Teaching magic tricks to children with disabilities can enhance their feelings of self-esteem and confidence, a study has shown.

The study, published in Health Psychology Research, is a collaboration between the University of Alabama at Birmingham’s Institute for Arts in Medicine, the School of Health Professions’ Department of Occupational Therapy and illusionist and educator Kevin Spencer. It shows the effectiveness of a virtual summer magic camp program in enhancing self-esteem in children and adolescents with attention-deficit/hyperactivity disorder. Children with ADHD can experience low self-esteem.

Learning and performing magic tricks can benefit children and adults with disabilities. The approach promotes motivation and improves physical, psychological, perceptual or social functions in those who participate and has been shown to be an effective treatment technique.

Magic trick programs have also been reported to enhance the self-esteem of children with severe emotional disturbances, and those with a diverse range of developmental disabilities such as communication difficulties, learning difficulties, (emotional) behavioral disorders, autism and ADHD.

The single-group study at UAB included six children with ADHD, ages 8-14, who participated in a virtual magic camp program designed for children with disabilities. The camp met three days a week, in sessions from 45 minutes to one hour, over four consecutive weeks, for a total of nine to 12 hours. Participants completed assessments before and after camp, and they and their parents were individually interviewed after camp to explore their camp experience.

Self-esteem scores after the magic camp were significantly higher than the self-esteem scores before camp. Findings were validated by the participants, who described gains in self-esteem after participating in the magic camp, and by the parents’ statements regarding the positive impact on their child’s psychological well-being.

ADHD is a common child and adolescent neurodevelopmental disorder. It is characterized by problems with attention skills, staying on task or being organized, and affects academic performance in school and daily activities. In addition to inattention and/or hyperactivity, children and adolescents with ADHD report psychological well-being difficulties such as low self-esteem. Considering their frequent challenges and failures in school, and adverse social feedback they encounter, these experiences may contribute to their low self-esteem.

Research on ADHD shows self-esteem problems can lead to maladaptive coping strategies, such as anxiety and depression, substance use and deviant peer choices, and disruptive behaviors such as bullying and peer victimization, the study says.

Psychosocial interventions have been recommended to help children and adolescents with ADHD cope with difficulties and failures in school and everyday life and increase self-esteem.

Future studies should investigate the holistic impact of magic camps on children and adolescents with ADHD and include measures that tap into other psychosocial attributes, such as social functioning, social skills and self-efficacy, the study authors say.

UAB Magic Camp, which is held each summer, is part of a collaboration between UAB Arts in Medicine, the UAB School of Health Professions’ Department of Occupational Therapy, Children’s of Alabama and Hocus Focus™. UAB occupational therapy students are trained in the protocol developed by illusionist and educator Kevin Spencer -; an international authority on the therapeutic use of magic tricks in physical and psycho-social rehabilitation -; and provide instruction to the campers.

Each camper is paired with two OT students for the duration of the three-week summer camp. Through this pairing, campers work at their own speed and have a personalized learning experience. The end of each camp will feature a streamed magic show performance for friends and family. Camp is free and open to children ages 9-18 who have been diagnosed with a disability. The virtual camp welcomes participants from all over the United States and internationally.

Source:

University of Alabama at Birmingham

Journal reference:

Yuen, H. K., et al. (2021) Contribution of a virtual magic camp to enhancing self-esteem in children with ADHD: A pilot study. Health Psychology Research. doi.org/10.52965/001c.26986.

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Advocacy work is key in bettering pediatric cancer outcomes.

While fundraising initiatives are essential, advocacy work is key in bettering children’s health outcomes. With September being childhood cancer awareness month, we should be looking at ways we can advocate for accessible health care and awareness in childhood pediatric cancer.

Although pediatric cancer treatment is always developing and changing as research is being done, childhood cancer rates have been rising slightly over the last ten years. With that, cancer is the second leading cause of death in children up to the age of fourteen.

In advocating for pediatric cancer, we cannot ignore and should address disparities that exist within the health care system. We should be asking questions about where these disparities come from and what steps can we take to confront them.

Even though pediatric cancer continues to alter the lives of many children and families, only four percent of federal cancer research funding is allocated to pediatric cancer. This makes advocacy work crucial in the fight against pediatric cancer.

The end goal should be universal health care. However, families struggling to pay for their child’s treatment need small steps to take place.

While pediatric cancer has reached an 83 percent survival rate, we have a long way to go when it comes to accessible health care. Children coming from low-income households make up 43 percent of pediatric cancer diagnoses, meaning they will face significant financial stress.

Maximum out-of-pocket limits are essential for families going through pediatric cancer treatment. These limits prevent families from spending a certain amount on medications and procedures through treatment. Each year, this limit changes. For 2021 it’s $8,550 for individual insurance plans and $17,100 for family plans.

Most families will reach this limit within the first three months of treatment. This protection is essential for these families, but many still struggle affording costs up to these limits. These maximum out-of-pocket spending limits need to be lowered and adjusted to meet family’s needs.

