One argument in America right now is whether kids can go back to school in the fall. Many teachers, their unions and some in government say it can’t be done safely due to COVID-19 coronavirus. Many parents and others in government say in-person learning should resume.
Those opposed to reopening the schools argue the risk of asymptomatic infected children passing the virus to teachers is too great. They say that teachers are in close proximity with students and that, even with mitigation techniques in place, it would be too much to ask of teachers. Especially, they say, for those teachers with underlying conditions.
Now, physicians have weighed in with science. In a commentary which has been published in the journal Pediatrics, a group of doctors has said that the risk of a child transmitting the COVID-19 coronavirus either to another child or to an adult is extremely low and the occurrences are rare and infrequent. They believe that with proper social distancing guidelines in effect, schools can and should reopen in the fall.
Pediatrics is a peer-reviewed journal associated with the American Academy of Pediatrics. In their commentary, William V. Raszka, M.D. and Benjamin Lee, M.D., both pediatric infectious disease specialists at the University of Vermont’s Larner College of Medicine also suggested that parents, teachers and school officials consider the rates of transmission in their communities when deciding whether to reopen.
Dr. Raszka is also an associate editor of Pediatrics.
In their commentary, titled “COVID-19 Transmission and Children: The Child Is Not to Blame,” they rely on a large amount of data from five recent studies. They include a new study published in the most recent edition of Pediatrics called “COVID-19 in Children and the Dynamics of Infection in Families.”
In this most recent study, conducted by Dr. Klara M. Posfay-Barbe and colleagues, of the University of Geneva Medical School, Contact tracing was used to study the households and families of 39 Swiss kids who were infected with COVID-19. They found that in only three (8%) of the cases was a child even suspected of being the index case, with the onset of symptoms in adult household contacts preceding positively-tested illness in the children.
The results of two Chinese studies reinforce the belief that children rarely transmit COVID-19, either to adults or to other children. In one study of hospitals around Wuhan, 9 out of 10 children admitted for testing or treatment to hospitals across several provinces were found to have contracted the virus from an adult. There was only one possible case of child-to-child transmission. The conclusions were drawn based on the timing of the disease onset.
Using contact tracing, a study of 68 children with COVID-19 admitted to Qingdao Women’s and Children’s Hospital between January 20 and February 27 of this year yielded similar results. Ninety-six percent of all juvenile cases were from household contacts of previously infected adults.
But wait, there’s more! In France, a study revealed that one boy with COVID-19 exposed more than 80 of his classmates to the disease at three different schools. While transmission of influenza and other respiratory diseases had been common at all the schools throughout the years, not one child contracted COVID-19.
In an even more astonishing series of events studied in New South Wales, nine infected staff members and nine infected children exposed a total of 735 students and another 128 staff to the virus. Of the 963 people exposed, a grand total of two secondary infections occurred. One of those was transmitted by a staffer to a student. The other was a high school student who contracted COVID-19, possibly as a result of exposure to two other infected students.
“The data are striking,” said Dr. Raszka. “The key takeaway is that children are not driving the pandemic. After six months, we have a wealth of accumulating data showing that children are less likely to become infected and seem less infectious; it is congregating adults who aren’t following safety protocols who are responsible for driving the upward curve.”
Many people point to the “uncontrolled outbreak” of COVID-19 across child care facilities in the state of Texas in the wake of that state’s economic reopening. The actual data may tell a different story.
There are 11,094 child care facilities across the state of Texas. As of the date of the doctors commentary in Pediatrics, 894 staffers and 441 children have been infected across 883 of those facilities. Without detailed contact tracing, it’s impossible to source the infections accurately, but here’s what the raw data really say.
As of March 2020, there were approximately 140,000 children using the state’s 11,094 child care service providers of all types. (1, 2) That means that there were COVID-19 infections in about 8 percent of those facilities.
Base on a quick review of the Texas “Minimum Standards for Child-Care Centers” document, it’s safe to assume that each facility has at least 4 staffers. Probably more, but let’s be conservative. That means that of the 44,376 staffers (at a minimum) in child care facilities across Texas, just 2 percent of them contracted COVID-19.
Mind you, that’s not the case fatality rate, that’s the infection rate. To date, there have been no deaths reported in connection with any of these cases. Dr. Raszka agrees that the data has the potential to be misinterpreted.
“There is widespread transmission of Covid-19 in Texas today, with many adults congregating without observing social distancing or wearing masks,” he said. “While we don’t yet know the dynamics of the outbreak, it is unlikely that infants and children in daycare are driving the surge. Based on the evidence, it’s more plausible that adults are passing the infection to the children in the vast majority of cases.”
If scientific studies and overwhelming data aren’t enough to make you see that children aren’t the spreaders of this virus, how about mathematical or epidemiological models?
Nearly every reputable model in use shows that instead of closing schools, we are better off implementing community-wide physical distancing and the broad use of face covers. There is little to be gained and far more to lose by keeping kids away from each other in the school setting. Schools in Western Europe and in Japan have been able to reopen without a rise in the rate of community transmission. This fact bears out the accuracy of the modeling and is a strong argument for reopening schools here in the US.
Be safe, but reopen the schools in the fall. The authors say it’s important for the healthy and natural development of children.
“By doing so, we could minimize the potentially profound adverse social, developmental, and health costs that our children will continue to suffer until an effective treatment or vaccine can be developed and distributed, or failing that, until we reach herd immunity,” the paper concludes.
While there are still areas of the US struggling to get hospitalizations under control, some of that problem is being exacerbated by the fact that tens of thousands of Americans put off necessary medical procedures for months. They were convinced by media and even some public health officials that going to the hospital might be a COVID-19 death sentence.
In Texas, the estimates of non-COVID-19 ICU admissions runs between 40 and 70 percent, depending on where you get your data. As data comes in, we see a similar pattern in other “spike” states. We’re testing significantly more people, so, yes, we will see more cases.
But as the death rate plummets and states get hospitalizations under control, we need to be looking ahead to what’s best for us as a society. This is especially true when we talk about kids. They need socialization and every new report coming out seems to reinforce the overwhelming superiority of in-person learning.
Listen to the doctors. You know, “follow the science.” Or is this no longer about a virus and maybe about some other, more political end, as has been suggested by more than one public figure? For the sake of us all, I hope not.
Doctors have spoken. Reopen the schools. It CAN be done safely. Parents will thank us and so will the kids.
Keep the faith and keep after it!
Journal Reference – Benjamin Lee, William V. Raszka. COVID-19 Transmission and Children: The Child Is Not to Blame. Pediatrics, 2020; e2020004879 DOI: 10.1542/peds.2020-004879
Klara M. Posfay-Barbe, Noemie Wagner, Magali Gauthey, Dehlia Moussaoui, Natasha Loevy, Alessandro Diana, Arnaud G. L’Huillier. COVID-19 in Children and the Dynamics of Infection in Families. Pediatrics, 2020; e20201576 DOI: 10.1542/peds.2020-1576