A General Practitioner’s concerns

Over the past few months, boys and girls have been  preparing to go back to school.  Many of them are participating in sports and are required to have a sports physical to get clearance to practice and play.  General Practitioners are asked to clear the kids and certify that they are healthy enough for rigorous athletics.

There are, unfortunately, two different sets of kids – those who are unvaccinated for COVID and those who are COVID vaccinated.  The GP generally understands the physiology of an unvaccinated kid and is reasonably confidant of the results of diagnostic questioning and testing for a sport’s clearance.  On the other hand, a GP who deals with a COVID vaccinated kid is confronted with a new physiology that involves an increased potential for cardiac issues such as myocarditis and pericarditis.

Most  GPs are not pediatric cardiologists.  Even if they have an ECG machine, they do not have the rigorous training associated with the cardiac specialties.  The question, therefore, is how can they clear a vaccinated child for athletic activity?   It is, of course, possible to refer all vaccinated kids to a pediatric cardiologist but the delays and costs are substantial.  (Among the greatest concerns of the vaccinated kid, and their parents, is the prospect of collapsing and dying during vigorous activity.  The word is out about the COVID vaccines having dangerous side effects – and videos and photos of collapsed and dead athletes haunt the internet.)

A GP is confronted with a bunch of personal and professional concerns.  How does he or she document the risks associated with COVID vaccination?  What type of follow-up testing should be performed?  What happens if a vaccinated kid collapses or drops dead during practice or play – what are the legal implications for the GP if that kid has been cleared?

Apparently, an MRI might be able to pick up cardiac damage associated with the COVID modRNA spike protein but then the question is “how damaging, injurious, and deadly” is the finding if at all?  Notably, an ECG machine is only useful if scaring is noted due to an abnormal change in the wave patterns.  There is some relatively new test equipment which combines artificial intelligence with an MCG machine.  One suggestion is to have pre-vaccine and post-vaccine tests for comparison in the hopes that such a before and after test might pick up or rule out cardiac changes associated with the vaccination.  But, once again, are any discovered differences meaningful?  Regardless, the risks still remain.   

The general consensus at this point is that an Automatic Electronic Defibrillator, AED, ought to be available at every athletic practice and game.   Further, coaches and assistants should be certified in AED use and capable of administering CPR.  (Notably, an automatic AED costs over $1000 so it is not a small expense for a school to have a number of them available for all of the various practices and games.  Like a fire extinguisher which sits inert on the wall, you have to hope that you never need to use an AED.  And like a fire extinguisher they have to be regularly maintained.)

The support pipeline for post vaccination use is complicated and fraught with realistic concerns for medical practitioners.  It is one thing to make and distribute a vaccine.  It is quite another to deal with its peculiarities and risks in practice over time.