But financial stress is not the only barrier families dealing with pediatric cancer face.

Race and socioeconomic status have an effect on cancer treatment and outcomes. Non-Hispanic white children are most likely to be diagnosed with cancer. However, the number of children who die of cancer is similar across these three groups. This indicates Black and non-white Hispanic children diagnosed with cancer are less likely to survive.

Along with findings showing that race affects the statistical outcomes of pediatric cancer, the Centers for Disease Control and Prevention has evidence suggesting location plays a role. There are several things that could influence rates of cancer varying by geographic location. For example, increased exposure to carcinogens with air pollution and genetic variation in some populations.

On top of families bearing the weight of cancer treatment, COVID-19 is another worry. Children now account for almost 25 percent of COVID-19 hospitalizations in Iowa. Children with cancer have a 20 percent chance of having severe symptoms with COVID-19, while other kids have a 1 to 6 percent chance of severe infection.

It is especially important to do this advocacy work now as this vulnerable population is facing the pandemic and rising threats with COVID-19.

These issues go beyond accessibility to health care and funding for research; however, these are still things we need to be advocating for. One thing that is essential in effective treatment is early diagnosis. Findings show that higher income countries with accessible health care generally have a pediatric cancer survival rate that is over eighty percent.

All children and families facing pediatric cancer deserve access to safe and affordable health care. Getting a diagnosis as early as possible and having the means to advocate for the best care possible are crucial. Advocacy work is a huge part of how the doors to better care can be opened.

Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.

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We’re coming off a year where, for many moms, just getting through the day was a goal. Keeping up with daily family to-dos that normally would go unremarked upon suddenly deserved a gold star — and if we didn’t keep up? Well, that called for giving ourselves some grace. And Gabrielle Union-Wade is proving to be #momgoals on both counts.

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The actress, author, activist, and mom knows that it was a hard year for parents in general — and moms in particular — to keep every plate spinning, which is why her family decided to participate in a public health campaign called Don’t Skip, which is encouraging families to get back on track with well-visits and recommended vaccines for kids.

The numbers are sobering: It’s estimated that 9 million doses of recommended childhood vaccines were missed in 2020, and according to one survey, 40 percent of parents admit their kids missed vaccines due to COVID-19.

Union-Wade spoke with SheKnows about the campaign, prioritizing her family’s health, and what she let slide during the pandemic. Speaking with her even inspired me to prioritize scheduling my own well visit with my GP — and one for my spouse, as well. We’d kept up with our kids’ visits — but not our own. So thank you, Gabrielle!

SheKnows: Given the fear and uncertainty so many of us have lived with over this past year, what was the conversation like in your family about making sure you kept up with normal things like well visits and vaccine schedules?

Gabrielle Union-Wade: Well, during the last year-plus, unfortunately, we had a couple of medical emergencies, so we had to get over our fear of going to the doctor and what that meant. And if we can go in a time of crisis, we can for sure go in to stay on schedule. So we got comfortable by talking to our doctors, making sure that they were comfortable — that their staff and their offices were ready and prepared — and we got that level of confidence to stay on track throughout the pandemic.

With this series of PSAs, we’re really just talking to parents and families and reminding them to get back in the schedule of talking to your doctor, your children’s doctor, scheduling those well-visits if you missed them, and scheduling your doctor-recommended vaccinations. That’s how we’re making every decision in our house. Like, I’m not listening to whoever has the most followers; I’m talking to my doctor about what makes the most sense for me and my family.

SK: Is there a message you want to share with people who did skip visits or vaccines, who may be feeling guilty now that their child is behind? Or maybe they’re just feeling vaccine-hesitant, in general?

GUW: I would just say, it’s okay to be afraid. It’s okay to feel guilty. It’s okay to feel literally everything that you’re feeling. Today’s a new day. Just take that first step, which is just to reach out to your doctor and start opening up those lines of communication. And the more you talk, the more you build trust and the more you build trust, the more you build confidence with everything healthcare-related.

Coming out of a time of so much misinformation, sometimes it’s hard to know which way is up, but centering healthcare professionals and your doctors and letting them lead, that is what has worked for our family.

SK: What are some of the best sources of education you’ve used to help yourself feel informed about the vaccines your kids need?

GUW: Literally, I just talked to my doctor. We took a lot of time in finding our healthcare providers, especially, Dahveon and Zaya’s doctors. So I felt confident texting them throughout this pandemic [and saying], ‘What do you think? I know you know my health history, my children’s health history, what do you think is best for us at this time?’ And that’s what we went with.

It’s weird to say, ‘Lean into facts.’ But in this day and age, two plus two totally equals five for some folks, and I don’t know what to do about those particular people. But folks who believe in science, facts, figures, I would say, listen to your healthcare provider that is familiar with your health history and your children’s health history. The internet can be confusing and media can be confusing, but hopefully, your doctor can declutter a lot of that and put it in plain language to help it make sense to you.

