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December 5, 2020

Chris Magryta: On screen time, herd immunity, returning to schools full time

Editor’s note: The following are a few recent excerpts from blog posts by Dr. Chris Magryta, who works at Salisbury Pediatric Associates. Read more at salisburypediatrics.com

By Dr. Chris Magryta

Continuing with the screen time theme, let’s look at a study in the Journal of Adolescent Health. Dr. Linda Charmaraman and colleagues looked into the effects of screen time use and sleep.

The results were expected and straightforward. They noted: “Quantity of social technology use (e.g., checking social media, problematic internet behaviors, mobile use), content viewed (e.g., emotional or violent videos, risky behaviors) and social context (e.g., bedtime behaviors, starting social media at an early age) were significantly related to later bedtimes and fewer hours of sleep on school nights. Parental rules restricting mobile phone and online use before bed and obtaining a smartphone at a later age were associated with increased sleep time and earlier bedtime.”

I have discussed many times over the years how sleep is necessary for memory consolidation, brain cleansing, inflammation reduction, mood and stress control and so much more. I have found that over the previous few years sleep duration is going down for teenage patients. The cause is primarily screen usage and a lack of parental involvement.

These are important and non-negotiable variables for teens if we are to help them grow and prosper mentally and physically.

Be involved in your teens choices regarding screens and time.

•••

It is becoming ever more clear that we are not seeing re-spikes in areas previously hammered by this virus. This is a bit of good news in the otherwise dismal case volume.

Herd immunity threshold — different then herd immunity — is a theory that has some solid evidence. It is basically the theory that we will see no further wildfire-type spread if enough people have been infected coupled with effective masking, social distancing and protecting the vulnerable. This is pretty much the Swedish experiment without the mask mandate.

This is not to say that we will be virus-free. The herd immunity threshold is not the same as herd immunity, which we use to discuss the volume of individuals infected or vaccinated to stop the spread of the infection and allow life to return to normal. Roughly 70 or more percent of individuals need to be immune for this to occur. However, this is pathogen specific and we are no where near it for COVID-19. On the other hand, if 30% of individuals are immune and the remainder of the population follows basic pandemic precautions, including social distancing, mask wearing, crowd avoidance, isolation of the vulnerable and self care, then the virus will go into case decline and resolution can begin to occur once a vaccine is initiated.

It appears likely that this is exactly what we are seeing nationally: No significant spikes in previously pounded cities coupled with new spikes in previously unaffected areas.

•••

The preponderance of the current data after eight months of COVID research points squarely to the reality that schools are not the source transmission problem, especially the less-than-12-year-old age range. There is now evidence that teachers may be at less risk because of potential prior cross-reactive immunity. This can be gained from frequent exposure to young children who carry or are sick with other coronaviruses. They are also at less risk when wearing a mask and remaining 6 feet from children. There is good evidence for safely returning to full-time school.

There are two caveats to this reality. First, if a teacher has a genetic weakness or other innate immune viral surveillance defect, they could have a negative outcome despite the low risk. These are lightning strikes in their rare probability. However, they can happen. Second, those individuals who have consciously neglected to care for themselves for years through poor lifestyle choices driving diabetes, hypertension, cardiovascular disease and obesity morbidity will be at greater risk for a negative outcome regardless of the aforementioned risk reduction of children exposure.

Thus, we should be pushing for schools to get back to full activity, in-person learning. Our children are suffering from mental and physical stagnation that may last for a generation. This is especially egregious for the most impoverished children in the country. Those individuals in the teaching profession at higher risk, as stated above, will need to make a choice.

This is frankly a class effect for all workers in every field.

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