As the Coronavirus pandemic spreads across the United States and our world, I worry about friends, family, and my community in general. The virus has the potential to be truly devastating, with the potential to cause thousands of deaths, especially among the elderly. Fortunately there is a ray of good news: the virus does not seem to cause severe disease in children. In fact, the data from China which experienced a majority of the cases and deaths early on in the pandemic, has been reassuring. Of approximately 3,300 deaths to date, child deaths have been rare. And in Washington, where we have had almost 200 deaths, there have been no deaths among children or young adults.  

While the elderly are at risk for developing severe and life threatening infections, children and young adults are more likely to have mild symptoms such as nasal congestion, sore throat and a mild cough. The good news is that our children seem to be spared, but there is a down side as well: since children have mild symptoms, they have the potential to easily  spread the coronavirus to adults. Not only should adults stay home when ill, but it is also vital that children stay home and not interact with other children even if they may only seem to have a “mild cold.”  In addition to staying home when sick, the concept of avoiding close person-to-person contact, also known as “social distancing,” is an essential measure to slow the spread of the virus. 

But how do we stop the virus? The coronavirus pandemic will stop when enough people are immune to prevent spread, social distancing efforts have paid off enough to interfere with spread, or an effective vaccine is created. Scientists are working hard to develop a vaccine and there is already at least one vaccine in early clinical trials. I am confident that science will come to our rescue with a vaccine to prevent coronavirus infection. The big question is how long it will take to create and produce enough of the vaccine for Americans to receive; the time frame currently cited in the medical community is that it make take a year.

While we hope for and envision a successful vaccine to combat the coronavirus, it is an important time to reflect upon and learn from other vaccination efforts to prevent adult deaths from infections. Namely, to stop the virus and prevent adult deaths, it may be most important to vaccinate children. A pneumonia vaccine called the “PCV13” as well as the influenza vaccine are perfect examples of how vaccinating children saves adult lives. Known as the “PVC-13,” the pneumococcal conjugate vaccine protects against 13 different strains of the pneumococcus bacteria, and was first recommended in 2000 to protect children from pneumonia and blood stream infections. The vaccine has been a tremendous success and has saved pediatric lives. The miracle of this vaccine however, was the surprise finding that by vaccinating children, researchers also saw a dramatic drop in adult deaths from pneumonia even though the adults had not received the vaccine. In other words, by reducing the infection in children, the bacteria could not be transmitted to adults, and as a result adults benefited as well. Five years ago, the CDC decided to try giving the PCV13 vaccine to adults with the hope of preventing even more adult pneumonia infections. After studying the effects of this intervention however, they found that vaccinating adults did not have the same benefit. Unfortunately, vaccinating adults with PCV-13 did not further reduce adult disease. 

Similarly, recent research has shown that giving the influenza vaccine to children may be more effective at preventing adult influenza deaths- more effective than vaccinating the adults themselves. 

There are two important reasons why vaccinating children can be more helpful than vaccinating adults when it comes to preventing adult disease. First, children are an extremely important way that disease spreads. Kids play with kids, don’t wash their hands very well, and are in general very good at sharing germs. By preventing infections in kids, we very effectively prevent the spread of infections to everyone else. 

Second, and very importantly, the immune systems of children respond much better to vaccination than the immune systems of adults. As a result, vaccines are better at preventing infections in children compared to adults. As adults age, they experience a process called “immunosenescence,” which is an aging process for the immune system such that the elderly become slower to respond to infections, and responses to infections are less strong. When older adults are given a vaccine, they are less likely to develop a protective immune response compared to children. Meanwhile, children typically develop an immune response to vaccines quickly and in a robust manner.

In summary, what does this mean for us today as we worry about the spread of coronavirus? 

1. To stop the spread of virus now, we need to use the only tool available to us: social distancing. Stay home and wash your hands frequently.  Don’t spread the infection; don’t get the infection.
2. Children thankfully appear to be spared severe disease and death, but are an important way the virus can spread to adults and other children.
3. When a vaccine becomes available, vaccinating our children may be critical to saving adult lives, and stopping the Coronavirus Pandemic.

Hello Kittitas County!

Thanks for being patient- it has been over a year since I last posted, but now it is time to get back at it!

Mental health:  happiness, sadness, stress, coping, and how we manage the challenges  of day to day life.
We could use more help in our community;  we need more mental health counselors and more resources to help people, of all ages, to live to their fullest. In Washington State, the ratio of community members to mental health providers is 360:1. In Kittitas County, the ratio is almost double at 710:1. This means that for an individual with mental health needs in our community, it is more difficult to receive help.

In a 2018 community health survey, Kittitas County residents rated mental health as their #1 concern. In a way, it is no surprise: Kittitas County data suggests our community is vulnerable to mental health stress. Kittitas County is one of the worst in the state when it comes to income disparity. We have many who are very wealthy and many more who are very poor. 17% of children live in poverty here, while 25% of homes are single parent households. A staggering 24% of high school students had a suicide plan in 2018. Meanwhile, Kittitas Fire and Rescue experienced a 74% increase in calls related to mental health issues from 2017 to 2019.

We need help, and you can help: Kittitas County Health Network supports a 1/10th of 1% sales tax initiative to provide funds to support mental health services in our community. This sales tax requires approval from our county commissioners. Write them or call them to encourage approval of the 1/10th of 1% sales tax initiative. To me, it’s clear- lets do it!
Learn more: on  March 6th I interviewed Greg Aubol, director of Central Washington Comprehensive Mental Health and Steve Panattoni, our Kittitas County Jail Superintendent, on my radio show about mental health in our community and the proposed sales tax. Listen to the podcast to hear from these amazing individuals working tirelessly to make our community a better place to live. Dr John’s Radio Show on Ellensburg Community Radio. Eburgradio.org. Follow the link to listen :