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My wife, Sally, is an infusion nurse at Lurie Children’s Hospital and is now in her 43rd year on the front lines. She received the COVID-19 vaccine on January 2nd.

I have been working from home as the NICU Quality Improvement neonatologist for Comer Children’s Hospital at University of Chicago and came down to get my COVID-19 vaccine #1. I have had the opportunity to see a number of frontline providers, friends, and colleagues and spend some time in my office. As I walked by the NICU and the Emergency Department in the Children’s Hospital, I have a lot of mixed feelings. Practicing clinically was always my favorite part of my “job” and I miss it. At the same time, I am now 69 years old and am still also teaching, editing, writing, and helping nurses, nurse practitioners (NP), medical students, residents, fellows, faculty, and physician assistant (PA) students with their education, research, and writing. But I am now also in a high risk group for severe COVID-19 disease having had a four vessel bypass in 2013.

I have so much respect and admiration for all of the nurses, PAs, NPs, and physicians at every level of training and practice who are on the front lines during this COVID-19 pandemic. My feelings are so much greater when I am on site and seeing the challenges you all face to protect yourselves and still provide care for the children and their families.

One of the great challenges we face during this pandemic is figuring out which of our patients is at greatest risk for developing severe SARS-COV-2 infection or COVID-19 disease. Using epidemiological and descriptive studies we have been able to identify some high risk groups including older adult patients, those pediatric and adults patients with chronic disease, are pregnant,  and/or who are immuncompromised. Children, in general, unless they have an underlying disease, tend to have milder clinical courses, unless they develop multi-inflammatory systemic disease (MIS-C). So, we have to be concerned about every one of our patients when we see them and follow them closely. Around 30% of adults may have ongoing clinical manifestations including fatigue, dyspnea, joint pain, and chest pain as long as 6 weeks after their acute course. The fact that there are viral variants and evidence from other studies about immunity post other coronavirus infections suggests that we will not have lifelong immunity post having the clinical infection. We are not sure how long the immunity will last post clinical infection or with the vaccine as well. The pandemic and our knowledge base continues to evolve.

We also have the challenge of encouraging our patients and their families to get the COVID-19 vaccine(s) when they become available and are determined to be safe for children and pregnant women.

And what looking after ourselves? As I talk with Sally after she comes home from caring for her pediatric patients, most of whom have chronic disease including cancer, autoimmune diseases, inborn errors of metabolism, the stress on her and all of you who are on the front lines is increased to levels that are exhausting. As a former intensive care pediatrician for 30+ years, I can only empathize and imagine what you are all dealing with during this pandemic.

So please continue to follow the newest, evolving clinical recommendations from the Center for Disease Control and Prevention (CDC), after careful review. Please also realize how much all of us who are watching all of you care for patients on the front lines respect and admire you for your dedication. But please, take care of yourselves!

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