In the Ongoing Conflict Between Ideology and Immunity, Which Side Will Protect the Children From Post-Acute Sequelae of COVID-19?

T he United States is currently riven by deep and bitter ideological and political fissures that threaten to diminish the health and well-being of future generations of Americans because of our inability to embrace public health measures that are necessary to contain the spread of the coronavirus. This Editor’s Page we will not delve into how or why the fissures developed in America, nor will we point accusatory fingers at one political side or the other. Rather we seek to highlight a growing concern that we are sowing the seeds of our future demise as a nation by not paying sufficient attention to how the current pandemic may affect the most vulnerable members of our society: our children. According to the American Academy of Pediatrics reports, more than 4.5 million children have tested positive for COVID-19 since the beginning of the pandemic, making up about 15% of all cases in the United States (1). With the COVID-19 delta variant, not only is the rate of infection rising in children but also the severity of infection and complications. As we have learned in time with adults, the health consequences of COVID-19 can outlast the acute infectious period and cause persistent and even debilitating symptoms in what has been termed long COVID, longhaul COVID, and more recently the formalized term post-acute sequelae of COVID-19 (PASC). First recognized in adults, PASC is beginning to emerge as a new area of concern in children, and its clinical contours in children are still being defined (2). In one study of PASC in children in Italy, that has the