Pediatricians had launched the alert, the news confirms it: saturation of pediatric emergencies, transfers of infants, deprogramming of surgeries, our children are in daily danger. The hospital collapsed. Was it a fatality? In 2019, the Minister of Health had ordered a “flash” mission “aiming to shed light on the causes of the recurrent saturation of pediatric intensive care units leading to the transfer of many patients outside the region and to make recommendations to remedy them.”
Three years and a pandemic later, no tangible improvement has concerned paediatrics, which on the contrary must also face the consequences of having let SARS-CoV-2 circulate without any further braking measures.
Pediatric emergencies in other countries are also saturated. In the United States, the director of the Centers for the Prevention of Infectious Diseases also warns of the increase in pediatric hospitalizations for Covid-19, which mainly affects babies under 6 months old who are not eligible for vaccination. In Canada, the public health council is “urgently” studying the reintroduction of mandatory masks, starting with schools, saying everyone must do their part in protecting the youngest members of the community.
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Evidence of delayed diagnosis and “triage” among children
In France, no measure has been announced. The government considers, as its spokesperson Olivier Véran explained, that “there is no need to force the wearing of a mask” because it is necessary to maintain the possibility of “keeping this measure under the elbow”. if the situation were to deteriorate”, obviously not including the children in the assessment of the situation. The famous plan to improve indoor air quality in nurseries, schools and hospitals never saw the light of day. “Under the elbow” is also undoubtedly the referral to the High Health Authority to give its opinion on the extension of the vaccine offer against Covid-19 to children over 6 months (and the reminder for those between 5 and 11 years old) following the recommendations of the European Medicines Agency.
The Minister of Health and Prevention, after having activated the ORSAN plan, wants to be reassuring by citing solutions such as the reform adding a fourth year of study in general medicine, supposed to “better train students in pediatrics”. A highly contested decision, which is part of a different time frame than the current emergency. On the other hand, the minister hastens to deny a pediatrician who spoke on the radio of the need to sort children, rejecting “such remarks which distort reality” and threatening an investigation.
At the same time, testimonies of delays in diagnosis, choices between children to be operated on, intervention or resuscitation in the rooms and in the corridors are multiplying everywhere. It is a question of choosing which children will receive care, in degraded mode moreover, and of a loss of opportunity for many of them: this situation is unacceptable.
This abandonment of prevention is accompanied by the evocation, including by the health authorities, of the theory of “immune debt”: children today would be very affected, not because of the continuous and intense circulation of a new virus against which they are not protected, but because of the previous adoption of preventive measures. The reduced circulation of pathogens would have reduced the immune defenses of children, or those of their pregnant mothers to take into account infants born after the measures were lifted. This concept, ignoring the continuous functioning of the immune system, which is in fact not like a muscle “to be trained”, may sound like a grandmother’s tale; but it is indeed a hypothesis introduced mainly by French pediatricians, including Robert Cohen, in 2021, and transformed by its promoters, the space of three articles (subsequently cited by them or others), into an allegedly proven fact, yet never demonstrated by any study.
Other possible explanations
“Representatives” of European pediatrics rely on the “immune debt” to call for the extension of the vaccination schedule in children. It is also mentioned to explain the current disaster at the hospital. Internationally, the concept has been disseminated via the networks of pediatric societies and has met with great success among opponents of health protection measures. Yet this is only a hypothesis, deemed implausible by immunology experts, disproved in cases of respiratory syncytial virus (RSV) by a 2002 study showing that natural reinfection with RSV does not reinforce the cell immunity.