SK: How do you and Dwyane have conversations about vaccines and preventative health with your family? Obviously, you have kids of varying ages who require varying levels of information…

GUW: We both come from families and [have] loved ones who rarely prioritized their health and ended up dying from things that are totally preventable. Ended up really suffering just because of a fear of going to the doctor, really suffering because they were afraid of a diagnosis. I watched my girlfriend die because she had deprioritized for her own health. I didn’t need anything to have to happen to me because I’ve watched it around me. So, from the time that we got together as a family, we have always centered our health and our wellness because we always looked at information as our power.

I can’t do anything without the information, and we can’t get the information without going to the doctor, taking full blood panels, not skipping out on our annual physicals and our mammograms, and everything else that’s recommended for our different ages. And we’ve just taken that through with the rest of our family. We don’t play around with anything. We are those people that are quick to text Kaav’s doctor, quick to text Zaya’s doctor, quick to text our own doctors to get that reassurance and that information. Because we’ve seen what can happen when you don’t.

SK: So it’s just a daily part of your family life?

GUW: Yeah. You have to completely normalize it. If something doesn’t feel right in your body, in your mind, let’s talk about it, let’s address it now. Whether it’s feelings bottling up or symptoms bottling up, let’s address them when they first arrive. So we want to make sure that our kids feel comfortable, whether something has gone wrong with their friends or with their heart or if any part of their body doesn’t feel right, let’s address it quickly.

SK: You joke in the PSA about letting Zaya skip making her bed. But seriously — what’s something you skipped this year that you really do feel good about?

GUW: We all had to skip some things to make life work during the pandemic. I skipped setting my alarm clock in the morning, doing some of my daily workouts, and putting on makeup, among other things. The problem is, a lot of families have also been skipping visits to their doctor, which has caused a big drop in recommended vaccinations, especially for children and preteens. Sadly, the long-term public health problems that come out of this drop could be major because so many children, preteens, and adults remain unvaccinated against a range of preventable diseases.

SK: We at SheKnows have been hugely inspired by your family’s acceptance and advocacy. What’s your advice for parents looking to be allies/accomplices and truly affirming to their LGBTQ+ kids?

GUW: We’ve learned a lot, but understand that there’s still so much we don’t know. Most parents think they need to have it all figured out, and the truth is, it’s okay if you don’t. The most important thing a parent can do is to be there for their child and support them in every aspect of life.

SK: Finally, congrats on Shady Baby! What’s it been like bringing that project into the world?

GUW: It’s been amazing. Inspired by our daughter, Kaavia, we wanted to create a children’s book that not only had a little Black girl as the main character but to also give the word “shady” a more positive association, using it as her superpower, moral compass, and inner strength. As a family, we also understand the platform that we have and the importance of doing right for our community. That’s why we get involved in various initiatives to help give back to our community, whether it’s LGBTQ+ rights, advocating for diversity and inclusion in the workplace, or our Don’t Skip public health campaign.

This interview has been edited and condensed for length and clarity.

Before you go, check out our gallery on Cute & Stylish Kids Face Masks.

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TULSA — Before they start honing their writing skills, incarcerated women enrolled in Liz Kollaja’s therapeutic poetry class are asked to take an Adverse Childhood Experience quiz.

The brief survey is designed to gauge how rough a person’s childhood was.

Nationally, 45% of children have experienced at least one of 10 ACEs, ranging from having a parent incarcerated to being physically and emotionally abused.

Those with a score of three or higher face an elevated risk of psychological and medical problems.

The average ACE score among incarcerated Oklahoma women is 5.75, according to Kollaja, who manages curriculum for the OU-TU School of Community Medicine and volunteers with Poetic Justice.

Nearly 400 women incarcerated at the Mabel Bassett and Eddie Warrior Correctional Centers have taken the assessment over the past three years.

“Looking at these numbers, it’s heartbreaking to see what they have gone through and what they have experienced,” Kollaja said. “It makes you realize that where they ended up, you can’t really blame them, because it’s often a normal reaction to that level of trauma to live the life they’ve lived.”

A panel of researchers, volunteers and community leaders discussed the link between traumatic childhood experiences and incarceration at the She Brews Coffee House in Tulsa on Saturday night. State Rep. Monroe Nichols, D-Tulsa, moderated the event, which was organized by the Oklahomans for Criminal Justice Reform.

Oklahoma ranks first in the U.S. in the number of people with an ACE score of at least two, according to a 2017 report from the National Survey of Children’s Health. One study from the United Kingdom found that those with an ACE score of four or higher were 20 times more likely than the general population to be incarcerated at some point in their life.

Carly Dunn, an Oklahoma State University research assistant whose work focuses on health outcomes in marginalized communities, said counseling and other mental health interventions are most effective in treating childhood trauma. But many Oklahomans, especially those in rural areas, face significant barriers to mental health care.

