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Mask or no mask? While for adults that may be a decision, most school districts around the country have opted in for this strategy to reduce Covid-19 transmission among their students. Aaron Milstone, a pediatric infectious disease expert at Johns Hopkins, comments.

Milstone: We’ve learned over time that masks really do help kids to stay in school. Not only are they going to prevent the spread of COVID virus this year, where we learned last year is they help prevent the spread of other respiratory viruses, like influenza, the common cold, even the illnesses that give kids vomiting and diarrhea in the winter. All those other viruses are equally disruptive for families so not only will masks help curb COVID spread but hopefully they’ll keep kids healthy this winter, and in school.  :26

Milstone points to soaring rates of infectious diseases like respiratory syncytial virus or RSV, around the country as masks and distancing have been relaxed or abandoned as evidence that these physical barriers have real benefits. He notes that parents may consider setting a good example by wearing mask also. At Johns Hopkins, I’m Elizabeth Tracey.

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Now that most children are back in school, the majority of them in person, parents and kids need to continue their vigilance against becoming infected with COVID. Allison Agwu, a pediatric infectious diseases expert at Johns Hopkins, says that starts with masking up.

Agwu: Masks, masks and more masks, and I think even if masks are not being required really masking in schools and out of schools, to protect yourself, particularly in indoor spaces or where you can’t guarantee the distancing. Many schools are putting in distancing within the desks, the lunch, etc, and emphasizing the importance if your school doesn’t have that, of masking, distancing and making sure you’re being safe, a few schools don’t do that, most are, and talking to your kids about abiding by those rules for masking and distancing  .:27

Agwu notes that parents can help their kids by making sure they’ve got more than one mask on hand if one is soiled, and helping them run through strategies to avoid risking contagion in settings like sports or the cafeteria. She says parental support is critical. At Johns Hopkins, I’m Elizabeth Tracey.

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Kids are back in school in person now in many parts of the United States and the world, yet both they and their parents are still worried about activities and contagion risk, especially in children younger than 12 years of age and others not yet vaccinated. Aaron Milstone, a pediatric infectious disease expert at Johns Hopkins, offers some words of encouragement.

Milstone: Kids are frustrated because they feel that things are being taken away from them. And I keep telling parents that parents are creative and resilient and we can find fun things for our kids to do, even in this pandemic. And we did that last year. So even in this fourth wave, even as we go through the winter, I mean parents really need to set a positive tone for their kids and say we can find fun and safe things for you to do. Put your mask on, get your vaccine, and if we’re smart we can continue to let kids enjoy the kind of day to day stuff and going back to school.  :28

Milstone says preparation is everything, including providing masks and backups to kids, helping kids strategize on ways to stay safe even if they’re among unmasked people, and being reassuring. At Johns Hopkins, I’m Elizabeth Tracey.

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Antibodies donated by people who’ve recovered from COVID infection, known as convalescent plasma, is a therapy that does have emergency use authorization by the FDA, and that must be given to hospitalized people early in the course of infection. Arturo Casadevall, a convalescent plasma expert at Johns Hopkins, says timing is critical.

Casadevall: It is important to know that there is a therapy that the FDA has on its emergency use authorization that has been underused. Patients it would great if they had a discussion with their physician. And it would be great if the physicians who admitted them to the hospital took the time to familiarize themselves as to what the available data is. It is mixed, we are the first ones to admit it. But that has to be taken in the view that it is relatively safe, the evidence is that if it is used early that is where the studies are showing the efficacy in reducing mortality. :33

Casadevall says people who are admitted to the hospital should ask their physicians if they are candidates for this therapy, which he says helps many avoid severe COVID. At Johns Hopkins, I’m Elizabeth Tracey.

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A treatment known as convalescent plasma, which is basically antibodies from someone who’s already recovered from COVID, can help in early COVID infection, but the caveat is early. Arturo Casadevall, a convalescent plasma expert at Johns Hopkins, says for people with certain health conditions, seeking early treatment is a wise idea.

Casadevall: The public needs to know that there are therapies available that work best if you seek early care. So if one is diabetic, if one has hypertension, if one has lung disease, it’s better to seek help when you have symptoms than to wait until you call EMS to come bring you in. Doctors in the emergency room, plasma can only be given to hospitalized patients, so once you make that decision to admit, that is the time to give them plasma.  :29

Casadevall and colleagues have recently linked increased rates of death due to COVID to reduced use of convalescent plasma, a treatment he calles largely safe and cost-effective. He hopes people will ask their physicians about it. At Johns Hopkins, I’m Elizabeth Tracey.

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Antibodies in the blood of people who’ve had COVID and recovered can help others avoid severe cases of the disease, use of this treatment in some has shown. Yet when larger scale clinical trials were undertaken, results were largely lackluster, and the treatment has fallen by the wayside. Arturo Casadevall, a convalescent plasma expert at Johns Hopkins, reflects on why results were mixed.

Casadevall: Last year there was a lot of excitement for convalescent plasma, half a million people got treated. Then came some really poorly designed clinical trials. People were treated very late. Well, if you do a trial and it didn’t work because you set it up not to work then plasma doesn’t work. And then what happened is there was a reduction in use. We were able to document that as the use went down more people died.  :26

Casadevall says convalescent plasma is a viable treatment for COVID infection, and he’s trying to make both physicians and patients aware of the need to use it early in the infection to maximize its benefits. At Johns Hopkins, I’m Elizabeth Tracey.

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Convalescent plasma is plasma donated by people who’ve already had COVID and recovered. Early in the pandemic this historically successful technique was attempted to stem the tide of COVID-related death, but now the therapy has fallen into disuse. Arturo Casadevall, a convalescent plasma expert at Johns Hopkins, explains.

Casadevall: We are talking about a therapy that is given once that costs $300.00. What is the risk benefit of this? And people are not using it. This therapy works best when given early. COVID has two phases, a viral phase and an inflammatory phase. The inflammatory phase is what puts you in the hospital. That’s because it interferes with gas exchange, people get short of breath. The antibody works on the viral phase, so many people when they show up in the emergency room are already too late to be helped. But not all of them are that late.   :30

Casadevall is trying to raise awareness of convalescent plasma therapy, which he says could benefit many and reduce the need for hospitalizations nationally. At Johns Hopkins, I’m Elizabeth Tracey.