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UK researchers have warned that as future waves of coronavirus disease 2019 (COVID-19) appear to be unavoidable, schools are likely to come under increased pressure to close.
The team says that the negative impacts that school closings could have on children and society at large should be properly considered before deciding whether to proceed.
The role that children play in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent that causes COVID-19, remains unclear.
However, current evidence suggests that, unlike other respiratory viruses, the educational environment only plays a small role in the transmission of SARS-CoV-2 once control measures have been implemented.
The researchers say that pandemic mitigation measures that affect the well-being of children should not be implemented unless there is sufficient evidence that this would help.
Matthew Snape (University of Oxford) and Russel Viner (University College London) have expressed their views in an opinion piece recently published in the magazine. Sciences.
Children were expected to be a key component in transmission
The continuing and unprecedented spread of SARS-CoV-2 has posed significant challenges in managing child and adolescent care around the world.
The widespread school closures in response to the COVID-19 pandemic reflect the reasonable assumption, given previous outbreaks of respiratory viruses, that children would play a key role in transmission.
However, a growing body of evidence has suggested that this is not necessarily the case.
Unlike the usual pattern of respiratory viral infection, children and adolescents have a significantly lower risk of developing symptomatic COVID-19, compared to all other age groups.
However, one concern is possible viral shedding among asymptomatic children and schools, becoming repositories of viral circulation from which transmission to students’ homes and beyond could occur.
Since schools have been closed in conjunction with the implementation of various other closure measures, it has been difficult to assess whether school closures provide any benefit over other interventions.
Evidence suggests that transmission through children is minimal
“Evidence from contact tracing studies suggests that children and adolescents are less susceptible to SARS-CoV-2 infection than adults,” the team writes.
Multiple studies have shown only minimal progressive transmission of SARS-CoV-2 in primary and secondary schools. Following the reopening of primary schools in the UK, for example, only 1 of 23,358 nasal swabs taken from children in June 2020 had detectable levels of the virus.
Furthermore, recent surveys conducted in several European countries found that the reopening of schools in April and May did not have a significant effect on community transmission. Overall, the number of infections continued to decline once schools reopened.
“In relation to the risk of contracting the disease, children and adolescents have been disproportionately affected by lockdown measures,” write Snape and Viner. “Child health advocates must ensure that children’s rights to medical and social care, mental health support and education are protected during the next waves of pandemics.”
The next few months will be important to evaluate the effectiveness of the interventions
Examples of mitigation measures being implemented as schools reopen throughout the Northern Hemisphere include creating separate cohorts or “bubbles” of students with minimal interaction, wearing face masks in crowded areas, and regular screening. of students and staff.
The next few months will provide a valuable window of time to assess which of these interventions are the most effective in reducing transmission. This will help create a standard “best practice” that ensures that young people’s rights to education are not violated, while protecting them in the wider community.
However, researchers say there will inevitably be cases of infected students attending school and that some school outbreaks are likely to occur.
The potential effects of keeping schools closed
However, keeping schools closed while the retail and hotel sectors reopen is hard to justify, given the indirect negative impacts this could have on youth and society, the team says. Estimates so far suggest that the impact on education could lead to a quarter of the nations’ workforce being less skilled after the mid-2020s and the loss of billions of dollars in wealth.
Other risks to children include the possible reappearance of diseases such as measles as a result of the interruption of vaccination programs and an increase in accidental and non-accidental injuries at home because children are less visible to protective services. .
Adverse effects on the mental health of young people should also be considered, the researchers write.
“For example, preliminary evidence suggests that suicide deaths among young people under 18 years of age increased during the lockdown in England,” they say.
Now there is an evidence base on which to base decisions
However, there is now an evidence base on which to base decisions, and school closures must be undertaken with fear given the indirect damage they incur, the team says.
“Pandemic mitigation measures that affect the well-being of children should only happen if there is evidence that they help because there is a lot of evidence that they do harm,” the authors conclude.
