Covid has changed the landscape for other common childhood illnesses

By BECKY GILLETTE

The COVID-19 pandemic has changed the landscape for other common childhood illnesses such as Respiratory Syncytial Virus (RSV).

“It is an interesting phenomenon,” said Arkansas Children’s Hospital Senior Vice President & Chief Medical Officer Greg Sharp, MD. “We didn’t see RSV the first year of COVID. About half the kids were at home instead of at school. RSV commonly affects infants and young children who are often infected when the virus is brought home by older siblings. So that spread of infection was significantly diminished by kids being homeschooled and precautions at school such as kids washing hands frequently, classrooms not as full, masks required and distancing, with a collective effect of decreasing normal infections.”

Normally the highest incidence of RSV illness is in the winter months. It will usually begin in late November with January to February the peak time for illness and hospitalizations. In the first winter of COVID, hospitalizations for RSV were very low.

“Then, in the spring and summer of 2021, COVID numbers were diminishing and people started to let their guard down,” Sharp said. “Many people quit wearing masks in social situations. We had a tremendous surge of RSV in May, June and July of 2021. We had a typical rate of January RSV and associated hospitalizations occur in June and July. We had never experienced that before. Our hospital was full, and other hospitals around the U.S. and the world experienced the same phenomenon.”

This year there has been a mini surge of RSV and other respiratory viruses in late summer which trended up after school started. “We are definitely seeing an increase and it is yet to be seen what will happen as we go through the winter months,” Sharp said. “While there are no vaccines for RSV, I would really advocate people get flu vaccines for themselves and their kids. Flu begins in the southern hemisphere during its winter which is our summer, and flu has been pretty significant over the southern hemisphere the past three months. There are predictions that this could be a bad flu year here. We need to get kids vaccinated for the flu.”

Another fallout of the pandemic has seen some children falling behind on childhood vaccinations. Sharp said there are a lot of reasons for that. In the first year, people were worried about taking their child to the doctor’s office where they might catch COVID. And some of the misinformation campaigns about COVID vaccines have led to parents having more concern about other childhood vaccines.

“We want families to talk to their child’s pediatrician or primary care provider about making the decision to vaccinate. There are many sources of misinformation online, but a trusted primary care physician or pediatrician can help families find good, reputable information backed up by science.”

Many scheduled vaccines are given during the first 18 months of life. If a child gets behind and doesn’t get them until they are required to attend public school, he or she is vulnerable during those gap years.

Studies have indicated many parents are reluctant to give kids, particularly those 5 and under, the COVID vaccines because COVID is generally milder in children than adults. It has been fairly uncommon for otherwise healthy children to have issues with severe COVID or long COVID. Severe illness in young children is not impossible, but has been less common. But Sharp said adverse effects of COVID vaccines in children have been very low, and the benefits far outweigh the risks.

“My grandchildren have been vaccinated, not just for protection of the child, but for the protection of others,” Sharp said. “A child might get a mild case of COVID, but goes to visit grandparents. We have seen severe illness and deaths in adults who were exposed to their children and grandchildren.”

Another trend is a large surge of behavioral problems with children as an indirect result of COVID. Sharp said some of that surrounds the upheavals in school the first year of COVID. Other factors are not having the same level of social interactions and some of the fear that surrounds the conversation about COVID. Some children have had family members become sick or die from COVID.

“All of these things have had a big impact on the psychological well-being of children,” Sharp said.

It was also a difficult time for children with autism spectrum disorder (ASD). While prevalence of ASD has progressively increased over the past 20 years, Sharp suspects this is largely due to increased awareness by parents, teachers and pediatricians who are more likely to recognize ASD now.

“The other thing is it is such a spectrum,” Sharp said. “On one end, you can have a child extremely affected who is essentially not verbal and very socially withdrawn. On the other end, you have mild symptomology with a child who faces some challenges in social situations. Then you have everything in between.”

Sharp considers being medical director at Arkansas Children’s Hospital a dream job.

“I grew up in a small town in Arkansas, Crossett,” Sharp said. “I went to medical school at the University of Arkansas for Medical Sciences, and fell in love with Children’s Hospital and pediatric healthcare. I decided to become a neurologist because at the time I was in pediatric residency, there was only one neurologist at this hospital. I recognized a need, and that determined my course to train to become a child neurologist in order to return to Arkansas Children’s.

His primary rule for the job he has now held for four years is to do what is best for the children. That can mean encouraging vaccinations, selecting the best therapy for a child, or growing or developing a new program. It’s all about meeting the needs of the children of our state.

An avid fly fisherman, he and his wife, Lynn, have a house on the Little Red River. On weekends, you will frequently find him on the Little Red fishing for trout. He recently went fly fishing in Alaska.

“I like being outside in nature,” Sharp said. “If you catch fish, that is a bonus but I pretty much release everything I catch. We have five grown daughters, and four grandchildren.

My wife and I used to have a weekly date night eating at a new restaurant. That and many other activities like going to church in person got curtailed significantly by COVID.  We are just now starting to get out more in public. The World Health Organization recently announced we are significantly trending toward the end of COVID and I think we all look forward to getting more back to life as normal.”

In addition to residencies in pediatrics at UAMS and ACH, Sharp did a residency/fellowship in child neurology at Mayo Clinic in Rochester, Minn.

Sharp is board certified by the American Board of Pediatrics and by the American Board of Psychiatry and Neurology with Special Competence in Child Neurology, and Added Qualification in Clinical Neurophysiology and Epilepsy.