Editor’s note: This commentary has been modified with permission by UMA from a letter by St. George pediatric providers.

As concerned physicians who have worked for years to keep people in Utah safe and healthy, we write today to Utah parents.

Extending and adding to the message given by community pediatric providers in Southern Utah, we hope to give parents clarity on the current situation for children in our community during this pandemic. The delta variant of COVID-19 (SARS-CoV-2 virus) has shown greater ability to infect younger people, including children, than the original strain, and it is much more contagious. We have seen an increase in cases among our patients, particularly children, which includes increased hospitalizations. We are hearing from our colleagues around the country of similar trends in their communities.

Throughout the state of Utah, we have had about 800 children require hospitalization due to COVID-19, some of whom have required intensive care and some of whom have developed MIS-C, a complication that affects many internal organs, especially the heart. Throughout the country we have lost about twice the number of children to this virus as the number of children who succumb to the flu each year.

Considering that information, we want to counter the misconception that children do not get COVID-19 or that the virus is not a concern for kids. While they do not get it as often as adults do, they do get it. We have seen it and cared for children who have it and have complications from it. Some of these children did not have any underlying health conditions.

We also want to remind parents that there is a wide spectrum of disease, and that mortality is not the only bad outcome. We’ve seen adolescents develop “long COVID” symptoms with chronic fatigue, shortness of breath and “brain fog.” Chronic COVID symptoms can affect a child’s quality of life. Primary Children’s Hospital has indicated that they are starting a long-COVID clinic in order to serve children in Utah with long COVID. Along with these “long COVID” symptoms comes the extra cost of providing health care for these kids, the effect on their ability to participate in sports and other activities, and the time requirements and worry parents have for their kids who have “long COVID” symptoms.

Furthermore, infections in children are important because kids can give it to their parents, older siblings, other relatives and neighbors. We are caring for patients whose worlds have been changed because of the loss of parents or grandparents.

For the above reasons, the Utah Medical Association, the American Academy of Pediatrics, the CDC, as well as the Utah State Board of Education have all recommended universal mask wearing for children at school. There is good science demonstrating that a mask keeps the person who is wearing it from passing the virus on to others and offers the wearer some personal protection. Masks are most effective when more people are wearing them. If we all pull together, we can help keep our children and each other’s children safe.

School is a setting in which the virus can be easily transmitted from family to family if no protective measures are taken. Kids often touch their face and nose; masks also help prevent some of this, which helps slow the spread.

Unfortunately, the Utah state Legislature passed a law back in May forbidding schools to require masks when cases were on the decline, not taking into consideration what might happen if we had another pandemic or an unforeseen variant such as delta. This has tied the hands of school districts, who must receive approval from legislators to require masks at school. We encourage families to still send their children to school in masks anyway.

We encourage parents to let their legislators know that they want masks to be required in schools to help protect their children and others.

We also reiterate the importance of isolation for COVID-positive students and quarantine for those exposed to COVID. If parents fail to keep their kids home, when necessary, it certainly places other children and their families at risk. We plead with parents to please not send their child to school if they have any cold symptoms. We have seen children with even mild symptoms come back positive for COVID-19, and a mild infection in a child could lead to severe disease or death in someone else. If they have any cough, fever, shortness of breath or sore throat, please get them tested for COVID-19 as soon as possible and stay home until they are negative. If they test positive, please keep them home for 10 days to avoid infecting others at school. If your child is exposed to COVID-19, please quarantine them at home for 14 days, unless they are vaccinated.

As physicians, we have reviewed the studies on the COVID-19 vaccine and are confident in recommending it for most children ages 12 and older. As with any vaccine, medicine or other intervention, the risks must be weighed against the benefits. Children are much more likely to get COVID-19 and have complications from it than they are to have bad side effects from the vaccine. We encourage parents to discuss their child’s vaccination with their child’s physician.

Unfortunately, it is inevitable that some individuals will oppose masking. Some also may not isolate when they are ill or even quarantine after being in contact with a positive case. Therefore, vaccination becomes parents’ last and most important defense for keeping them and their families safe.

Sharon Richens, M.D., is president of the Utah Medical Association.

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