Editor's Note: (Kent Sepkowitz is a CNN medical analyst and a physician and infection control expert at Memorial Sloan Kettering Cancer Center in New York. The views expressed in this commentary are his own. View more opinion at CNN.)
(CNN) Each week seems to bring another alarming development on the Covid-19 Delta variant. Just last week, we learned of an outbreak among hundreds of vaccinated people in Provincetown, Massachusetts. Of particular concern is the evidence of high amounts of virus in respiratory samples of vaccinated individuals suggesting that they can in fact be contagious.
In response to the new information, the US Centers for Disease Control and Prevention has adjusted guidelines to again recommend masks for certain situations. Though the real message of the latest outbreak is how well the vaccines work at preventing death, reintroducing masks is the right decision, since it will help decrease transmission at a time of rising Delta-related cases nationally.
On cue, the CDC's latest update is being met with the usual tomato-throwing response from the anti-vaccine, anti-mask, anti-science, anti-logic members of the blab-o-sphere who have declared the CDC hopelessly lost, unscientific and waffling.
But after 18 months of this pandemic, who can call the CDC action and the public reaction a surprise? Governmental entities that make decisions, such as the CDC, are always easy targets for anti-government and anti-whatever enthusiasts.
Even the immediate OMG shrieks from usually level-headed reporters and newspapers -- the Delta variant is as contagious as chicken pox! (a previously known fact) and a correct if click-bait-y emphasis on the high percent of cases that had been vaccinated -- also are predictable. The virus is scary. It is not contained. Half the country is not fully vaccinated. All of this deserves headlines, which, by their nature, err on the side of provocation.
What is odd about the focus on the Provincetown outbreak is that it is not the important Delta variant story this week. It is only a minor addition to the Covid-19 story.
Here's the real news: there is growing evidence that -- for whatever reason (higher viral loads, something different about how the virus is handled by less mature immune systems, or something else), children infected by the Delta variant may develop a more severe form of the disease compared to illness caused by other forms of the virus.
In a recent NPR interview, Dr. Rick Barr, who leads the Arkansas Children's Hospital, said that the "Delta variant is acting very, very differently with respect to kids ... just in the month of July, we have [admitted] over 40 to the children's hospital. .. and a number of those have ended up in the intensive care unit."
Half the kids were below 12 years of age and not eligible for vaccine but the other half -- also not fully vaccinated, were 12 years old and up.
And Arkansas is not the only Southern state reporting the increase of child hospitalizations.
All this suggests that the next real area for debate is not whether the current vaccines are good enough against the Delta variant (they are, overwhelmingly) or whether we should mask up and spread out (yes, obviously), but rather what should we do about the children who are not yet eligible for vaccination under a US Food and Drug Administration Emergency Use Authorization (EUA) but will be heading back to school in a month, or sooner -- during an outbreak of a viral variant that could get much more severe?
Now, that is a problem worthy of real debate -- not political posturing -- of weighing pros and cons carefully and daring to be bold. To that end, one possible advantage of the endless stunt-driven tomatoes that are tossed is that when an actual moment of truth occurs, the CDC already will have developed the requisite thick skin necessary to withstand the criticism and make the best decision to protect the public health. I hope.
Not that the CDC or anyone else is asking but here is my suggestion: if additional evidence suggests more severe disease in kids infected by the Delta variant, unvaccinated children must not attend school in person. Sorry. Delta has changed the premise of last year's decisions. If and when the EUA is granted for elementary school-aged children, then vaccinate them and send them off on the school bus.
But even then, please leave the windows down.