Will COVID-19 children be extended if they return to school?

Is it safe for children to return to school while the coronavirus is loose?

That depends on what can happen if a student becomes infected. Will the virus jump to their classmates, who could feed its spread throughout the student body? Will she find her way to her teacher and climb into the break room, also putting campus teachers at risk?

Scientists don’t have definitive answers to questions like these, and they probably won’t for a while.

Schools are dealing with this uncertainty in different ways. In Southern California, the state’s two largest districts, Los Angeles Unified and San Diego Unified, said they would start the new school year with full-time distance learning. Among them is Orange County, where the Board of Education voted to allow students to come to campus without requiring masks or social distancing.

A report released Wednesday by the National Academies of Science, Engineering and Medicine acknowledges the existence of binding schools.

“There is insufficient evidence to determine how easily children and young people contract the virus and how contagious they are once they do,” the report says. This knowledge gap “makes it extremely difficult for decision makers to measure the health risks of physically opening schools and creating plans to operate them in ways that reduce virus transmission.”

But decisions must be made anyway. Here is a closer look at what scientists know about children and COVID-19, and what it suggests about the risks of sending them back to school.

Do children have any kind of natural protection against the coronavirus?

They appear to be less susceptible to the virus, and that’s especially true for younger children.

Data from the US Centers for Disease Control and Prevention show that, as of May 30, the incidence of COVID-19 was 51.1 cases per 100,000 children under the age of 10 and 117.3 cases per 100,000 children. and young adults between the ages of 10 and 19. Both of those numbers were well below the national figure of 403.6 cases per 100,000 Americans.

Scientists are not sure what explains this phenomenon. One theory is that children’s cells have fewer ACE2 receptors that the coronavirus needs to bind to start an infection. The researchers analyzed the expression level of the ACE2 gene in 305 people between the ages of 4 and 60 and found that it increased steadily with age.

“A lower expression of ACE2 in children relative to adults may help explain why COVID-19 is less common in children,” the researchers reported in the Journal of the American Medical Assn.

But that does not mean that children cannot get sick. In fact, a small number of pediatric patients have developed a serious disease called multi-system inflammatory syndrome, or MIS-C, in children.

“While the balance of the data shows that children are less susceptible to infection and less likely to transmit it, less susceptible does not mean they are not susceptible,” said Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration. . this week on Face the Nation.

If children are less likely to become infected, does that not mean they are less likely to spread it?

Probably. After all, you can’t spread a virus if you don’t have it in the first place.

Some health experts suspect that one reason why infection rates have been lower in children than in adults is that they have been relatively isolated at home while their parents have left the house to work, shop, or socialize. Once the children return to school, they can begin to catch up.

Still, there is evidence that children simply do not have the same coronavirus spreading power as adults. Studies that track how infections spread through homes in the US, Switzerland, and several Asian countries have shown that adults are much more likely than children to bring the virus into their homes, said Dr. Naomi Bardach, UC pediatrician and policy researcher. San Francisco.

“Most of the time, the adult in the home was the one who was originally infected,” added Dr. Ibukun Christine Akinboyo, medical director of pediatric infection prevention at Duke University Medical Center. “If it was the child, there seemed to be less than a 15% risk that the child would transmit through the home.”

Should we be thinking of kindergarten kids the same way as high school seniors?

No. On the one hand, infection rates are lower for elementary school children than for adolescents.

Another consideration is that high school students can do more to protect themselves than young children. For example, they should be able to wear a mask the entire time they’re on campus, something kindergarten kids probably can’t handle. Older students should also be better at social distancing.

And when they get home, high school students can operate more independently than elementary school children. That could help mitigate the risk that a teenager, if infected, would pass the virus on to family members at home, said Dr. Charlene Wong, a pediatrician who also studies health behaviors at Duke University.

Is it safe for children to be on campus if they are too young to have a mask on their faces?

Pediatricians recognize that younger children may not wear masks at all times, keep separate from their classmates, or keep their hands away from their faces. But since they are less vulnerable to infection, that’s probably fine, they said.

Data from the Netherlands supports the idea that “children play a minor role in the spread of the new coronavirus,” said Dr. George Rutherford, an infectious disease expert at UCSF.

That country allows children as young as 12 to get closer to both children and adults without having to worry about social estrangement, he said. Even teens ages 13 to 17 can be in close contact. But since adults account for the bulk of the viral spread, they should be kept at least six feet apart from each other whenever possible.

What has happened in other countries when the students returned to school?

In general, not much. For example:

• A report from Australia’s National Center for Immunization Research and Surveillance examined 15 schools in New South Wales that reported cases of COVID-19 in March and April. Nine students had confirmed coronavirus infections during that time, and may have spread it to a total of two peers out of a total of 735 who were considered “close contacts.” Nine adults in those schools also contracted the coronavirus, but did not pass it on to any of their 128 “close contacts” between teachers and staff, health authorities concluded.

• Ireland’s first known patient with COVID-19 was a boy who visited northern Italy in early March, just as that country’s coronavirus crisis was beginning to take off. Schools in Ireland closed shortly thereafter on March 12; By then, health officials had identified a total of three infected students, one in elementary school and two in high school, along with a teacher and two other adult instructors. None of the children’s 924 classmates infected them with the virus at school, nor did 101 school contacts from the three infected adults. Even outside of school, the six infected people did not transmit the virus to any of the 1,001 children who were among their closest contacts, according to a report in the journal Eurosurveillance.

• A study published in the journal Clinical Infectious Diseases traced what happened after an English tourist who contracted the coronavirus in Singapore visited a ski chalet in France. He transmitted the virus to 11 others, including a boy who then visited three schools and a ski class. None of that boy’s contacts became infected.

• In the Netherlands, schools and childcare centers began to reopen on May 11, and by June 8 students had returned to campus full time. The country’s National Institute of Public Health and Environment said it has received “some reports” of infections among school employees since it resumed normal operations, but none of them infected children on campus. In addition, the average number of people who contract the virus from a single infected person has remained below one since March.

Although no significant outbreaks of coronavirus have been tracked in schools, that doesn’t mean it won’t occur in the future, Akinboyo said, especially since the virus is more widespread in the community now than in the early days of the pandemic.

We should also keep in mind that the US population is more diverse than in most other countries, so their experiences may not reflect what is likely to happen here, said Lisa Gennetian, a Duke economist who studies the child poverty.

Closing schools and switching to distance education was hugely damaging. Did it really help curb the pandemic?

It seems like the answer should be yes, but it might have helped less than you think.

Several studies have attempted to quantify the benefits of measures to curb the spread of the coronavirus, including quarantines, orders to stay home, school closings, and social distancing policies. Taken together, these policies seemed to prevent transmission of the virus, though how much is unclear.

A preliminary study focusing on Hong Kong found that measures aimed at keeping people separate may have reduced the spread of the community by as much as 44%, but the authors did not estimate how much of that benefit could be attributed to school closings.

A review in the Lancet Child and Adolescent Health journal yielded only one study that used models to estimate the impact of school closings on community health. Members of the Imperial College COVID-19 Response Team calculated that if all primary and secondary schools were closed, along with 25% of universities, COVID-19 deaths in the UK would be reduced by 2% to 4%. In part, those numbers are low because the benefit of keeping children out of school was offset by a 25% increase in time spent in the community, not to mention a 50% increase in close contact with members of the family.