The cost of preventing pediatric influenza deaths

By Dianela Perdomo.

How much is the life of one child worth?

That is part of the question I asked myself when reflecting on influenza’s latest disappearance. In the U.S., the past three flu seasons have resulted in 144 to 199 pediatric deaths from influenza infection. Strikingly, only one pediatric flu death was recorded during the 2020–2021 influenza season.

This decrease in deaths is attributed to various COVID-19 public health policies like school closures and mask wearing. Although most kids recover from the flu, young children and those who are immunocompromised are at highest risk for severe influenza infections requiring hospitalization. Severe infection sometimes results in deaths — deaths that were prevented during the latest flu season through policies like school closures, mask wearing, etc.

As we emerge from the pandemic, the hope of many is that the restrictive policies aimed at limiting transmission will be lifted. However, in doing so we must accept that the secondary consequences of these measures, like preventing pediatric influenza deaths, will be lost. Is there an ethical obligation to prevent these kinds of deaths in the future, or is keeping influenza below epidemic thresholds good enough?

My paper, “Should coronavirus policies remain in place to prevent future pediatric influenza deaths?”, dives into some of the public health policies enacted during the pandemic and their impact on the overall flourishing of children.

Although many of these measures were associated with a decrease in pediatric flu deaths, they also had negative consequences. While closing schools limits viral transmission, it also harms quality of education, motivation, sense of purpose, socialization and mental well-being. Additional research exploring increasing rates of suicide among children found that “either online schooling or overwhelming academic distress was placed as the second most suicide stressors”.

No measure is free of downsides, and downsides alone are not grounds for dismissal. When writing this paper, I speculated that the prolonged risk to health under COVID-19 fostered a ripe proclivity to adopting health promoting policies, without full consideration of their downside.

The environment of fear, frustration, and uncertainty engulfing the pandemic has influenced what we consider important on individual and societal levels. Increased public awareness of health risks have been met with a greater concern for health, appreciating its value. We have compromised on other social goods for the sake of upholding health. Policies which closed businesses, limited social gatherings, and enforced mask wearing conflict with values of economic prosperity, socialization, and liberty.

These measures are certainly warranted under a pandemic. The question is whether novel threats and novel fears should influence our prior risk tolerance – such as the risk of child dying from influenza.

While there is an appeal to adopting policies that prevent the most death and disease, we must carefully weigh the consequences of these measures outside of the realm of health. Oftentimes these policies come at the expense of other worthwhile social values, and hence are considered measures of last resort.

Ultimately, I argue that the cost of pandemic measures on a diverse value landscape is too high to justify their use beyond the narrow regulation of COVID-19 transmission.


Paper: Should coronavirus policies remain in place to prevent future pediatric influenza deaths?

Author: Dianela Perdomo

Affiliations: Johns Hopkins School of Medicine

Competing interests: No competing interests

Social media accounts of post author: Twitter: dperdom0; Instagram: dpperdomo

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