TRAVERSE CITY — As of Friday at 4 p.m., Traverse City Area Public Schools had recorded just 14 COVID cases in district schools since Dec. 22, the beginning of their Christmas break.

The reality of pediatric COVID cases in the area is much different, local pediatricians say.

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“We have been overwhelmed with the number of kids coming into our office in the last two weeks requesting COVID testing, having symptoms of COVID and with positive COVID tests,” said Dr. Stephanie Galdes, a pediatrician at Kids Creek Children’s Clinic. “It has dramatically changed in the last two weeks.”

KCCC had 16 patients test positive for COVID in the office between Monday and Thursday, the most doctors there have seen in one week since the beginning of the pandemic, Galdes said. They saw a 29 percent positivity rate in their office in that time frame, and they even denied appointments to patients who were presumed positive with stable, mild symptoms, she said.

At Grand Traverse Children’s Clinic, 18 out of 68 patients tested for COVID were positive — a 26 percent positivity rate — between Monday and Thursday, Galdes said.

“Our patient volumes in the office are through the roof. We are so busy right now that our office schedule fills in less than an hour,” said Dr. Tuan Bui, a pediatrician at GTCC. “And the only reason it takes that long to build is because we only have so many people manning the phones.”

KCCC and GTCC report positive COVID tests to the Grand Traverse County Health Department which is tasked with reporting school-associated COVID cases to school districts for them to record on their websites. As previously reported, the COVID case reporting and contact tracing process is often slowed because of staffing shortages at GTCHD.

Galdes and Bui are in a group of 16 pediatricians who, over the past two years, have frequently written emails to the TCAPS Board of Education to inform trustees about local COVID data, share how their clinics and patients are faring and advise on certain issues, such as in-person schooling and masking.

Recently, these emails have focused on TCAPS’s universal mask mandate, which was dropped just before the first of the new year.

While TCAPS is just one of many school districts in the area without a mask mandate, it makes up about 43 percent of the students in the Northwest Education Services intermediate school district and most of the patients at KCCC and GTCC.

The decision to sunset TCAPS’s mask mandate left pediatricians frustrated and concerned about how students’ mental health and community spread will worsen in the coming weeks.

One of the top concerns is an increase in children becoming exposed to and contracting COVID. TCAPS trustees’ decision to sunset the mask mandate was made around the impending approval of the vaccine for 5- to 11-year-olds, but even after two months of the vaccine being approved, only about 25 percent of kids in that age range are fully vaccinated in Grand Traverse County, according to Michigan.gov’s COVID-19 Vaccine Dashboard.

Even though children tend to get less sick with COVID, if more children contract COVID, it is only inevitable that pediatric hospitalizations will go up as well, Galdes said. And it’s difficult to tell who will fare better than others and what the long-term impacts of even a mild case of COVID can be.

“An individual kid who gets sick with COVID — assuming that they’re healthy, they don’t have any underlying conditions — statistically, will probably do very well,” Bui said. “But I can’t tell you who is going to have a good outcome and who isn’t.”

Ben Lamphere, a pediatric hospitalist, said right now is the “worst time” to drop the mask mandate at TCAPS because of the high transmissibility of the Omicron variant.

“I’m afraid that having a large number of unmasked people in a closed environment will serve as a vector to infect those who are more susceptible,” Lamphere said. “I’m afraid that kids will get sicker but I’m more afraid that those kids’ parents and aunts and uncles and grandparents and strangers at the grocery store will get sicker too.”

Lamphere works with hospitalized children at Munson Medical Center and treats adult COVID patients. He is not part of the group of 16 pediatricians who email the board.

Increased COVID spread in the community can lead to a slew of other problems; increased strain on an already overwhelmed healthcare system, more anxiety among adults and children and non-COVID related medical issues slipping through the cracks.

James Robertson, who also signs onto the emails to the board, is the pediatric section chief at Munson Healthcare. He owns KCCC and sees patients there as well. He said, despite the fact that the omicron variant may be mild for some patients, the health care system still is overloaded with COVID patients, many of which are unvaccinated.

With the number of people in the ICU and in critical care in the hospital, beds are not as available to non-COVID patients, Robertson said.

“We take referrals from up north, from Charlevoix, from Alpena — those people generally come to Munson,” Robertson said. “And so right now, if you have a stroke or a heart attack in one of those outlying places, generally speaking, Munson doesn’t have any intensive care beds to accept you.”

He said he is worried that exposing more kids to COVID will worsen this situation.

In order to combat COVID spread in their communities, some school districts have canceled classes for days at a time. Other school districts in Michigan, such as Lansing Public Schools and Detroit Community Schools, have shifted to remote instruction as a way to avoid COVID spreading between classmates.

However, pediatricians are weary of short-term solutions.

Without in-person school, kids struggle with mental health on a large scale, Galdes said. At the beginning of the pandemic, when classes were forced online, she said K–12 age students struggled immensely with sleep routines, healthy eating and the lack of structure to their days.

“What we saw at the beginning of the pandemic when schools shut down was awful,” Galdes said. “I mean, the amount of mental illness we saw in our pediatric population — in our elementary kids, our middle school kids, our high school kids — was horrible.”

Some parents and community members have voiced concerns that students are getting more anxious and depressed from wearing masks. Galdes said she has not seen that “one single bit”. Robertson said it is also likely that forcing kids to make the decision of whether to mask themselves is incredibly stressful for them.

“To put a high school kid in a position where they have to wear a mask and justify it to somebody else because it was left up to them or not wear a mask and justify it to somebody else, is just incredibly anxiety-producing, especially for people that have underlying anxiety,” Robertson said.

In just the first week back from school, many of these pediatricians’ fears have come to fruition; TCAPS classes were canceled and moved to online temporarily for secondary students because of mass of teachers calling out sick. On Thursday, 93 out of TCAPS’s 500 teachers were absent.

The TCAPS board of education’s next meeting is Monday, and a discussion about how COVID is affecting the schools is on the agenda, said Board President Scott Newman-Bale. Trustees will discuss masking, remote instruction and staffing shortages.

While in-person instruction is highly valued by Newman-Bale and the other board members, he said virtual instruction would allow quarantining staff to still work from home. There is less flexibility this year with shifting to remote instruction for school districts, but the possibility still is there.

Newman-Bale said he is looking forward to discussing these issues with his fellow board members again, because they cannot discuss outside of meetings.

Galdes, Robertson and the other pediatricians have continued to speak with the board of education trustees in the weeks between their board meetings about local COVID cases and how the pediatrician clinics are faring.

“I would love to tell the school board, ‘We’re not seeing any COVID, our numbers are down, let’s take these masks off and let’s move on.’ And I know we’ll be there at some point. We are just definitely not there right now.”

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