Cincinnati Pediatric Society responds to the question, "Should we infect children with COVID-19?"

We, as the board of the Cincinnati Pediatric Society, are writing in response to the opinion article recently authored by Jack Rubinstein titled “Opinion: I want my kids to get coronavirus - and you should too.”  The Cincinnati Pediatric Society is an organization that includes over 100 pediatricians, pediatric subspecialists, and pediatric nurse practitioners in Southwest Ohio.  We were unsettled after reading this article and would like to address some of the claims made.

First, the statement that “we have come to a point where we need to start getting people infected with novel coronavirus” is not only untrue, but dangerous.  No medical group, from the WHO to the CDC to the AAP to the ODH, is recommending intentional exposure or infection at this point.  To date, it is uncertain that infection protects from a future infection or illness due to the virus.  Even a small change in COVID-19 could mean people again being susceptible to infection and developing illness.  Whether those who were infected during the first wave of illness will be immune to a changed strain is an unanswered question.

Second, while we agree that the current restrictions in place cannot be a long-term solution, loosening those restrictions before there is a plan in place will put people at risk of illness and death.  Yes, a vaccine is still many months away and there is currently no known treatment other than supportive care.  However, local and statewide hospitals and groups are currently preparing to ramp up for widespread testing.  This will allow a better understanding of how prevalent coronavirus is and enable appropriate limits on quarantine.  Dr. Rubinstein’s assertion that children and younger adults are less likely to get seriously ill is accurate, but the truth of the matter is that healthy people of every age, from child up to the elderly, have died from infection by the novel coronavirus.  This is not a choosy virus; while the severity may be lessened in younger people, it is by no means benign.  Current information indicates that 10-15% of adults infected with COVID-19 are hospitalized, with mortality rates of 10% or higher.  The rate of children with severe or life-threatening disease is closer to 1%.  However, to put this in perspective based on conservative models and data, if 25% of the children under 18 in the Cincinnati metropolitan area were infected, we would expect about 7,500 hospitalized children and 900 admitted to the ICU, many who will not survive.  These numbers reflect all children, not just those who are at higher risk of serious complications due to underlying health conditions.

Finally, we take issue with the claim that we will be able to safeguard medical staff with appropriate personal protective equipment (PPE).  While it is true that we currently have enough, we will surely come up short if there is a new wave of new infections caused by premature exposure of the population and a crop of new cases.  PPE is already being rationed in hospitals and doctors’ offices across the state; increasing the number of suspected or confirmed cases would cause our already stretched resources to disappear at an alarming rate.  The only way to ensure our health care system can “provide everyone with a hospital bed, medical staff and, when needed, ventilators” will be to make certain there is not a peak of new cases that exceeds our ability to care for them.  We have flattened the curve at this point - we cannot allow a spike in the future.  Many of our members are primary care pediatricians, meaning that we are also small business owners.  We understand the strain that the stay at home order has put on small businesses and the economy, but we cannot allow our efforts up to this point to be in vain.

We agree with Dr. Rubinstein on one very important thing - Ohio and its leadership have done an outstanding job with its response to the coronavirus epidemic.  We are so appreciative of Governor DeWine, Dr. Acton, and the state and local health departments.  We are grateful our leaders have made difficult decisions, even in the face of opposition.  We are in awe of healthcare and other essential workers.  And last but not least, we are humbled by the people of Ohio who have done so much to keep everyone in our state safe.  We are #InThisTogetherOhiO

Board of Cincinnati Pediatric Society

Lauren Huff, MD, FAAP         Meredith Frost, MD, FAAP                  Abigail Stein, MD, FAAP

President                              Past President                                     Treasurer