Increased state investment in mental health services could help keep those with traumatic childhood experiences out of the criminal justice system and ultimately reduce the state’s prison population, Dunn said. As of February 2020, Oklahoma had the second-highest incarceration rate in the U.S. behind Louisiana.

While corrections department funding has steadily increased over the past five years, state mental health providers have had to scale back services like individual therapy sessions.

“Right now we’re investing in prisons, but if we divert that funding to provide the resources and tools that people need, we’ll see an impact,” Dunn said. “There’s a large return on investment associated with people versus prisons.”

There’s also a financial incentive to keep more people out of prisons. The Oklahoma Department of Mental Health and Substance Abuse Services estimates it costs the state $2,000 per year to provide treatment to a person, while incarceration is more than 10 times as expensive.

Gina Richie, who spent two decades in and out of Oklahoma prisons on drug-related charges, said she wants lawmakers to make addressing childhood trauma a priority. While incarcerated, Richie said her three children developed many of the same mental health issues she suffers from. Her middle daughter took her own life last year.

“I hope that we can get to a place where people with mental health disorders or substance abuse disorders don’t get sent to prison for their condition,” Richie said.

State officials will soon receive new guidance on programs and services that could help combat childhood trauma. The Oklahoma Trauma Care Informed Task Force, formed in 2018 to explore solutions and give the state a strategy to treat people with ACEs, plans to issue a report with policy recommendations in November.

Oklahoma Watch is a nonprofit, nonpartisan media organization that produces in-depth and investigative content on a range of public-policy issues facing the state. For more Oklahoma Watch content, go to oklahomawatch.org.

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A report out of Chicago last week about a judge ordering a mother to temporarily lose custody of her son for refusing to get the COVID-19  vaccine — and then reversing his decision — has some parents questioning the possibility of such a ruling.

Rebecca Firlit told FOX 32 Chicago last week that Cook County Judge James Shapiro revoked all of her parenting time with her son until she gets vaccinated.

“He was placing his views on me. And taking my son away from me,” Firlit said of Shapiro.

Firlit, who has reportedly been divorced for seven years and shares custody of her son with her ex-husband, said she does not want to get the vaccine due to previous adverse reactions to vaccines, according to FOX 32.

Shapiro, however, reversed his decision on Monday after it gained traction in the media, leaving some parents wondering whether it is possible for parents to lose custody of their children if they refuse to get the vaccine.

Rebecca Firlit and her son (Credit: FOX 32 Chicago)

Fox News spoke to several family law attorneys who agree that if a child is immunocompromised, a judge presiding over a custody battle may order a parent to get vaccinated if the issue is properly presented at court.

Joryn Jenkins, a family lawyer in private practice at Open Palm Law in Florida, pointed to three reasons a judge may require parents to receive a COVID-19 vaccine in divorce court: first, a parent would have to properly bring the issue before the court; second, the child may have pre-existing conditions that would put him or her at risk of getting a severe COVID-19 infection if living with unvaccinated parents; third, the court acts in the best interest of the child, and if requiring parents to get vaccinated is in the child’s best interest, a judge may order parents to get the shot.

COVID-19 CASES INCREASING AMONG US CHILDREN, DATA SHOWS

Still, Jenkins described Shapiro as a “maverick” in his decision because the subject of the vaccine was not brought to the court by either Firlit or her ex-husband.

Morghan Richardson, a matrimonial law partner at Davidoff Hutcher & Citron, also noted that Firlit said she was reactive to vaccines and had a medical reason not to get the vaccine.

“Judges can only decide issues that are brought before the court and … brought before the court in a certain way,” Jenkins told Fox News. “So basically, he denied this gal due process, which is a deep down constitutional issue. … She had no idea that this was going to be something they’d be talking about. So she wasn’t prepared.”

Health worker administers a dose of a Pfizer COVID-19 vaccine during a vaccination clinic at the Grand Yesha Ballroom in Philadelphia.  (AP Photo/Matt Rourke, File)

She mentioned a case in New Jersey in last August in which two parents fought over whether their child should get vaccinated, and the court ultimately decided that the mother was not credible in her argument against her son getting vaccinated, and the judge determined that it was in the best interest of the child to get vaccinated based on the father’s reasoning, so he did.

Assuming no laws are in place requiring either the parents or child to get the vaccine, the judge then determines what arguments parents have either for or against getting the shot. The judge may ask whether the parents or child are immunocompromised, whether the child attends public school and sees “lots of other kids,” whether the child has siblings or if those siblings are immunocompromised, whether parents are reactive to vaccines and so on, Jenkins explained. 

DOCS URGE KIDS’ ROUTINE VACCINATIONS AFTER MISSED SHOTS AMID PANDEMIC

“So the judge is going to look at all of the reasons, the rationales, and then he’s going to make a judgment call,” she said. “You know, there’s all kinds of arguments that when parents really hate each other, they will come up with the nastiest arguments and judges have to make those decisions.”