Other explanations are possible: new variants, co-infections, infections by other viruses. For example, we have known since 2021 that in toddlers, SARS-CoV-2 can also be responsible for bronchiolitis. South Africa had even warned that it was the main symptomatology induced by Omicron when it appeared. In a study in 23 pediatric emergency departments in Europe and Israel, out of 315 infants with a diagnosis of bronchiolitis, 16 were positive for SARS-CoV-2, one for RSV, the others being infected with rhinoviruses. However, in the absence of reliable and transparent data, it is impossible to know the role of the different viruses in the current epidemic. In addition, another hypothesis that deserves to be studied is the possible weakening of the immune system due to Covid-19. This possibility, already put forward by an American immunologist for almost 2 years, seems to find confirmation in a study recently published in the prestigious journal Nature. A possibility that risks compromising the progress made for a century for life expectancy, which the pandemic has already swept away in the United States.
So child neglect, pandemic denial, and a fallacious, untested assumption – quite the opposite – are dictating public health decisions meant to protect our children, now and in the future. The dogmatic refusal of prevention is unbearable, while caregivers sort children. Faced with the tragedies that play out daily in pediatric hospitals, prevention, considered a “revolution” and number one objective in Emmanuel Macron’s health program, can no longer remain just a simple word in the title of the Ministry of health. To flatten the curve of bronchiolitis and relieve exhausted caregivers, as for Covid-19, masking in transport and confined enclosed places must be a reasoned obligation, regulated by the public authorities; vaccination against Covid-19 should be extended and promoted, as should health education.
We call on the President of the Republic and the government to return to reality by acting concretely without further delay: the health of caregivers and children depends on their commitment to the return of the collective, under penalty of sad tomorrows.
Elisa ZENO, research engineer, PhD, co-founder of the Ecole et Familles Oubliées collective
Louis LEBRUN, medical specialist in public health
Matthieu CALAFIORE, general practitioner, director of the general medicine department of Lille
Igor AURIANT, Resuscitator
Charlotte JACQUEMOT, neuroscience researcher, Adios Corona collective
Christian LEHMANN, general practitioner
Marie FERNET, lawyer, parent of students
Stéphane DEDIEU, university professor
Arnaud MERCIER, professor in communication, Paris-Assas University
Jérôme MARTY, general practitioner president UFMLS
Thierry AMOUROUX, spokesperson for the National Union of Nursing Professionals SNPI
Aude ROSSIGNEUX, journalist and parent of students
Raphaëlle LAPOTRE, library curator, parent
Mrs COULON Audrey, childminder and parent
Corinne DEPAGNE, pulmonologist
Renaud GUERIN, engineer.
Hélène POIRIER, doctor
Valérie REVERT, mother of 3 children, on sabbatical leave
Gisèle DASTE, student’s parent
Céline CASTERA Nurse
Nathalie PIAT, web developer and parent
Laure SOULE, lawyer
Matthieu CHAUVEAU, certified teacher and parent of students
Céline BON, parent of students
Yannick FREYMANN, general practitioner
Nicolas PECASTAINGS, graphic designer
Solenn LESVEN, parent of students
Marie-Anne PANET, medical doctor
Julie GRASSET, President Association CoeurVide19
Corinne PLANTE, student’s parent
Julien CAZENAVE parent of student
Solenn TANGUY, teacher and parent, Winslow Public Health Collective
Christophe LEFEVRE doctor and father
Marion PONSOT, research team assistant
Alain HOMSI, director
Anita DANIEL, member of the collective zero covid solidarity
Michaël ROCHOY, general practitioner
Natica BARTKOWIAK, assistante sociale.
Pierre LAGNEL, journalist
Cathie ERISSY Secretary General of the Association for the Promotion of the Nursing Profession APPI
Andreea-Cristina MAS, founder Covid Long Pediatric Collective
David SIMARD, doctor of health philosophy, parent
Armelle VAUTROT, academic and therapist, student parent
Matthieu PICCOLI, hospital doctor
Frédéric BURNEL, physical science teacher
Cécile PHILIPPE, economist, parent
Katia RENAULT, Parent of students
Jonathan FAVRE, general practitioner
Annabelle JARRY, student parent
Philippe BORREL, author-director of documentary films
Alexander SAMUEL, teacher
Philippe MOREAU CHEVROLET, communication advisor, screenwriter and professor at Sciences Po Paris
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