‘It’s not a trifle for children’

Yale doc recommends masks for those under 12 years old

NEW HAVEN — While children under 12 cannot yet receive the COVID-19 vaccine, Dr. Thomas Balcezak, Yale New Haven chief clinical officer, said Tuesday that masks are their best defense and “there is evidence now that kids can be severely impacted” by the disease.

More children appear to be getting the disease or the multisystem inflammatory syndrome, “sometimes for two to six weeks after they come down with COVID-19,” he said during an online media briefing. “It’s not a trifle for children,” he said.

Since the beginning of the pandemic, there have been 180 pediatric COVID patients in Yale New Haven’s hospitals, Balcezak said. On Tuesday, there was one, a 16-year-old in intensive care, according to spokesman Vincent Petrini.

Balcezak said his pediatrician colleagues have said masks have no negative effects on children, including on their speech and language abilities. He said, “Although the majority of kids don’t get sick or have symptoms, they can be an active reservoir for the disease.”

He said the wait for children to be eligible to be

vaccinated is because testing is required to see what reactions they will have and to determine the appropriate dose. “I think we’ll see by the end of the year at least some EUA [emergency] authorization for kids under the age of 12,” possibly as young as 6, Balcezak said.

With more than three times the number of hospitalized patients in Yale New Haven Health’s five hospitals than there were a month ago, officials stressed vaccination as the best way to fight COVID-19.

On Tuesday, there were 137 hospitalized patients, 37 of whom — more than a quarter — were fully vaccinated, said Christopher O’Connor, president of Yale New Haven Health. A month ago there were 52 inpatients. He said 37 patients are in intensive care, with 23 on ventilators, compared with 10 and five a month ago.

Balcezak said more than 27,000 of the health system’s employees, at least 83 percent, have been vaccinated, which Yale New Haven has mandated. “With Pfizer’s recent full approval by the FDA, we are hoping that we will see more people choose to be vaccinated,” he said.

“We have some holdouts, but we are rapidly approaching our Aug. 31 deadline to get your first dose, and we will be holding firm to our mandate to our medical staff and employees, and by and large it’s going very well,” Balcezak said.

O’Connor said if employees refuse to get vaccinated, “they’ll no longer work for Yale New Haven Health.”

Balcezak said “there is a segment of the folks that have not yet chosen to be vaccinated who were waiting” for Monday’s full approval by the Food and Drug Administration for the PfizerBioNTech vaccine. He said the FDA’s “giving it their full-throated approval” is something “people should take comfort in.”

For Yale New Haven’s employees, “basically two exemptions for medical conditions exist,” Balcezak said. One is if someone has had an episode of GuillainBarré syndrome; the other is if someone has a severe reaction to their first shot, such as an anaphylactic episode.

Other employees have been deferred, such as those who are temporarily immunocompromised because of cancer treatments, he said.

Religious or spiritual exemption requests are evaluated by the Spiritual Care Department and can involve an interview “to fully understand the duration of those beliefs and where they’re founded.”

Balcezak said the best way to persuade people to get the vaccine is through “appreciative inquiry” to try to educate skeptics rather than by a “frontal assault,” which he said does not work. He also responded to those whose concerns are not based in science, such as those who are worried about long-term side effects.

“There are no vaccines in history that have long-term effects, other than immunity, that have not been seen in the short term,” within four to six weeks after inoculation, he said.

“We are concerned about potential long-term side effects of a vaccine … and somehow we have some cognitive dissonance where we don’t recognize that the disease COVID-19 has innumerable long-term side effects that have been recorded,” such as long-haul COVID.

He also said while fetal cell lines derived from abortions, some as old as the 1960s, were used in development and testing of vaccines, there are no fetal cells in the vaccines themselves.

O’Connor said businesses and other organizations need to decide whether to mandate vaccinations “based upon their facts. I think it’s important we let science lead the way. … The protection of our patients and staff are of utmost concern, so that’s why we did it.”

Balcezak said the increase in cases, which are almost all from the delta variant, are because of the vaccines tend to wane over time, and because delta delivers 1,000 times more virus to the system.

“The consensus out there right now is while the three vaccines that are available in the U.S. are slightly less effective against the delta variant, that really is not a big concern,” Balcezak said.

“Even the best vaccines, these vaccines, are only 95 percent effective,” he said. “If we bombard you with enough virus, some of you will get sick. We are being bombarded with this virus even if we don’t know it all the time.”

Balcezak said about 300 immunocompromised people have been given a third dose of vaccine, and “we will provide third doses when the FDA approves that” for non-compromised people.

Balcezak said while he hopes people get vaccinated and follow public health measures so COVID will “really fade away like SARS did,” he believes it’s more likely “we’re going to be living with COVID for a long time. Across our health system, we’re going to see a handful to about 100 cases up and down in cyclical fashion over the next year or so.”

The situation will get worse, however, if a new variant that can evade the vaccines or that infects people in a new way appears, he said.

On Tuesday, there were 54 COVID patients in Yale New Haven Hospital, 50 in Bridgeport Hospital, 12 in Greenwich Hospital, 13 in Lawrence and Memorial Hospital in New London and eight in Westerly Hospital in Rhode Island, O’Connor said.

Balcezak