John L. Collar, an attorney practicing at Atlanta family law firm Boyd Collar Nolen Tuggle & Roddenbery, believes it is unlikely a judge would order parents to get vaccinated.

“I would say it’s unconstitutional, truthfully, but I just think that’s why the trial courts are not really going to get into their constitutionality issues associated with it,” Collar said of requiring parents to get vaccinated. “Then you have these public policy considerations, and I just don’t think the trial courts are going to get involved unless the child is being somehow subjected unnecessarily to risk associated with a parent being unvaccinated or vaccinated. You know, now we have the breakthrough covid cases. And so if that type of fatal situation is created, then I could see how a court may step in and modify custody, at least temporarily, just to protect the child.”

Dr. Chadi Ibrahim receives the Pfizer-BioNTech COVID-19 vaccine from Susan Grand at the Beaumont Service Center, Tuesday, Dec. 15, 2020 in Southfield, Mich. (AP Photo/Carlos Osorio)

Collar echoed Jenkin’s sentiment that judges make custody rulings with one basic standard in mind: serving the best interests of the child.

He added that a judge may consider requiring a parent to get vaccinated if “they’re exposing their child to a situation that puts the child at risk for contracting COVID,” especially if infection presents “a medical risk for a child.”

Richardson believes courts will “absolutely” see the COVID-19 vaccine “create situations where one parent refuses to allow the vaccine” once it is approved for children under 12. Those parents, she said, “will most likely lose that fight.”

CDC NOT CHANGING SCHOOL GUIDANCE AMID DELTA SPREAD, WALENSKY SAYS

“This has happened with respect to other vaccinations,” she explained. “Most courts are following the advancement of science and the protection of public health. Unless there is a compelling reason not to get a child vaccinated, the fight ends with a shot.”

“What was so unusual about the case with Judge Shapiro was the court ordered the mother to be vaccinated or not see her child. This is different because in other cases the child is the recipient of the vaccine, not the parents,” Richardson said. “But parental behavior can be examined in determining what’s best for the kids in a custody case. Clearly, not exposing the kids to potential viruses would be best. But also eating organic food or exercising is best. So where do we draw the line?”

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Richardson, like Jenkins and Collar, agreed that in cases involving a child with health issues that may put them at risk of a more severe COVID-19 infection, “it would be much more reasonable to expect the parents and those around the child to be vaccinated.”

The FDA is seeking to expand emergency approval of Pfizer’s COVID-19 vaccine to younger children ages 8 and up by September, sources told Fox News in August. The vaccine is currently eligible for children as young as 12, and trials are underway in younger age groups.

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At least 45 small school districts across Texas have been forced to temporarily stop offering in-person classes as a result of COVID-19 cases in the first few weeks of the new school year, according to the Texas Education Agency.

The shutdowns, which affected about 42,000 students as of Thursday, come as cases caused by the highly contagious delta variant have plagued administrators who hoped for a normal return to the school year.

Caseloads have left districts scrambling when many have said they have fewer tools at their disposal to combat the spread of the virus and have had to come up with their own strategies that can differ from district to district. Administrators are tasked with protecting students’ and staff members’ health, providing a quality education and staying open enough days to avoid tacking on extra days at the end of the school year.

“By far this is worse in terms of planning than last year,” said Tim Savoy, spokesperson for Hays Consolidated Independent School District, which closed some classrooms. “There’s no question about it. Last year we had a lot of tools at our disposal: We could require masks, and we could provide a virtual option that was funded. … [Then], the delta variant really kind of appeared and just exploded on us.”

State data about the number of coronavirus cases in districts that have closed at least once during the school year thus far is incomplete — 19 have not reported any cases in students or staff to the state, while case totals in 22 districts have been suppressed by the state due to privacy policies. The list of public school closures in Texas is also incomplete, according to TEA. The agency is tracking closures informally based on media and district reports since districts are not required to report closures to TEA, said Frank Ward, an agency spokesperson.

From Aug. 23-29, there were 27,353 new positive COVID-19 cases among students in Texas public schools, according to the Texas Department of State Health Services, making it the biggest one-week increase in the entire pandemic. The state reports 51,904 cases among students and 13,026 among staff since the school year began. That’s about 1% of the 5.3 million students enrolled in the state as of January.

Children’s hospitals, which have been inundated with COVID-19 patients at levels never seen before during the pandemic, have also seen an uptick in patients as the school year is underway, said Dr. Corwin Warmink, medical director of emergency services for Cook Children’s Health Care System in Fort Worth.

“Every year when school starts, we expect a bump in volume [in our emergency room] — we planned for it, we scheduled for it,” Warmink said at a news conference Wednesday. “In the regular year we’ll see about 300 kids a day during this time. On Monday, we saw 601, an all-time record. … At 600, we’re physically unable to care for kids in a timely fashion.”

