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It will be serious for children and parents in the next week: then the chancellor and the prime ministers of the federal states want to discuss again how school lessons should continue in the pandemic given the high rates of infection by Sars-CoV-2 in the country. The fear that there may be large numbers of unrecognized corona cases in schools has been raised time and again. For example, SPD health politician Karl Lauterbach called for classes in the classroom to be cut in half. The assumption: There are numerous undetected cases among children because infected children often do not develop any symptoms. As a result, they may not be tested enough.
The directors of more than 100 German children’s clinics are now countering this assumption. Under the leadership of Michael Kabesch, Director of the St. Hedwig Children’s Clinic at the University of Regensburg, data from more than 110,000 children and adolescents who had been admitted to 105 of the 245 German children’s clinics in the last six were evaluated. months to the reference date of November 18. and had undergone a crown test. Only 0.53 percent of these tests were positive.
“It is highly unlikely that there are a large number of unreported cases among children and young people,” says Johannes Huebner, deputy director of the Hauner Children’s Hospital at the University of Munich, “in our opinion, schools should be left open.” For Peter Walger, of the board of directors of the German Society of Hospital Hygiene, the result of the survey is “a very thick stone in the mosaic: there are no relevant subtests in children that still reveal secrets to us.”
Pediatrician Huebner admits that the data collected is not a study in the strict sense. But a complete random sample was fully evaluated. “I think our sample actually overestimates the proportion of children infected at the end,” says Hübner, because one-fifth of the participating clinics had not examined all patients, only those with respiratory symptoms or gastrointestinal which are common in children . they are a sign of a corona infection. In these clinics, up to three percent of the children tested tested positive for Sars-CoV-2, while in the clinics that tested all children it was only 0 to 0.2 percent. This corresponds almost exactly to data from the Robert Koch Institute, according to which 0.21 percent of students have tested positive for Sars-CoV-2.
Children are likely to be more likely to be infected at home
“The findings from the clinics correspond well with what was previously reported from Italy,” says virologist Sandra Ciesek of the University of Frankfurt: “Children admitted to the hospital for reasons other than suspected Sars-CoV-2, they rarely get infected with the virus. This also fits very well with other studies that do not suggest that children often shed the virus undetected. “
So far, there has been little evidence of suspicion of a particularly high number of unreported cases among children. So far, “you have not seen any studies that suggest that there are large numbers of unreported cases among children shedding the virus, at least not to a greater extent than in all other age groups,” says Sandra Ciesek. Therefore, scientists sometimes settle for guesswork. For example, Berlin virologist Christian Drosten concluded from the fact that more and more people aged 40 to 50 are infected with Sars-CoV-2 that there is a high number of unreported cases: this age group generally includes parents of younger children, he concluded, while “A lower incidence can be observed in age groups whose children are away from home”: “That points to an undetected incidence in children,” Drosten wrote on Twitter.
An examination of nearly 12,000 blood samples from a diabetes screening test in Bavaria recently revealed six times more corona infections among tested children than are officially known. But the blood samples came from April to July; far fewer tests were done then than today. Furthermore, recent studies show “that an immune reaction can be detected in children who have had contact with the virus without ever having excreted the virus in relevant quantities”, explains Sandra Ciesek. “So you may have detectable antibodies, but at no point were they really infectious.”
It’s up to adults to contain the pandemic
“We were often amazed by certain assumptions that were publicly discussed,” says Matthias Keller, medical director of the Third Order Children’s Clinic in Passau. “Our results now confirm what we saw at the children’s clinic and in conversations with colleagues: that there are very few children with Sars-CoV-2 infections.” Some children’s clinics also looked at the question of where the child was infected. “Often it was the family environment and not the school,” Keller says.
“Leave the schools open!” Demanded the German Academy of Child and Adolescent Medicine as the coordinating organization for pediatric medical societies in a statement over the weekend. The spring closure showed the far-reaching negative consequences that school closings had for children. Increasingly, the data showed that the original fear of schools as sources of infection had not been realized. Although there are corona infections in schools, “it rarely spreads to other people there. There is no evidence of outbreaks with many proven secondary infections (so-called super spread events).”
Efforts to contain the pandemic should be carried out by adults by restricting their contacts, pediatricians demand. “The responsibility rests with parents, caregivers, teachers and the entire adult population to protect children and adolescents who are entrusted from infection” and thus enable them to attend school.
