administered by Vermont Care Partners, a statewide network of 16 non-profit community-based agencies providing mental health, substance use, and intellectual and developmental disability services and supports. 

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