Districts handle closures as a result of COVID-19 differently: Smaller ones tend to temporarily close all campuses, and larger ones close classrooms, grade levels and individual schools.

“Each week that the kids have been back, we’ve just seen those numbers increase dramatically, and that has been very stressful and very concerning to me,” said Phil Edwards, superintendent of Angleton ISD, which has almost 7,000 students.

On Tuesday, Angleton announced it would close its campuses through next Tuesday, while still allowing extracurricular activities to proceed, and it is not requiring students to work remotely. Angleton ISD reported that as of Thursday, the district has more than 200 positive COVID-19 cases among students, employees and staff thus far this school year.

There are a number of factors at play that led to the district closing, Edwards said, such as staffing levels and the number of students who have quarantined due to COVID-19 exposure.

In Hays Consolidated ISD, 10% of the students in a group such as a class, grade level or school testing positive within one week triggers remote conferencing, a state-sanctioned form of temporary remote learning, for up to 10 days, Savoy said. Recently, five classrooms within the district closed down.

Under remote conferencing, schools are still able to count attendance, which the state uses to determine district funding. But the program isn’t the same as a full-time virtual option, Savoy said. Senate Bill 15, which is headed to Gov. Greg Abbott’s desk, would fund virtual learning until September 2023 and give school districts the option to set up their own virtual programs. However, the legislation comes with a slew of caveats which could exclude many students of color.

Another tool districts relied on last year — the ability to require students to wear masks — is caught in back-and-forth legal battles after Abbott issued an order banning mask mandates in schools.

“Last school year, people had accepted that we were in a pandemic situation, and it was stressful, but everybody had the patience and understanding of the seriousness of it,” Savoy said. “This year, because we were coming out of the pandemic and then it suddenly came back on us, people are tired and they’re frustrated, and rightfully so, they’re exhausted. And so people are more upset this year about the provisions that we are or are not implementing.”

Despite receiving a recommendation from its local health authority to close all of its campuses, Leander ISD decided to stick with a group-centered approach in how it handles COVID-19 clusters. As of Friday, the district had more than 900 COVID-19 cases among students and staff and has moved about 20 elementary school classes and sixth graders at three schools to remote conferencing, said Corey Ryan, a district spokesperson. Ryan said that at the moment, it seems like the best option, as some schools in the district have seen very few or no cases, many students rely on services and protection at school that they can’t access at home, and the district has staffing shortages.

“It’s honestly a really tough balancing act for schools to do,” Ryan said about deciding whether or not to shut down an entire district.

Teachers dying due to complications from COVID-19 is also a sobering reality for some districts. In Connally ISD, two teachers died in late August from COVID-19 within less than a week of each other. The deaths and an upswing in COVID-19 cases on campuses prompted the district to shut down all its campuses, said Jill Bottelberghe, the district’s assistant superintendent of human resources.

“We are seeing people who have just one symptom and who are coming up positive, and it can be as simple as a runny nose, and then we have even had some who have been asymptomatic, and they come up positive but yet they have the ability to spread it to people who it may very much impact,” Bottelberghe said.

The district is planning to resume classes Tuesday. Bottelberghe said the district is consulting with the local district attorney to see what the repercussions would be if it were to require masks and go against Abbott’s order.

“Every day it seems like there’s something new and a new challenge to overcome,” Bottelberghe said.

Join us Sept. 20-25 at the 2021 Texas Tribune Festival. Tickets are on sale now for this multi-day celebration of big, bold ideas about politics, public policy and the day’s news, curated by The Texas Tribune’s award-winning journalists. Learn more.

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Dr. Alexandra Clark never thought the COVID-19 pandemic would lead to an increasing number of children hospitalized and suffering. 

As the division chief of general pediatrics and pediatric hospital medicine at Loma Linda University Children’s Hospital, she has seen it all in the last few months among patients as young as 2 months to as old as 17: children diagnosed with COVID-19 pneumonia, “ugly chest X-rays,” the need for oxygen support and signs of multisystem inflammatory syndrome in children (MIS-C), the latter of which can involve different body parts becoming inflamed.

But the most difficult part of it all has been watching unvaccinated children ages 12 to 17 suffer serious ailments from COVID-19, which could have been prevented.

“It’s really hard for us in health care to see these preventable infections, these illnesses, impacting the lives of children and families in such profound ways,” Clark said. 

“We recently had a young boy admitted to our pediatric ICU, and his mother was simultaneously admitted to the medical ICU. This father/husband was needing to choose ‘do I spend time with which of my gravely ill family members?’ That’s a story that didn’t need to happen.”

COVID-19 cases among children have been steadily increasing in Riverside County for weeks, and with school back in session, they have climbed even more. In the 0 to 17 age group, there were 441 new COVID-19 cases reported for the week ending July 28; 637 cases for the week ending Aug. 4; 982 cases for the week ending Aug. 11; 1,087 cases for the week ending Aug. 18; 1,476 cases for the week ending Aug. 25; and 1,500 cases for the week ending Sept. 1. 

