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Are children a major source of COVID-19 infection? After 10 months of a pandemic that has claimed 1.2 million lives, experts remain divided on the issue, even as governments must decide whether to keep classrooms open or closed.
During the first wave of infection, a scientific consensus was formed around the concern that children could be a crucial vector, as they are for the flu, in the spread of the new coronavirus.
And then, entering the summer, the opposite idea prevailed: Children, especially the youngest ones, did not infect others as much, several studies suggested.
“If you look at the scientific literature, it’s actually not very clear,” said Dominique Costagliola, an epidemiologist at the Marie and Pierre Curie Faculty of the Sorbonne University in Paris.
These seemingly contradictory results have not made things easier for policy makers struggling to balance the health of their citizens and their economies.
Several studies have shown that children, who rarely show symptoms when infected, do not spread much to other family members during lockdowns in the spring.
But that was during a period when schools were closed and the spread of the virus had slowed down, said epidemiologist Zoe Hyde, a professor at the University of Western Australia.
“Most of the COVID-19 and child studies have been conducted during very unusual periods of confinement or at a time of low community transmission,” he noted in the Medical Journal of Australia.
More recently, however, a new wave of studies from the United States (US), India, and South Korea have challenged the idea that children are not so contagious.
Findings published last week by the US Centers for Disease Control based on a study of 300 people in September concluded that “transmission of SARS-CoV-2 among household members was frequent from children. or adults “.
A much larger study of Britain released Tuesday paints a different picture.
Politically charged question
“Living with children aged 0-11 years was not associated with an increased risk of recorded SARS-CoV-2 infection, COVID-19-related hospitalization or ICU admission,” research from the London School of Hygiene and Tropical Medicine and the University of Oxford, based on data from more than nine million adults, it concluded.
For children 12 to 18 years old, there was a risk, but it was still small, the study found.
Children “can pass it on to others,” said Maria Van Kerkhove, an epidemiologist with the World Health Organization’s Health Emergencies Program. “Although, that appears to occur less frequently than adult-to-adult transmission.”
Younger children, he added, appear to transmit less to each other than adolescents, where peer infection occurs at roughly the same rate as among adults.
“When they show symptoms, children shed the virus in amounts similar to adults and can infect others in a similar way to adults,” the European Center for Disease Prevention and Control said in August. “How infectious asymptomatic children are is unknown.”
If the ability of children to transmit COVID remains in doubt, there is no doubt that they are generally asymptomatic or have less severe forms of the disease compared to adults.
An important but very rare exception is a syndrome in which the immune system of infected children, especially young ones, turns against itself.
Adding urgency to the scientific debate about children and COVID infection is the politically charged question of whether to keep schools open or not.
Most schools in dozens of countries were closed during the spring closure, putting great pressure on parents and compromising their children’s education.
“Everyone understands how important schools are to children, not only for their education, but also for their well-being, mental health and safety,” Van Kerkhove said.
“In some situations, it’s where a lot of kids get food.”
‘The risk is not zero’
Many countries, including France, Great Britain, Austria and Ireland, have implemented partial closures nationwide in recent weeks to slow the rapid spread of the virus, but chose to keep schools open this time.
“The risk related to schools is not zero, nobody says that,” said Daniel Levy-Bruhl, an official with France’s public health surveillance agency.
Isolated cases should be put into perspective, he added.
“There are a large number of schools open around the world and, for the most part, there are few problems.”
The French government, allowing the possibility that children are more contagious than suspected, has imposed the use of masks in school for children six years and older. The age limit before was 11 years.
“Even if they are less contagious than people over 14, young children have a lot of contact with each other and with adults,” Costagliola said. “Many contacts mean more contaminations.” – AFP
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