Covid-19: What you need to know today

Children in some of the Germany’s provinces returned to school this week, the first in Europe to do so. The schools are ensuring social distancing, hand hygiene, and proper ventilation, although masks are not mandatory in classrooms in some regions (they are in others, and are also mandatory in the corridors). Deutsche Welle reported that “schools are considered low-risk”, citing research by doctors at the University Clinic of Leipzig that showed that “fewer than 20” of the 2,600 students and teachers tested showed Covid-19 antibodies, an indication of past infections. The cup-half-empty way of looking at that finding (which, this writer believes, is the best approach to dealing with Covid-19; prepare first, and then take what comes your way) would be that students and teachers are vulnerable to infection given the low immunity in the study group, but Germany’s management of the pandemic, thus far, has been exemplary, so I will hold my criticism.

There can also be no arguing with the fact that children will have to return to schools sooner than later. On Tuesday, United Nation secretary general Antonio Guterres said the world could face “a generational catastrophe that could waste untold human potential, undermine decades of progress, and exacerbate entrenched inequalities”. Guterres said a billion students across 160 countries have been affected and that the “decisions governments and partners now take will have lasting impact on hundreds of millions of young people, and the development prospects of countries for decades to come” (see front page). The UN chief’s reference to decisions is clearly about the reopening of schools and colleges – something that has challenged policymakers around the world, including in India where online learning disadvantages those students who are already disadvantaged, amplifying the divide between them and others , which the country can ill-afford.

But the risks of opening too early are significant.

Israel, for instance, opened schools in May, only to see a wave of cases which set off the country’s second wave of infections, and caused school closures (and mass quarantines).

The country is now making plans to open in fall for the school year; like many other countries, Israel has decided that not opening schools this year is not an option.

Still, the experience of Israel comes up in any discussion on school openings; indeed, in education and government circles, the country’s hasty reopening of schools has become a cautionary tale.

Like Israel, the Australian state of Victoria reopened schools only when it looked like it had the pandemic well under control, but after a resurgence of cases – not linked to the schools, but the sharing of a cigarette lighter among guards at a facility where international travellers were being quarantined – the state finally decided, late last week, to close most schools again.

What does science say? The most authoritative research on the subject is a paper published in JAMA Pediatrics by doctors from the infectious diseases and pediatrics departments of the Ann and Robert H Lurie Children’s Hospital, Chicago, and from the Northwestern University Feinberg School of Medicine, Chicago.

The study found that very young children (younger than five years), with even mild infections, have more of the viral RNA of the Sars-cov-2 virus which causes Covid-19 in their nasopharynx (the upper part of the pharynx, between the nose and the mouth) than “older children and adults”… and that while the “infectious virus” itself wasn’t measured “pediatric studies [have] reported a correlation between higher nucleic acid levels and the ability to culture infectious virus”.

The study concluded that “young children can potentially be important drivers” of the infection’s spread in the “general population”. The study, which covered 145 patients, comes with caveats associated with any study of this size, but it pretty much rules out day-care or school for very young children.

And more research is needed on older children and their role as potential super spreaders.

Yet, as Guterres pointed out on Tuesday, the alternative isn’t acceptable.

PS: India’s decision is made easier by the fact that Covid-19 cases are continuing to rise and spread across the country (India saw 1,852,668 cases cumulatively till Monday night, of which 584,674 were active), which pretty much rules out opening schools for now – although when the time comes to open them, it will be interesting to see how the country goes about it.