As of Monday, there have been 47,610 COVID-19 cases for the 0 to 17 age group since the start of the pandemic, beating the 18 to 24 age group (45,548 cases), 65 to 84 age group (29,234 cases) and 85 and older age group (4,279 cases).

In just June, July and August, there have been 2,050 COVID-19 cases among unvaccinated 12- to 17-year-olds, compared to 60 in vaccinated children, Riverside County Public Health Director Kim Saruwatari shared during a recent Board of Supervisors meeting, adding that 97% of cases in the eligible population have been among the unvaccinated or partially vaccinated.

To make matters worse, there have been four deaths in the 0 to 17 age group in Riverside County since the start of the pandemic, including a 4-year-old, the youngest person to die, from western Riverside County with no underlying health conditions.

“Our hearts are breaking in health care to see so much suffering for so long,” Clark said. “We’re just at the place where we know that there is very good ability to decrease the risk of severe disease with the vaccine.”

Read more: Unvaccinated people 37x more likely to get COVID-19, 120x more likely to die than the vaccinated in Riverside County

Read more: COVID-19: 4-year-old among 8 new deaths reported in Riverside County

Trends seen among children

So far, Coachella Valley hospitals report they have not admitted COVID-19 patients younger than 18 this summer. If a child were to get sick with COVID-19 and need a higher level of care, they would be transferred to Loma Linda University Children’s Hospital.

At that hospital, there have been one, 12 and 41 admissions for the months of June, July and August, respectively. 

Briana Pastorino, director of public relations at Loma Linda University Health, said the children’s hospital is running a daily census in the mid-teens of hospitalized patients who are COVID-19 positive.

In the last COVID-19 surge, Clark said there were more children coming into the hospital for other ailments or care, but they also ended up testing positive for the virus. This time around, “a large percentage” of children are being admitted because of COVID pneumonia, she said. The majority of admissions have come from those 12 and older. 

For those with COVID pneumonia, many have required longer amounts and higher levels of oxygen, along with IV antiviral medicine and high doses of steroids to suppress the immune response. Clark has also noticed a correlation between children’s obesity and the severity of illness. The most severe pediatric patients have been those whose body mass index is greater than the 90th to 95th percentile, which places them in the overweight or obese weight status categories.

The hospital has also seen its first cases, three since June, of MIS-C patients from the delta surge. Much is unknown about the condition, such as what causes it, but inflammation can occur in children’s heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.

Symptoms of MIS-C include a fever and any of the following: abdominal pain, bloodshot eyes, chest tightness/pain, diarrhea, extreme fatigue, headache, low blood pressure, neck pain, rash or vomiting.

“This MIS-C is very specific to this COVID SARS-CoV-2, and the amount of illness we’re seeing in children after their original COVID infection with the MIS-C is very unique,” she said.

Among teenagers, Clark said some have experienced heart problems with dilation of their arteries. At this point, though, it’s “impossible” to know the long-term impacts to children’s overall health and wellbeing, which is “a real tragedy because these children have many, many years to live still, and we want to try and decrease the risk of long-term side effects from an infectious process that we have the ability to prevent.”

Clark anticipates that over the next two to four weeks the hospital will see more MIS-C cases.

MIS-C is similar to Kawasaki disease, a long-standing inflammatory disease, which primarily affects children younger than 5.

How to keep kids safe

With school back in session, parents are increasingly worried about children getting sick with COVID-19. 

Locally, both the Desert Sands Unified and Palm Springs Unified school districts have more than 75 confirmed COVID-19 cases among students and staff members, while the Coachella Valley Unified School District has reported 34 student and staff cases.

Loma Linda University Children’s Health has a pediatric urgent care in Indio, and Clark said visits have “skyrocketed” since Coachella Valley schools opened, mainly with parents bringing in kids with cold-like symptoms.

Keeping children safe in schools is possible, Clark said, if mitigation factors are in place, such as getting everyone 12 and older vaccinated, keeping masks on during the school day and encouraging frequenthand-washing. 

The dramatic rise in COVID-19 cases and hospitalizations due to the more transmissible delta variant is significantly impacting all age groups, particularly Americans ages 11 or younger who are not yet eligible to receive vaccinations.More than 500,000 children tested positive for COVID-19 in the U.S. from Aug. 5 to Aug. 26, according to state data collected by the American Academy of Pediatrics. At least 203,962 of those cases were reported in the week of Aug. 19 to Aug. 26; In late June, one weekly reported number was just shy of 8,500.With concerns building over safely allowing children to return to in-person learning at schools, health experts agree that mask mandates are an effective tool in stemming infections.”The virus is raging in all these children who are unvaccinated, which is why in schools mask mandates are so important,” CNN medical analyst Dr. Jonathan Reiner told Jake Tapper last week, pointing out that inoculation rates are also low among adolescents who are eligible. “They have no other protection. They’re literally sitting ducks.”More states and school districts across the country are imposing mask and vaccine mandates, while others are working to limit COVID-19 exposure among the unvaccinated. New York Gov. Kathy Hochul announced on Tuesday plans to implement mandatory weekly COVID-19 testing for state school staff who are not vaccinated.”We all need to remain vigilant to protect each other — and that means coming in to get your shot and booster shot, wearing masks in indoor spaces, and exercising basic safety measures that we are all familiar with by now,” Hochul said.For teens ages 12 and up attending classes, it remains imperative for them to receive vaccinations to help curb the spread of COVID-19, officials say. And vaccine mandates, while unpopular to some, may be a necessary step.”I believe that mandating vaccines for children to appear in school is a good idea,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN this week, noting that this would not be a radical idea to impose.”This is not something new. We have mandates in many places in schools, particularly public schools, that if in fact you want a child to come in — we’ve done this for decades and decades requiring (vaccines for) polio, measles, mumps, rubella, hepatitis,” Fauci said. “So this would not be something new, requiring vaccinations for children to come to school.” Officials expect additional vaccine data soonCognizant of the anxiousness felt by some parents and guardians sending their children back to school unvaccinated, health officials say they are working expediently to review whether the age of vaccine eligibility can be lowered.If authorized, the CDC would move quickly to recommend the use of COVID-19 vaccines in younger children, agency director Dr. Rochelle Walensky said.”Everybody is looking at this with urgency. Everyone recognizes how important it is for those children to have access to vaccines,” Walensky said during a National Parent Teacher Association town hall Wednesday.The U.S. Food and Drug Administration (FDA) must approve or authorize the vaccines in younger children first, Walensky noted. And the vaccine makers must make the case to the FDA with clinical trial data.”My understanding of the timeline is pretty consistent with what is being said — the middle of fall is my understanding, early fall is when we will anticipate seeing the data — and then it will lie with the hands of the FDA. And I’m hopeful for the end of the year,” she said.Pfizer/BioNTech’s vaccine has been fully approved by the FDA for Americans 16 and older, and emergency use authorization has been granted for those 12 and up. The Moderna and Johnson & Johnson vaccines are under emergency use authorization only for adults 18 and older.Moderna announced last week that it had completed its submission to the FDA for full approval, and has also filed with the FDA for an emergency use authorization for its vaccine in people age 12 and older.Clinical trials of vaccines for children under the age of 12 are ongoing.Fauci said Wednesday that the FDA should have the data to consider authorizing a COVID-19 vaccine for children under 12 by the end of September.”We should have enough of the data to examine and make a decision as we get into late September, the beginning of October,” Fauci said. “Then the data will be presented to the FDA, and the FDA will make a determination whether they will grant that under an emergency use authorization or some other mechanism.”When asked whether a COVID-19 vaccine will be authorized for young children before Thanksgiving, Fauci said he hopes so, but does not want to get ahead of the FDA.Group says nursing shortage is a ‘national crisis’With the rise in hospitalizations felt nationwide, a health care industry that is exhausted and consistently exposed to COVID-19 infection has sometimes resulted in fewer employees. States and networks have clamored for greater levels of staffing at a critical time of the pandemic.The American Nurses Association has called on the U.S. Department of Health and Human Services to declare the nation’s shortage of nurses a “national crisis,” according to a letter the group sent to HHS Secretary Xavier Becerra.”The nation’s health care delivery systems are overwhelmed, and nurses are tired and frustrated as this persistent pandemic rages on with no end in sight. Nurses alone cannot solve this longstanding issue and it is not our burden to carry,” association president Ernest Grant said on Wednesday.Hospital staff remain at risk for COVID-19, researchers reported on Wednesday. Due to a combination of waning vaccine protection and the delta variant, coronavirus infections have steadily risen among vaccinated healthcare workers in San Diego, Dr. Jocelyn Keehner and Dr. Lucy Horton of the University of California San Diego Health wrote in a letter to the New England Journal of Medicine.They note that their findings support arguments for using masks more frequently as well as potentially offering booster doses of vaccine if similar evidence is gathered elsewhere.The strain placed on health care systems is likely to continue into the near future, but there are signs that the situation could start to improve.For the second week in a row, an ensemble forecast from the CDC has projected that new COVID-19 hospitalizations are likely to remain stable or have an uncertain trend over the next four weeks. Before last week, the forecasts had projected increasing hospitalizations since mid-July.Yet despite the potential news that the surge could soon ease, the CDC urges caution with the data since actual numbers have fallen outside the range of previous predictions. CDC’s latest forecast predicts 550,000 to 1,600,000 new cases likely to be reported in the week ending Sept. 25.In the short term, Fauci told CNN’s Wolf Blitzer that it will help for people to practice mitigation measures, like masking and avoiding congregate settings.”In the intermediate and longer term, it’s going to be vaccines that are going to solve this problem,” Fauci said.